Codeine is a painkiller derived from morphine. It is used to treat mild to moderate degrees of pain. It is also used as a cough medicine and to treat diarrhoea.
It comes in three forms:
- Tablets (15mg, 30mg or 60mg).
- A liquid that is swallowed (containing 25mg of codeine in each 5ml dose or, as in cough syrup, 15mg per 5ml dose).
- An injection, which is usually only given in hospital.
Codeine is available on prescription. Lower doses can be bought in pharmacies, usually mixed with another painkiller such as paracetamol (co-codamol), ibuprofen or aspirin. Codeine is an opiate, derived from morphine, and like all opioids it can be addictive and that's why it can lead to prescription drug dependence. Due to its addictive properties it can also make it very difficult to detox from Codeine at home, therefore residential rehabilitation is often recommended due to the level of support required.
Codeine is one of the mostly commonly prescribed painkillers and as such access to it is readily available.
Addiction is a disorder of the brain’s reward system where the user is compelled to engage in rewarding behaviours – in this case, taking codeine – despite an awareness of the negative consequences. Over time, repeated exposure to addictive substances changes the levels of certain chemicals in the brain. Higher levels of chemicals such as dopamine drives the affected person to continually recreate the positive feelings that result from higher levels of these chemicals, deepening the addiction in order to prevent a drop in dopamine and negative feelings.
Codeine is addictive as it can produce a feeling of pleasure and a relaxing ‘high’, a rewarding stimulus which addicted individuals are compelled to replicate. Codeine is also physically addictive – long-term users often feel the need to take codeine to avoid withdrawal symptoms.
There are no definite ‘rules’ when it comes to causes of codeine addiction. Despite being in similar circumstances, one person may develop an addiction when another person does not. However, a number of factors that may cause codeine addiction have been identified, such as environment, psychology, genetics and brain chemistry. There has also been great debate about whether trauma triggers addiction.
You can read more about the real 'gateway drugs' in the UK here.
It can be difficult to spot a codeine addiction as those affected often go to great lengths to hide their condition due to the stigma associated with drug abuse and addiction.
However, there are a number of physical and behavioural symptoms that may suggest a codeine addiction.
- Nausea and vomiting
- A blue tinge to lips and fingernails
- Muscle twitches or spasms
- Dizziness and fainting
- A dry mouth
- Itching and rashes
- Difficulty urinating
- Low blood pressure
- Slower breathing
- Clammy hands and feet
- Stomach pain
- Changes in vision
Codeine abuse – and indeed drug abuse of any kind – is different to codeine addiction. Addiction means the user has a strong urge to take codeine, regardless of the consequences. However, drug abuse is often the first step on the road to addiction.
Codeine abuse can make it difficult for people to handle their usual responsibilities at work and at home. It may also lead people to behave in a way they wouldn’t usually and develop physical side effects.
Codeine addiction develops once someone becomes more tolerant of the drug, needing to take more to achieve the same results and/or suffering from withdrawal symptoms without codeine. Addiction also means that, despite understanding that codeine has harmful effects, the person continues to take it.