Codeine Symptoms And Warning Signs
Codeine is prescribed to treat cough and pain and is misused for its calming effects. Signs of misuse include slurred speech, dizziness, and seizures.
Author Kristen Fuller, MD
Signs Of Codeine Abuse
Codeine is a prescription opioid prescribed to relieve mild to moderate pain and suppress cough. It is most commonly abused for its calming and euphoric effects.
Although it’s not as addictive as other opiates, codeine is still dangerous and habit-forming. It’s essential to recognize the signs and symptoms associated with codeine misuse, as these warning signs can help you determine if a loved one has a budding substance abuse problem.
Common signs of codeine abuse include:
- Drowsiness
- Slurred speech
- Dry mouth
- Short attention span
- Impaired judgment
- Pinpoint pupils
- Lack of coordination
- Apathetic behavior
Why Do People Abuse Codeine?
Codeine is an opioid pain reliever that acts on the dopamine reward system in the brain, resulting in pleasurable feelings and relaxation. Because it is considered a weaker opioid, many people falsely assume that codeine is not dangerous or addictive, so they may abuse codeine without knowing or assuming the risks.
People may abuse codeine for the following reasons:
- To self-medicate their chronic or acute pain
- To numb negative feelings associated with past trauma, stress, and depression
- To get high
Codeine is a primary ingredient in the drink “lean,” also known as Purple Drank or sizzurp. Lean is a dangerous and illicit mixture combining cough syrup made from codeine and promethazine (an antihistamine) with a soft drink and sometimes candy. This mixture produces feelings of euphoria, relaxation, and lethargy, and people using lean will often “lean” to one side because they are so lethargic.
Codeine is about one-tenth as potent as morphine.
What Are The Effects Of Codeine?
The immediate side effects of codeine vary based on the individual and the amount of the drug taken. These side effects can range from mild to life-threatening. Some possible short-term side effects of codeine include:
- Drowsiness
- Itching or rash
- Constipation and stomach cramps
- Nausea
- Dry mouth
- Blurred vision
- Low blood pressure
- Dizziness
- Seizures
Long-Term Side Effects Of Codeine Abuse
Prolonged and frequent codeine abuse can lead to maladaptive behaviors and health problems.
Since codeine is metabolized by the liver, prolonged use can lead to liver inflammation and damage. Codeine is often combined with acetaminophen in many formulations, and since the liver also metabolizes acetaminophen, this can significantly increase the risk of liver failure, especially in the presence of alcohol consumption.
Additionally, long-term codeine use increases the risk of bowel disorders. Because codeine is an opioid, it slows down gut motility and other processes in the digestive system, causing chronic constipation. Over time, this can lead to bowel obstruction.
Additional long-term effects of codeine abuse include:
- Depression
- Anxiety
- Fatigue
- Impaired memory
- Kidney damage, especially when combined with ibuprofen.
- Muscle spasms
- Tolerance
- Dependence
- Addiction
- Death
How Do You Know If Someone Is Abusing Codeine?
Because codeine is commonly prescribed, it is also widely abused. The following are warning signs that someone is abusing codeine:
- Obtaining multiple prescriptions of codeine
- Doctor shopping
- Appearing “dazed”
- Confusion
- Drastic changes in mood
- Drowsiness, lethargy
- Pinpoint pupils
- Decline in work or school performance
- Unusual, secretive behavior
- Losing interest in previously enjoyed activities or hobbies
- Irritability
- Social withdrawal or changes in friend groups
How Is Codeine Used Correctly?
Codeine is used correctly when taken as prescribed, meaning it is prescribed for mild to moderate pain or for cough suppression for the short term.
Taken as prescribed also means codeine is taken at the correct dosage, timing, and frequency that is written on the prescription, and it is not taken with other opioids, alcohol, benzodiazepines, or other medications that can have interactions. It is essential that you do not take more than is prescribed, take it more frequently, or for a longer duration than prescribed.
Care That's Covered by Insurance
Explore rehabs that accept your insurance today! Start your recovery journey with peace of mind, knowing your care is covered.
Addiction Center is not affiliated with any insurance.
Is Codeine Dangerous Even When Used Correctly?
Taking codeine correctly can drastically reduce the risk of developing a tolerance or dependence. However, since codeine is an opioid, the risk of developing a tolerance is always present.
People who have a genetic variation in their metabolism, making them “ultrarapid metabolizers,” can still be incredibly susceptible to codeine overdose, because it is an opioid and carries inherent risk factors, such as respiratory depression.
In the first 24-48 hours after taking codeine, monitor breathing; if it slows or becomes shallow, seek emergency medical care right away.
How Is Codeine Addiction Treated?
Codeine addiction is treated with a multidisciplinary approach using a combination of medications and psychotherapy approaches that are generally used for all types of opioid addiction.
Medications for opioid use disorder (MOUD) are FDA-approved medications used to treat urges, cravings, and withdrawal symptoms to help manage opioid addiction, including codeine addiction, and support long-term recovery. These FDA medications include:
MOUD is combined with counseling and behavioral therapy approaches, such as:
- Cognitive-behavioral therapy
- Motivational enhancement therapy
- Contingency management
- 12-step facilitation
Codeine withdrawal can be very uncomfortable and even painful. Although it is usually not life-threatening, FDA-approved medications are used to help ease withdrawal effects to prevent relapse, as many users will relapse as a way to stop these uncomfortable and painful withdrawal symptoms. These symptoms may be minor or severe, depending on the extent of the addiction. Without proper treatment, many people who try to give up codeine turn back to the drug in an attempt to ease their physical and emotional pain.
Explore These Featured Centers
Find Help For Codeine Addiction
If you or a loved one is struggling with codeine abuse, help is available. For more information on treatment options, visit our rehab directory or contact a treatment provider today.
