Codeine is a drug that’s found in concentrations of just 1 percent in opium poppy plants. But since its discovery in 1832, it’s grown in popularity. It’s also mixed with other drugs such as acetaminophen to create more potent pain relievers.
Codeine is a commonly prescribed drug that’s used to treat moderate-to-severe pain. It’s a naturally occurring opiate that’s found in poppy plants alongside other alkaloids like morphine. It’s an ingredient in a variety of medications, and it may be the most commonly used narcotic pain reliever around the world.
It was once widely used in cough medications and could even be purchased over the counter. The drug is still used in prescription cough medications. Though codeine is a standard ingredient in many cough medicines, there is very little evidence to support its effectiveness is suppressing coughs in common ailments like upper respiratory infections.
However, as a pain reliever, it may ease sore throats. Like other opioids, codeine is potentially addictive and may lead to chemical dependence when abused or used for too long. The U.S. Food and Drug Administration recently limited the use of medications containing codeine to adults age 18 or older because of its higher risk profile in children. Codeine can cause chemical dependence, which can mean people can experience uncomfortable withdrawal symptoms when they quit or cut back.
Learn more about codeine withdrawal and how it can be safely treated.
Once you become dependent on codeine, it can cause a substance use disorder that worsens over time. Because you develop a strong tolerance for codeine, higher and higher doses are needed to achieve the same effects. Codeine use works by binding to opioid receptors in the brain. Though it only has a weak affinity for its preferred opioid receptor, the body breaks it down into an active metabolite called morphine, which binds more easily. The drug activates opioid receptors, which are responsible for regulating pain signals in the nervous system. These receptors would normally bind with your body’s own opioid: endorphin.
Endorphins help us rest and recover from minor injuries and muscle soreness. Moderate-to-severe pain may be too much for your endorphins to handle. Prescription opioids like codeine are more powerful and can treat more intense pain symptoms. However, as your body gets used to codeine, quitting can cause uncomfortable withdrawal symptoms.
Opioids typically cause flu-like symptoms that can be uncomfortable and even extremely unpleasant. Though opioids aren’t generally life-threatening during withdrawal, severely uncomfortable symptoms and cravings can be a significant barrier to treatment. Opioid withdrawal symptoms can include:
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Your codeine withdrawal timeline may depend on how long you were dependent on the drug and the size of your usual dose. The size of your last dose can also prolong or hasten the amount of time you have before it and your first symptoms. However, your experience is likely to look something like the following:
Medical detoxification is the highest level on the continuum of care in addiction treatment. It involves 24-hour medically managed treatment for about five to 10 days, depending on your needs. Not everyone who has a codeine-related opioid use disorder will need medical detox, but it might help people with severe cases.
Medical detox is usually reserved for individuals who are likely to go through severe withdrawal symptoms. However, detox can also help people with other health complications or conditions in addition to withdrawal symptoms. When you enter an addiction recovery program, medical and clinical professionals will help determine the right level of care for your needs.
After you complete detox, or if you don’t need detox, it is advised that you continue treatment in another level of care. If you have medical or psychological needs that require 24-hour care, you might go through an inpatient or outpatient program. If you can live on your own safely, without a threat of medical complications or relapse, you may go through an outpatient program. Addiction treatment should be tailored to your individual needs for it to be effective. When you enter a program, you will visit with a therapist each week to create a treatment plan and reevaluate it regularly.
Center for Drug Evaluation and Research. (2018, January 11). FDA removes approval of Rx opioid cough and cold med in kids under 18. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-requires-labeling-changes-prescription-opioid-cough-and-cold
Eccles, R., Morris, S., & Jawad, M. (2011, October 7). Lack of effect of codeine in the treatment of cough associated with acute upper respiratory tract infection. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2710.1992.tb01289.x
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
Scheve, T. (2019, July 25). What are endorphins? Retrieved from https://science.howstuffworks.com/life/inside-the-mind/emotions/endorphins.htm
U.S. National Library of Medicine. (2018, March 3). Codeine: MedlinePlus Drug Information. Retrieved from https://medlineplus.gov/druginfo/meds/a682065.html