Codeine Addiction & Abuse
Codeine is an opioid medication, and opioids, in general, are misused by around 10 million people in the United States each year.1,2 In Nevada, prescription opioids were involved in 235 overdose deaths in 2018, which made up the majority of opioid overdose deaths of all types, including deaths from heroin. 3 The number of people misusing codeine cough syrup is not as easy to determine, but a recent survey indicated that 4.6% of adolescents had used cough syrup inappropriately nationwide.4 The purpose of this page is to educate readers on codeine and codeine addiction, as well as how to access help in Nevada or nationwide.
What is Codeine?
Codeine is classified as a Schedule II drug by the Drug Enforcement Administration (DEA), which means it has legitimate medical uses, but it does have some potential for abuse. Codeine is extracted from the opioid poppy plant, and is found in prescription painkillers, antidiarrheal medications, and cough suppressants. Codeine is sold in over-the-counter cough syrups as well.1
The term “sipping lean,” or just the term “lean,” are colloquial names for a common way to abuse codeine. Sipping lean refers to the practice of mixing codeine cough syrups with soda or juice and using this combination to get high. Lean is sometimes also called sizzurp. The practice of sippling lean was popularized in the 1990s, especially through rap songs. This practice is especially popular among adolescents, and even though cough syrup is sold over-the-counter, it is dangerous when misused and overdoses and deaths can and do occur when people misuse them.4
Codeine, like all opioids, has certain short and long-term side effects. These include the risk of overdose, as well as:5
- Stomach pain.
- Nausea and/or vomiting.
- Feeling dizzy.
If you take codeine for a long period of time, you can become physically dependent on it, which means you will experience symptoms of physical withdrawal if you suddenly stop taking the drug. You are also likely to develop a tolerance to it, which means that your body gets used to the effects of codeine and you have to keep taking more and more of it to continue to get the same effects from it. Over time, you can also become addicted, which means you take codeine compulsively, and find yourself unable to control your use of codeine.6 You may wonder how long it takes to get addicted to codeine. Addiction occurs differently in everyone, but it can happen more quickly than you expect. It is also important to be aware that codeine, like all opioids, can lead to serious consequences, including severe and chronic constipation.7 Other long-term side effects that can occur from using codeine include:8
- Constriction of blood vessels in the eye, which can lead to vision problems.
- Sexual dysfunction in men.
- Irregular periods in women.
- Vision issues due to the constriction of blood vessels in the eye.
- HIV or hepatitis if you inject codeine.
Codeine can also have other negative outcomes for your physical health, which can include: 9
- Problems with sleep.
- Weak bones.
- More sensitivity to pain.
- Higher risk of falling and suffering a fracture.
Signs & Symptoms of Codeine Addiction
You may be worried that you or a loved one have an addiction to codeine. You may even wonder if you can die of codeine addiction. While only a trained professional can determine that you have a substance use disorder after completing a thorough assessment, there are behavioral signs and physical symptoms, which include:8
- An inability to fulfill your roles at home or work.
- Engaging in high-risk behaviors, like driving, while you are using codeine.
- Arguing with loved ones about your codeine use.
- Choosing to use codeine rather than pursue your normal interests, like playing sports or socializing with friends.
- Continuing to use codeine even though you want to stop or cut back.
- Spending a lot of time obtaining codeine and using it.
- Using codeine even though you know it is making you physically, depressed, or anxious.
- Craving codeine.
- Needing to have codeine to feel “normal” physically, which indicates you are dependent on it.
If you are dependent on codeine and you abruptly stop using it, you will have physical withdrawal symptoms. These vary from one person to another, but typically, you will experience:9, 10
- Nausea and vomiting.
- Rapid or irregular heartbeat.
- Muscle and/or bone pain.
- Excessive sweating.
- Hot and cold flashes.
- Dental pain.
How to Treat Codeine Abuse
When you go through opioid withdrawal, whether it is from codeine or another opioid, your treatment can take on several forms. There are numerous settings available for codeine abuse treatment, and primarily, these are inpatient or outpatient programs. An inpatient program, where you live in a treatment facility, may be necessary if you have any other substance use issues, such as alcoholism or a benzodiazepine (i.e., Xanax or Valium) addiction. Also, if you have any underlying medical conditions, or you have a mental health diagnosis, such as depression or suicidal thoughts, you may need to be in an inpatient program. 10 Some people can complete codeine abuse treatment on an outpatient basis, but this depends on many factors. If you are otherwise healthy, have not had previous failed attempts at outpatient rehab, have a strong support system at home, and have no other substance abuse issues, you may be able to complete treatment on an outpatient basis. However, the only way to know this for certain is to complete a thorough evaluation with a substance use provider. Outpatient treatment typically involves going to treatment 2 to 3 hours per day, 2 to 3 times per week.
The first stage of treatment for codeine abuse is detox, which is the process of getting codeine safely out of your body while monitoring you for any complications. In addition, detox can help you manage your withdrawal symptoms, which can be highly unpleasant. Severe outcomes from codeine withdrawal are relatively rare, but you should never attempt codeine detox at home without medical supervision. A detox program will help you manage your symptoms and may use various types of medication to do this to make your codeine detox as easy as possible. After detox, you need ongoing treatment because detox is not treatment. Treatment after detox will help you understand why you began using codeine and how to prevent relapse going forward.10
Finding Help for Codeine Abuse
American Addiction Centers offers codeine rehab at several locations across the United States, including in Las Vegas, Nevada. At American Addiction Centers, you will find compassionate and caring staff who will work with you to develop an individualized treatment plan tailored to your needs for codeine abuse recovery. Call our 24/7 helpline today @ 702-800-2682. It is free and confidential to call us and talk about your codeine abuse treatment options. Let American Addiction Centers help you start today on your journey to recovery.
- National Library of Medicine.
- Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States.
- National Institute on Drug Abuse. (2020). Nevada: Opioid-involved overdose deaths and related harms.
- National Institute on Drug Abuse. (2020). Cough and cold medicines.
- University of Michigan. (2021).
- National Institute on Drug Abuse. (2017). Tolerance, dependence, addiction. What’s the difference?
- Tuteja, A. K., Biskupiak, J., Stoddard, G. J., & Lipman, A. G. (2010). Opioid-induced bowel disorders and narcotic bowel syndrome in patients with chronic non-cancer pain.Neurogastroenterology & Motility, 22(4), 424-496.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Pub.
- Baldini, A., Von Korff, M., & Lin, E. H. (2012). A review of potential adverse effects of long-term opioid therapy: A practitioner’s guide. The Primary Care Companion for CNS Disorders, 14(3).
- Substance Abuse and Mental Health Services Administration. (2015). Detoxification and substance abuse treatment.
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