What are the Symptoms and Treatment of Codeine Addiction?
In This Article
Codeine is a naturally occurring substance that makes up 0.7% to 2.5% of opium. It’s available as a solo prescription pain medication or mixed with other substances in some over-the-counter medicines.
Doctors may prescribe codeine to alleviate mild or moderate pain and suppress coughing. Many people rely on it for pain management.
As a Schedule II drug, codeine has a high potential for abuse. It can lead to severe psychological or physical dependence among those dependent on it, increasing the risk of overdose and death.
Why Do People Misuse Codeine?
Some people misuse codeine for relaxation, euphoria, and a dopamine rush. Opioid users, unable to access heroin or stronger opioids, may turn to codeine to alleviate cravings and withdrawal symptoms.
Those prescribed codeine can also misuse it. As tolerance develops, they might receive higher prescription doses or self-medicate in higher doses.
What are the Risk Factors for Codeine Addiction?
A genetic predisposition to addiction or a previous history of substance abuse can make a person more prone to codeine addiction. Other risk factors include having a stressful home environment or having easy access to drugs.
Psychological risk factors for codeine addiction include stress and anxiety. A person is also at risk of addiction if they experience trauma or have depression.
What are the Signs of Codeine Addiction?
Codeine addiction develops with excessive or regular use. These behaviors may indicate that you've developed an addiction:
- Buying codeine illegally or on the street
- Faking symptoms for prescription codeine
- “Shopping” for doctors to get multiple prescriptions
- Stealing codeine from a healthcare provider
- Stealing money to buy the drug
- Being unable to stop taking codeine after unsuccessful attempts
- Taking other opioids if codeine is unavailable
- Experiencing withdrawal symptoms when not taking codeine
What are Codeine Withdrawal Symptoms?
When you become addicted to codeine, your body starts depending on it. If you stop using it abruptly, your body has to get used to functioning without it, which leads to uncomfortable withdrawal symptoms.
- Runny nose
- Watery eyes
- Nausea
- Vomiting
- Stomach cramps
- Diarrhea
- Loss of appetite
- Weight loss
- Muscle aches
- Sweating
- Goosebumps
- Agitation
- Anxiety
- Cravings for more codeine
- Restlessness
- Widened pupils
- Irritability
- Difficulty falling asleep or staying asleep
- Fast breathing or heartbeat
Don't try to quit codeine on your own. Your doctor can help you gradually reduce your dose, which makes withdrawal symptoms much easier to handle.
What are Codeine Overdose Symptoms?
Opiates like codeine can weaken the central nervous system, which controls your heartbeat and breathing. A codeine overdose can be dangerous, if not fatal.
Some symptoms of codeine overdose include:
- Slowed breathing
- Cold, clammy skin
- Dizziness or drowsiness
- Muscle weakness
- Lightheadedness
- Fainting
- Vomiting
- Slow heartbeat or weak pulse
- Low blood pressure
- Intestinal spasms
- Convulsions
- Bluish lips or fingernails
- Pinpoint pupils
- Coma
- Death
From 1999 to 2019, about 500,000 people died from opioid overdose. Nearly half of these overdose deaths are due to prescription opioids like codeine.2,3
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Codeine Addiction Treatment
Treatment for codeine addiction doesn’t differ from that of other opioids. Available codeine treatment programs include:
- Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision
- Outpatient treatment: A treatment program where you can leave the rehab facility
- Cognitive behavioral therapy: A short-term therapy technique that explores the link between thought patterns and addiction
- Medication-assisted treatment: Involves using medication, counseling, and therapy to treat addiction
- Support groups: Groups or organizations that provide a community to help maintain sobriety after treatment
How Is Codeine Addiction Diagnosed?
Diagnosing any opioid addiction requires a thorough medical evaluation. To diagnose you, healthcare providers use lab tests and monitor prescription medications.
They also use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to diagnose opioid use disorder (OUD). Some of its eleven criteria include:
- Excessive cravings
- Recurrent use
- Tolerance
- Withdrawal symptoms
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How Can You Prevent Codeine Addiction?
Here are a few guidelines for using codeine safely:
- Take codeine precisely as your doctor prescribed
- Don’t increase your dose or frequency of use unless prescribed
- Don’t crush, chew, or dissolve the pills
- Don’t stop taking codeine suddenly
- Ask your doctor how to stop taking codeine safely
- Tell your doctor about any codeine cravings or withdrawal
- Don’t share codeine with anyone, especially someone with a drug abuse history
- Don’t keep leftover medication; other people might misuse it
- Don’t drink alcohol while taking codeine
- Don’t ingest codeine with interacting drugs
- Skip a missed dose if it’s time for the next
- Don’t take two doses to make up for a missed one
You should also tell your doctor if you're pregnant. A newborn baby might undergo withdrawal if you take codeine regularly during pregnancy.
What are Codeine’s Drug Interactions?
Codeine can interact with central nervous system depressants and increase the risk of severe respiratory depression and sedation. These depressants include alcohol and benzodiazepines.
Other substances you should never mix with codeine include:
- Cough, cold, and allergy medications
- Medicines for asthma, motion sickness, or IBS
- Other opioids
- Sedatives like Valium
- Muscle relaxants
- Antidepressants
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
The possibility of dangerous interactions underscores the importance of cautious use and medical guidance.
Resources for Help and Support
If you or someone you know is struggling with codeine addiction, there are resources available to help. Consider reaching out to:
- National Helpline: 1-800-237-TALK (8255)
- Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment locator
- National Institute on Drug Abuse (NIDA) Helpline: 1-800-662-HELP (4357)
- National Alliance on Mental Illness (NAMI) Helpline: 1-800-950-NAMI (6264)
- Your primary care provider or a mental health professional: Consult them for personalized guidance and treatment options for mental illness symptoms
Guidance for Caregivers and Family Members
Here are some ways to support the recovery of those struggling with codeine addiction:
- Educate yourself about the drug: Research and learn more about codeine addiction, and effects on the body to better understand your loved one's struggles.
- Encourage them to seek treatment: Voice your support and encouragement to seek professional help and offer to accompany them to appointments or find a treatment facility.
- Be patient and understanding: Be patient and understanding with your loved one as they work towards sobriety and experience setbacks.
- Avoid enabling behaviors: Avoid giving your loved one money or making excuses for their behavior.
- Take care of yourself: Recharge your energy by taking care of your well-being and seeking support from others.
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Summary
Codeine is a prescription opiate for mild or moderate pain. It's also a Schedule II substance with a high potential for abuse and addiction.
Users often misuse this opiate for its euphoric side effects. As such, codeine abuse can lead to tolerance, dependence, addiction, and even death. Fortunately, various treatment options are available to help you recover from substance abuse.
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- U.S. Department of Health and Human Services. “Module 5: Assessing and Addressing Opioid Use Disorder (OUD).” Centers for Disease Control and Prevention.
- U.S. Department of Health and Human Services. “Opioid Data Analysis and Resources.” Centers for Disease Control and Prevention, 2023.
- U.S. Department of Health and Human Services. “Overdose Death Rates Involving Opioids, by Type, United States, 1999-2020.” Centers for Disease Control and Prevention, 2022.
- National Center for Biotechnology Information. "Codeine." PubChem, 2023.
- “Opioid Addiction 2016 Facts & Figures.” American Society of Addiction Medicine.
- “Codeine.” University of Michigan Health, 2019.
- U.S. Department of Health and Human Services. “Codeine.” MedlinePlus, 2023.
- Dydyk et al. “Opioid Use Disorder.” StatPearls Publishing, 2023.
- “Opioid Use Disorder” Johns Hopkins Medicine.
- U.S. Department of Health and Human Services. “Treatment.” National Institute on Drug Abuse, 2023.
