Codeine often seems like a common part of modern, everyday life. Consider this: In a study in the journal Pediatrics, researchers found than 2.9 percent of emergency department visits in people ranging from age 3 to 17 in 2010 resulted in a prescription for codeine.
That comes even though national guidelines suggest that codeine shouldn’t be used in young people.
When people think about pain relief, they may think about codeine, and sometimes, people think about codeine when they think about addiction. While abuse of codeine can come with some very serious consequences, it doesn’t have to be a permanent part of an addicted person’s life. With the right kind of help at the right time, people can overcome their codeine concerns.
A Codeine Profile
Codeine is a natural drug that’s synthesized from ingredients harvested in poppy plants. Those ingredients are molded and shaped in laboratories until they’re packaged in pills and syrups that can be sold in pharmacies.
Typically, codeine is used for pain control. The drug doesn’t seem capable of actually reducing a signal of pain, but it can help to make other brain cells associated with pleasure move into overdrive. That means a dose of codeine can distract the brain with happiness, so signals of pain that are still present are also easier to ignore.
While codeine works this way in every person who takes the drug, the speed and the power of each dose can vary from person to person, says the Australian Prescriber. Each dose must go through a series of complicated chemical reactions that transform codeine into a chemical the brain can recognize. Some people seem capable of making those transformations very quickly, and they can use up an entire dose of codeine very fast. Others don’t have the same kind of uptake capabilities, so the drug doesn’t work as well for them.
In general, codeine isn’t considered the most powerful painkiller available. It does seem to boost signals of euphoria, but there are other drugs out there that pack a bigger punch and that deliver sensations that last just a little bit longer.
A Growing Addiction
Since codeine isn’t the most powerful painkiller out there, it’s reasonable to wonder how dangerous it really is. Don’t people naturally look for the drug that has the greatest capacity to bring happiness about?
The research suggests something different. For example, in a study in the International Journal of Drug Policy, researchers found that codeine abusers appreciate the substance simply because it’s easy to get. They could visit medicine cabinets owned by family members and get a drug supply, or they could visit doctors and feign just a few symptoms to get the drugs they wanted. It may not be hard for them to get the drug, and that can make it an appealing substance to abuse.
While it’s easy to abuse, codeine isn’t an easy drug to be addicted to. People who are addicted to codeine often must go to great lengths to avoid feeling ill. When an addiction is in play, the body becomes accustomed to around-the-clock access to the drug, and without that, people can feel flu-like symptoms. One man, as profiled by The Daily Mail, became so addicted to his codeine pills that he felt the need to take doses in the middle of the night. At one point, he was taking five times the recommended safe limit for codeine, just because he felt so sick when he tapered his dose that he didn’t feel it was safe to skip his pills.
People who abuse codeine often develop an addiction slowly. They might begin the process by taking the medication as recommended, but they might begin to cheat those instructions by taking doses too close together or taking too many pills all at once. Those who have valid prescriptions might have addictions that are hard to spot, as their use might not seem dangerous. On the surface, it might seem as though these people are simply following instructions from their doctors. GINAD suggests that people with codeine addictions often develop recognizable physical symptoms, including:
- Dry mouth
- Itchy skin
- Lack of sex drive
People with a prescription might have all of these symptoms in addition to the need to refill prescriptions more frequently than they should. These people might also shop for new doctors or visit the emergency room on a regular basis, so they can get more drugs.
Those without a prescription might have these same physical signs, but they might also seem desperate for money. Codeine products are available from street dealers, but the cost of these products can be staggering. For example, The Partnership for Drug-Free Kids suggests that one bottle of cough syrup containing codeine can cost $200 from street dealers. People with addictions might shell out huge amounts of money for the drugs they believe they need.
Often, painkillers are prime targets of abuse by people who already have a demonstrated history of addiction to some other substance. For people like this, abusing a substance that’s meant to help is just part of life, and they transition to codeine abuse with relative ease. The real danger, when it comes to codeine, is that it seems to appeal to everyone, including people who have no documented drug abuse history.
In a study of the issue, published in the Medical Journal of Australia, researchers found that many people who abused codeine products had no history of prior drug abuse. These people weren’t transitioning from another drug to codeine, and they weren’t adding codeine to another drug they often took. They had no history of abuse, and presumably, they came to addiction via prescriptions that just spun out of control.
An addiction to codeine is incredibly serious, and it comes with some staggering consequences. People with these addictions struggle to keep their families together, and they find dealing with everyday life exceedingly difficult. They’re exclusively focused on the drug, hoping to get more and trying to take more, and they can’t think about anything else. The social consequences of these addictions can be dire.
There are physical consequences, too, as codeine is often packaged in pills that also contain acetaminophen. This ingredient is meant to kill pain signals, and it’s processed by the liver. At very high doses, acetaminophen can kill off liver cells, making people feel incredibly ill. At very high doses, the damage done to the liver can’t be reversed.
Codeine itself can also be dangerous, as it can suppress breathing rates. People who take high doses may feel sleepy and calm, and in time, they may seem to drift away into a cloud of relaxation. If that continues, their breathing rates can continue to slow and slow until they’re not breathing quickly enough to keep vital tissues alive. Brain cells can shut down, blood can clot, and lungs can clog. All of those symptoms can lead to death.
Any painkiller in the opiate class can cause this kind of overdose. It’s not a problem that’s exclusive to codeine, but codeine comes with special risks due to its unusual metabolism rate. Since some people process the drug very quickly, they can overdose at rates that might seem appropriate or normal to other people, say researchers writing in CMAJ. That could be a hidden problem until people hit on the right dose and overwhelm their bodies.
Help for Codeine Addictions
Codeine is one of the oldest drugs still available in pharmacies, and researchers have spent decades studying how it works and what it does. That’s a boon for people with addictions, as it means researchers know a lot about how to help people with codeine addictions.
Since people feel so ill and sick without a codeine dose, clinicians use medications that act on codeine receptors. When these medications are in place, people can get sober without feeling flu-like symptoms. They might feel slightly queasy or uncomfortable, but they won’t feel sick enough to consider a return to codeine use.
At Michael’s House, we know that codeine recovery is possible. Why? Because we’ve helped hundreds of people to start new healthy lives in recovery. We’d like to help you. Please call to find out more about our programs. We’re here to help.