Codeine is a medication that is used to treat mild to moderate pain and to suppress cough.

Like any medication, cocaine use comes with the potential for many side effects, such as sleepiness, nausea, flu-like symptoms, depressed breathing, and over-sedation.

How is Codeine Used?

According to the U.S. National Library of Medicine, codeine is in the opiate analgesic class of drugs. It is a popular ingredient in both prescription and over-the-counter cold and cough medication.

Codeine is frequently combined with acetaminophen, aspirin, promethazine, and carisoprodol.

These combinations are used in medications to treat cough, the flu, and allergies. Codeine comes in liquid form, such as in cough syrups, or in pill form.

The medication is an opioid in the same class as other opioid pharmaceuticals, such as Vicodin, morphine, methadone, and fentanyl. Opioid drugs bind to the opioid receptors in the brain, changing the perception of pain and producing a rewarding influx of neurotransmitters in brain chemistry.

Many prescription opioid drugs are Schedule II drugs, but codeine may be scheduled differently, depending on the amount of the drug in the preparation. Preparations that have less than 90 milligrams of codeine are considered Schedule III drugs by the  U.S. Drug Enforcement Administration. This means that they have low to moderate potential for dependency.

In other countries, codeine may be available without a prescription. Some researchers have questioned the use of codeine in over-the-counter medications because of its potential for abuse among adults and adolescents. Recreational misuse of codeine can cause confusion, loss of motor coordination, psychoactive symptoms and death from respiratory depression.

Some preparations of cough medications containing codeine have been used as a recreational party drug by teenagers. Teens can access the drug fairly easily by taking it from their parents’ medicine cabinets, and the drug has a potential for a euphoric response when taken in large quantitates.

This trend has caused concern about the availability of codeine in these medications and its potential for misuse.

What are the Side Effects of Codeine Use?

One of the most dangerous side effects of codeine is the potential for life-threatening respiratory distress. Codeine functions as a central nervous system depressant, which has effects on breathing and heart rate.

Respiratory depression is a potential side effect of all opioid drugs. Too much sedation and respiratory depression can lead a user to stop breathing, resulting in a fatal overdose.

This risk is elevated any time a dosage has been increased or codeine is mixed with other substances that have a similar depressant effect on the respiratory system.

Codeine has many other potential side effects.

  • Drowsiness
  • Euphoria
  • Slurring of words
  • Loss of motor coordination
  • Flu-like symptoms
  • Nausea
  • Oversedation
  • Depressed heart rate

The risk of experiencing side effects and potentially dangerous overdose is increased if you take more codeine than is prescribed or if you are misusing codeine recreationally. The combination of codeine with other substances like alcohol will increase the chance of adverse outcomes.

According to The Mayo Clinic, codeine can result in overdose. Signs of a codeine overdose include chest pain, small pupils, severe drowsiness, unresponsiveness, and reduced heart rate. Call 911 immediately if an overdose is suspected.

Regular use can result in dependency, causing withdrawal symptoms when the medication is stopped.

The Following are Withdrawal Symptoms from Codeine:

  • Restlessness
  • Dilated pupils
  • Irritability
  • Anxiety
  • Runny nose
  • Watery eyes
  • Sleep disturbance
  • Excessive yawning
  • Sweating
  • Elevated respiratory rate
  • High heart rate
  • Chills
  • Nausea
  • Vomiting
  • Cramping
  • Muscle aches

These symptoms may be more intense depending on the level of consumption prior to stopping the medication.

How do Adverse Side Effects Develop?

The risk for experiencing adverse side effects increases with higher dosages of the medication or with prolonged use. Risk will also increase if the drug is not taken as prescribed or otherwise misused.

Withdrawal symptoms are more likely to appear if someone has been taking high doses of codeine over a prolonged period of time. Like other opiate analgesics, codeine can be habit-forming. Excessive consumption can result in the buildup of tolerance, dependency, and potentially addiction.

Codeine should not be mixed with other drugs unless instructed to do so by a doctor. Always follow your doctor’s instructions regarding the dosage and frequency of codeine ingestion. Drinking alcohol with codeine increases the risk of adverse side effects.

Codeine can be particularly risky when consumed with other medications that have a sedative effect.

The combination of codeine with other medications that also depress the central nervous system puts the user at risk for oversedation, unconsciousness, and fatal overdose.

Who Should not Use Codeine?

People who have a personal or family history of addiction should be aware of the risks of dependency on codeine. Anyone who has a history of addiction to opioids should not use products with codeine, as it could trigger abuse.

There are several reasons that codeine is not always the best choice, but it remains a good option for some people. Concerns surrounding codeine use include the effectiveness of the medication, risks posed by consumption, the potential for addiction, and possible side effects for certain populations.

Clinical studies have found that codeine is no more effective than ibuprofen for controlling mild to moderate pain, and many patients have more side effects when using codeine. With other medications that can be substituted for the same treatments, some care providers believe that alternatives pose less risk for patients with similar effectiveness.

Elderly people may also have additional risks with codeine use due to the potential impact of the side effects of codeine in this population. Elderly people are more likely to have a risk of falls due to the loss of motor coordination from opioids.

Elderly people also may have multiple other conditions for which they take medication, which could complicate the risk factors. This also increases the potential for drug interactions and exacerbated side effects.

When Does it Work Well?

Codeine may be an effective medication when stronger pain relievers are not necessary. It is less potent than morphine and many other opioid drugs, so it can be a good option for people who do not have a high tolerance for opioids.

It also has not been associated with liver damage, as many other prescription medications have been.

Avoid Abuse

Codeine should never be taken recreationally. Recreational use of codeine can increase the risk for adverse side effects, overdose. and addiction.

Anyone with risk factors for adverse effects from opioids should discuss these concerns with their doctor before consuming medication with codeine in it.

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