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What is Codeine?

Codeine is an FDA-approved medication that is prescribed to relieve mild to moderate pain. It may also be used in combination with some other medications to reduce coughing. Codeine does not treat the cause of symptoms or speed up recovery. Instead, it eases symptoms.

Codeine is part of a class of medications called opiate (narcotic) analgesics, as well as a class of medications called antitussives. It works by changing the way your brain and central nervous system (CNS) respond to pain. It also works by decreasing the activity in the part of your brain that causes you to cough.

It’s often prescribed on its own or in combination with acetaminophen, aspirin, carisoprodol, and promethazine. It can be found as an ingredient in the following medications:

  • Acetaminophen and codeine phosphate
  • Fioricet
  • Promethazine cough syrup
  • Robitussin A-C
  • Triacin-C
  • Tuzistra XR
  • Tylenol

While Codeine can help to relieve your symptoms, it may be habit forming. Codeine is a very addictive medication. Therefore, it’s important that you only take it as prescribed. Do not take more of it, and do not take it more often than directed by your doctor.

As always, consult your doctor about any concerns you may have about starting a new medication. If you or your family have a history of addiction, let your doctor know. If you are taking other medications that may interact with Codeine, also tell your doctor.

If problems or concerns arise while taking Codeine, consult your healthcare provider. You can discuss a new treatment plan to manage your pain. This may be a different pain medicine or an alternative form of treatment altogether.

You may also call the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP for more health information.

Side Effects & Dangers of Codeine Use

Like all medications, Codeine does have some side effects. Some are worse than others. Here are some side effects you should be aware of:

  • Drowsiness
  • Constipation
  • Headaches
  • Lightheadedness
  • Shallow breathing
  • Stomach pain
  • Difficulty urinating
  • Low blood pressure
  • Agitation
  • Hallucinations
  • Sweating
  • Confusion
  • Miscoordination
  • Nausea with or without vomiting
  • Weakness
  • Dizziness
  • Low libido
  • Difficulty breathing or swallowing
  • Changes to heartbeat
  • Fever
  • Shivering
  • Muscle stiffness
  • Muscle twitching
  • Diarrhea
  • Rash or hives
  • Itchiness
  • Vision changes
  • Seizures
  • Addiction
  • Death

Addiction is possible. And, if you ingest too much Codeine, it can kill you. 

In fact, about 21 to 29 percent of patients who are prescribed opioids for chronic pain misuse them. Meanwhile, between eight and 12 percent of patients who are prescribed opioids develop an opioid use disorder.

Misusing opioids like Codeine can also lead to other dangerous drug addictions. About four to six percent of people who misuse prescription opioids transition to heroin down the line. In other words, about 80 percent of people who use heroin first misused prescription opioids.

If you or someone you know has been prescribed Codeine to treat pain, pay mind to the signs of misuse. Consult your healthcare professional if you are worried that you may be developing an addiction to Codeine.

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Can You Overdose on Codeine?

While Codeine can offer pain relief, it’s also risky because it’s addictive. Codeine belongs to the class of drugs known as opioids. There are synthetic, semisynthetic, and natural drugs that have morphine-like properties.

Studies show that, every day, 128 people in the United States die from overdosing on opioids, including Codeine. Nearly 450,000 people died from opioid overdoses (including both prescription and illicit opioids) from 1999 to 2019.

You can overdose on Codeine if you take any more of it or more often than prescribed. Only take Codeine as directed by your doctor.

If you or someone you know may have overdosed on Codeine, contact emergency medical help immediately. You can call the poison control helpline at 1-800-222-1222. If the victim is in crisis, immediately call emergency services at 911.

How Does an Overdose Occur?

Codeine comes in the form of a tablet, capsule, and solution to be taken orally. It’s usually prescribed every four to six hours as needed. But you should read your label carefully and only take the directed dose for you.

If you miss a dose and are not prescribed to take Codeine regularly, you should skip it and resume your regular schedule. If you are prescribed to take Codeine regularly, call your doctor to ask if it is safe to take it when you remember. 

If you have any questions about your prescription, reach out to your doctor or ask your pharmacist to explain. If you take more Codeine than prescribed or more often than prescribed, you can overdose.

If an overdose does occur, it can be fatal. Seek medical attention immediately. 

Codeine Overdose Symptoms 

The symptoms of a codeine overdose include all of the above symptoms but worse. For example, you may feel very nauseous and very fatigued. But the symptoms of an overdose may also include the following:

  • Bluish fingernails and lips
  • Extreme trouble breathing
  • Cold, clammy skin
  • Flushing of the skin
  • Loss of consciousness
  • Coma
  • Weak pulse
  • Respiratory depression
  • Tiny pupils
  • Spasms of the stomach and intestines

Again, if you suspect that you or someone you know has overdosed on Codeine, call for medical help immediately. A Codeine overdose can be fatal, especially if left untreated.

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What Other Substances Interact With Codeine?

Codeine may interact with certain other prescription and over-the-counter drugs. Some of these medications include the following:

  • Alvimopan
  • Bremelanotide
  • Dacomitinib
  • Eluxadoline
  • Fentanyl
  • Givosiran
  • Hydrocodone
  • Isocarboxazid
  • Linezolid
  • Methylene blue
  • Nalbuphine
  • Ozanimod
  • Phenelzine
  • Rasagiline
  • Selinexor
  • Ticagrelor
  • Valerian

It’s important to talk to your doctor about any other medications you are taking. If you’re unsure whether or not your current medications will interact with Codeine, ask your doctor. Before starting new medications during your Codeine prescription, also consult your doctor.

Treatment for an Overdose

If someone you know overdoses on Codeine, call for emergency medical help immediately. If you are experiencing an emergency and need an ambulance, dial 911. If you’re not sure whether or not the situation is a true emergency, it is still recommended to call 911.

You can also call the poison control helpline at 1-800-222-1222. Or you can call SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) for free, confidential, 24/7 information on mental health and substance use disorders. 

You can also text 741741 if you are in a crisis. The Crisis Text Line is free, 24/7, and confidential. A live, trained crisis counselor will quickly respond through the secure texting platform.

Can an Opioid Overdose Cause Permanent Damage?

Yes, an opioid overdose can cause permanent damage. While Codeine is considered less potent than other opiates, overdosing on it can kill you.

Overdosing on Codeine can cause irreversible brain damage. If you or someone you know may have overdosed on Codeine, seek medical attention immediately. The sooner you receive medical help, the better.

Treatment Options for Opioid Abuse & Addiction

There are several options for people suffering from opioid addiction. These include:

  • Medication-Assisted Therapy (MAT) There are three medications approved to treat opioid use disorder: buprenorphine, methadone, and naltrexone. Buprenorphine and methadone can help you manage withdrawal symptoms throughout the detoxification process. Naltrexone is less commonly used, but it blocks your opioid receptors, making it impossible to get high. Medication-assisted therapy is most effective when combined with other forms of treatment.
  • Inpatient Programs — Inpatient programs are the most intensive and effective treatment options for opioid addiction. These programs guide you through medically supervised detoxification, then behavioral therapy and other services (possibly including MAT), will be added to your treatment. They typically last 30, 60, or 90 days, however they may be longer if necessary.
  • Partial Hospitalization Programs (PHPs) PHPs are also known as intensive outpatient programs (IOPs). They are the next most intensive type of treatment for opioid addiction. They provide similar services to inpatient programs such as detoxification, behavioral therapy medical services, and custom treatments such as MAT. The difference is that in a PHP, the patient returns home to sleep. Some programs will include transportation and meals, but this varies by program. Partial hospitalization programs are helpful for both new patients and patients who have completed inpatient treatment and still need intensive recovery therapy.
  • Outpatient Programs Outpatient programs work best for people who have a high level of motivation to recover. They create treatment programs that work around your schedule. These programs can either be an effective treatment option for new patients or a part of an aftercare program for people who complete inpatient or partial hospitalization program.

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Resources

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(Codeine) Dosing, Indications, Interactions, Adverse Effects, and More, 27 Feb. 2020, reference.medscape.com/drug/codeine-343310#3

“Codeine (Oral Route) Side Effects.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Feb. 2021, www.mayoclinic.org/drugs-supplements/codeine-oral-route/side-effects/drg-20074022

“Codeine Overdose.” Mount Sinai Health System, www.mountsinai.org/health-library/poison/codeine-overdose

“Codeine Overdose: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/ency/article/002613.htm

“Codeine: MedlinePlus Drug Information.” MedlinePlus, U.S. National Library of Medicine, medlineplus.gov/druginfo/meds/a682065.html

“Codeine: Side Effects, Dosages, Treatment, Interactions, Warnings.” RxList, RxList, 14 Apr. 2017, www.rxlist.com/consumer_codeine/drugs-condition.htm

“Opioid Data Analysis and Resources.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Jan. 2021, www.cdc.gov/drugoverdose/data/analysis.html.

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