Codeine is an opioid medication commonly prescribed to treat a cough or mild to moderate pain. When used as prescribed, this medication is generally safe, however, when abused, codeine can cause addiction and great harm to a person’s life. Frequently abused codeine painkillers include Tylenol #3 and #4.
Codeine addiction is characterized by frequent patterns of drug seeking and using, cravings, tolerance, and withdrawal. Because of this, a person may make sure they always have the drug nearby. An individual may also continue to abuse the drug even when they know it’s creating problems with loved ones or damaging their health.
Major Signs Of Codeine Abuse And Addiction
1. A person goes to great lengths to maintain a constant supply of the drug.
When a person is addicted and using codeine in a compulsive way, they will likely invest a great deal of time and effort to make sure they have the drug on hand. To do this, they may hide or hoard pills or cough syrup. Some people may steal codeine from loved ones or feign an illness in the hopes their friends or family give them medication. Other people may purchase the drug illegally off the street.
While many states have enacted legislation and changed laws to help prevent doctor shopping, a number of people may still try to go from doctor to doctor to get his drug. A person may pretend they are in pain or feeling sick in an attempt to get a refill or new prescription for this medication as well.
2. A person experiences strong urges or cravings to use the drug.
As a substance use disorder becomes severe, cravings for codeine will take over a person’s thoughts in a way that becomes disruptive to their life.
A person will increasingly focus on finding and using the drug, to the extent they begin to ignore important areas of their life. At this time, they may make comments about the drug and express an overwhelming need to use it.
3. A person alters the form of the medication or uses it in a way other than prescribed.
When a person is abusing a drug they may change the way it is administered. In the case of codeine cough syrup, one of the most popular methods is mixing it into a drink.
Promethazine-codeine cough syrup is commonly combined with soda or pop to produce a drink referred to as sizzurp or purple drank. One version of purple drank consists of cough syrup and alcohol.
Being that codeine is an oral medication, the drug is primarily swallowed when abused, however, some people may crush it so they can snort or smoke it. To avoid taking excess amounts of Tylenol, a person may also perform a cold water extraction. To do this, a person crushes the medication, dissolves it in water, and freezes the mixture. Finding this preparation is a sign of abuse.
Taking codeine in larger-than-prescribed doses or at more frequent intervals is also a major sign of abuse. If a person is taking codeine to create a euphoric state or to self-medicate a physical or mental health problem, this is also indicative of abuse.
4. A person continues to take the drug even after it causes health or relationship problems.
Substance abuse can create or aggravate physical and mental health problems. But when a person is severely addicted to codeine, they may continue to use it even when it’s harming them in these ways. The acetaminophen contained in Tylenol #3 or #4 can cause massive liver damage. An addicted person may abuse these substances despite developing liver problems.
People with depression and anxiety may take opioids more frequently, however, if they’re self-medicating these problems or pain, either condition could get worse without the proper help. Opioid abuse can also cause the symptoms of depression or bipolar disorder to become more severe.
5. The way a person experiences pain changes.
When a person is abusing codeine on a regular basis it can change the way their body reacts to pain. As a person develops a tolerance to codeine, their body may also become tolerant to the pain-fighting properties of this drug. If this occurs, a typical dose of codeine or another opioid pain reliever may not work to reduce a person’s pain.
On the other hand, chronic codeine abuse could cause a person to develop codeine-induced hyperalgesia. This state creates a reduced tolerance to pain that causes a person to become more sensitive to pain. Sometimes a sensation that shouldn’t cause pain, such as a light touch, elicits a painful response. This is called opioid-induced allodynia.
6. Withdrawal symptoms occur if a person stops taking codeine cold turkey.
Taking codeine on a regular basis can cause a person to become physically dependent to it. This means that the body becomes reliant on the drug’s chemical influence to function. If a person suddenly quits codeine, or even substantially reduces their dosage, they may also experience withdrawal.
Signs of codeine withdrawal include:
- achy muscles
- enlarged pupils
- nausea or vomiting
- runny nose
- stomach cramps
- teary eyes
If a person won’t stop taking codeine because they’re afraid of withdrawal setting in, this can be a sign of abuse. Some people may also take the drug to relieve withdrawal symptoms once they’re already began.
Treating Codeine Addiction
Opioid addiction can cause an intense physical dependence. In these situations, a person may require two stages of treatment, a medical detox and rehab.
A medically supervised detoxification program provides 24-hour support and observation as a person’s body cleanses the drug from its system. Medications, such as buprenorphine, will likely be used to reduce symptoms of withdrawal.
Detox is only the first step of treatment. Opioid addictions can be severe, and because of this, a person may need the intensive level of support that is offered in an inpatient drug rehab program.
The most effective programs will also treat the conditions a person may have been self-treating with codeine or any that arose from abuse. Treating these conditions will reduce the likelihood that a person relapses to begin self-medicating these problems again.
If a person was using codeine to self-medicate pain, treatment clinicians may administer a non-addictive alternative to moderate pain or suggest holistic treatments, such as massage or acupuncture.
Individuals who are struggling with anxiety, depression, or any other mental health disorder should receive comprehensive dual diagnosis care. This treatment addresses both the substance use and mental health disorder, so that a person has the highest chance of long-lasting recovery success.
Contact DrugRehab.org to get more resources on codeine addiction and treatment.
- MedlinePlus — Codeine, Opiate and opioid withdrawal
- Michigan Health — How to Spot Signs of Opioid Addiction
- National Institute on Drug Abuse — Drug Facts: Cough and Cold Medicine Abuse
- Neurology Reviews — Codeine and Morphine May Increase Pain Sensitivity Equally
- US National Library of Medicine — How Resistant to Tampering are Codeine Containing Analgesics on the Market? Assessing the Potential for Opioid Extraction
- The Washington Post — Greater opioid use and mental health disorders are linked in a new study