Whether intentional or accidental, an opioid overdose can be dangerous or even life-threatening.
Although codeine is typically considered less severe than some other opioid pain relievers, overdosing on it can be just as serious.
Knowing the signs and symptoms of a codeine overdose and what to do if you suspect one can save your life or the life of someone you love. There are steps that you can take even if you do not have immediate access to naloxone, the overdose-reversing drug, and we cover all of them in this article.
What is Codeine?
Codeine is a pain medication that is also frequently used to treat a cough. It is typically prescribed to provide short-term pain relief for an individual suffering from mild to moderate pain and shouldn’t be prescribed for chronic pain.
Most of the time, codeine can be found in cold and flu medications, as well as cough suppressants. These medications typically include analgesics combined with either codeine or dihydrocodeine.
This substance may also be known as ‘codeine phosphate’ and is derived from morphine. Despite this, it is much less potent and considered a lot safer than its source. When you take codeine as instructed, the risk of respiratory depression is much lower than with other opioids.
As with any other opioid pain reliever, you should be extra sure to take it exactly as instructed by your healthcare professional. Also, similar to other opioids, this drug carries a risk of causing tolerance or dependence on codeine. For this reason, any medication containing this substance should come with a warning label, making you aware of this risk.
Over-the-Counter Medications That Contain Codeine
Codeine used to be available in the form of various over-the-counter pain and cough medications, but this is no longer the case. This medication is now available only by prescription in several forms—independently or in combination with acetaminophen or aspirin.
The reason for this is simple—even though codeine is considered to be safer than most other opioids, it is still an opioid. This means that its use can still be associated with the risk of misuse, abuse, and potential codeine overdose.
As of April 20th, 2017, the Food and Drug Administration placed restrictions on who can be prescribed codeine. It put its strongest warning against any child under the age of 12 taking codeine in any instance.
In fact, they recommend that no one under the age of 18 be prescribed this substance, but in some cases, it can be prescribed to teens between the ages of 12 and 18. It is also not recommended for pregnant women or breastfeeding mothers.
Effects of Codeine
All medications can come with their own set of side effects, and codeine is no exception to this.
When taking codeine, you may experience the intended effects, like pain relief or a suppressed cough. But, in addition to that, you may also experience some of the following uncomfortable side effects:
- Abdominal discomfort
- Pinpoint pupils
- Loss of consciousness or extreme fatigue
- Decreased respiratory rate
- Decreased heart rate
- Decreased blood pressure
- Loss of memory
- Dry mouth
- Excessive sweating
All of the symptoms above are commonly experienced even when codeine is used as intended for a short period of time. However, codeine abuse and prolonged use can lead to a whole new set of side effects that are likely to be much more severe. The difference is that these side effects don’t go away when you stop using.
Codeine addiction can result in serious, long-term damage to your mind and body for years after use. The issues you may experience as a codeine addict include:
- Insomnia/Difficulty sleeping
- Blurred vision
- Dangerous blockages or ruptures in the intestines
- Memory loss
- Long-term organ damage
- Brain damage due to reduced respiratory rates and oxygen levels
- Cognitive difficulties
How Long Do Codeine Effects Last?
The length of time that codeine side effects can last can vary greatly, anywhere from a few hours to years after your last use. There are several determining factors when it comes to this, the most significant one being whether codeine has been used as instructed or abused.
As mentioned above, codeine abuse can lead to long-term damage to your entire body. But when taken as prescribed by your physician, it is far less likely to cause lasting side effects. Still, you will likely experience some short-term side effects.
When used as directed, codeine’s effects typically last for up to four hours. However, the drug can still be found in your system for up to 21 hours after the last use in your saliva, 48 hours after the last use in your urine, and ten weeks after the last use in your hair.
In addition to the type of test used to detect the presence of codeine in your system, the length of time that it remains in your system can also depend on:
- Fluid intake
- Kidney or liver impairment
What is Codeine Abuse?
For the most part, prescription-strength codeine is considered to be safe and tolerable. However, it should always be taken exactly as prescribed or indicated on the bottle. This medication poses the most significant risk when used or abused in high doses.
Because this drug is available in both liquid and tablet form, there are several ways that it can be abused, including:
- Taking codeine that has been prescribed to someone else
- Taking it at a dose or frequency other than that prescribed by your physician
- Taking it in combination with alcohol or other drugs
- Combining codeine with soda (also known as ‘lean’ or ‘purple drank’)
- Crushing codeine tablets, combining them with water, and injecting them intravenously or intramuscularly
- Crushing and snorting codeine tablets
Continuously abusing codeine in any of its forms puts you at increased risk of developing an addiction.
As with most opioids, the intended effects (such as pain relief) are often accompanied by a variety of other side effects, like euphoria and relaxation. These effects trigger the brain’s reward system, encouraging repeat use.
Continued use will lead to your body developing tolerance and dependency, making it increasingly challenging to stop taking the substance. One sign that you or someone you love has become addicted to codeine is experiencing withdrawal symptoms with any attempt to detox.
In the majority of cases, people begin taking codeine to help ease their physical and emotional pain. They may think that this is harmless initially, but over time, prolonged use of this drug can cause respiratory failure, coma, and even death.
The signs and symptoms of codeine addiction can be different for everyone, depending on how long they have been abusing the drug, what dosage they’re taking, and how often they’re taking it. But, below, you can find the signs and symptoms most commonly associated with an addiction to codeine.
- Mood swings
- Withdrawing from loved ones or social situations
- Visiting several different doctors to get more prescriptions for codeine
- Frequent visits to the emergency room for pain or faking illness
- Financial difficulties
- Legal issues
- Relationship issues
- Poor performance at work and school
In some instances, codeine is not the only drug being abused. It is not uncommon for it to be a gateway drug to other opioids that are potentially more dangerous, like morphine or oxycodone.
Codeine Overdose Symptoms
Almost 50,000 deaths occurred in 2019 due to opioid-related overdoses, including codeine. Although it is frequently referred to as a less dangerous opioid, a codeine overdose is possible and especially likely when you take a dose higher than recommended by your physician. This can happen intentionally or accidentally.
There are several signs and symptoms that can help determine if someone is experiencing a codeine overdose. These might include:
- Reduced heart rate
- Blueish lips and fingernails
- Muscle weakness
- Decreased circulation
- Shortness of breath
- Decreased blood pressure
- Extreme fatigue
- Loss of consciousness
- Severe itching
- Slurred speech
If you think that you or someone you know has overdosed on codeine, it is crucial to seek emergency medical attention immediately. If naloxone is readily available, it can be given as a codeine overdose treatment and help reverse an overdose when administered soon enough.
If you think that you may have accidentally overdosed on codeine but you are not yet experiencing any life-threatening symptoms, you can contact the national toll-free Poison Control help hotline to talk with experts in poisoning. They will be able to give you instructions on what to do next in order to avoid a codeine overdose death.
Codeine Withdrawal Symptoms
After prolonged use of any opioid, including codeine, your body can develop a tolerance and even a dependence upon the drug. Once that happens, it will be extremely difficult and uncomfortable for you to come off of the substance.
This uncomfortable phenomenon that you experience when your body detoxes from the drug that it has become dependent on is known as withdrawal.
Although withdrawal is rarely fatal, the symptoms can still be quite extreme. It is in your best interest to seek medical assistance when you are planning to stop using an opioid, as your physician can help you with minimal discomfort.
The symptoms of withdrawal from codeine can include:
- Dilated pupils
- Abdominal discomfort
- Diarrhea, nausea, or vomiting
- Body aches/muscle cramps
- Extreme fatigue
- Excessive sweating
- Flu symptoms
- Strong cravings for the drug
There is no one specific length of time that codeine withdrawal is expected to last—it can vary from person to person. The general rule of thumb is that the longer you have been abusing codeine, the more challenging and uncomfortable the withdrawal process will be.
Some additional factors that can influence the length that your withdrawal lasts can include:
- Medical conditions
- Mental health
- Social support system
- Whether you have tapered off the drug or stopped using it abruptly
Typically, the worst symptoms will be over by day 7 of being drug-free. Although there may still be some lingering ones beyond this point, they are likely to be milder and much more tolerable.
ANR Opioid Dependence Treatment
If you or someone you love is struggling with codeine addiction or trying to break free from the cycle of withdrawal and relapse, the ANR Clinic has the solution that you have been looking for.
Dr. Andre Waismann has developed Accelerated Neuro-Regulation (ANR) to treat the biological root of addiction with modern technology. He has used this method to help over 24,000 people overcome their dependency without struggling with cravings or symptoms of withdrawal.
This is achieved by modulating and regulating the brain’s endorphin and opioid receptor levels and returning your brain to its pre-addiction state. The entire treatment typically requires only a 36-hour hospital stay, during which the patient is closely monitored, and a few post-discharge follow-up visits.
Get started today to help us achieve our goal of putting an end to the opioid epidemic and to help yourself return to a life of normalcy. We are ready to help you be your best self and live a fulfilling life—check out how ANR has helped so many others overcome their opioid dependency.
Although society views codeine as less potent and dangerous than most other opioids, that does not make your addiction any less serious. This is not a situation that you should have to navigate on your own, because addiction and dependence can occur even when the drug has been used exactly as directed. Here at the ANR clinic, we can even help you avoid the uncomfortable experience of withdrawal. Put an end to the vicious cycle of codeine addiction, withdrawal, relapse, and potential codeine overdose today by setting up your consultation. You will take back control of your life and conquer your substance use disorder in as little as a few days!