Understanding Codeine Abuse & Addiction
Codeine, which is a type of opioid, is a controlled substance that is available by prescription from a doctor or medical professional. It is prescribed to treat pain and is often mixed with other over the counter pain relievers like ibuprofen.1
What is Codeine Used For?
Codeine is used to treat mild to moderate pain and to relieve cough.2 Because it is an opioid, codeine has the potential to be abused. Like other opioids, codeine affects the brain and central nervous system to change the way pain is perceived by the body. When prescribed for coughing, it slows down the movement in the brain that triggers coughing.2
Once ingested, codeine binds to opioid receptors in the brain, releasing dopamine, which causes feelings of pleasure; it is this release of dopamine and feeling of pleasure that reinforces such behavior.3 This reaction in the brain and body can lead to abuse of codeine and addiction.
How is Codeine Abused?
Generally speaking, any mind-altering substance has the potential to be abused. You have probably heard about the opioid epidemic that has swept through our nation. Opioids have the potential to be highly addictive because of how they work on the brain and the nervous system. Opioids have a history of being overly prescribed by practitioners, which started long before anyone knew their addictive potential and the devastating impact they have on a person who develops an addiction to them.
When used as directed, codeine can be safe. It is not intended for chronic use due to its addictive properties. Codeine can be misused and abused in multiple ways:3
- Taking the medication in a way that is not prescribed, i.e., inhaling or intravenous injection
- Taking more than prescribed or for longer than prescribed
- Taking someone else’s medication that was not intended for you
- Taking it to intentionally get high
Who is at Risk of Codeine Addiction?
Certain risk factors may make you more likely to develop an addiction to codeine and other opioids. Based on current research, those risk factors can include:4
- Home and family environments that encourage misuse and abuse of substances.
- History of substance abuse.
- Untreated mental health and psychiatric disorders.
- Younger age.
- A social network that includes friends who misuse substances.
A family history of addiction can also increase your risk of developing an addiction to codeine and other substances. It is important to remember that addiction doesn’t discriminate. You can become addicted without having risk factors.
What are the Side Effects of Codeine?
Like many prescription drugs, codeine has both short-term and long-term effects. The longer you use or abuse a substance, the more severe the effects can be. The effects of codeine use can range from mild to severe. Unfortunately, the risk of using any opioid is overdose and death.
Short-Term Side Effects of Codeine
The short-term effects of codeine are what make it desirable and increase its abuse potential. These include feelings of relaxation, euphoria, and happiness. 3 Other short-term physiological and psychological side effects can be immediate and dangerous, including:5
- Feelings of depression and extreme sadness.
- Unusual behavior and thoughts, i.e., anger and aggression.
- Problems with urination.
- Changes in breathing, including shallow and noisy breathing.
- Slow heart rate and a weakened pulse.
- Lower cortisol levels, which can lead to nausea, fatigue, and vomiting.
- Feeling dizzy, light-headed, or faint.
When codeine is taken, you can expect to feel the effects within an hour or so. The effects will last for several hours; it is prescribed to be taken every 4-6 hours.2
Codeine and Alcohol
Mixing codeine with other substances, including alcohol, can have life-altering consequences. Codeine is often mixed with another type of pain reliever like ibuprofen. Therefore, mixing alcohol and codeine comes with additional risks because multiple substances are interacting with one another. The dangers of mixing alcohol with codeine range from mild to severe, and include:6
- Nausea and stomach pain.
- Bleeding ulcers.
- Liver damage.
- Rapid heartbeat.
- Problems breathing.
- Impaired memory.
- Unusual behavior.
- Impaired control of fine motor skills.
Long-Term Side Effects of Codeine
The long-term effects of codeine can be detrimental and can include physical and mental changes, some of which are irreversible. Research shows that the long-term side effects of codeine abuse can lead to: 6 (page 2)
- Sleep-disordered breathing.
- Serious respiratory problems.
- Constipation and gastrointestinal issues.6
- Cardiovascular issues including heart failure.6
- Reproductive issues. 6
- Higher levels of anxiety and depression. 6
Signs of Codeine Addiction
The signs of codeine addiction vary and include both behavioral and physical symptoms, which can present as changes in a person’s behavior, physical appearance, and physical health status. Behaviors in addiction can greatly affect a person’s physical appearance. For example, common behaviors in addiction include failure to take care of your activities of daily living like showering and washing clothes. Mental and emotional changes can also occur, which can result in mood swings, irritability, and anger.
Physical Signs of Codeine Addiction
Common physical signs of codeine addiction can include:7
- Poor personal hygiene that can lead to weight loss, medical and dental problems, and odor.
- Flu-like symptoms including a runny nose, fever, and chills.
- Intense and uncontrollable cravings.
Behavioral Signs of Codeine Addiction
Behavioral signs of codeine addiction can look like many things. It can be difficult to watch a loved one engage in these detrimental and life-altering behaviors. It is important to remember that these are signs of addiction and not a reflection of the person’s values or integrity. These behavioral signs can include: 7 & 8
- Frantic attempts to get codeine (lying, purchasing drugs illegally, and stealing money to get the drug).
- Excessive preoccupation with the drug (change in behavior and mood without codeine).
- Misuse of their prescription (using more than intended, taking someone else’s, using longer than intended, and ingesting the drug in a way not instructed by a doctor).
- Social isolation and withdrawal that can significantly strain relationships.
- Failure to adhere to responsibilities in many facets of life, which can lead to issues in parenting, work problems, legal issues, and unemployment and financial problems.
- Withdrawing from once pleasurable activities and hobbies.
- Changes in mood, such as depression and other mental health issues.
Can I Quit On My Own?
If you think you may have a problem and are considering quitting on your own, there’s important information on codeine withdrawal that you should consider. Detoxification from codeine can be very unpleasant and difficult. Detoxing under the supervision of medical professionals can make the experience as safe and comfortable as possible for you.
Common symptoms of withdrawal can include: 3
- Sleep problems.
- Cold flashes.
- Uncontrollable leg movements.
- Muscle and bone pain.
While these symptoms are generally not life-threatening, they can be intense and incredibly uncomfortable. A lot of people who try to quit on their own may find it difficult to do so without the help of medical interventions due to the severity of their withdrawal symptoms. These symptoms can begin within a few hours after you have taken codeine.
Are You Struggling with Codeine Addiction?
Do you recognize one or more of these symptoms? Are you looking for help but unsure where to start? If you answered yes to either of these questions, you should consider codeine addiction treatment for yourself or your loved one. Treatment is available.
How American Addiction Centers Can Help
As a leading addiction treatment provider in the United States, American Addiction Centers focuses on not only treating the addiction itself, but the causes that led to its development. At American Addiction Centers, treatment is specialized to meet the needs of each person.
Our Treatment Program
Our treatment model focuses on identifying any existing mental illnesses or mental health issues that may stimulate the need to cope with issues by using alcohol.
Our treatment facilities then focus on providing an initial support system for those attending treatment and teach them healthier ways to cope with their alcohol dependence.
We offer a full continuum of care that encompasses the primary types of treatment all the way from detox for those initially struggling to aftercare options like sober living, counseling sessions, and support groups for the recovering alcoholic.
To find out more, or to get started, American Addiction Centers operates a confidential addiction hotline available 24/7 to help people find their path to recovery.
Still Unsure About Seeking Treatment?
Learning about addiction and treatment options may feel overwhelming. If you are still unsure about how treatment works, how to ask for help, or how to get treatment, consider the following guides:
1.Lee, E. & Cooper, R.S. (2019). Codeine addiction and internet forum use and support: Qualitative netnographic study. JMIR Mental Health. 6(4). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658256/
2.U.S. National Library of Medicine. (2018). Codeine.
3. National Institute on Drug Abuse. (2020). Prescription opioids.
4. National Library of Medicine. (2017). Risk factors for opioid-use disorder and overdose.
5.Univeristy of Michigan. (2019). Codeine.
6.National Institute on Alcohol Abuse & Alcoholism. (2014). Harmful interactions.
7.Johns Hopkins Medicine. (n.d.). Opioid addiction.
8. Joy, K. (2018). How to spot signs of opioid addiction.