Codeine Addiction: Effects, Dangers, and Treatment

Codeine is a prescription opioids painkiller that, while generally safe when taken as prescribed, has a high potential for misuse and addiction.^1,2 Misusing codeine to experience a euphoric “high,”³ increases the potential risks of developing dependence or addiction.⁴ While codeine misuse and addiction can be devastating, evidence-based addiction treatment can lead to positive health outcomes. Understanding what codeine is, how it can cause addiction and other negative health effects, and how to seek addiction treatment can help one in achieving recovery.

What Is Codeine?

Codeine is an opioid that is derived from the seed of the opium plant.⁴ It works by binding to receptors in the brain that modulate pain, leading to feelings of pleasure and pain relief..⁵ Painkilling qualities is a main reason why providers may prescribe codeine for pain related to cancer treatment and palliative care.⁶

Codeine can also suppress cough, which is why it is an ingredient in some prescription cough, allergy, and cold medicines.⁷ In a handful of states, these medications can be dispensed in small amounts by pharmacists without a prescription.⁷ It is important to note that not all cough medicines are the same.

Is Codeine Addictive?

Codeine has a high potential for misuse, dependence and addiction.⁵ Because of its addictive potential, providers typically prescribe codeine for a short time.⁴ The risk of developing an addiction to codeine is greater if a person takes more than prescribed by their provider.⁴

Codeine Side Effects and Risks

Codeine, like all opioids, is a narcotic analgesic (pain killer). In addition to blunting or blocking pain, codeine also can result in sedation and respiratory depression, though it is not usually classified as a CNS depressant.¹²

Short-term effects of codeine use may include:

• Nausea.³
• Constipation.³
• Drowsiness.³
• Slowed breathing.³

Codeine misuse, such as taking it in higher doses or taking codeine you were not prescribed, can result in dangerous health consequences. This is especially true if misused over an extended period of time.³ Misuse of codeine increases the risk of addiction.³ It also increases the risk of overdose, especially if combined with sedatives, such as benzodiazepines, prescription sleep medications, or alcohol.¹³ An opioid overdose can result in brain damage, coma, or death.

Codeine Overdose

In 2020, opioids were involved in more than 50,000 overdose deaths in the U.S.¹⁴ An overdose means that there is more of a substance present in the body than the body is able to handle.¹⁵ If someone misuses codeine, there is an increased risk for an overdose, particularly if taken in larger quantities or when combined with other substances that depress respiratory function (e.g., benzodiazepines, alcohol).¹⁶

Overdose is a medical emergency, and therefore, it is necessary to call 911 when signs of an overdose are present.¹⁶

Codeine Overdose Symptoms

Signs of a codeine overdose can include:¹⁷

• Decreased or loss of consciousness
• Slowed, shallow, or stopped breathing.
• Pale or cold skin.
• Limp body.
• Constricted (i.e., pinpoint) pupils

Codeine Addiction Treatment

Codeine misuse can result in addiction, which is the uncontrollable use of a substance despite significant negative consequences. Codeine addiction is a treatable medical disease.¹⁸ Depending on a person’s needs and the severity of the codeine addiction, different levels of treatment are available.¹⁹ The main levels include medical detoxification (detox), inpatient or residential treatment, and outpatient treatment.^19,20

• Detox: This is generally the first step in the treatment process for someone who is physically dependent on codeine.²⁰ Simply put, detox is the process by which the body rids itself of substances.
• Inpatient or residential treatment: This type of treatment is appropriate for someone who is dealing with severe codeine addiction.¹⁴ It involves residing at the facility 24/7 and includes therapy, group counseling, psychoeducation, and medication treatment.^14,24 Inpatient treatment can occur in a hospital or residential treatment setting at a licensed rehab center.
• Intensive outpatient programs (IOP) involve attending a facility 3-5 times per week for a few hours each time for therapy, group counseling, psychoeducation, and medication treatment.¹⁴ These programs are available for those who need more intensive treatment than a standard outpatient program but who also need to work or attend to responsibilities at home.¹⁴ IOPs can also be for those who are stepping down from inpatient or residential programs.¹⁴
• Outpatient treatment: This type of treatment allows patients to continue to live at home, attend school, or return to work while still receiving care.^{14(“Level 1”)} It can also be used as step-down treatment from inpatient or a more intensive outpatient program. Standard outpatient treatment typically includes meeting with a therapist at least once per week and receiving medication to treat opioid use disorder (OUD).¹⁴

It is not uncommon for those dealing with OUD to also have another mental health condition. In 2016, 62% of American adults who had OUD also had a co-occurring mental health disorder.¹⁸ While this might complicate treatment, both the OUD and mental health disorder can be treated simultaneously with a multidisciplinary team that includes therapists, psychiatrists, and medical providers.¹⁸

Finding Codeine Addiction Treatment

Codeine addiction can develop quickly and may be difficult to overcome without professional support. Whether taken on its own or combined with other substances, long-term use can lead to physical dependence and serious health risks. Fortunately, effective treatment options are available. Many rehab centers offer medical detox, behavioral therapy, and long-term recovery planning tailored to your unique needs. You can find codeine addiction treatment programs near you that provide compassionate, evidence-based care. Don’t wait to seek help. Taking the first step today can lead to a healthier, substance-free future.

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