Codeine is a prescription painkiller in the opioid class. Doctors typically use it to address mild or moderate pain. Codeine is available as a solo product, but it's often mixed with other ingredients (like aspirin) to combat pain on multiple fronts.[1]
Like all opioids, codeine attaches to receptors in the brain, triggering the release of powerful euphoric chemicals. Some people initially use codeine for pain relief but then progress to chronic use of the drug to recapture euphoria and manage withdrawal symptoms.
Codeine is an opioid, and with repeated use, it can work less effectively. Some people change the way they take the drug (such as crushing and snorting it) or switch to stronger opioids (like heroin) to avoid painful withdrawal symptoms. For people like this, codeine is a gateway to significant and powerful struggles with drug misuse.
Medication for Addiction Treatment (MAT) programs use medications and therapies to combat opioid-related damage. Enrolling in these programs could help you quit all opioid misuse for good.
Experts say codeine is at the center of America's opioid addiction problem.[2] It's the most commonly taken opioid, and for many people, it serves as an introduction to stronger drugs.
Codeine enters the bloodstream quickly, and it crosses into brain cells within minutes. Once there, it latches to opioid receptors and triggers chemical reactions. Codeine stays active in the body for hours, but euphoria wears off more quickly. Some people take repeated doses to keep the high going.
Other opioids (like fentanyl) are stronger than codeine, and they're often associated with higher rates of opioid use disorder (OUD). But since codeine offers the first taste of opioids for many people, it’s considered very dangerous.
Opioid use disorders don't discriminate. Anyone can misuse these medications, including those with a valid prescription.
Doctors often use codeine to help their patients recover from dental procedures, muscle strains or acute pain. And in many parts of the world, codeine is available without a prescription.[3] Vast numbers of people use these products, and many are misusing them.
Years ago, doctors considered codeine relatively harmless. People used the drug to address almost every type of pain, and they gave it to uncomfortable children too.
As the risks of opioids became clear, prescribing habits changed. In fact, officials at the U.S. Food and Drug Administration became so concerned about codeine that they required a Black Box Warning on the label of each product.[4]
That label says codeine can cause misuse, abuse, addiction, overdose and death. It also tells parents that these drugs are too risky to give children, even if they’re in pain.
Known codeine side effects include the following:[5]
People taking the drug as prescribed by a doctor can experience some or all of these problems. Those who misuse the drug could face even more significant issues.
Your body becomes accustomed to codeine, and in time, you will need larger doses. Without them, you may feel sick between each dose. Sometimes, people switch to stronger opioids due to this tolerance.
While you might crave codeine for the chemical changes it delivers, the drug can also suppress your nervous system, leading to profound sedation and death. Anyone who takes codeine for long periods or uses too much could face this problem.
Addiction is a mental health issue caused by drug misuse. Anyone who takes codeine for long periods could develop opioid use disorder, characterized by compulsive use despite the consequences.
Someone with codeine addiction (or OUD) might display the following symptoms:
Someone with codeine addiction may feel psychologically unable to quit the drug — and they may want to do so. Chemical changes caused by codeine make quitting very difficult. This isn’t as simple as being a willpower problem. Instead, it’s an issue caused by drug-related changes to brain cells.
After long-term use, your body becomes accustomed to the continual presence of codeine. If you quit using it abruptly, you may develop a series of uncomfortable symptoms. Opioid withdrawal is a life-threatening consequence of codeine physical dependence.[6]
Codeine withdrawal symptoms include the following:
Without treatment, these symptoms can lead to severe dehydration, harming your organs. People struggling with withdrawal may also relapse to opioid misuse, and they could overdose on the first dose they take, particularly since they may take the same dose they previously took, even though their tolerance has lowered.
All opioids are central nervous system depressants, capable of slowing breathing rates. Take too much, and these drugs can stop you from breathing altogether. An opioid overdose is life-threatening.
In 2020, 4.9 deaths per 100,000 people were caused by commonly prescribed opioids like codeine. In that same period, 17.8 people in 100,000 died from overdoses to synthetic opioids like fentanyl.[7] Stronger drugs come with a higher overdose risk. But no opioid, including codeine, is completely safe.
Many people who overdose while using codeine take other drugs at the same time. In one study, close to 84% of codeine-related deaths also involved other drugs.[8] But taking codeine alone can also cause a fatal overdose.
People who overdose may exhibit the following signs:[9]
You can overdose while taking a dose that seems safe. You can also overdose on drugs you obtain from a pharmacy.
Medication for Addiction Treatment (MAT) programs are designed to alter the chemical imbalances that make quitting codeine so difficult.
Medications like Suboxone (buprenorphine/naloxone) are weak opioid agonists that link to the same receptors used by codeine. These medications won't make you feel high, but they can help to block severe drug cravings and withdrawal symptoms. Using them can give you a clear head, so you can build a healthy life without drugs.
The goal of MAT is to help re-establish the ability to live a self-directed life.[10] If you're struggling to quit codeine, these therapies could offer the help you need.
Bicycle Health uses telemedicine techniques to deliver MAT where you are right now. Talk with a doctor via a video chat, and pick up your medications at your pharmacy. You’ll then stay in touch with your doctor and a caring team of professionals, and start living the life you always wanted.
Contact us to find out if this program is right for you. You don’t have to wait another day to get started on your journey to a better life.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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