Codeine Addiction and Treatment

Last Updated: June 3, 2020

Authored by Sharon Levy, MD, MPH

Codeine is an opiate drug that is commonly prescribed for pain management and sometimes for the suppression of coughs. Codeine is addictive for those who develop a tolerance or experience prolonged use and carries a high potential for abuse.

Codeine Effects

Prescription pain relievers are a necessary part of the medical intervention. After surgery, or during times of severe illness or injury, strong painkillers are needed to help patients get the necessary rest in order to heal. Codeine is not the strongest of the prescription painkillers, as it is listed as being only “moderate.” It is usually taken orally and may be used for multiple conditions if the pain is severe enough. It is also sometimes used as a cough suppressant.

What are the symptoms of codeine abuse?

The symptoms of codeine abuse include:

  • Dizziness
  • Inability to focus
  • Abdominal pain
  • Constipation
  • Sedated appearance
  • Itchy skin
  • Vision Changes
  • Fainting

Codeine Side Effects

These can include:

  • Nausea and vomiting
  • Drowsiness
  • A headache
  • Difficulty breathing

The higher the dosage taken, the more likely these side effects are to occur. Doctors generally prescribe the lowest possible dosage required to manage symptoms. However, Codeine carries a high risk for abuse. If someone is experiencing a Codeine addiction, inpatient treatment should be sought right away.
Some people may process Codeine more rapidly than others, leading to an increased risk of addiction and side effects. Pregnant women and those who have recently given birth or are breastfeeding may process Codeine much more quickly than average.
Reports of new mothers taking Codeine for afterbirth pains or episiotomy related pain and breastfeeding have surfaced. In these stories, the drug was broken down so quickly inside the mothers’ bodies, it was passed in lethal doses through the breast milk the women fed their babies, thus causing fatal overdose in the infants.
Abuse of Codeine is classified as any usage not prescribed or recommended by a physician.
Many individuals do not start out with the intention of engaging in drug abuse. In many instances, patients are given Codeine to help with pain or with a cough. After taking it for a time, their bodies develop a tolerance to it, and the initial dosage no longer works. They may up the dose, either themselves or by talking to their doctors. Eventually, even this higher dose no longer works, and even more medication is needed to achieve the desired effects. This is how addiction begins. The higher the initial dose, the more likely a full-blown addiction is to occur.
At some point, a doctor will stop increasing the dosage or will refuse to write any further prescriptions altogether. Withdrawal symptoms may result at this point, the final indication that an addiction has occurred.

Risk Groups

Codeine is prescribed for those with pain due to surgical procedures or injuries. Those who suffer from chronic pain may be more likely to abuse codeine and other pain medications. It is often used in combination with other drugs, and typical at-risk groups may be inclined to combine Codeine with illegal drugs and alcohol.
Veterans, for instance, often suffer from post-traumatic stress disorder, depression, and anxiety. They may use drugs and alcohol, including pain medications to deal with injuries related to combat, as well as stress disorders.
Those with chronic health conditions may also be at risk, as well as those in professional fields with high stress and coordinating anxiety or insomnia.

How common is codeine abuse?

Almost 34 million individuals take codeine annually. Nearly 5 million people reported using codeine and other prescription painkillers without a prescription in 2008. Approximately 20% of all drug-related treatment admissions are for opiate abuse, including codeine.

Warning Signs

Additional symptoms will generally occur as a person becomes addicted to Codeine. Abuse leads to issues like:

  • Dizziness
  • Inability to focus
  • Abdominal pain
  • Constipation
  • Sedated appearance
  • Itchy skin
  • Vision Changes
  • Fainting

Overdose may cause:

  • Clammy, cold skin
  • Shallow breathing
  • Slow heart rate
  • Seizures
  • Limpness
  • Death

Codeine is not the most used drug from an opiate class, but has the capability to act as a gateway drug. Users eventually may branch out into using harder prescription pain medications, as well as illegal drugs such as heroin. This especially becomes a likelihood if a patient is no longer able to get a prescription for the Codeine, or if they are taking large amounts of the drug and not getting the same level of “Codeine high” as they did the first times.

Additional Warning Signs

It may not always be readily apparent if someone has an addiction or is abusing drugs. To answer if one has a problem, it is important to answer the following questions:

  • Does one find oneself daydreaming about the drug?
  • Does one take the drug every day, or try to?
  • Does one experience painful withdrawals if not having the drug every day?
  • Does one spend money on the drug even when can’t afford it?
  • Has one’s home life or work life suffered?
  • Does one continue to use the drug, even when it’s affected the life negatively?
  • Has one found it difficult or impossible to stop using?

If the answers are “yes” to any of these questions, then one probably has a drug addiction, or may be in the development of an addiction.
Warning signs to watch for in family members may begin much more subtly, but as the addiction progresses and time wears on, one will probably begin to notice changes in the loved one.
He or she may:

  • Become more withdrawn or sullen, or may suddenly become outgoing
  • Spend money he or she doesn’t have with no explanations on what it was used for
  • Behave secretively, lock doors, refuse to tell where they are going
  • Have a sudden decrease in energy
  • Have frequent mood swings or personality changes
  • Lose interest in activities they once enjoyed
  • Stop dressing nice, abandon personal hygiene habits
  • Visits doctors frequently, often having multiple prescriptions for the same medication

If there are any reasons to believe that a loved one is engaging in drug abuse, or has a full-blown addiction, there are steps to take to get them the help that is needed.

  • Nearly 34 million individuals take codeine annually.
  • In 2008, nearly 5 million people reported using codeine and other prescription painkillers without a prescription.
  • Approximately 20% of all drug-related addiction treatment services are for opiate abuse, including codeine.

Treatment for Codeine Addiction

The most effective treatment for codeine abuse is the inpatient rehab program. Since quitting codeine can cause dangerous and fatal complications, it is recommended to wean off slowly with the help of trained medical professionals.
Although drug addiction is often hard to overcome, especially when one is going it alone, there are ways to help oneself or the loved one to get clean and sober. The first step is acknowledging and determining that a problem exists. Someone who doesn’t recognize the fact that he or she has issues with drug abuse will probably not last through the rigors of therapy and detoxification due to acceptance issues.
Since abstinence from any drug suddenly is dangerous, and in some cases fatal, it is highly recommended to wean off slowly, and only under the supervision of a trained medical professional. This will help prevent any potentially fatal side effects from taking place.
Group therapy sessions and one on one counseling are also highly recommended. Both of these options help users to recognize pitfalls, interact with others who have been in their shoes, and discuss the reasons behind the drug addiction and why it happened in the first place.
While all of these avenues can be accomplished separately, an inpatient treatment facility will provide access to all of them in one location, combined with the safety of being in an enclosed environment where access to drugs is nil. This will increase the chance of success over the long haul.

Page Sources

  1. Medline Plus. Codeine. 2019.
  2. The US Food and Drug Administration. FDA Drug Safety Communication: FDA restricts use of prescription codeine pain and cough medicines and tramadol pain medicines in children; recommends against use in breastfeeding women. 2018.

Published on: October 2nd, 2015

Updated on: June 3rd, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.


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