Codeine is a mild narcotic and painkiller used to treat moderate pain and diarrhea. Its main use is for individuals who have irritable bowel syndrome. It also is used as a cough suppressant and is included in various drug combinations, such as Halotussin AC, Brontex, Vanacof, Cheratussin AC and Guiatuss AC.
Codeine Comes in Many Forms
Codeine is available in different forms. It is available as tablets, syrups, oral solutions, suspensions and capsules. Despite its effectiveness in relieving pain and cough episodes, codeine puts users at significant risk of developing a severe physiological dependence and drug abuse. This is because codeine is an opioid. Therefore, it is kept behind the counter and bought as a prescription-only drug. This is to minimize the cases of nonmedical use and its abuse.
Codeine’s Uses and Side Effects
Some countries monitor the purchase of products containing codeine to track how much an individual buys. Legal restrictions are dependent on the percentage of codeine in the particular drug. Codeine is not meant for long-term usage. The consequences of using it for an extended period include:
- Chronic constipation
- Physical dependence
- Sexual dysfunction
- Low sex drive
- Disrupted menstrual cycles
- Risk of overdose
- Muscle tension and twitches
- Tolerance, which is when a user needs more of the drug to experience the same effect
- Withdrawal symptoms, such as a runny nose, cravings, abdominal cramps, aching of muscles and joints, depression, restlessness, fever, chills, sweating and irritability
How a Codeine Addiction Develops
Addiction to codeine and any other drug containing opiates usually occurs very quickly and becomes extremely difficult to overcome. One may not even realize he or she is getting addicted until he or she can’t go a day without it. A person’s body chemistry will determine his or her development of tolerance to the drug. Some people’s bodies break down codeine much faster than others, putting them at a higher risk of getting addicted to it.
Addiction to opiates has been around for ages. They are abused mostly due to its ability to cause euphoria and relaxation when taken in high doses. People who misuse the drug either chew, inject, crush or snort the tablets. A common but dangerous way of taking codeine is combining it with soda and cannabis or hard candies. This mixture is referred to as “purple drank” or “sizzurp.” Some people mix the syrup with alcohol.
How Is Codeine Broken Down in the Body?
When codeine gets into the body, it is metabolized by the liver. This results in the production of metabolites. Codeine is converted into codeine-6-glucuronide, norcodeine and morphine. Codeine 6 glucuronide and norcodeine do not cause any drug effects on their own, meaning they are inactive. Morphine, however, affects the brain. It alters the brain’s reward center, leading to feelings of well-being and pleasure, among other effects. Morphine occurs naturally and makes up 2% of opium. Owing to the above, the abuse of codeine has become quite rampant.
Codeine and the produced metabolites are excreted through urine. A urine test not only detects codeine but its metabolites as well. A substance known as hydrocodone may also be present in the urine. It is a minor metabolite of codeine.
The half-life of codeine is between three and four hours. This is the amount of time it takes for half a dose of codeine to leave a person’s body. When someone uses codeine, the timelines for detection are as follows.
- It can be detected in most people’s urine for up to 48 hours after the last use. For chronic users, it may go up to one week.
- It can be detected 21 hours in saliva after the last use.
- It can be detected in hair follicles for up to 10 weeks after the last use.
In addition to a test being used to discover the presence of codeine, detectability of the chemicals can depend on other factors, such as:
- The weight of the person
- The urine concentration, which is affected by a person’s fluid intake
- Kidney or liver dysfunction
- The amount of codeine a person took before the test and the time that has passed before the test
- Metabolism, which is affected by ethnicity, age and gender
- The urine’s pH levels
- The period of time during which a person took codeine
Who Abuses Codeine?
Since codeine is used to treat various common health issues, such as pain, cough and diarrhea, there’s a wide range of people who can become addicted to it. A study published in the 2013 edition of Addictive Behaviors found that there are certain groups, however, who are more likely to abuse codeine than others. These include males, Native Americans, students from urban environments, LGBT persons and Hispanic individuals. This study was based on the Southern U.S. culture of purple drank, or sizzurp intake, a drink mixture containing codeine and soda or alcohol.
Younger individuals are more likely to seek codeine medications for recreational purposes. These may be youngsters who have no experience with drugs and want to only try something they perceive to be of no harm.
Despite codeine becoming morphine in the body, it is only a fraction as potent as pure morphine. Once these youngsters establish a high tolerance to codeine and are unable to get euphorically high, they pursue stronger and more dangerous opioids.
Other populations at risk for codeine addiction include polydrug users as codeine is usually mixed with alcohol, soda and cannabis. Opioid users may seek codeine to reduce withdrawal symptoms either because they are trying to quit or their access to more powerful opioids has been cut off.
Taking a less powerful opioid leads to stimulation of the brain’s reward center, which calms cravings and reduces withdrawal’s physical symptoms. This process is dangerous, and medical detoxification is recommended instead.
In some cases, a person gets addicted to opioids even if he or she takes the required dosage and follows the prescription correctly. This is rare, but if it happens, it is crucial to seek medical assistance right away.
You will know if you are addicted if you realize you can’t get through the day without the drug. This usually occurs when the body develops a high tolerance for the drug and is caused by self-medication with higher doses or when the doctor prescribes a higher dose.
Dangers of Mixing Alcohol With Codeine
Mixing any opioid drugs with alcohol is dangerous. People, however, often mix them for recreational purposes. The effects of codeine include pleasurable feelings and a low perception of pain. Alcohol serves to emphasize these effects temporarily. One will, therefore, feel more relaxed and pleasant.
Both codeine and alcohol interact with neurotransmitters in the brain, particularly serotonin and dopamine. Alcohol affects the GABA receptors while codeine affects the opioid receptors.
Serotonin and dopamine are chemicals that influence and determine a person’s mood. When there are more of them present in the brain, a person feels happier and better. This increases the chances of someone overdosing or getting hooked on the drug.
When the drugs wear off, and these neurotransmitters reduce, one may end up feeling depressed. The body’s reward system, which is primarily fed by dopamine, will cause a person to seek the substance that made him or her happy to begin with. One eventually gets stuck in this loop and is said to be addicted.
Signs That Point to a Codeine Addiction
The most common side effect of codeine is nausea. This mainly occurs when it is consumed in cough syrups. Codeine addiction can also cause:
- Anxiety and depression
- Weight loss
- Sleeping more than usual
- Nodding off
- Decreased appetite
- Slowed breathing
- Clammy hands or feet
- Mood swings
- Stomach pain
- Changes in vision
Long-term use of codeine can cause an increased risk of bowel damage, infection of the lung, sleep disorders and an irregular heart rate. In advanced stages, it may cause brain damage.
These are all physical effects that harm the body. In addition to these, codeine addiction has a poignant impact on life satisfaction and social relationships. A person’s responsibilities and relationships suffer. He or she may lose his or her jobs and friends. A codeine addict finds it difficult to interact with other people. He or she loses his or her ability to concentrate as constant mood swings, and drowsiness makes it hard to focus.
Once the brain gets used to codeine stimulating dopamine production, it stops producing chemicals that activate the body’s reward center. An addicted person will, therefore, feel the need to take codeine for any level of pleasure.
The inability to feel any pleasure is called anhedonia and is very common with opiate addiction. People become addicts very easily and quickly, but once they get hooked, it becomes difficult to quit.
Stopping the use of codeine after a period of addiction, however, comes with withdrawal symptoms. These are the changes in the brain and body experience in the drug’s absence after getting used to it. They can no longer function properly without the medication. Common codeine withdrawal symptoms include:
- Runny nose
- Watery eyes
- Stomach cramps
- Loss of appetite
- Muscle pains
- Weight loss
These symptoms may be mistaken for a bad flu or other illnesses. If one was a heavy user of codeine, it may be worse and require medical intervention. It is, therefore, advisable to consult a doctor before getting off codeine. It would be best if you did this immediately after realizing that you have an addiction. With medical help, the experience becomes more bearable, and you reduce the risk of relapsing.
A short break from opiates may result in tolerance reduction. However, starting at the same dose from before the attempt to stop was made may result in a dangerous overdose.
Treatment of Codeine Addiction
As hard as it may seem to overcome an addiction to codeine, it is possible. You should seek medical assistance before your addiction progresses. Here at Granite Recovery Centers, we offer a range of treatment programs that will help you regain control over your life.
Medical detoxification is usually the first step in treating a codeine addiction. In severe cases, the patient is prescribed drugs to help him or her safely detox without having to undergo severe withdrawal symptoms.
Aside from the physical dependence that occurs with excessive codeine consumption, the other challenge facing codeine users is withdrawal symptoms that can range from insomnia to depression. These symptoms can, however, be alleviated through supervised medical detox.
Once a person completes the detox process, it is essential that he or she joins an inpatient treatment program. This allows codeine addicts to receive uninterrupted care without temptations. Inpatient rehabilitation programs vary from 30 to 90 days. It depends on the level of addiction.
A change in environment could also help one recover easily and fast. The most common drug used during codeine addiction recovery is Suboxone, which contains naloxone and buprenorphine. To avoid relapsing, one is advised to not use other drugs apart from what is necessary and has been prescribed for treatment.
Suboxone has proven to be effective in the recovery of opiate dependency. The buprenorphine component in Suboxone helps to reduce one’s cravings. Naloxone, on the other hand, prevents or reverses any intoxicating effects of codeine if the patient happens to relapse. Codeine overdose is also treated using naloxone. In the early stages of recovery, buprenorphine on its own is sufficient to treat one of addiction.
Granite Recovery Centers offers specialized support and group counseling to help recovering addicts learn how to live happy and healthy lives without codeine. Our mental health program helps patients suffering from co-occurring disorders, such as addictions to multiple substances and mental health issues.
After inpatient treatment, a person must keep up with his or her treatment for a lasting and smoother recovery. Going back to society means being exposed to temptations, which puts one at a greater risk of relapsing back to codeine addiction. Consider joining a support group and undertaking counseling to help you stay on the right path, overcome temptations that trigger codeine cravings and cope with underlying issues.
Beat your addiction today! Medication, therapy and other forms of support will help you regain control over your life.