Though it’s included in cough syrup partially for cough suppression, there’s not technically enough evidence that it possesses this attribute. It’s actually better for treating diarrhea, especially in association with irritable bowel syndrome.
This substance is broken down by the liver and reverts into morphine. It’s a naturally occurring substance that makes up about 2 percent of opium, and is the most commonly ingested opiate. Once broken down, the drug affects the brain’s reward center, producing feelings of pleasure and wellbeing, among other effects.
Due to these factors, abuse of codeine has become a serious problem in many nations.
As an opiate, addiction to codeine is absolutely possible. This fact is responsible for cough syrups containing the drug being taken off shelves and restricted to behind the counter at the pharmacy. Some countries also monitor customer purchases of these products, electronically recording each purchase to track how much each individual buys. Legal restrictions on codeine in the US depend on how high the concentration of the drug is in each medication. Cough syrups are either Schedule III or V, depending on the formula.
Addiction to opiates can occur quickly and be very difficult to overcome. A person’s reaction to and development of tolerance to codeine depends largely on body chemistry – some people break down the drug faster than others. Abuse of and addiction to opioids have been going on for many decades; as a result, much research has been done on addiction to these drugs and treatment of that addiction.
Young people appear to be much more likely to seek out codeine medications specifically for recreational abuse. These are typically youngsters who have little to no experience with drug abuse and want to start out with what they perceive to be a seemingly harmless substance. Though codeine becomes morphine in the body, it’s only 8-12 percent as powerful as pure morphine, according to the Global Information Network about Drugs. Once these individuals find themselves with a tolerance to codeine and unable to achieve a euphoric high, they may pursue stronger opioids such as Vicodin or heroin.
Adolescent use of prescription painkillers may be the most concerning, with 467,000 American adolescents using these drugs for nonmedical purposes in the year 2014 alone. Of these, 168,000 were considered to have an addiction.
There are some key signs of abuse of any opioid, but the most common side effect of medications containing codeine is nausea, especially in cough syrups. Those who take more than the recommended dose of one of these medications are likely to become nauseous. Therefore, they may also keep anti-nausea medications handy.Other effects of codeine abuse include:
Over long periods of time, codeine abuse can cause an increase in lung infections, bowel damage, sleep disorders, irregular heart rate, and even brain damage. Beyond the physical effects, drug addiction tends to have a profound impact on life satisfaction. As the individual becomes increasingly preoccupied with obtaining and taking the drug, relationships and responsibilities suffer. The person may lose friends, have difficulties with family members, and find it difficult to make it to school or work. Constant drowsiness and mood swings make it nearly impossible to focus.
All of these are signs that an addiction to some kind of substance has developed. According to the National Institute on Drug Abuse, there were 2.1 million Americans addicted to prescription opioid painkillers in 2012. It’s easy to become addicted to an opiate and difficult to stop using, as the brain eventually stops producing its own chemicals that stimulate the reward center. After enough of a tolerance has developed, an addicted individual will need to take the opiate just to feel any level of pleasure. Anhedonia, the inability to feel pleasure, is a common symptom of opiate addiction.
People who are addicted to codeine will also experience withdrawal symptoms when they stop taking it. This is the result of the changes in the body and brain that occur as they try to adjust to the constant presence of the drug until they no longer function properly without it.
Common codeine withdrawal symptoms include:
For some, these symptoms can seem like a bad flu. For long-term, heavy users, it’s typically much worse and may require medical intervention. It’s best to consult a doctor before trying to get off codeine if an addiction is suspected. Though withdrawal from opioids is not generally dangerous, it can cause dehydration and may be too unpleasant to bear without professional help. Relapse can be especially dangerous, as many individuals will be unaware that even a short break from an opioid can result in a reduction of tolerance, and starting again at the same dose from before the attempt to stop can result in a dangerous overdose.
Although codeine is a mild opiate compared to others, overdose is still possible and can be deadly. Opiates depress the central nervous system, which controls essential functions like the heartbeat and respiratory system. Especially if combined with other opioids or alcohol, a codeine overdose can cause breathing to slow to dangerous levels, reducing the amount of oxygen to the brain. Once this happens, rapid cell death begins, and the affected individual can endure coma, brain damage, or even death.According to a 2016 report by the Centers for Disease Control and Prevention, overdose deaths involving opioids have increased by 200 percent since the year 2000. Signs of an overdose should be considered a medical emergency, and emergency medical services should be sought immediately. Symptoms of codeine overdose include:
Opioid overdose can be treated with medications that block the receptors in the pleasure center of the brain, but intervention needs to be quick enough to prevent brain damage due to oxygen deprivation.
If the medication is mixed with other substances like acetaminophen, as is common when people are attempting to get through a bad flu (or even opioid withdrawal symptoms), there is a significant risk of liver damage. Acetaminophen produces a substance that is very hard on the liver when broken down, and if the liver is trying to filter a large amount of an opiate at the same time, it can cause serious stress and result in permanent liver damage.
At this point, treatment options should be assessed.