In the late 1990s, doctors increasingly prescribed opioids like methadone, oxycodone, and hydrocodone.

That led to a dramatic rise in overdose deaths. Heroin and fentanyl use caused spikes in overdose deaths in 2010 and 2013. Between 1999 and 2016, 350,000 people died from overdoses involving opioids, including prescription and synthetic forms.  Even as doctors prescribed these medications more often, the amount of pain American patients reported had not changed.

Part of that statistic includes the abuse of codeine cough syrup. Despite the dangers, the recreational practice of sipping cough syrup, either alone or with soda or alcohol, has been normalized within popular culture.

Famous musicians have touted the effects of promethazine-codeine cough syrup use in songs even as people have died from its use. While not as potent as heroin or oxycodone, long-term codeine use can lead to permanent organ damage, memory loss, muscle problems, breathing difficulties, and death. When codeine is mixed with alcohol, the consequences become more severe.

What is Codeine?

Codeine is prescribed by doctors to treat mild-to-moderate pain and acts on the central nervous system. It is also used as a suppressant in cough medicine and is grouped with other medicines known as narcotic analgesics.

Depending on how it is prepared, the U.S. Drug Enforcement Agency (DEA) classifies codeine as a Schedule II, III, or V substance.

As a mild opioid, it can be easily abused. Over time, codeine use will cause the body to slow the production of endorphins. Thus, the amount prescribed codeine may no longer impart the same highs, which may users to consume larger amounts. In some cases, when users can no longer achieve the same high with the prescribed dosage, they turn to potent illegal drugs such as heroin and fentanyl to satiate that craving.

How does Codeine Work?

Like other opioids, codeine attaches itself to the brain and body. The medicine informs the brain to block pain and produce feelings of calm and happiness. It does this by triggering the release of endorphins which performs those vital functions.

Codeine works on these areas of the brain and nervous system:

  • The Limbic System. When it hits this area, codeine can trigger feelings of pleasure, relaxation, and contentment.
  • The Brainstem. Codeine blocks this area from receiving pain signals. It also helps to slow breathing and halt coughing.
  • The Spinal Cord. Codeine decreases pain in this area of the body.

When used exactly as directed, codeine can take between 10 minutes to 30 minutes, on average, to go into effect. The medicine usually lasts between four-to-six hours. Taking more than the prescribed amount can make the drug habit-forming.

What are the Effects of Codeine?

Although codeine is a milder opioid, its misuse can trigger life-threatening consequences over time. Common short-term effects on the brain’s opioid receptors and dopamine levels are:

  • Pain relief
  • Euphoria
  • Intoxication
  • Nausea
  • Drowsiness
  • Rashes
  • Constipation
  • Hallucinations
  • Dizziness
  • Tremors
  • Difficulty urinating

When Taken in High Doses, Codeine Can Provoke:

  • Dangerous shallow breathing
  • Low heart rate
  • Low blood pressure

Those effects can generate a host of issues, including a loss of consciousness, respiratory problems, and cardiac arrest. The lack of oxygen in the bloodstream can lead to permanent organ damage.

What are the Signs of Addiction?

Chronic codeine abuse include:

  • Nightmares
  • Insomnia
  • Kidney damage
  • Liver damage
  • Muscle coordination problems
  • Memory problems
  • Respiratory depression
  • Seizures

Because codeine addiction is not immediate, the signs of addiction may be harder to recognize. The ravages of addiction become more immediate when a person begins to exhibit these signs:

  • Increased tolerance for codeine
  • Difficulty performing daily tasks without codeine
  • A noticeable decline in work or academic performance due to codeine
  • The inability to halt codeine use despite previous attempts
  • The need to justify codeine use
  • Using more than the prescribed amount
  • Stealing valuables or money to obtain codeine
  • Persistent codeine use despite signs of harm
  • Lying to hide codeine use
  • Experiencing withdrawal symptoms when not taking codeine
  • Loss of interest in hobbies and activities
  • Neglect of personal hygiene and appearance

If you or a loved one is exhibiting any of these behaviors, then it is paramount that detoxification and treatment are sought.

What is Involved in Addiction Treatment?

As with all addiction treatment, detox can mean the difference between sustained sobriety and utter relapse. It ultimately is a life or death decision. Codeine addiction may not carry the severity of other opioid dependencies, but failure to enroll in a medically supervised detoxification program can be hazardous to your well-being. Medical professionals suggest detox because it offers the best shot at helping users overcome their addictions.

A medical detox entails ridding you of the substance over the course of four to six days or longer if needed. A team of medical professionals will evaluate and determine your best course for recovery. They also will find the most effective therapies for your condition based on the stated goals. They may administer medication that will help you achieve sobriety and establish control over your addiction.

Once detox is completed, they may recommend that you are placed in a residential treatment program where you will have room and board and access to therapy and counseling services every day.

You will learn vital coping mechanisms and strategies to help you combat your addiction. This residential treatment phase lasts between 30 days and 90 days depending on the case.

If further treatment is needed at the conclusion of this phase, then you can participate in our partial hospitalization program. PHP is offered at these South Florida treatment center locations: Ocean Breeze Recovery (OBR), Pathway to Hope (PTH), and The Palm Beach Institute (PBI).

How Dangerous is Codeine?

Though it is at a lower grade of strength when compared to morphine, codeine remains highly addictive. As longtime users adjust to prescribed dosages, it is likely they will increase their intake, heightening their chances at addiction. Codeine dependency can produce alarming physical impairments, including overdose.

Signs that show a user has lapsed into a codeine overdose include:

  • Shallow breathing
  • Clammy skin
  • Lightheadedness
  • Muscle spasms
  • Weak pulse
  • Excessive vomiting
  • Low blood pressure
  • Blue lips
  • Loss of consciousness
  • Cardiac arrest

If someone has overdosed on codeine, you must immediately call 911 to avoid serious, permanent organ damage or death.

Abuse Statistics

  • About 80% of people who use heroin first misused prescription opioids, including codeine.
  • More than 115 people in the U.S. die each day after overdosing on opioids.
  • Roughly 21%to 29% of patients prescribed opioids for chronic pain misuse them.
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