Codeine is an opiate medication used for treating pain or suppressing cough. Codeine addiction can occur through an increase in tolerance and dosage of the prescription opioid over time, or due to recreational codeine abuse.

Cough medications that contain codeine are now available only by request or prescriptions, having been removed from the aisles due to individuals using the medication to obtain a high. In fact, codeine misuse has been popular among teens and young adults for several years. Even after pharmaceutical companies shifted to dextromethorphan, or DXM, for cough suppressants young people continue to abuse these medications. The cough syrup abuse is celebrated in rap music and often referred to in slang terms like Sizzurp, Purple Drank, and Lean.

Codeine, when used as a pain reliever following oral surgery or a minor to moderate injury, can also wind up being problematic. Codeine-based prescription drugs, such as Vicodin, Lorcet, and Norco (hydrocodone) work as analgesics by binding to the opioid receptors in the brain, spinal cord, and gastrointestinal tract. This provides powerful relief from pain, but at the risk of becoming habit forming. 

Whether codeine is abused via cough suppressant products, prescription pain relievers, or purchased on the street for its euphoric effects, codeine abuse and addiction is a serious problem. As with any other opioid, codeine addiction requires a medically supervised detox and an addiction recovery treatment program to break free from its grip.

About Codeine Addiction

Codeine is derived from the poppy plant and has been used for medical treatment for 200 years. While codeine is not as potent as other synthetic opioids, when abused with high dosing the drug can cause similar effects. Although codeine is available as a stand-alone prescription analgesic in pill form, it is often combined with other ingredients. These medications, such as Vicodin or Norco, may include other pain relievers like Tylenol and are available in pill, capsule, or liquid forms. 

Codeine-containing medications are used to treat a variety of symptoms, including cough, diarrhea, and low-level pain. Codeine is a Schedule II substance, meaning that it has a high potential for abuse, which could result in addiction or dependence. In medications that contain 90 milligrams or less of codeine, the classification is Schedule III, designating a slightly lower risk of abuse.

The drug acts by blocking pain signals to the brain, acting much the same way as other opiates and morphine do. Those who abuse codeine usually do so for its calming effects. In a majority of individuals who abuse the drug, the body will convert a portion of the codeine to morphine.

Recognizing the signs of codeine abuse or addiction can help get a loved one the help they need. Signs of codeine addiction include:

• Tolerance increases, leading to higher dosing
• Stealing codeine-based medications from family or friends
• Doctor shopping
• Neglecting responsibilities
• Obsessing about obtaining the codeine
• Financial problems due to the increasing addiction
• Obtaining codeine-based drugs from the street or online sources
• Continuing to use codeine even as negative consequences mount
• Try to cut back or quit codeine abuse but cannot
• Experience withdrawal symptoms when codeine not available

Effects of Codeine Abuse

As with other opioids, the body will become more tolerant to the drug’s effects, prompting the individual to begin using heavier doses. Over time, the drug may be abused along with other substances, such as benzodiazepines or alcohol, to achieve the desired effects. Codeine abuse can also result in the individual switching to a more powerful opioid, such as oxycodone.

While the initial effect of the drug is relaxation, pain relief, and mild euphoria, prolonged use will begin to cause adverse effects. These might include:

• Itching or rash
• Dizziness
• Drowsiness
• Pinpoint pupils
• Weakness
• Chronic constipation
• Sweating
• Confusion
• Vision changes
• Itching
• Nausea and vomiting
• Slowed heart rate
• Shallow breathing
• Problems urinating
• Psychosis
• Memory problems
• Lowered blood pressure
• Seizures

Because it is an opioid, escalating codeine abuse may depress the central nervous system, dangerously slowing the respiratory rate. Risk of overdose death is further increased if the codeine is used with alcohol, which could lead to respiratory failure.

Long-term health problems caused by codeine abuse include liver damage, kidney damage, mental health disorders like depression or anxiety, impaired memory, or muscle spasms.

Medical Detox for Codeine

Codeine withdrawal can be a painful process, so a tapering schedule to incrementally reduce dosing over a period of time is recommended. Medical support should be provided throughout the detox process. Within 6-12 hours following the last dose of codeine, withdrawal symptoms will emerge. The length of the detox period as well as the severity of the withdrawal symptoms will depend on the severity of the hydrocodone addiction.  Generally symptoms peak on days 2-3 and begin to subside on day 5. The total withdrawal timeline can last from 7-28 days.

Codeine withdrawal symptoms include:

• Muscle aches and pain
• Increased pain sensitivity
• Sleep disturbances
• Runny nose
• Watery eyes
• Chills
• Excessive yawning
• Goosebumps
• Nausea and vomiting
• Diarrhea
• Sweating
• Irritability
• Anxiety
• Depression
• Drug cravings
• Suicidal thoughts

During detox the symptoms will be mitigated by use of both non-prescription and prescription medications. The OTC medications can reduce the discomforts of the flu-like symptoms, the diarrhea, fever, muscle aches, and headaches. Benzodiazepines can be used to curb feelings of anxiety, restlessness, and insomnia.

Treatment for Codeine Addiction

To overcome the codeine addiction or dependency, it is critical to make changes in thought/behavior patterns. Without making these core shifts in thinking and reacting, cravings for the drug, or ingrained addictive thought processes, would simply drive the person right back into using codeine. Detox without addiction treatment is likely to result in nearly immediate relapse, so treatment should always be a part of the plan when initiating the recovery process.

After detox is completed, a rehab program will help the person accomplish these fundamental changes using cognitive behavioral therapy as an essential tool. Codeine addiction recovery is made possible through comprehensive rehab programs that feature a variety of treatment elements. These activities include:

Individual psychotherapy: Therapy is at the core of addiction recovery treatment protocol. Psychotherapy helps individuals make fundamental changes in their thought patterns and their subsequent behavioral responses to them. This is accomplished using a number of evidence-based therapies, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and contingency management, (CM), to name a few.

Group counseling sessions: During small group sessions, participants are encouraged to share their personal experiences and feelings as the therapist guides the topics of discussion. This provides social support in a safe, supportive setting and allows participants to bond. 12-step programming is often integrated into group sessions.

Family-focused therapy: Many rehabs include a family element that involves inviting the client’s family members to join in family-focused therapy and activities. These allow the family members to begin to heal, while also helping them learn effective communication skills and conflict resolution strategies.

Education: Addiction education teaches individuals about the neurobiology of addiction, showing them how brain structures are impacted by codeine and how it leads to addiction. Relapse prevention planning is included in these classes, guiding clients to identify their triggers for codeine use and equipping them with recovery skills to avoid relapse.

Holistic activities: Practicing stress-reduction is an essential component in rehab programs today. Stress is the number one trigger to relapse, so teaching individuals relaxation skills can help them manage emotional stressors.

Recreation and nutritional counseling: Recreational activities provide a break from programming while providing a means to get exercise. Individuals are advised on how sound nutrition can help restore brain health and general wellness in recovery.

Maintaining Codeine Abstinence After Rehab

Once the rehab program has been successfully completed, the individual will embark on the continuing care aspect of recovery. These activities are intrinsic to achieving long-term recovery success. Continuing care helps the client face future triggers, stressors, or life challenges by providing the support needed to maintain sobriety. Continuing care services might include:

• Sober living housing. If the home setting is stressful or family members are not supportive of the individual’s recovery efforts, then it is not conducive to a achieving a sustained recovery. A sober living environment offers a supportive home setting that is free of substances.
• Ongoing individual and/or group therapy. Therapy is essential in codeine addiction recovery. Therapy provides a source of ongoing support during early recovery, assisting individuals in overcoming the hurdles that are often encountered in recovery.
• Participation in recovery community. 12-step programs used in its A.A. and N.A., or alternative 12-step programs, can provide social support in recovery. 
• Cultivating a sober lifestyle. Surrounding yourself with others who are committed to sobriety is essential in codeine addiction recovery. Seek out sober groups and activities where new sober friendships can be formed.
• Exercise and nutrition. Mounting evidence supports the important role of healthy lifestyle habits in recovery. Getting regular exercise and maintaining a healthy diet will reinforce overall wellness in recovery.

By incorporating these continuing care actions into your new routine in recovery, the risk of relapse is diminished and the chance of long-term success is significantly increased.

Solutions 4 Recovery a Leading Rehab for Codeine Addiction Treatment

Solutions 4 Recovery is an addiction and dual diagnosis recovery program based in Orange County, California. Solutions 4 Recovery utilizes an integrated approach to treating codeine addiction. Solutions uses a carefully planned individualized treatment strategy that combines evidence-based therapies, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), with holistic therapies to further enhance the clinical interventions. If you have any questions about codeine addiction treatment, please contact Solutions 4 Recovery today at (888) 417-1874.