Codeine Abuse & Addiction

What Is Codeine?

Codeine is a prescription opioid medication usually used to treat coughs and sometimes pain. Codeine works by interacting with mu-opioid receptors on brain cells (neurons). Medical experts do not understand why the drug works for treating coughs. Because codeine is an opioid, the risk of addiction comes with the drug’s use.

Many different prescription medications contain codeine. A few of these include:

  • Fioricet with codeine
  • Cotabflu
  • Colrex Compound
  • Tylenol with Codeine #3
  • Fiorinal with Codeine
  • Pediatuss
  • Phenflu CD
  • Maxiflu CD

Codeine is part of a class of drugs called narcotic analgesics which means it treats pain by acting on the central nervous system, and it can be used for the treatment of pain ranging from mild to moderate. It’s considered less potent than a lot of other opiates, so people tend to falsely believe they won’t become addicted, but that’s not the case.

Codeine Addiction

Codeine Formulations

Codeine usually comes as a cough syrup mixed with other ingredients, but can also come in other formulations. The Drug Enforcement Administration (DEA) has schedules for controlled prescription medications.

Codeine comes in different forms. The DEA places codeine formulations into schedules based on how abusable it is:

  • Codeine tablets: Schedule II. Codeine is not very potent compared to other opioids, so it is not prescribed very often.
  • Acetaminophen and codeine tablet (Tylenol #2, Tylenol #3, or Tylenol #4): Schedule III. Codeine and acetaminophen tablets are used for treating pain. These are commonly prescribed in the community. Acetaminophen is added to help prevent abuse because taking too many causes gastrointestinal (GI) symptoms like an upset stomach. It can also cause liver damage and acetaminophen overdose symptoms.
  • Acetaminophen and codeine syrup: Schedule V. This syrup formulation is scheduled lower than tablets because liquid drugs are harder to abuse. A person can only fit so much liquid in their stomach.
  • Guaifenesin and codeine syrup: Schedule V. Guaifenesin is a mucolytic (medication that breaks up mucus). However, it does not prevent abuse like acetaminophen. The lower scheduling for this formulation is because the concentration is low.
  • Promethazine and codeine syrup: Schedule V. Promethazine is another medication that prevents coughing. The concentration of codeine in promethazine is low, resulting in lower scheduling.

Understanding Codeine Abuse

So what if you’re a person in Colorado, whether it be Denver, Boulder, Colorado Springs or anywhere statewide, and your doctor has prescribed codeine to you? What should you know about the addiction potential that comes with this drug?

When you’re prescribed codeine in any form, it comes with a warning. Codeine has the potential for addiction, abuse, and misuse, and this misuse can result in overdose or death. As with other opioids, when you take codeine it can depress your respiratory system to the point you enter a coma or die. If you take codeine when pregnant, you’re also warned that it can lead to neonatal opioid withdrawal syndrome.

In order to avoid the risk of addiction that comes with the use of codeine, people are warned to take it only as instructed by their doctor. This means not taking larger doses than what’s instructed, or taking it more often than you’re prescribed. It’s also imperative that people never take codeine without a prescription because that is automatically considered abuse.

While the side effects of codeine abuse may be less pronounced than what’s seen with other opioids, they can still include dilated pupils, apathetic behavior, slurred speech, drowsiness, impaired judgment and coordination problems.

Why Is Codeine Addictive?

As was touched on above, codeine is an opiate, so while it may be less strong or seem less risky as compared to other opiates, it does have the potential for abuse. Codeine can be more problematic than many people even realize because since people see it as less potent, they also see it as harmless and that’s simply untrue. Codeine, like other opiates, impacts the central nervous system and that’s how it uniquely attacks pain.

At the same time, when you take a drug like codeine that affects the CNS, it floods the brain with dopamine at a higher level than what could be naturally produced. The result is that your brain wants to continue seeking out the substance that triggered that response because it affects your brain’s reward center. That’s what leads to the potential for abuse and addiction of codeine and other drugs that act on the brain in a similar way.

Opiates impact the brain in a way that makes it relatively easy for an addiction and physical dependence to develop, and it’s difficult to break that addiction once it occurs because these drugs change the brain and the interaction of neurotransmitters in the central nervous system.

What happens with codeine since it is less potent than other opioids but still addictive is that people will take this drug, and then they will move onto more stronger opioids once they’ve developed an addiction and a tolerance. In many ways and for many people codeine can be seen as a weaker gateway to other opiates.

Codeine Addiction Facts

According to the National Institute on Drug Abuse, prescription medications for cough and cold that contain psychoactive or mind-altering properties are often used at doses that are higher than recommended, and they are also commonly abused. When these drugs contain elements like expectorants or antihistamines, they’re abused at even higher rates.

Some other facts about codeine addiction include:

  • Codeine can depress breathing and other essential bodily functions
  • When someone takes codeine, it is naturally converted to morphine, which is how the mind-altering and euphoric effects are felt, and in general, about 10 percent of codeine becomes morphine
  • When someone takes codeine, the effects start around 10 to 30 minutes after they ingest it and last anywhere from four to six hours
  • A physical and psychological addiction can develop even after just two weeks of continual use
  • Opioid abuse is a significant problem in Colorado, and state lawmakers have been working to combat the opioid epidemic happening in metro areas like Colorado Springs, Boulder, and Denver, and throughout the state
  • Certain areas in Colorado are seeing big spikes in not only prescription opioid abuse, but also heroin addiction and addiction to the two drugs are often related to one another
  • Recently in Colorado state legislators passed new measures that will establish a research center at Colorado University to look at various prevention and treatment options
  • Some lawmakers have said opioid abuse, which includes codeine abuse, is one of the number one problems facing the state of Colorado regarding severity
  • Drugged driving is on the rise in Colorado, along with overdoses and related deaths

Getting Help With Codeine Addiction

So, to sum up, codeine is a prescription drug that’s often included in cough and pain medicines. While it is only intended to be available by prescription, it is abused, and it is an addictive drug. As with other opioids, codeine is a problem in Colorado, and it’s currently something that’s being looked at by lawmakers and medical professionals as the state tries to curb this kind of drug abuse.

If you or a loved one is struggling with codeine addiction reach out to The Recovery Village at Palmer Lake today. We have representatives standing by to discuss treatment options with you.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.