Codeine, probably best known as the main ingredient in prescription-strength cough syrup, is the most commonly used opiate in the world, according to the World Health Organization. It is also used to treat mild to moderate pain and is one of most over-prescribed medications in America.
It is frequently used improperly or illegally, with more than 30 million Americans using codeine each year for recreational or other unapproved purposes, according to the CDC.
Like all opioids, codeine can be very addictive, which is why cough syrups that contain the drug have been taken off the shelves and are now only available with a prescription. Still, because codeine is less regulated than other opiates such as morphine or hydrocodone, it is relatively easy to obtain. And even though it is less potent, codeine provides effects that are similar to morphine, including euphoria, relaxation or drowsiness.
Most codeine addicts begin using the drug as a prescription medication for pain relief or a legitimate condition such as a cough. Users run a high risk of developing tolerance and dependence on codeine and may start using it to treat any type of physical or emotional pain they have.
Many people think of it as a harmless drug because it is not as strong as other opioids, but with high doses and continued use, codeine can cause comas, respiratory failure and even death, especially when it is combined with other opioids or alcohol.
Codeine can also be a gateway drug that leads to other opioids such as heroin or morphine. As users become tolerant of codeine, they may try mixing it with other substances to attain the same high they experienced when they first started using it. This is especially dangerous when they combine codeine and alcohol, because they both act on the central nervous system, the combination of codeine and alcohol can cause respiratory failure and dangerous levels of depression in the brain.
When taken normally, codeine should be used every four to six hours or as directed by a physician. It is still available by prescription. As a Schedule II drug, codeine has a high potential for abuse and is known to cause severe physical and psychological dependencies. In some forms, codeine may not be a Schedule II drug. It may be classified as a Schedule II, III, IV or V drug depending on the mixture. For example, cough syrups with under 200 mg of codeine per 100 milliliters, like the commonly used Robitussin AC, are Schedule V drugs. They have a low risk of abuse but may still need a prescription for use.
One of the most popular misuses of codeine is a recreational drug called “purple drank.” Its signature color comes from the promethazine cough syrup that it is mixed with.
Also known as “sizzurp,” and “lean,” purple drank is typically served in a Styrofoam cup. It is mentioned frequently in pop culture and has been referenced on TV shows and in songs by artists such as Lil’ Wayne and Three 6 Mafia.
It creates what is sometimes called a “swooning euphoria,” and the effects can last up to five hours. It is often called “lean” because people who use it appear drunk and literally have to lean on something to stay upright.
This potent combination can cause dizziness, impaired vision, memory loss, hallucinations and seizures. It has been responsible for hospitalizations and even death. Lil’ Wayne was once admitted to intensive care with seizures and unconsciousness caused by extremely high levels of codeine. The rapper Mac Miller, who later died of a drug overdose, spoke often about his addiction to purple drank.
Signs of use include irritable behavior, a change in sleep patterns, disinterest in social activities or school, and new friends who may also abuse codeine. Signs that someone may be overdosing on purple drank include:
Codeine, as well as other opioids, have a high risk of causing a fatal overdose. Codeine, even in lower quantities, still has the potential to cause the depression of the central nervous system. As a result, it is possible that a person could take codeine and then stop breathing.
If the person taking codeine mixes it with alcohol, there is an even greater risk that they will overdose.
Codeine is often used in cough medications and common cold remedies, so it’s possible for anyone to become addicted to this drug. In one study, it was determined that codeine was more likely to be abused by:
It is more likely for young people to seek out codeine, because it is often easier to obtain. It is used recreationally by those with little or no experience, because they think it is harmless. Unfortunately, it has the potential to cause addiction.
Codeine isn’t as powerful as other opioids, like morphine, but it can still lead to someone developing a tolerance. It could also lead to someone looking for stronger opioids, like heroin, to eliminate their cravings.
Polydrug users also tend to abuse codeine. It is often mixed with marijuana or alcohol. Codeine is often used as a remedy for stronger opioids’ withdrawal symptoms, too. For example, someone trying to get off heroin may use codeine to minimize their withdrawal symptoms. Sometimes, this works to calm cravings and reduce the symptoms of withdrawal, even though codeine is much less powerful than heroin or other opioids. It’s not safe to do this without medical oversight, and detox is advised.
There are many signs of codeine addiction that you can recognize. The main effects of codeine abuse include:
If you abuse codeine for a long time, then there is an increased risk of damage to the major organs. For example, some of the long-term symptoms of codeine abuse may include:
In a person’s personal, school or work life, there could be signs of codeine abuse as well. These might include beginning to steal from others to pay for the addiction, skipping work or school or becoming increasingly preoccupied with getting and keeping the drug on hand.
Codeine is a narcotic drug, and it can lead to overdoses. Deaths from prescription opioid medications are more common than deaths from overdosing on other kinds of drugs, which is why it is so important to take the signs seriously.
The signs of a codeine overdose will be similar or the same as those of other opioids. Some common signs to watch out for include:
These are just some of the symptoms that may occur. You should also be aware that these signs of an overdose could also happen even if a person has taken the correct amount of codeine. Everyone’s body reacts differently to this drug, which is why anyone taking it should be monitored for their reaction.
If you see the signs of an opioid overdose, then you need to take action right away. Call 911 to get the person help for the overdose. If they are not breathing, you should follow the instructions given by the 911 operator to perform CPR or deliver a dose of NARCAN if it is available.
You may also want to call the poison control center if you’re not sure if your loved one has taken too much codeine. If you find that they have, you can take them to the hospital or call 911 to have emergency support come to you.
It is possible to treat an opioid overdose and reverse the effects. However, the outlook for the patient will depend on what the codeine was combined with. Codeine and acetaminophen, for example, has two active drugs. The acetaminophen could lead to organ damage on its own in high doses.
Codeine withdrawal can be serious, though it usually isn’t life-threatening. There are some common withdrawal symptoms that most people deal with when trying to stop the medication.
These may include:
The withdrawal symptoms may feel like having a bad flu. For some, the symptoms aren’t severe enough to warrant medical intervention, but monitoring is still a good idea. Why? Even though opioid withdrawal isn’t usually life-threatening, it is possible that you could become dehydrated or have symptoms that make you unable to care for yourself in the short-term.
During the withdrawal stage, it is also very simple to end up relapsing due to pain and generally feeling unwell.
Getting the right codeine treatment is important. During your codeine rehab program, you will likely need to first complete detoxification. Codeine detoxification begins the moment you take the last hit or dose of the drug.
Codeine doesn’t stay in the body for very long. If you have been taking codeine at high doses or for a long period of time, then you may start to have withdrawal symptoms quickly.
For most people, the onset of withdrawal symptoms begin within 12 hours after the last dose. From there, they may develop the initial signs of withdrawal, such as feeling shaky or having a headache.
Within the 24 to 40 hours following the last dose, the symptoms may progress into flu-like symptoms. Fortunately, these should peak at between three and five days. At that time, the symptoms should begin to abate.
The majority of people see their symptoms resolve, in general, within a week. After that, post-detox symptoms, like feeling poorly motivated or having mood swings, may continue to occur. If someone has post-acute withdrawal syndrome, then those symptoms could continue for months or years. Most people don’t have these symptoms in the long-term.
Codeine is less potent than many other opiates, but withdrawal symptoms during drug detox is still difficult. You may experience muscle cramps, tremors, anxiety and sleeplessness, and possibly more serious side effects such as vomiting and dehydration. With our detox program at Harbor Village, we can alleviate many of those symptoms with medications such as Suboxone and around-the-clock supervision that ensures your recovery is as safe and comfortable as possible.
Suboxone has been proven effective in helping overcome addiction to codeine and other opioids. It contains buprenorphine, which helps reduce cravings, and naloxone, which blocks effects of the codeine if you have a relapse.
After detox, our team of therapists and counselors employ holistic, evidence-based therapies such as cognitive behavioral therapy, group, and recreation therapy, dialectical behavior therapy, and more as part of your individualized addiction treatment program. These are the core of your recovery plan, and they are used to identify and treat underlying mental health disorders that may be at the root of your substance abuse. These psychotherapies equip you with new life skills and coping mechanisms for dealing with situations that may trigger your addiction to codeine.
We offer ongoing support through a series of aftercare programs that help you stay clean and sober after your rehab treatment ends. This includes support groups, counseling, and other therapy sessions as needed to keep you on the road to recovery.
Codeine help is available for you and those you love. If you’re dealing with a substance use disorder, know that you don’t have to go through this alone.