Codeine is a prescription opioid used for pain relief and cough suppression and can be addictive when misused or abused. Codeine addiction is characterized by a pattern of chronic use and problematic behaviors despite negative consequences. It is progressive, meaning that the condition tends to worsen over time if the person doesn’t seek treatment. Those who suffer from addiction are unable to control their codeine use and experience significant impairment and distress in their lives as a result of use.
Codeine belongs to the opioid drug class, which also includes other opioid medications such as hydrocodone, oxycodone, and morphine. In 2014, 4.3 million people were nonmedical users of narcotic painkillers, including codeine 1. The term “nonmedical” means that they were using codeine in a way other than prescribed or without a prescription.
You will find the following information in this article:
- Signs and symptoms of codeine addiction.
- Treating codeine addiction.
- Financing treatment.
- Causes of addiction.
- Long-term effects of codeine abuse.
- Find a treatment center.
Signs and Symptoms of Codeine Addiction
Preventing Drug Dependence and RelapseRecovering from addiction is not easy, but with the right support and professional help, it is possible to make a successful recovery. Read More
Codeine is an effective, yet addictive, opioid pain medication. Doctors typically prescribe it for mild to moderate cases of pain or to reduce coughing. Sometimes codeine is combined with other drugs, such as acetaminophen or aspirin, to enhance its analgesic effects.
Like other opioids, codeine binds to the opioid receptors in your spinal cord, brain, and gastrointestinal (GI) tract. This action is responsible for the pain relief that users experience 2. People become addicted to codeine for a variety of reasons. Some people may develop an addiction resulting from physical dependence, a fear of withdrawal symptoms, or the belief that their pain will return, while others use the drug without a prescription and develop an addiction. People misuse and abuse codeine in a number of ways, such as:
- Taking more codeine than prescribed.
- Taking codeine for longer than prescribed.
- Using codeine in a different way than prescribed (snorting, injecting, etc.).
- Obtaining codeine through illicit means.
There are several signs and symptoms of codeine addiction. Codeine addiction falls under the category of “opioid use disorder” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Some of the behavioral signs and symptoms of codeine addiction include 3:
- Taking more codeine than originally intended or for longer periods of time.
- Failing to cease or cut down codeine use.
- Spending excessive amounts of time to obtain codeine, use codeine, and recover from its effects.
- Having strong cravings to use codeine.
- Failing to maintain everyday life activities, such as failing to meet work or family obligations, or having persistent interpersonal problems.
- Giving up hobbies or other important activities, such as seeing friends.
- Continuing to use despite awareness of the physical and psychological consequences.
- Stealing or committing other crimes.
- Exhibiting secretive behavior or lying about whereabouts.
Physical and psychological symptoms of codeine abuse and addiction may include 1,3,4:
- Extreme drowsiness.
- Euphoria followed by apathy.
- Dysphoria, or a general state of unhappiness or unease.
- Slurred speech.
- Memory problems.
- Slowed movements and thoughts.
- Respiratory depression.
- Intravenous signs, such as track lines or collapsed veins due to injection.
- Intranasal signs, such as nose bleeds due to snorting.
- Withdrawal symptoms, such as excessive sweating, vomiting, muscle aches, “goose bumps,” diarrhea, fever, agitation, and insomnia.
- Tolerance, or the need for greater amounts of codeine to produce the desired effects.
Treating Codeine Addiction
No matter what, it’s important to remember that an addiction to codeine is treatable, and it’s never too late to seek a recovery program. While some people try to quit using codeine on their own, it’s beneficial to obtain treatment in a recovery program for a number of reasons.
Some of the reasons recovery programs can be so helpful for obtaining and maintaining sobriety include:
- The availability of supervised medical detox to help mitigate withdrawal symptoms.
- The support, monitoring, and guidance of trained substance abuse specialists—you don’t have to manage it all on your own.
- The education you receive on codeine abuse, addiction, and recovery.
- The day-to-day structure of a recovery program.
You can choose from a number of different rehab options; one isn’t necessarily superior to another. The best treatment program for you is the one that meets your individual preferences, beliefs, and needs.
Some of the treatment types you might choose from include:
- Detox: This is typically the first step towards recovery. Professional detoxification may be completed at a standalone detox program or as part of a comprehensive treatment program. Medical care staff will provide you with 24-hour medical supervision to help you withdraw from codeine comfortably and safely.
- Inpatient: This form of treatment involves a residential stay of several weeks to a few months at a recovery center and offers around-the-clock care and supervision. You’ll participate in a wide range of treatment modalities, such as individual therapy, group counseling, and 12-step groups.
- Outpatient: Outpatient treatment is a relatively less-structured yet effective form of treatment for those who are unable to attend a residential program. Outpatient treatment involves many of the same treatments as inpatient, but you live at home and attend your program one to several times per week.
- Luxury: A luxury treatment facility might resemble a stay at a five-star hotel. In addition to the standard treatment protocol, you’ll also be offered a wide range of top-notch amenities, such as massage therapy, gourmet meals, personal training, and high-end accommodations.
- Executive: This form of treatment is similar to luxury treatment, but it is catered to executives who wish to continue working while recovering from a codeine addiction.
- 12-step programs: Based on the original 12-steps of recovery laid out by Alcoholics Anonymous (AA), people attend 12-step groups to help maintain sobriety. Many people benefit from the fellowship of others who have been in their shoes and the structure and support of the 12-step model. Narcotics Anonymous (NA) or Pills Anonymous (PA) are both suitable options for someone recovering from an addiction to codeine.
- Holistic: A treatment center with a holistic approach focuses on healing the mind, body, and spirit through a number of complementary and alternative treatment modalities, such as music and art therapy, yoga, meditation, and acupuncture.
- Teen: Teens dealing with addiction have unique developmental, social, and psychological needs. Adolescent recovery programs focus on providing the support, education, and counseling teens need throughout the recovery process.
- Gender specific: Just as some people prefer to attend women- or men-only fitness centers, some people feel more comfortable being in treatment with others of their own gender. These treatment centers offer the same level of care and support but allow only men or women into their programs. One small study reports that women with severe legal and drug problems who attend same-gender treatment programs may fare better in than those who attend mixed-gender treatment 5. Research on male-only treatment programs is still in the early stages, but men-only programs may be beneficial for men who prefer this type of setting 6.
- Veteran: These treatment programs often focus on underlying issues and co-occurring mental or physical health issues unique to veterans, such as PTSD.
People dependent on codeine may be treated with a combination of behavioral therapy and medications, such as methadone, buprenorphine, and naltrexone. Methadone and buprenorphine can help to alleviate withdrawal symptoms and reduce cravings for codeine 7. Naltrexone works in a unique way by blocking the desired effects of opioids, such as sedation and euphoria, so if someone in recovery relapses, they won’t experience intoxication 7.
While medication-assisted treatment can be beneficial for a number of types of opioid dependence, this approach is best carried out alongside of simultaneously administered, evidence-based behavioral therapeutic interventions, which may include 8:
- Cognitive behavioral therapy (CBT): The therapist examines the connection between maladaptive thoughts, feelings, and behaviors related to codeine abuse and works to rectify them.
- Contingency Management (CM): CM aims to increase patient motivation by offering tangible rewards for abstinence.
Treatment CostsThere are a number of ways of financing addiction treatment, depending on the type of program entered and the particular clinic or hospital being used. Read More
The cost of codeine addiction treatment varies considerably. Private recovery programs may cost more than public, government-funded rehabs. 12-step groups, such as NA, are free to join, while luxury or executive treatment programs may cost $25,000 or more per month. The cost depends on a variety of factors, such as the program location, the available amenities, the type of treatment program, and your insurance policy.
If you have insurance, call your insurance company to learn about your insurance coverage and addiction treatment options.
If you don’t have insurance, you can still finance your addiction treatment in other ways. Being creative and using a combination of payment methods might be one way to pay for treatment. Some of the ways people in recovery have financed treatment include:
- Using a sliding scale or payment plan: Some treatment centers will adjust their fees based on your income and ability to pay, or at least offer you a payment plan where you can pay off a part of the cost every month.
- Asking friends or family: Chances are your loved ones are interested in helping you obtain sobriety. Asking for a loan or donation might be one way you can make ends meet.
- Starting a crowdfunding campaign: This is an increasingly common way for people to raise some or all of the funds they need to pay for treatment. Crowdfunding websites allow you to create a campaign that shares your story with a large audience, many of whom are willing to help.
- Using a credit card: This option allows you to pay off your treatment costs in monthly installments over the course of time.
- Taking money from your savings account: You’ve been saving the money for a time when you need it most—there’s no better way to use your savings than to put it toward achieving a clean and sober lifestyle.
Nothing is more important than your health, happiness, and sobriety. Don’t be put off by the cost of treatment. Taking control of your life is more important than anything else.
What Causes Addiction?
People become addicted to codeine for a number of reasons—there’s no one specific factor that automatically leads to addiction. Addiction is a multi-faceted condition that can have many causes. Some of these contributing factors include:
- Heritability: Genetic predisposition can be a powerful contributor but is not the sole cause of addiction. Biology isn’t destiny. There are a number of factors that influence whether specific genes are expressed. Scientists estimate that genes account for about 40 to 60% of your chance of developing an addiction 9.
- Peer or family influences: Exposure to others who abuse substances is one of the most important factors that determines your initial drug use, while genes influence whether your use becomes problematic 10.
- Mental health: People who have a co-existing mental health disorder, such as depression or schizophrenia, may be more susceptible to developing a substance abuse disorder 9.
- Poor social skills: People who don’t know how to interact with others or who display antisocial behaviors may have a higher risk for addiction. 9
- Availability of drugs: The easier it is to obtain drugs , the more likelihood someone will initiate drug abuse, which could progress to problematic use 9.
Long-term Effects of Codeine Abuse
If you or someone you know has an addiction to codeine, it’s never too late to get treatment; seek help before the addiction progresses further.
Remember, codeine addiction tends to become more severe over time as the user continues to abuse the substance. Tolerance, which means that the individual requires higher doses of codeine to experience the desired effects of intoxication, and dependence, the body’s adaptation to the presence of codeine, are likely to develop with chronic use. Once a user is dependent on codeine, uncomfortable withdrawal symptoms will occur if the user reduces or quits use. These withdrawal symptoms often contribute to relapse in those who are trying to get clean. If you or someone you know has an addiction to codeine, it’s never too late to get treatment; seek help before the addiction progresses further. If codeine abuse continues, there are many mental and physical health consequences that can occur.
Some potential long-term effects of codeine addiction and abuse include 3,4:
- Nasal septum perforation in intranasal users.
- Increased risk of HIV, hepatitis, infection of the heart lining, and tuberculosis in intravenous users.
- Track lines, collapsed veins, cellulitis, and abscesses in injecting users.
- Persistently dry mouth and nose, due to a lack of mucous membrane secretion.
- Severe constipation.
- Sexual dysfunction.
- Irregular menses and reproductive problems in women.
- Brain damage and coma due to respiratory depression.
- Impaired stress-management, behavioral regulation, and decision-making abilities.
- Risk of overdose, which can lead to death.
In addition, any addiction can cause you to spiral out of control and wreak havoc on your entire life. The potential consequences of addiction may include:
- Relationship problems, leading to divorce or loss of friendships.
- Financial difficulties, which may lead to bankruptcy, loss of housing, or depleted bank accounts.
- Poor performance at work or school, leading to job loss or expulsion from school.
- Child neglect, which can have serious consequences, including involvement with the child protective system.
- Legal problems, including driving under the influence or incarceration.
- Accidents and injuries due to violence.
Get Help for Codeine Addiction Today
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- National Institute on Drug Abuse. (2014). Prescription Drug Abuse: What are the possible consequences of opioid use and abuse?
- Niv, N. and Hser, Y. (2007). Women-only and mixed-gender drug abuse treatment programs: Service needs, utilization and outcomes. Drug and Alcohol Dependence, 87 [2-3], 194–201.
- Center for Substance Abuse Treatment. (2013). Substance Abuse and Mental Health Services Administration, Addressing the Specific Behavioral Health Needs of Men: Treatment Modalities and Settings.
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- Ducci, F. and Goldman, D. (2012). The Genetic Basis of Addictive Disorders. The Psychiatric Clinics of North America,  2, 495-519.
- U.S. National Library of Medicine. (2015). Medline Plus, Codeine overdose.