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Codeine (codeine sulfate) is a medication used for treating pain in the class of narcotic drugs called opioids, which refers to any synthetic, semisynthetic, or natural drug with morphine-like properties.
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Codeine is a prescription drug. People can use codeine alone or with other medicines. When used to treat pain, codeine works by changing how the brain and central nervous system (CNS) respond to the pain. Codeine also works to decrease the activity in the part of the brain that causes coughing.
Codeine belongs to a class of medications known as opioid (narcotic) analgesics and antitussives. It is considered a schedule II controlled substance. The risk for codeine overdose and abuse increases with the misuse of alcohol and other substances.
Codeine is also available with acetaminophen, aspirin, carisoprodol, and promethazine. It is used as an ingredient in many cold medications and cough syrups.
There are several side effects and risks associated with codeine use, including:
It generally takes about one hour for codeine’s effects to kick in, which last between three to four hours, depending on the dose.
Codeine’s effects vary from person-to-person and depend on each individual’s size, how much they’ve taken, if their stomach is empty, and other drugs/alcohol they’ve consumed.
The plasma half-life of codeine is about 2.9 hours. The elimination of codeine is done mainly via the kidneys, which excrete approximately 90% of an oral dose within 24 hours. However, there are tests healthcare providers can perform that can detect codeine for up to 10 weeks.
Drug testing via a urine test can detect codeine for up to 2 to 3 days.
Hair follicle testing can detect codeine for up to 10 weeks.
The window to detect codeine on a blood test is 24 hours.
A saliva test can detect codeine for 1 to 4 days, depending on certain factors. If you chew gum or eat things high in citric acid, it will lower the levels of Codeine in the saliva.
Codeine is a highly-addictive opiate pain reliever. As a person’s tolerance to codeine builds, they will need higher doses to feel its effects. This can lead to drug abuse (misuse) as prolonged codeine use can leave users physically and psychologically dependent on the drug.
Though codeine is less addictive than other painkillers like oxycodone and hydrocodone, people can still become addicted to codeine. Severe codeine addicts may even start to feel withdrawal symptoms within a few hours of their last dose.
When withdrawal symptoms start and how severe they are depends on a number of factors, including:
Codeine withdrawal symptoms and the severity vary from person-to-person. Common withdrawal symptoms include:
For some, codeine withdrawal symptoms will feel like a bad case of the flu. For heavy users, the symptoms are much worse and may require medical care. Though codeine withdrawal is not generally dangerous, it can cause lowered hydration levels and be too much to bear without medical intervention.
There are many codeine treatment programs across the country.
Treatment options for codeine addiction include tapering codeine use instead of quitting the drug cold turkey. Medication-assisted treatment (MAT) is also usually necessary. This is why it’s a good idea to be under the watch of a clinician or at a treatment center or other inpatient program to be supervised during withdrawal. By tapering codeine use, the body has time to adjust to less and less codeine until it no longer needs it to function.
Methadone is another tool that doctors use to treat codeine addiction. Methadone changes how the brain and central nervous system (CNS) respond to pain to lessen the uncomfortable and dangerous symptoms associated with opiate withdrawal. It also works to block the euphoric effects of codeine.
Buprenorphine, methadone, and naltrexone are also used to treat opioid use disorders to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.
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Codeine: MedlinePlus Drug Information. (n.d.). https://medlineplus.gov/druginfo/meds/a682065.html
Codeine. (n.d.) https://www.uofmhealth.org/health-library/d00012a1
Controlled Substance Schedules. (n.d.). https://www.deadiversion.usdoj.gov/schedules/