Codeine Addiction & Treatment: Effects, Signs, & Symptoms

Codeine is a mild opioid pain reliever commonly prescribed to treat mild to moderate pain or as a cough suppressant. Despite its legitimate medical uses, codeine carries a considerable risk of dependence and addiction. This risk can be overlooked because codeine is often considered less potent than other opioids like morphine or oxycodone. However, misuse can lead to addiction, posing severe health and social consequences. In this article, we’ll explore what codeine addiction is, why it develops, how it affects everyday life and what treatment looks like at every stage of recovery.

What is Codeine Addiction?

Codeine addiction is a chronic, relapsing disorder characterized by compulsive drug-seeking and continued use despite harmful consequences. Codeine works in the central nervous system to relieve pain and suppress cough by binding to opioid receptors. It also stimulates the release of dopamine, the brain’s “reward” chemical. This sense of pleasure or reward can encourage repeated use. Over time, the body can adapt, leading to tolerance and withdrawal symptoms if the drug is reduced or stopped abruptly.

Many people who start using codeine do so under medical supervision to manage pain or a persistent cough. However, codeine carries the risk of misuse. Some people exceed prescribed doses to enhance its pain-relieving effects or to experience euphoria. Repeated use of higher doses can pave the way to psychological and physical dependence, making it extremely difficult to stop without professional help.

Key Points:

• Codeine is considered a milder opioid but still carries a risk of addiction.
• Tolerance (needing larger doses for the same effect) can develop quickly.
• Psychological and physical dependence can make stopping codeine use difficult without professional support.

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What Are the Causes of Codeine Addiction?

There is no single cause of addiction, and codeine addiction often results from a combination of factors:

• Genetic Predisposition: Research suggests that genetics can influence how a person responds to opioids, including codeine. If you have family members who have struggled with addiction, you may be more susceptible to developing codeine addiction.
• Biological Factors: Codeine targets the opioid receptors in the brain that regulate pain, mood and stress. Frequent codeine use can alter brain chemistry, fostering dependence. Changes in the reward pathways can push a person to continue using codeine to avoid withdrawal symptoms and maintain a sense of normalcy.
• Environmental Influences: Stressful home environments, exposure to substance use, trauma or peer pressure can all increase the likelihood of misusing codeine. Individuals who live in communities where prescription drug misuse is common or readily accessible may also be at higher risk.
• Prescription Mismanagement: Overprescribing or using codeine for longer than medically necessary can escalate misuse. Some people may be unaware of the addictive potential and inadvertently become dependent on the drug.
• Co-Occurring Mental Health Conditions: Anxiety, depression and other mental health disorders can make someone more inclined to misuse codeine as a way to self-medicate. For instance, a person living with chronic anxiety might rely on codeine’s sedative effects as a coping mechanism, eventually becoming dependent on it.

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What Are The Signs and Symptoms of Codeine Addiction?

Recognizing the signs and symptoms of codeine addiction can be challenging, especially if you or a loved one are using a valid prescription. However, certain behavioral and physical indicators can signal a growing issue:

• Physical Signs
  • Drowsiness or sedation
  • Constricted pupils
  • Slowed breathing rate
  • Constipation
  • Nausea or vomiting
  • Physical withdrawal symptoms when codeine use is reduced or stopped (e.g., muscle aches, restlessness, sweating)
• Behavioral Signs
  • Obsessive thinking about obtaining and using codeine
  • Using codeine in higher doses or more frequently than prescribed
  • “Doctor shopping” to obtain multiple prescriptions
  • Isolation from friends and family to hide drug use
  • Lack of interest in activities once enjoyed
• Psychological Signs
  • Mood swings, ranging from euphoria to irritability or depression
  • Anxiety related to not having enough codeine available
  • Difficulty concentrating or remembering details
  • Continued use despite recognizing negative consequences

Early detection can be essential for successful intervention. If you or someone you know is exhibiting these symptoms, it may be time to seek professional help.

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What’s the Difference Between Codeine Abuse and Addiction?

Codeine abuse and codeine addiction are related but distinct concepts. Abuse can be an early phase on the spectrum that leads to full-blown addiction if not addressed:

• Codeine Abuse: Occasional misuse of codeine. For example, taking more than the prescribed dose to boost the pain-relieving or euphoric effects. A person who abuses codeine may still be able to control their use in some situations. However, ongoing misuse raises the risk of developing tolerance and physical dependence.
• Codeine Addiction: Characterized by uncontrollable urges to use codeine, despite harmful consequences like relationship problems, legal issues or health complications. By this stage, the person’s life revolves around getting and using codeine. They may experience severe withdrawal symptoms and have little to no control over their drug use.

In short, abuse can sometimes be managed if addressed early. Addiction typically involves a stronger physical and psychological hold, requiring comprehensive treatment to overcome.

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How Does Codeine Addiction Impact Your Life?

Codeine addiction can affect virtually every aspect of someone’s life, including:

• Physical Health: Long-term use can lead to liver damage (especially if codeine is combined with acetaminophen), respiratory issues, decreased immune function and various gastrointestinal problems. Overdose risk is heightened when codeine is mixed with other substances, such as alcohol or benzodiazepines.
• Emotional and Mental Well-Being: Mood swings, anxiety and depression can worsen over time. Individuals may feel isolated, hopeless or deeply ashamed of their addiction, contributing to a harmful cycle of use.
• Relationships: Codeine addiction often fuels secrecy, deception and strained communication within relationships. Loved ones may feel helpless or betrayed, and trust can erode.
• Career and Finances: Maintaining codeine addiction can be expensive. Loss of productivity or employment can compound financial strain. Legal issues, such as prescription forgery or DUI charges, can create additional burdens.
• Quality of Life: As the addiction escalates, activities and hobbies fall by the wayside. Daily life becomes centered on obtaining and using codeine, leaving little room for other pursuits.

By disrupting physical, emotional, social and financial stability, codeine addiction can have devastating and long-lasting consequences. Recognizing these impacts early can motivate someone to seek the help they need.

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What Happens During Codeine Rehabilitation?

Codeine rehabilitation involves a structured, multifaceted approach designed to address all aspects of addiction—physical, psychological and social. While treatment plans are individualized, the general process includes:

• Assessment and Evaluation: Upon entering rehab, medical and mental health professionals conduct thorough evaluations. These assessments determine the severity of the addiction, identify co-occurring conditions and guide the creation of a personalized treatment plan.
• Medical Detox: Codeine detox typically involves gradually tapering off the drug or using medications to manage withdrawal symptoms safely. Medical supervision is crucial to monitor vital signs and address any complications. Withdrawal symptoms may include muscle aches, agitation, nausea, diarrhea and insomnia.
• Therapeutic Interventions:
  • Individual Therapy: Cognitive behavioral therapy (CBT) and other modalities help individuals understand the underlying causes of addiction, develop coping strategies and learn healthier thought patterns.
  • Group Therapy: Meeting with peers who have similar struggles can offer validation, support and a sense of community.
  • Family Therapy: Loved ones learn how to support recovery, heal fractured relationships and set healthy boundaries.
• Medication-Assisted Treatment (MAT): Depending on the severity of the addiction, certain medications (like buprenorphine or methadone) may be prescribed to reduce cravings and withdrawal discomfort, improving treatment engagement and success rates.
• Aftercare Planning: Recovery is an ongoing process. Before leaving rehab, patients work with treatment teams to establish an aftercare plan. This might include continued therapy, support groups or sober living arrangements.

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When to Seek Help for Codeine Addiction

Seeking help early can drastically improve treatment outcomes. But how do you know when it’s time? Here are some indicators:

• Escalating Use: If you need increasingly larger doses to achieve the same effect or if you’re finding it impossible to function without codeine.
• Cravings and Obsessions: Feeling preoccupied with thoughts of obtaining and using codeine.
• Withdrawal Symptoms: Experiencing physical withdrawal (e.g., agitation, nausea, muscle aches) when you miss a dose or try to cut back.
• Inability to Quit: If you have tried to reduce or stop your codeine use but have been unable to do so.
• Continued Use Despite Problems: Ongoing relationship strife, job loss or deteriorating health that can be traced back to codeine use.

If any of these apply, reaching out for help can be life-saving. At The Recovery Village Cherry Hill at Cooper, we offer evidence-based treatment and compassionate support to guide you on the path to recovery.

What Happens After Codeine Rehab?

Recovery from codeine addiction doesn’t end once you complete a rehab program. It’s a long-term process that involves continuous self-care and maintenance:

• Aftercare Planning: Before leaving a program, you’ll work closely with a treatment team to map out your recovery journey. This often includes ongoing therapy appointments, medication check-ins (if applicable) and support group meetings.
• Sober Living Environment: Some people transition into a sober living home where they can practice independence in a drug-free environment. This step helps reinforce newly acquired recovery skills before fully returning to daily life responsibilities.
• Ongoing Therapy and Counseling: Individual, group or family therapy can help you navigate challenges, manage triggers and prevent relapse. Therapy provides a structured environment for continuous growth and accountability.
• Peer Support Groups: Maintaining connections with peer support groups, such as 12-step programs or other recovery communities, can be invaluable. Hearing others’ experiences and sharing your own fosters a sense of unity and motivation.
• Lifestyle Adjustments: Engaging in healthy habits like regular exercise, balanced nutrition and stress management can greatly improve your ability to cope with potential triggers. Mindful activities, including yoga or meditation, can further bolster mental health.
• Relapse Prevention Plan: Recovery is rarely a straight line. Having a plan in place if you feel yourself slipping (e.g., reaching out to a sponsor or counselor, scheduling an urgent therapy session, or temporarily attending more support group meetings) can help you navigate challenges without a full relapse.

Codeine Treatment Options

Depending on the severity of your struggle with codeine, The Recovery Village Cherry Hill at Cooper has options to help you stop taking the drug. These include:

Medical Detox

Our inpatient detox center has a specially trained health care team that can help to comfortably wean you off codeine.

MAT

While you undergo codeine detox, our medical team can discuss options including medication-assisted treatment, or MAT, with methadone or buprenorphine to keep you away from codeine long-term.

Residential Rehab

Once your body is free from codeine, inpatient therapy helps you learn ways to live life without codeine and explore why you became reliant on the drug in the first place.

Outpatient Rehab

Outpatient rehab typically follows inpatient rehab and can coach you on the skills you need as you begin to enter your new life without codeine. Teletherapy may also be available.

Aftercare

After rehab is complete, the lifelong process of aftercare begins. Aftercare sets you up for continued success with support groups and relapse prevention training.

Co-Occurring Disorders

Our co-occurring disorders treatment addresses both your codeine addiction and underlying mental health problems that may have exacerbated your codeine struggle.

FAQs

What schedule is codeine?

Codeine by itself is a Schedule II drug. However, codeine is also available in combination with other drugs and can be scheduled differently as a result.

Is codeine an opiate?

Codeine is an opiate drug that is chemically related to morphine. Codeine breaks down into morphine inside the body.

How long does codeine stay in your system?

Codeine can stay in your body for different lengths of time, depending on what is being tested. The drug can show up in urine for up to 3 days and can be present in saliva for up to 2 days. Lastly, a 1.5-inch section of hair can show if codeine was taken in the past 90 days.

Is codeine over the counter?

Codeine is a controlled substance, so it is a prescription-only drug. It is not available over the counter.

How much codeine is too much?

The amount of codeine that a person can safely take varies based on multiple factors. These include the person’s physiology, their genetic ability to break down codeine and morphine, their kidney function, and if their body is used to codeine or other opioids. A common initial dose for codeine when taken alone is 15 mg every 4 hours as needed.