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Lee Spinks

Written by:

Lee Spinks

Dr Mateen Durrani – MBBS, DPM, MSc, BCPsych

Medically Reviewed by:

Dr Mateen Durrani – MBBS, DPM, MSc, BCPsych

Last Updated:

January 2nd, 2025

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Codeine addiction

The opioid crisis, a global health catastrophe, has claimed countless lives and caused insurmountable pain. Opioid addiction, while not as widespread in the UK as in the US, is still a pressing issue, with opioids such as codeine causing a significant portion of the problem. Codeine addiction can lead to serious physical, emotional and societal effects. While overcoming codeine addiction may seem like a colossal challenge, professional help is available if you are ready to change your life.

Codeine pill tablet box

  • Page Content
  • What is codeine?
  • What is codeine addiction?
  • Am I addicted to codeine?
  • What causes codeine addiction?
  • What are the health effects of codeine?
  • What are the signs of codeine overdose?
  • How does codeine addiction affect your life?
  • What does codeine addiction recovery involve?
  • How to get help for codeine addiction
  • Frequently asked questions

What is codeine?

Codeine is a prescription opioid medication typically used to manage mild to moderate pain and cough. It is available in various forms, including tablets, liquids and as a part of combination medications. Codeine acts on the brain’s opioid receptors, reducing pain perception and inducing relaxation and euphoria. However, these desirable effects make codeine a target for abuse, with people often exceeding prescribed doses or using it recreationally. Codeine is a Class B drug in the UK, meaning it is illegal to sell or possess it without a prescription.

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    What is codeine addiction?

    Codeine addiction is a type of prescription drug addiction characterised by an inability to control codeine use, leading to harmful consequences. Let’s examine three fictional characters who develop codeine addiction through different pathways:

    Codeine addiction through recreational use

    Samantha is a diligent university student who initially turns to codeine as a recreational escape from academic stress and pressure. Over time, her occasional use becomes a necessity, as she needs to take higher doses to achieve the same effects. Sarah continues using codeine regularly, not for the euphoria but to avoid the withdrawal symptoms that set in when the effects of the drug wear off.

    Codeine addiction through prescription

    David is introduced to codeine following a painful car accident when his doctor prescribes the drug to help manage his pain. David finds the pain relief comforting and the feelings of calm and relaxation a welcome reprieve from the stress of his accident. Over time, however, he develops a tolerance and needs more codeine to get the same pain. Before he knows it, David has developed a dependence on the drug, experiencing withdrawal symptoms when he tries to stop or cut back his use. Even after his physical injuries have healed, he finds himself unable to stop using codeine.

    Codeine addiction through self-medication

    Susan is a middle-aged woman who has been struggling with social anxiety for years and turns to codeine to help her relax in social settings. At first, the codeine provides the relief she desperately seeks, but as her body builds tolerance, she finds herself taking more and more of the drug. Over time, Karen becomes physically and psychologically dependent on codeine, needing it to feel normal and function in her daily life.

    In all these cases, what starts as innocent or necessary use spirals into a full-fledged addiction, highlighting how easily and subtly codeine addiction can take hold. If you see parallels between these stories and your own experience, it is essential to seek professional help.

    Am I addicted to codeine?

    Recognising codeine addiction can be challenging, particularly if you were originally prescribed the medication for a general condition. If you are unsure whether you are addicted to codeine, ask yourself these questions:

    • Do I take codeine in larger amounts or for longer than intended?
    • Have I tried and failed to cut down or control my codeine use?
    • Do I spend a lot of time obtaining, using or recovering from codeine?
    • Is my codeine use affecting my responsibilities at work, school or home?
    • Have I continued using codeine despite it causing problems in my life?
    • Have I given up important social, occupational or recreational activities due to codeine use?
    • Have I developed a tolerance, needing more codeine to achieve the desired effect?
    • Do I experience withdrawal symptoms when I try to stop using codeine?

    If you answered ‘yes’ to several of these questions, they are likely to indicate codeine addiction signs.

    What causes codeine addiction?

    Codeine addiction is multifactorial, with several risk factors increasing your chances:

    • Genetic predisposition: Those with a family history of substance abuse are more likely to abuse or misuse codeine and go on to develop a codeine addiction.
    • Mental health conditions: People with anxiety, depression, or other mental health disorders are more prone to self-medicate with drugs like codeine.
    • Environment: Peer pressure, family influence, and socioeconomic status can contribute to codeine misuse and resulting codeine addiction.
    • Chronic pain: People with chronic pain conditions may overuse their prescription, leading to codeine addiction.
    • Age: Younger individuals are more likely to experiment with drugs like codeine, potentially leading to addiction.
    • Lack of knowledge: Misunderstanding the addictive nature of codeine can lead to misuse and an increased risk of codeine addiction.
    • Access and availability: Easy access to codeine can facilitate misuse and increase the risk of codeine addiction.

    What are the health effects of codeine?

    Codeine has a wide range of physical and psychological effects that can severely impact your health, particularly with prolonged or excessive use.

    Here are some of the health effects associated with codeine addiction:

    • Respiratory distress: Codeine impacts the central nervous system and can slow breathing, leading to hypoxia (insufficient oxygen reaching the brain). Hypoxia can have both short- and long-term mental and neurological effects, including coma and permanent brain damage. In severe cases, respiratory distress can escalate to respiratory failure, a life-threatening condition that requires immediate medical intervention.
    • Constipation: Codeine often causes gastrointestinal issues, one of the most common being constipation. Over time, this can lead to more serious problems, such as bowel obstruction or faecal impaction.
    • Mental health issues: Regular use of codeine can have significant psychological effects, including heightened feelings of anxiety and episodes of depression as well as severe mood swings, which can strain personal relationships and affect professional commitments.
    • Liver damage: Codeine is often combined with other medications, such as paracetamol (also known as acetaminophen). When taken in large quantities, paracetamol can cause liver damage, leading to potentially life-threatening conditions such as liver failure. This damage can be gradual and silent, only becoming apparent when the condition is advanced.
    • Sleep problems: Codeine can disrupt normal sleep patterns, leading to problems such as insomnia or disturbed, unrestful sleep. This lack of quality sleep can result in chronic fatigue, poor concentration and other health issues over time.
    • Impaired cognitive function: Long-term codeine use can impact cognitive function, leading to difficulties with concentration, decision making and memory.
      Weakened immune system: Some research suggests that opioids like codeine can weaken the immune system, making individuals more susceptible to infections.

    What are the signs of codeine overdose?

    A codeine overdose is a serious and potentially fatal condition that requires immediate medical attention. Overdose can occur when a person intentionally or accidentally takes more than the recommended dose of codeine.

    Symptoms of codeine overdose can vary in intensity depending on the amount of the drug taken and individual tolerance levels. They typically include:

    • Slow, laboured or irregular breathing
    • Blue lips or fingernails
    • Cold and clammy skin
    • Extreme drowsiness or loss of consciousness
    • Fainting
    • Seizures
    • Pinpoint pupils
    • Nausea or vomiting

    Overdose is a medical emergency that requires immediate professional attention. If you suspect someone has overdosed on codeine, it’s crucial to call emergency services right away. While waiting for help, try to keep the person awake and, if possible, turn them on their side to prevent choking if they vomit.

    How does codeine addiction affect your life?

    Codeine addiction doesn’t just affect your health; it also infiltrates every aspect of your life, leading to a ripple effect of consequences. These can include:

    • Relationship troubles: Codeine addiction can cause you to lie to loved ones about your codeine use or pull away from them to hide your addiction, leading to feelings of isolation. Family and friends may also struggle to understand your codeine addiction, causing further friction.
    • Workplace issues: Codeine addiction can also affect your career and performance at work leading to potential job loss, missed promotions or a tarnished reputation.
    • Legal troubles: Illegal possession or distribution of codeine, driving under the influence or engaging in illegal activities to fund your codeine addiction can lead to arrests, fines or even imprisonment.
    • Financial woes: Maintaining a codeine habit can be expensive, and over time, this can lead to financial strain, including debt, inability to pay bills or meet other financial obligations and even bankruptcy.

    What does codeine addiction recovery involve?

    Codeine addiction treatment begins with detox, where the drug is gradually removed from your system under medical supervision to manage withdrawal symptoms. This is followed by rehab, which includes therapies like cognitive-behavioural therapy, motivational interviewing and group therapy, equipping you with coping mechanisms to prevent relapse.

    How to get help for codeine addiction

    If you’re struggling with codeine addiction, don’t despair. Oasis Runcorn is here to help you. Our expert team will guide you through codeine detox and rehab and provide you with the tools needed to live a codeine-free life. Reach out today, and let us help you start your journey to recovery.

    Frequently asked questions

    How does codeine compare to other opioids?
    Codeine is a weaker opioid compared to drugs like morphine, hydrocodone or oxycodone but it still carries a risk of dependence and addiction, especially with long-term or improper use. It is also worth noting that codeine’s effects can vary significantly among individuals due to differences in how it is metabolised, which can affect both its medical effectiveness and potential for harm.
    Can codeine addiction lead to other forms of opioid/opiate abuse?
    Yes, codeine addiction can potentially lead to the misuse of other, stronger opioids. This is known as the “gateway effect.” As a person develops tolerance to codeine, they may start seeking out more potent opioids to achieve the desired effects, leading to the misuse of drugs like hydrocodone, oxycodone or even heroin. Similarly, if the person is unable to obtain codeine, they might turn to other available opioids to avoid withdrawal symptoms.
    How much codeine is safe per day?
    The safe amount of codeine to take per day depends on the individual’s health, the reason for use, and the form of codeine (whether in prescription medication or over-the-counter preparations). For adults, the typical prescribed dose for pain relief is 15-60 mg every 4-6 hours, with a maximum of 360 mg per day.

    However, it is important never to exceed the prescribed dose, as codeine can be addictive and cause side effects such as drowsiness, constipation, and respiratory depression. Always follow your doctor’s guidance and avoid self-medicating or combining codeine with other substances like alcohol.

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