Commonly combined with ibuprofen or acetaminophen to augment its painkilling properties, codeine is an opioid analgesic that has been prescribed in the United States for decades. It is derived from a naturally occurring alkaloid of the opium poppy plant. Although it is regarded as a rather weak opioid with fewer risks than other high potency opioids like fentanyl, codeine is still highly addictive and can be a very dangerous drug to consume.
What Is Codeine?
When it was first discovered in 1832 by Pierre Robiquet, codeine was marketed as a ‘pain soother’ alongside many other opioid medications made from the opium poppy plant. After codeine had been on the market for a few years, patients also noticed it had a noticeable effect on suppressing a cough and even a positive effect on individuals suffering from diarrhea. Today codeine is an extremely popular cough suppressant, with the vast majority of prescription cough syrups containing some about of the drug.
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Codeine has been combined with a variety of other drugs such as decongestants, muscle relaxers, and other pain relievers to aid in different ailments. The often misguided view of codeine as a ‘safe and weak’ opioid has made some of these particularly dangerous combinations possible. Combining codeine with a muscle relaxer, for example, can put a patient at risk for suffocation and respiratory arrest.
In the United States, codeine is heavily regulated and is available only by prescription. Since the opioid epidemic has hit the spotlight, the government and other healthcare regulating bodies have taken extreme measures to ensure the act of prescribing and purchasing codeine is controlled. Codeine is now regulated by the Controlled Substances Act and is listed as a Schedule II narcotic. Other medications containing codeine, such as cough syrups or codeine with acetaminophen, are listed as schedule III or IV, depending on their potency.
Pharmacies in many states now utilize an automated prescription system in an attempt to track drug seekers who ‘doctor shop’ in order to fill additional prescriptions of codeine and other opioids. Systems like this enable doctors and pharmacies to see a patient’s prescription history and allow them to deny a prescription to a patient if they believe the patient is abusing or selling prescription medications.
How Does Codeine Affect Your Body?
As an opioid, codeine suppresses nerve endings to help control or dull pain that is received by neurons in your central nervous system. Codeine bonds to opioid receptors in your brain to block the triggering of neurons which can in turn stimulate your brain to process pain. The chemical signals in your brain and spinal cord are dulled or interrupted through this bonding. In turn, this means that any stimulation you feel, such as pain, will only be received by sluggish and inactive nerve endings.
Codeine can also impact the performance of nerve endings throughout your body. Many patients who have been prescribed codeine in the past have reported nausea, inability to feel pleasure or stimulation, and general numbness and tingling. When codeine causes nerve endings in other organs of the body to become sluggish, it can drastically affect your day-to-day life.
Constipation is also a common side effect of codeine, caused by the suppression of nerve endings in the gut and lower intestine. When these nerve endings are slowed, the normal passing of waste cannot occur in the digestive system. When waste is ready to be disposed of, it will press against nerve endings in the upper intestine, causing them to trigger and begin the digestive cycle. Without these nerve endings actively receiving this signal, your body cannot properly digest and dispose of waste.
Similarly to the interruption in your body’s digestive cycle, codeine can also affect the nerve endings that control breathing, heart rate, and blood pressure. While all of these are functions of the body that are controlled subconsciously, your central nervous system plays an essential role in regulating these functions. If these nerve endings are dulled too much by a large dose or prolonged use of codeine, it is possible for respiration to slow to a fatal rate. If brain lacks oxygen for a long enough period of time, it could result in a fatality.
Texas Codeine Abuse
The abuse of codeine and other prescription opioids has increased over the past two decades, especially among school aged teens from grades 7-12. Codeine abuse is defined as taking the drug without a prescription, or taking codeine more frequently or in higher doses than what was prescribed by a physician.
Trends in American culture have even emerged around the use of codeine without a prescription, including ‘purple drank’ which contains codeine cough syrup mixed with citrus flavored soda. This concoction can be found at many high school parties in Texas and across the country, and has been rapped about and spotlighted on popular TV shows. This lax approach to such a dangerous drug could be partially responsible for an increase in teen and young adult codeine abuse.
According to a 2014 study conducted jointly by the Texas Department of State Health Services (DSHS) and the Public Policy Research Institute (PPRI) at Texas A&M University, codeine cough syrup was a rising trend among school aged students in the state. 10.8% of school aged students in grades 7-12 reported using codeine cough syrup without a prescription, with 5.1% reporting having used it in the past month.
Although new laws have tried to limit and track codeine use and prescriptions, it was not long ago that opioid prescriptions were written without record and without worry. There are many ways for teens and young adults to purchase codeine illegally, and many professional dealers who are willing to sell it to them. Keep an open dialogue with your kids and loved ones, education and intervention are the best tools to fight drug abuse early on.
What Are The Risks Of Codeine Addiction?
Side effects are commonly mentioned when talking about prescription codeine. Long-term effects of prolonged codeine use and abuse, however, can vary wildly from the side effects stated on your prescription bottle. Common side effects that are listed with codeine include drowsiness, dizziness, constipation, difficulty urinating, cotton mouth, mood swings, itching, nausea, and vomiting.
Prolonged use of codeine, or abusing codeine in large amount or with other drugs, can cause more dramatic and permanent damage on the body. Even when used exactly as prescribed, you are still at risk for codeine dependency on a long-term basis. Some of the long-term effects of codeine abuse include:
- Liver and kidney damage
- Major depression
- Uncontrollable shaking
- Night sweats/cold sweats
- Malnutrition due to nausea and vomiting
- Bradycardia (slow heart rate)
- Respiratory arrest
- Phantom pains
- Uncontrollable muscle spasms
Codeine can also put an individual at high risk for addiction or dependency. Even when taken exactly as prescribed, genetics, mental health, environment, and medication interactions can play a role in opioid dependencies. Always talk to your physician about any history you have with drug addiction or dependency when considering codeine or any other opioid prescription.
Get Help Today
Did some of the side effects mentioned in this article sound familiar to you? If you believe a loved one is suffering from a codeine addiction or is abusing codeine, professional help is only a call away. Getting the help your loved one needs can be the difference between continuing down the road they’re on or starting their journey to sobriety.
Your call is always 100% confidential. Our addiction treatment specialists are standing by to hear your story and give you more information on the customized treatment plans we have to offer. We are here to help, give us a call today.
- British Journal of Anesthesia — Codeine Phosphate in Paediatric Medicine
- New England Journal of Medicine — New Evidence about an Old Drug — Risk with Codeine after Adenotonsillectomy