Codeine Addiction and Treatment


Codeine Addiction and Treatment

Table of Contents

  1. Introduction
  2. What is Codeine?
  3. Forms and Names
  4. Why and How Codeine is Used
  5. Health Risks of Opioid Use Disorder
  6. Treatment


Codeine is an opioid that may require treatment at a rehab facility. Opioid use disorder plagues many Americans around the country. As one of the worst drug epidemics in history, the opioid crisis is a serious public health concern. Over 70,000 deaths in the United States can be linked to drug overdoses, and most of them involve the use of opioids.1

According to The National Safety Council, one in every 10 Americans knows someone who has died from opioid use.2 Codeine is one of the opiates that contribute to this drug crisis in America.

Substance use disorder is the leading cause of accidental death in America, and opioids are at the heart of this epidemic. As prescription pain reliever sales are on the rise – they quadrupled between the years of 1999 and 2010 – the misuse of painkillers has led to increases in heroin use. More than 20,101 deaths from overdose are related to prescription opiates. Four out of five people who are new to abusing heroin began their addiction by misusing prescription painkillers.3

What Is Codeine?

Codeine can be found in some of the strongest prescription cough medicines on the market. Like morphine and hydrocodone, it is a narcotic pain reliever. The body naturally converts a small amount into morphine.4

Besides cough syrup, it can also be added to prescription pills as a mild to moderate pain reliever.

Although useful at managing a cough or pain, it is a Schedule II narcotic that can become addictive.

The History of Codeine

First discovered by French chemist Pierre Jean Robiquet in 1832, codeine is derived from the milky sap of the opium poppy flower.

During the first half of the 18th century, opium was widely used for recreational purposes, especially in Great Britain and China. High global demand created a competitive international market for opium. When China tried to halt the export of opium from its shores, England retaliated, and the Opium Wars began.

In 1905, the United States outlawed opium which opened a black market for illegal opium trade from Southeast Asia.

Today, codeine can be extracted directly from the plant itself, or processed in a lab.

Forms and Names of Codeine

Codeine comes in many different forms: pills, powders, syrups. Some of the prescription drugs include:

Robitussin A-C

Tylenol with codeine

Also, known chemically as methylmorphine, it has many “street names” used by those with substance use disorders. Drugs with codeine ingredients could be called:

Captain Cody


Little C

School Boy

Tylenol with codeine is sometimes referred to as:







It is frequently mixed with a soft drink, typically Sprite or Mountain Dew, or with alcohol. These could be known as:

Purple Drank


Texas Tea


Myths About Codeine

The idea that because codeine is a somewhat weaker opioid, it is not as dangerous as other narcotics is false. Unsafe recreational use of the drug and other substances can have deadly consequences when the danger is downplayed.

Why and How Codeine Is Used

Though it is one of the weaker prescription opioids, it can be just as addictive.

When it enters the body, like many opioids, it can cause feelings of euphoria, relaxation, and drowsiness. The reasons for use vary greatly.

Persons with a substance use disorder may no longer need codeine for pain but continue to take it for the associated euphoria or “high.” Continued use of opioids, without the consultation of a doctor, can build up tolerance and dependence on the drug.

Some decide to combine it with alcohol, sometimes called “lean”, for a more intense “high.” This combination is especially dangerous – even deadly – as it can cause difficulty breathing and oxygen deprivation.

Codeine Can Be Addictive

Just five to seven days of ongoing use can cause dependency. It’s use can also lead to the use of stronger opioids, such as oxycodone or heroin.

Individuals with mental disorders are particularly susceptible to the self-medicating with opioids. This is especially true of co-occurring disorders like depression, anxiety, bipolar or antisocial personality disorders.

Health Risks of Opioid Use Disorder

Opioid use disorder is associated with many health risks. Codeine can cause serious respiratory depression issues that can become life threatening.5 Side effects can vary widely. The short-term effects of the drug can range from quite mild to very dangerous.

Some side effects include:



Lowered blood pressure

Itchiness or rash

Dry mouth



Blurry vision


Some long-term side effects include:

Major depression

Acute pancreatitis

Liver damage

Financial and legal problems

Higher sensitivity to pain

Cold, clammy skin


Feeling tired and worn out

Kidney damage

Domestic problems


Decreased muscle tone


Damaged social relationships

Some memory loss

Muscle twitches and cramps

Job loss

Cardiac issues



Treatment is necessary in cases of opioid use disorder. If codeine use suddenly stops, some withdrawal effects may take place. Since it is a short-acting drug, withdrawal symptoms can occur within 12 hours of stopping the opioid use. Therefore, it is important to undergo withdrawal with medical supervision.

Withdrawal from codeine can be similar to withdrawal symptoms from other opioids.

Some typical withdrawal symptoms include:

Rehab facilities are usually the safest and most helpful option for overcoming serious withdrawal symptoms and maintaining a successful recovery. After overcoming the withdrawal symptoms, maintaining detoxification is the first step in recovering from addiction.


  1. Drug Overdose Deaths | Drug Overdose | CDC Injury Center. (2019, June 27). Retrieved October 20, 2019
  2. Prescription Nation 2018: Facing America’s Opioid Epidemic. National Safety Council. 2018. 
  3. Opioid Addiction 2016 Figures & Facts. American Society of Addiction Medicine, 2016. 
  4. Bhandari, M., Bhandari, A., & Bhandari, A. (2011). Recent updates on codeine. Pharmaceutical Methods, 2(1), 3–8. doi:10.4103/2229-4708.81082. 
  5. Ibid.