As a professional violinist, Leni had a habit of purchasing extra-strength codeine over-the-counter to ease the chronic pain she’d develop in her shoulder when she played the instrument. It worked at first. But before long, Leni began an ascent down a slippery slope toward addiction. Soon she was taking 20-30 codeine tablets a day, moving from one pharmacy to another to inconspicuously purchase more boxes, not to get high, but to keep from getting sick.
Without codeine to fuel her addiction, Leni went into withdrawal. Nausea, sweating, shaking and the hallucinations combined to create a horrendous experience. She could not sleep, eat or drink water. She was terrified.
Individuals like Leni who are addicted to codeine can’t live with the drug and can’t live without it. Often, they will use up a supply of codeine too quickly and either seek alternative means to obtain the opioid to hold off uncomfortable withdrawal symptoms until it’s time for another prescription to be filled. In the meantime, they are destroying themselves and their families.
Codeine is an opioid, which means the medication is in the same class of dangerous drugs like heroin, oxycodone, hydrocodone, methadone, and morphine. In the short-term, codeine can block mild to moderate pain or reduce a cough, but within days, the body can become dependent for more of the medication.
Millions of Americans take codeine, which is usually combined with other drugs, such as acetaminophen, in prescription pain relievers or over-the-counter cough and cold medicines. Many of those people are unaware of just how addictive codeine can be. And because of the ease with which the opiate can be purchased, too many people use the drug for reasons other than for what it was intended.
When taken as instructed, cough and cold medicines that contain codeine can be safe and effective. But codeine is a narcotic and, in higher doses, it can produce a “buzz” or high.In some people, codeine metabolizes rapidly in the liver and reaches higher than normal levels in the body. This can cause dangerously slow breathing and may cause death, especially in a child. The most frequent potential side effects of codeine may include
Codeine overdose occurs when an individual takes more than the normal or prescribed amount of this medicine, either accidentally or intentionally. Symptoms of a codeine overdose may include:
Codeine withdrawal develops in a way similar to other opiates. Continued high doses of codeine disrupt the way the brain works by changing how nerve cells send, receive and process information. Nerve cells – or neurons — send messages to each other by releasing neurotransmitters, such as dopamine, which regulates movement, emotion, cognition, motivation, and feelings of pleasure. When dopamine is released, the neurotransmitter attaches to molecules in the neuron called receptors. Once ingested, codeine mimics the way in which natural neurotransmitters attach to these receptors. The result is the release of excessive levels of dopamine. Withdrawal is the body’s response to the removal of dopamine that the receptor had become desensitized to over time.
Codeine withdrawal is not considered life-threatening. However, an individual dependent on codeine will likely experience withdrawal symptoms. The intensity level and symptoms from withdrawal will vary depending on the dosage concentration, frequency of use, if the use was combined with alcohol or drugs, genetics and whether or not the individual attempts to stop gradually or quit altogether. When codeine use is discontinued, the body needs time to recover. As the body adjusts to the removal of codeine, withdrawal symptoms may include:
Codeine withdrawal can begin as soon as a few hours after the last use. Some of these symptoms will include:
The length of withdrawal symptoms will depend on the individual, but most withdrawal discomfort will peak after a few days. Leading up to that period, an individual may endure:
Most physical symptoms will conclude after about a week. Psychological side effects, such as depression, may linger for months.
A doctor can help ease the discomfort from withdrawal by tapering off a codeine dosage. By weaning an individual off the opiate, receptors will continue to receive a level of codeine to ward off severe withdrawal symptoms. Medications, such as antidepressants and other drugs specific to symptoms, can be used to alleviate withdrawal discomfort.
Fighting an addiction to codeine can be overwhelming when attempted alone. If you are tired of what codeine has done to your body – nausea, sweating, tremors – and previous attempts to stop usage have led to relapse, and back to where you started, detoxification under the care of medical professionals should be your next choice.
Detox takes place at either a hospital or residential substance abuse treatment facility. Here, in a safe and peaceful environment, doctors can prescribe medications to alleviate any initial side effects and physical discomfort, and certified healthcare staff can help you manage the general symptoms of withdrawal and monitor your progress to prevent complications associated with difficulty breathing, elevated heart rates, and anxiety.
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Detox is just the first step toward recovery. Perhaps the greatest danger related to codeine withdrawal is a decision to return to use. Remember, codeine is an opioid. That classification presents a high risk of relapse. If you are committed to sustained sobriety, an extended stay at a residential treatment center should be part of your recovery plan. Here, to strengthen your resistance to relapse and to start feeling good about yourself during your stay, you will also be exposed to group therapy, one-on-one counseling, educational lectures and workshops as part of your individualized recovery program.
World Health Organization. Retrieved from https://www.who.int/bulletin/volumes/95/5/17-020517/en/
American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
U.S. Department of Health and Human Services, Substance Abuse and Services Administration. Retrieved from https://www.samhsa.gov/find-help/atod
National Institute on Drug Abuse. Retrieved from https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction/effective-treatments-opioid-addiction
Mayo Clinic. Retrieved from https://www.mayoclinic.org/drugs-supplements/codeine-oral-route/description/drg-20074022