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Codeine Addiction

Codeine Addiction Treatment

What is Codeine?

What is Codeine? Codeine is a member of the opioid family of drugs that are derived from the opium poppy and synthesized in a laboratory to create an analgesic drug that is commonly prescribed for the treatment of chronic pain, off-label use in cough, restless leg syndrome, and sometimes diarrhea [1]. Codeine is considered a narcotic, and it does carry a potential for causing addiction though it is not typically considered as dangerous as some other opiates such as Hydrocodone or OxycodoneMixing codeine with alcohol impairs the medication’s desired impact, which often leads people to drink or ingest more substances to achieve a similar high. This increase can lead to an opioid overdosealcohol poisoning, or both.

Codeine is also available in combination with acetaminophen (Capital and Codeine, Tylenol with Codeine), aspirin, carisoprodol, and promethazine and as an ingredient in many coughs and cold medications. Codeine (alone or in combination with other medications) comes as a tablet, a capsule, and a solution (liquid) to take by mouth. It is usually taken every 4 to 6 hours as needed [2]. The Drug Enforcement Administration classifies codeine as a Schedule II drug, meaning that it has a high potential for abuse and its use could cause psychological or physical dependence.

Codeine is the most commonly taken opioid medication. It is at the center of the opioid addiction crisis in the United States and thus is highly regulated. Its main indication is pain and cough. Chronic pain, defined by the International Association for the Study of Pain, is pain persisting beyond the standard tissue healing time, which is three months. The most prevalent causes of non-cancer chronic pain include back pain, fibromyalgia, osteoarthritis, and headache.

Street Name for Codeine

Many people addicted to codeine use street names for the drug to hide their substance abuse. They may use slang when talking with dealers or others who may have access to the drug.

Street names for codeine include:

  • Pancakes and syrup
  • Schoolboy
  • Lean (when added to cough syrup medication)
  • Purple drank (when added to cough syrup medication)
  • Cody
  • Captain Cody
  • Doors and fours
  • Little C
  • Loads
codeine addiction treatment
When people exceed the prescribed amount, codeine can be habit-forming,

What is Purple Drank?

Purple drank also known as lean is a street term for the mixture of codeine and promethazine. Formerly a common cough syrup, it’s now often used to get a ‘buzz.’ Promethazine is used for nausea and to alter sensorium (what you feel, hear, see, and think). It’s sometimes mixed with alcohol or other substances. Purple drank can also be a combination of codeine cough syrup, soda, hard candy, occasionally alcohol, and the antihistamine. It is highly addictive and potentially damaging to the body. It’s possible for a person to develop a purple drank addiction in a relatively short amount of time because of the way opioids short-circuit the brain’s reward response system.

Codeine Background Information

Derived from:

It can be synthesized organically from poppy plants, typically synthesized from morphine for pharmaceutical applications.

Ways used:

Ingested, crushed, and snorted, rectal administration via suppository

Scientific Name:


How Long in Bodily System

Half-life: 9-11 hours. Typically takes four days to eliminate from the body; takes as much as a week in long-term users.

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Codeine, What is it Used For


Codeine is useful in the treatment of various etiologies producing chronic cough. Also, 46% of patients with chronic cough do not have a distinct etiology despite a proper diagnostic evaluation. Codeine produces a decrease in cough frequency and severity in these patients. However, there is limited literature demonstrating the efficacy of codeine in chronic cough. The dose can vary from 15 mg to 120 mg a day. It is, however, indicated in the management of prolonged cough (in specific populations like lung cancer), usually as 30 mg every 4 to 6 hours as needed [3].

Restless Leg Syndrome

Codeine is effective in the treatment of restless leg syndrome when given at night time, especially for those whose symptoms are not relieved by other medications.

Persistent Diarrhea (Palliative)

Codeine and loperamide are equally effective, and the choice between them has its basis in assessing the physician evaluating the small but undoubted addictive potential of codeine versus the higher cost of loperamide and an individual difference in patient’s vulnerability to adverse effects.

Can You Get Addicted to Codeine?

Like other opioid-based drugs, codeine has the potential for addiction. You can become addicted to codeine even if you’re taking a combination product such as Tylenol with Codeine. Quitting codeine use can put your body through withdrawal.

Substance Abuse Disorder
Codeine Addiction can occur quickly and be very difficult to overcome.

Drinking promethazine-codeine cough syrup mixed with soda (a combination called syrup, sizzurp, purple drank, barre, or lean) was referenced frequently in some popular music beginning in the late 1990s and has become increasingly popular among youth in several areas of the country. Sometimes, the drug is mixed with alcohol, while other times it may be sweetened with hard candies.

Codeine is not only addictive as a mild opioid, but it can also generate hazardous effects, along with life-threatening symptoms. The effects that occur with short-term use can compel someone to take larger doses of the drug. Codeine addiction does not happen the minute a person begins abusing codeine cough syrup, but if they continue to do so on a regular basis, the same issues that happen with all opioid drugs when abused can still occur.

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Codeine Addiction Symptoms

The symptoms of codeine abuse are varied among people struggling with addiction, depending largely upon the length of time a person abuses codeine, the amount used, and the frequency of usage. Some of the most common symptoms of codeine abuse are:

Physical symptoms:

  • Blue tinges on the lips and fingernail beds
  • Fainting
  • Dizziness
  • Dry mouth
  • Constipation
  • Itching
  • Urinary retention
  • Low blood pressure
  • Rashes
  • Decreased sex drive
  • Respiratory depression
  • Seizures

Behavioral symptoms:

  • Social isolation
  • Withdrawing socially from loved ones
  • Apathy
  • Sleepiness
  • Forging prescriptions in order to obtain more codeine
  • Doctor shopping, or visiting a number of doctors in order to obtain greater amounts of codeine
  • Frequent ER visits for vague complaints of pain
  • Stealing or borrowing codeine from friends and loved ones
  • Financial problems
  • Indifference toward loved ones, jobs, and social activities
  • Healthcare fraud
  • Legal problems
  • Interpersonal relationship problems
  • Ordering codeine on the internet
  • Poor work or school performance
  • Faking illnesses to obtain more codeine
  • Lying to hide the amount of codeine being abused
  • “Nodding off” during conversations
  • Fixation on codeine

Mood symptoms:

  • Anxiety
  • Depression
  • Euphoria
  • Emotional numbing
  • Sense of well-being and calmness
  • Mood swings

Psychological symptoms:

  • Hallucinations
  • .Psychosis
  • Delusions
  • Decreased memory
  • Worsening of mental health
  • Increased mental illness symptoms
  • Lack of emotions
codeine addiction treatment
Codeine addiction requires the treatment services offered by a reputable, professional recovery program. 

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Side Effects of Codeine Addiction

Can codeine cause low blood pressure? Yes, codeine increases the risk of compromised ability to maintain blood pressure due to peripheral vasodilation and other mechanisms. Peripheral vasodilation means the drug dilates your distal blood vessels and lowers the blood pressure. The long-term effects of codeine addiction can impact nearly every area of an individual’s life. These effects may include:

  • Liver damage
  • Acute pancreatitis
  • Kidney damage
  • Increased sensitivity to pain
  • Major depression
  • Cold and clammy skin
  • Muscle twitches, cramps, spasms, and pain
  • Respiratory depression
  • Lack of muscle tone
  • Job loss
  • Legal problems
  • Domestic abuse
  • Incarceration
  • Homelessness
  • Divorce
  • Coma
  • Seizures
  • Death

Causes and Risk Factors for Codeine Addiction

Codeine is addictive for two main reasons. First, taking Codeine can produce a pleasant euphoric and sedative “high” in the user, which can drive repeated consumption as the user seeks to replicate that pleasurable experience. Repeated codeine consumption constitutes an addictive, rewarding stimulus, with the reward centers of the user adapting to the repeated experience of that behavior and driving further instances of consumption. Codeine is also physically addictive, taking this drug repeatedly over a period of time can give rise to dependence, and a dependent user will need to continue to take codeine to stave off withdrawal symptoms.

A person’s genetics are known to influence their susceptibility to addiction, and a family history of substance abuse and addiction and/or of other mental health disorders is a leading risk factor for codeine addiction.

Brain Chemistry

The role of the brain in the development of substance use disorder is an area of very significant study and research. Irregularities – potentially, but by no means necessarily, resulting from injury or illness – in the brain’s reward centers and other parts of the brain greatly increase the risk of addiction to codeine. Mental health issues linked with brain chemistry – for example, depression and anxiety – are also very important risk factors for codeine addiction.


Environmental factors, including childhood abuse, stress, and trauma, associating with a peer group in which alcohol or drug abuse is common, having easy access to codeine, suffering from any illness or injury requiring pain medication, and financial difficulties, are all known to increase the likelihood that a person will abuse this drug and develop an addiction to it.

Psychological and Personality Factors

People who are prone to engage in risk-taking behavior, fill a strong desire to fit in, have a tendency to show off, have low self-esteem, and have an inclination towards engaging in substance abuse generally are all more likely than the average to develop codeine addiction.

codeine addiction treatment
In a residential treatment facility, you can receive comprehensive therapy and care to address the psychological and emotional components of your codeine addiction.

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Can You Overdose on Codeine

When an individual overdoses on codeine, there is a possibility that that individual may die. Because of this, codeine overdose is one of the most dangerous health effects for someone abusing the drug. Codeine and other opioids present a high risk of fatal overdose due to their effect on depressing the central nervous system (CNS), which can slow or stop the heart and lungs. This often results in the person’s death, especially if they are not rushed to the hospital and treated quickly enough.

If someone you know is addicted to codeine, it is crucial to know the symptoms of a codeine overdose. Someone who has overdosed on codeine will exhibit these symptoms:

  • Difficulty breathing
  • Loss of muscle tone
  • Excessive drowsiness
  • Fainting
  • Loss of consciousness
  • Dizziness
  • Fainting
  • Clammy and cold skin
  • Slowed heartbeat
  • Coma

When you see these overdose symptoms in a person struggling with codeine addiction, call 911 immediately and get the person to the hospital. Their life may be in danger. Deaths from prescription opioid medications now outnumber overdose deaths from other drugs (including cocaine and heroin).

Side Effects of Codeine Withdrawal

Individuals who are addicted to this prescription drug will also experience withdrawal symptoms when they stop taking it. This is the result of the changes in the brain and body that occur as they try to adjust to the constant presence of Codeine until they no longer function properly without it.

Common codeine withdrawal symptoms include:

  • Runny nose
  • Watery eyes
  • Nausea
  • Vomiting
  • Stomach cramps
  • Diarrhea
  • Loss of appetite
  • Weight loss
  • Muscle pains

For some people, these symptoms can seem like bad flu. For long-term, heavy users, it’s typically much worse and may need medical intervention. It’s best to consult a physician before trying to get off of this drug if addiction is suspected. Though withdrawal from opioids is not generally dangerous, it may cause dehydration and be too unpleasant to bear without professional help. Relapse can be especially risky, as many users will be unaware that even a short break from an opioid can result in a reduction of tolerance. It is starting again at the same dose as before the attempt to stop can result in a dangerous overdose.

Addiction to Codeine Treatment 

Codeine detox can be provided in an inpatient drug rehab, managed and monitored by experienced medical professionals, and possibly made somewhat easier with Medication-assisted treatment (MAT). The exact details of a codeine detox program will vary from one rehab to another. Make sure to consult an addiction specialist if you are contemplating a codeine detox in rehab, so you know exactly what to expect.

Therapy lies at the heart of all addiction treatment: while detoxification and withdrawal remove the immediate physical pressures of dependence on Codeine, they do not address the underlying psychological causes of addiction. Therapy can reveal and tackle the root causes of addiction, enabling the person to identify and remediate the behaviors which have led to the development of addiction, as well as providing you with psychological defense mechanisms against relapse, which you can leverage throughout recovery.

Therapy in an inpatient addiction treatment center comes in a very wide variety of methodologies and forms, and rehab may be provided in both individual and group settings. Someone undergoing addiction therapy may need to try out more than one different therapy style before settling on one which is most beneficial to them.

codeine addiction treatment
To reduce the risks associated with withdrawal, the codeine addiction rehabilitation process focuses on tapering off the drug instead of stopping it suddenly. 

Overcoming Your Codeine Addiction

First and foremost, if you think that a loved one shows signs of addiction to prescription drugs like Codeine, you should first research the drug and addiction associated with it so that you can better understand what your loved one needs. This begs the question, “how long does Codeine stay in your system?” You must plan an intervention to provide your loved ones with options to battle their addiction in a safe and supportive environment. During this intervention, make sure that you offer compassion and support instead of judgment. Lastly, offer your support throughout the entire codeine addiction treatment process.

In addition, prolonged Codeine addiction can have severe physical and psychological effects, so it is essential to seek codeine addiction treatment as soon as possible. Inpatient drug rehab offers intensive care that can help you get through the early stages of withdrawal promptly. 

Medically-Assisted Detox

Medical detox is often considered the first stage of treatment. It will help you navigate the complicated process of withdrawal, but it doesn’t address patterns of thought and behavior that contribute to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient drug rehab helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.


Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
  • Solution Focused Therapy – is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. In many cases, traumatic experiences can result in a mental health disorder and substance abuse. Dual diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Please, do not try to detox on your own. The detox process can be painful and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We Level Up provide proper care with round-the-clock medical staff to medically assist your recovery with our Codeine Addiction Treatment Program. So, reclaim your life, and call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

codeine addiction treatment
Inpatient programs are the most intensive and effective treatment options for codeine addiction.

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[1] NCBI –
[2] NIH –
[3] NCBI –
[4] NCBI –
[5] Mixing Prescription Drugs with Alcohol – We Level Up NJ

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