Codeine Abuse

Codeine is a legal opiate (narcotic) medication prescribed by doctors to relieve mild to moderate pain, or reduce coughing. When used for pain relief, codeine functions by altering how the brain and nervous system react to pain. When used to reduce coughing, it works by decreasing activity in the part of the brain that causes coughing.

Codeine can be habit-forming and must be taken exactly as directed by your doctor. Taking a larger dose, or taking codeine more frequently or for a longer period of time than prescribed, will lead to physical dependence and addiction.

Understanding Codeine Abuse

Codeine is an opioid that also acts as a cough suppressant. Although only available by prescription, codeine, in both pill and syrup forms, is sometimes taken recreationally, leading to addiction. When taken at a higher than prescribed dose, it will produce euphoria and sedation.

According to the National Institute on Drug Abuse, “codeine attaches to the same cell receptors targeted by illegal opioids like heroin. Consuming more than the daily recommended therapeutic dose… can produce euphoria similar to that produced by other opioid drugs; people addicted to codeine may consume several times the recommended, safe amount.”

When abused in this way, codeine also causes the brain to release more dopamine, commonly known as the “feel-good” chemical, in the brain’s reward pathway. Seeking to repeat the experience will lead to addiction, which the National Institute on Drug Abuse describes as “a chronic relapsing brain disease characterized by inability to stop using a drug despite damaging consequences to a person’s life and health.”

Signs and Symptoms of Codeine Abuse

Codeine can cause a number of side effects, such as:

  • mood changes
  • lightheadedness
  • drowsiness
  • headache
  • difficulty urinating
  • constipation
  • stomach pain

More serious side effects may also occur, some requiring emergency medical attention. According to the U.S. National Library of Medicine, you should seek medical help if you or a loved one experiences any of the following symptoms while taking codeine:

  • sleepiness
  • agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
  • nausea, vomiting, loss of appetite, weakness, or dizziness
  • inability to get or keep an erection
  • irregular menstruation
  • decreased sexual desire
  • noisy or shallow breathing
  • difficulty breathing or swallowing
  • changes in heartbeat
  • rash, itching, or hives
  • changes in vision
  • seizures

Dangers of Codeine Abuse

Sustained use of codeine will create a tolerance for the drug, forcing addicts to increase their dosage to experience the same effects. Taking large amounts of codeine will increase the number and severity of side effects, and cause the user to run a much greater risk of fatality.

Unusual dizziness, lightheadedness, extreme sleepiness, slowed or difficult breathing, or unresponsiveness could be signs of overdose. Codeine can cause users to slip into a state of deep sedation or coma, or to stop breathing altogether.

Drinking alcohol with codeine or taking codeine in combination with other drugs will increase the likelihood of adverse effects, including fatalities.

Who Abuses Codeine?

A person of any age, gender, financial status, or ethnicity can become addicted to codeine. Some people become addicted accidentally while taking codeine as a pain reliever or cough suppressant. According to The National Institute on Drug Abuse, “regular use—even as prescribed by a doctor—can produce dependence, and when misused or abused, opioid pain relievers can lead to fatal overdose. The current epidemic of prescription opioid abuse has led to increased use of heroin, which presents similar dangers.”

Starting in the late 1990s, drinking codeine cough syrup mixed with soda became popular with American youth and was frequently referenced in popular music. Drinking codeine in this way is a combination sometimes called syrup, sizzurp, barre, purple drank, or lean. Some users will blend “purple drank” with alcohol, which will increase both the effects and the deadly risks of consuming the drug.

Codeine Addiction

Anyone, from any walk of life, can become addicted to codeine. When its legal forms are used appropriately, under a doctor’s instructions, these medicines can be beneficial, and improve a patient’s quality of life during illness or recovery from surgery or injury. But overuse and abuse of codeine will lead to addiction, and serious mental and physical consequences.

Because this medication is prescribed by doctors, some users mistakenly believe that codeine is harmless, and non-addictive. Codeine is only safe when taken in a small, precise dosage, as determined by a medical doctor, to treat a specific medical concern. When you use codeine to self-medicate or get high, addiction occurs.

Am I Addicted to Codeine?

If you fear that you are addicted to codeine, read and honestly answer the questions below:

  • Do I abuse codeine every day?
  • Do I abuse the drug in order to combat feelings of unhappiness, loneliness, depression, etc.?
  • Have friends or family members mentioned more than once that they are worried about my drug use?
  • Do I become hostile or angry when they do so?
  • Do I ever experience side effects as listed above, or withdrawal symptoms such as: an inability to feel pleasure, feeling irritable or anxious, sweating, runny nose, yawning, muscle aches, fatigue and/or difficulty sleeping, thoughts of suicide, fast heartbeat, intense cravings, enlarged pupils, loss of appetite, chills, nausea, stomach pain or diarrhea?
  • Do I feel like I can’t have fun, be normal, or complete everyday tasks without codeine?
  • Am I secretive about my drug use, and/or do I lie about when I use or how much I take?
  • Do I need more and more codeine each time I abuse the drug in order to feel its effects?
  • Have I experienced any major problems in the last year, such as a breakup, job loss, car accident, family problems, financial problems, or getting arrested as a result of my drug use?
  • Despite these problems, do I feel unable to stop using codeine on my own?

If you answered yes to one or more of these questions, you may be addicted to codeine and in need of professional help.

Codeine Addiction Treatment

Addiction is a chronic, relapsing disease. The NIDA explains that “repeated drug use changes the brain, including parts of the brain that enable you to exert self-control. These and other changes can be seen clearly in brain imaging studies of people with drug addictions.”

This is why addicts require professional help to break the cycle of addiction. The treatment specialists at a qualified drug and alcohol rehab are trained in how to manage substance abuse issues and lead addicts safely to recovery.

There are a wide variety of affordable treatment options available, but all of them begin with abstaining from drug use.


Abstinence and detoxification is the first step to any recovery plan. A person needs clarity of mind and a body free from addictive substances before they can be effectively treated. Because withdrawing from codeine can be very unpleasant, detoxing in a rehab center under the care of medical professionals is ideal. A doctor may have you taper off of codeine gradually, to minimize withdrawal symptoms. Whatever the approach, having expert assistance will ensure that you detox safely, with as little discomfort as possible.


Whether addicts choose inpatient residential treatment, and/or outpatient treatment, all substance abuse recovery plans will include talk therapy. Individual therapy allows patients to work intensively on issues specific only to them, while group therapy allows them to both support and experience support from other addicts who are struggling with similar challenges. Family therapy is a valuable tool to ensure individuals encounter the best possible environment at home, to prevent relapse.

Other treatment options include:

  • 12-step meetings: Meetings based on the 12-step program that originated with Alcoholics Anonymous are an invaluable resource to support long term sobriety.
  • Cognitive-behavioral therapy: CBT teaches patients to retrain their brains with new methods of coping with stress and cravings, and avoiding trigger situations
  • Treatment for co-occurring conditions: most addicts suffer from undiagnosed mental health issues that underlie and fuel their substance abuse. These co-occurring disorders must be addressed as a part of recovery.
  • Nutrition, fitness and recreational therapy: a strong body is just as important as a strong mind when it comes to long-term recovery. The better a person feels, the more prepared they will be to handle life as it comes.