Codeine is known chemically as 3-methylmorphine. It is a naturally-occurring opioid found in the opium poppy plant and is the second most abundant opioid in opium which is an extract of the latex from the poppy plant. It is a powerful narcotic with many medical uses, and it is also the prototype for weaker opioids such as hydrocodone and oxycodone, and as well has a significant potential for dependence, like many opioids.
Codeine is available in pure form with a prescription. It is a schedule II drug in the United States, so its use is closely regulated. Other preparations of codeine have fewer restrictions on their use, depending on their concentration. The preparations of pure codeine include Contin and Perduretas. Contin contains 100 mg of codeine, and Perduretas contains 50 mg of codeine. Both of these preparations are timed-released tablets, meaning the codeine is metabolized over a period of time. This reduces the potential for abuse since the user does not receive the effects of the codeine all at once. Many preparations also combine codeine with other drugs such as aspirin and paracetamol, especially cough syrups.
Medical Uses for Codeine
The most common medical uses of codeine are the relief of mild to moderate pain suppressing coughs. Doctors may also prescribe codeine for the treatment of diarrhea in cases where traditional drugs such as loperamide, diphenoxylate, and paregoric are ineffective or contraindicated. Additional medical uses of codeine include the suppression of premature labor contractions, relief from itching, and the treatment of myocardial infarctions. Healthcare providers may also administer codeine in a hospital setting as a sedative.
The most common adverse effects are drowsiness and constipation. Less common side effects include the following:
- Urinary retention
Serious side effects such as seizures and respiratory depression are rare in therapeutic doses. The long-term effects of codeine include apathy, diminished libido, and memory loss which are generally common to all opiates. Some people may also be allergic to codeine, causing swelling and rashes.
The euphoric effect of codeine is the primary reason codeine is addictive, an effect generally common to all opiates. This is more likely to occur in doses above the therapeutic level, although therapeutic doses of codeine may also cause dependence with prolonged use. A user will develop a tolerance to the effects of codeine at different rates. For example, a tolerance to euphoric effects occurs relatively quickly while a tolerance to the constipation-inducing effect of codeine develops very slowly.
Respiratory depression is the greatest risk for a codeine abuser. The abuser typically increases the dosage to achieve the desired euphoric effect, which increases the chance of an overdose. Codeine breaks down into morphine when it is metabolized, which means a codeine user can pass morphine to her baby through breast milk.
Withdrawal symptoms occur when a drug user who is dependent upon its effects suddenly stops taking the drug. This is especially likely with opiates such as codeine. The most common withdrawal symptoms of codeine include the following:
- Abdominal cramps
- Muscle spasms
- Runny nose
Long-term users of codeine will typically need to eliminate their dependence on this drug through an addiction treatment program, commonly known as rehab. This generally involves reducing the user’s intake of codeine gradually to minimize the severity of the withdrawal symptoms. The clients in a rehab center undergo the withdrawal process under the supervision of a medical professional to ensure the client’s safety.
People enter the therapy phase of rehabilitation once they are no longer physically dependent on the effects of codeine. The objective of this phase is to prevent the client from using codeine after the end of the treatment program. Counseling, another phase of treatment, is used to find the underlying reason for the addiction. This, among many other phases of recovery, is used to ensure a healthy life after addiction.