Codeine Addiction And Abuse

What Is Codeine?

Codeine is a naturally occurring opioid that comes from the opium poppy plant. As a prescription opioid, it is often combined with other medications, such as acetaminophen or aspirin, in products used to relieve pain or suppress a cough.

Codeine itself is a “prodrug,” which means it needs to be metabolized by your liver into morphine before it can produce its pain-relieving and euphoric effects in your brain.

The process of converting codeine to morphine can vary from person to person. Your genetic makeup influences how quickly your body converts codeine to morphine, which can affect both the drug’s efficacy and its potential for misuse.

It is used instead of pure morphine because, in the form of codeine, the release is slower and more controlled. When codeine binds to opioid receptors in your brain, it not only dulls pain but also triggers a release of dopamine, creating feelings of pleasure. This mechanism can lead to repeated use and the development of a substance use disorder.

Is Codeine Addictive?

Yes, codeine is addictive. As an opioid, it acts on the reward centers in your brain, and even when taken as prescribed, dependence can occur. The risk of addiction increases when someone takes it in larger doses, more frequently, or for a longer period than prescribed.

Your body can quickly become tolerant to codeine, meaning you need higher doses to achieve the same initial level of pain relief or euphoria. As your tolerance builds, you may also develop a physical dependence. Dependence means your body has adapted to the presence of the drug, and you will experience withdrawal symptoms if you stop taking it abruptly.

While physical dependence can be a component of addiction, the two are not the same. Addiction, or a severe substance use disorder, is characterized by compulsive drug-seeking and use despite experiencing harmful consequences.

How Do You Recognize A Codeine Addiction?

Identifying a codeine addiction involves looking for patterns of behavior and physical signs that suggest that the drug has become a priority in your daily life. It’s not just about the amount taken, but the impact it has on a person’s actions and health. Recognizing these codeine addiction signs is a critical step toward seeking help.

Physical and psychological codeine abuse symptoms may include:

• Appearing unusually sedated or drowsy (“nodding off“)
• Constricted (pinpoint) pupils
• Experiencing frequent constipation, nausea, or itching
• Displaying mood swings, anxiety, or irritability, especially if the drug is unavailable
• Going through periods of withdrawal when not taking the drug

Observing these physical and mood-related changes in a person is a strong indication that their body has developed a dependence on codeine and requires it to function.

Additionally, behavioral changes that signify a codeine addiction can include:

• Doctor shopping, or visiting multiple doctors to obtain new prescriptions
• Withdrawing from friends and family, becoming secretive and defensive
• Neglecting responsibilities at work, school, or home
• Losing interest in hobbies and activities
• Continuing to use codeine despite experiencing negative social, financial, or health-related consequences

These behaviors reflect the compulsive nature of addiction, where seeking and using the drug becomes the individual’s highest priority, often leading to personal deterioration.

What Are The Side Effects Of Codeine?

Even when used as directed, codeine can cause a range of side effects. These effects occur because the drug depresses your central nervous system. Common side effects include:

• Drowsiness and sedation
• Dizziness or lightheadedness
• Nausea and vomiting
• Constipation
• Sweating
• Itching
• Dry mouth

When codeine is misused, taken without a prescription, in higher doses, or by a method other than directed (such as crushing and snorting pills), these side effects can become dangerous. The dangers of codeine abuse become particularly concerning, significantly increasing the risk of severe respiratory depression and overdose.

What Are The Long-Term Health Risks Of Codeine Abuse?

Misuse of codeine can lead to significant and sometimes permanent damage to your physical and psychological health.

Prolonged use can result in:

• Increased tolerance and dependence: Your body will require more of the drug to feel its effects.
• Liver damage: Many codeine-containing medications also include acetaminophen. High doses over time can cause acute liver failure.
• Gastrointestinal issues: Chronic, severe constipation from codeine use can lead to bowel obstructions and other digestive complications.
• Respiratory problems: Long-term opioid use can lead to a slow breathing rate, which may result in hypoxia, a condition where too little oxygen reaches the brain.
• Hormonal imbalances: Opioid abuse can disrupt your endocrine system, potentially leading to reduced libido, infertility, and fatigue.
• Mental health deterioration: Codeine misuse is often linked to the development or worsening of depression, anxiety, and other mood disorders.

These long-term health risks are a serious aspect of the dangers of codeine abuse.

What’s The Difference Between Codeine Abuse And Addiction?

While the terms are often used interchangeably, codeine abuse and addiction describe different, though sometimes overlapping, patterns of use.

Codeine abuse refers to any use of the medication outside of its prescribed purpose. This includes taking it for the experience or feeling it causes, using someone else’s prescription, or taking it in a way other than directed. For instance, crushing pills to snort or inject the powder is a form of abuse. Abuse is characterized by the behavior of misuse. Abuse can lead to addiction, but addiction is characterized by loss of control.

Addiction, clinically known as a substance use disorder, is a chronic brain disease. It is defined by the inability to stop using despite severe harm and negative consequences. A person with an addiction will experience intense cravings and a compulsive need to seek out and use codeine, even if it damages their health, ruins relationships, or leads to financial or legal trouble. While abuse can lead to addiction, not everyone who abuses codeine will become addicted; however, abuse always increases the risk.

Dangers Of Mixing Alcohol And Codeine

Mixing codeine and alcohol can be fatal, as both substances are central nervous system depressants. When combined, their effects are multiplied, not simply added, a phenomenon known as synergism.

This combination can lead to:

• Sedation and dizziness, which increase the risk of accidents and falls
• Depressed respiration, where breathing becomes dangerously slow or stops entirely
• Significantly increased risk of overdose and death
• Heightened risk of loss of consciousness, coma, and permanent brain damage from oxygen deprivation

Even small amounts of alcohol combined with a prescribed dose of codeine can be risky. You should never consume alcohol while taking codeine.

What Are The Signs Of Codeine Overdose?

An overdose occurs when a person takes more codeine than their body can process, leading to a life-threatening shutdown of vital functions.

Signs of an opioid overdose include:

• Slow, shallow, or stopped breathing
• Extreme sleepiness or unresponsiveness
• Cold, clammy skin
• A bluish tint to the lips and fingernails
• Pinpoint pupils
• A slow or erratic heartbeat
• Gurgling sounds or a snore-like gasp, which can indicate a blocked airway

The opioid overdose reversal drug naloxone (brand name Narcan) can be administered by bystanders and can temporarily reverse the effects of an overdose until emergency services arrive. If you or someone you know uses codeine, especially at high doses or with other depressants, having naloxone on hand can save a life.

A codeine overdose is a medical emergency. If you suspect someone is overdosing, call for emergency medical help immediately.

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Getting Help For A Codeine Addiction

Overcoming a codeine addiction can be challenging, but recovery is possible with the proper support and treatment.

Because codeine withdrawal can be uncomfortable and medically complex, it is strongly recommended that you seek professional help. A detoxification program, often the first step, provides medical supervision to manage withdrawal symptoms safely.

Following detox, comprehensive treatment addresses the underlying psychological and behavioral patterns of addiction. This may involve:

• Inpatient Treatment: Providing a structured, live-in environment with intensive therapy and support.
• Outpatient Programs: Allowing you to live at home while attending treatment sessions during the week.
• Behavioral Therapies: Counseling, such as cognitive behavioral therapy, helps you identify and change damaging thought patterns and behaviors related to drug use.
• Medication-Assisted Treatment: In some cases, medications may be used to reduce cravings and withdrawal symptoms, supporting long-term recovery.
• Support Groups: Connecting with peers in recovery through groups can provide ongoing encouragement and a sense of community.

If you recognize signs of addiction in yourself or a loved one, immediate action is crucial. You can begin by consulting your primary care physician or an addiction specialist for an initial assessment. If you’re ready to enter a treatment program, visit our rehab directory or contact a treatment provider today to learn more about your many treatment options.