Codeine is an opioid medication that is used to treat moderate to severe pain or cough symptoms. Codeine works by stimulating opioid receptors in the brain, slowing certain nerve signals that can create pain or a need to cough. The side effects that codeine can cause are almost always a result of the slowing of nerve signals that occurs when codeine interacts with opioid receptors.

When codeine interacts with opioid receptors in the brain, it also causes the release of chemicals called endorphins. These chemicals cause a sensation of pleasure when they are released into the brain and can lead to a euphoric sensation called a high. Because of the high that codeine can create, some people may use codeine to obtain a high, rather than to treat the medical problem for which it was prescribed. This use can lead to cravings for codeine and create a codeine addiction.

How Addictive is Codeine?

Codeine is an opioid, and opioids are known to be highly addictive. Someone who takes codeine for more than three days is at risk of developing an addiction to the drug. It is recommended that doctors avoid prescribing more than a seven-day supply of codeine to help reduce the risk of addiction for their patients. The longer that someone takes codeine, and the more that they take, the higher the risk of addiction. While three days is the recommended maximum, it is still possible that codeine that is taken in smaller doses for less than three days may create an addiction.

Short-Term Codeine Side Effects

There are several side effects of codeine that may develop after a single dose of codeine. Codeine can cause physical and behavioral side effects as it slows nerve signals in the brain.

Physical Side Effects

The short-term physical side effects of codeine occur because of the changes in the neurological system that codeine causes. These include:

  • Drowsiness
  • Itching
  • Constricted pupils
  • Nausea
  • Vomiting
  • Constipation
  • Decreased breathing

Short-term physical side effects can be dangerous or deadly if too much codeine is used. Physical symptoms of an overdose include having very decreased or absent breathing, being very difficult or impossible to wake and death.

Behavioral Side Effects

Short-term behavioral side effects are related to how codeine suppresses signals in the brain and are caused by chemical changes, as opposed to psychological changes. Short-term behavioral side effects of codeine include :

  • Slurred speech
  • Decreased responsiveness
  • Sleepiness during activities or conversations
  • Confusion

These behavioral symptoms are more common with those who have taken a large dose of codeine or are taking other medications or alcohol with codeine.

How Codeine is Abused

Codeine abuse can occur when someone is prescribed codeine to treat pain, but it is more common with cough medications containing codeine. These cough medications may contain codeine along with another drug and may be easier to obtain than pain medications containing codeine. While codeine is mainly ingested, those seeking a high from codeine may also snort it or attempt to inject it. However, that method is uncommon, as codeine is weaker that many other opioids. Those who are seeking a stronger high will take a stronger, more dangerous opioid instead of using a riskier way of taking codeine.

Codeine Abuse Facts and Statistics

Codeine abuse statistics show us that over 2.8 million people misused codeine in 2017.  While the opioid epidemic and statistics relating to the epidemic have been thoroughly studied, codeine abuse facts, specifically, have not been as well studied. This result is likely because codeine is not as strong as other opioids and is not as likely to be used in a fatal overdose. More of the attention is given to stronger opioids such as morphine or heroin, and specific codeine statistics are not as readily available.

  • Prevalence in Men – Statistics show that men are more likely than women to overdose on prescription opioids, such as codeine.
  • Prevalence in Women – While women are less likely to overdose on prescription opioids, they are more likely than men to misuse them or take them differently from how they were prescribed.
  • Teen Abuse –  3.6% of teenagers between 12 and 17 years old report misusing an opioid. While hard statistics are not available, codeine is easier to obtain than many of the other opioids and it is likely that codeine is one of the more commonly misused opioids among teenagers.
  • Senior Abuse – Senior drug abuse has been rising, and 12% to 15% of seniors are misusing prescription drugs.

How to Address Codeine Addiction

Those who have developed an addiction to codeine will often want to stop using codeine. Codeine addiction can lead to the use of more dangerous opioids or other hard drugs. It can also lead to an increased risk of overdose and disrupt many aspects of normal life. Fortunately, for those with an addiction to codeine, treatment is often very helpful and can lead to a complete recovery. There are several different types of treatment that can help someone with codeine addiction.

  • Detox

    Detox is the process of stopping drug use and having it clear from the bloodstream. Codeine detox is not dangerous, but will create several unpleasant withdrawal symptoms that may make it difficult to stop using codeine. While detox can be done at home, it is recommended that people use a detox facility where the symptoms can be treated as they occur. This will help the detox to be more likely to be successful.

  • Residential

    Residential treatment involves checking into a rehab center and receiving treatment. Treatment will start with detox, but will primarily involve learning how to maintain sobriety once detox completes.

  • Outpatient

    Outpatient treatment involves similar treatment to rehab, but does not require checking in to a facility. Outpatient treatment involves multiple doctor or therapy appointments, but allows clients to maintain their normal schedule outside of treatment. Outpatient treatment is best for those who are not likely to have strong withdrawal symptoms and are seeking codeine addiction treatment for the first time.

  • Dual Diagnosis

    Dual diagnosis, also called co-occurring disorders, is when someone has both a substance use disorder and a mental illness that require treatment. Both conditions will make the other worse, and someone with dual diagnosis will require more specialized treatment involving treatment of codeine addiction and mental health condition at the same time.

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Key Points: Understanding Codeine Side Effects and Addiction

Keep the following key points in mind when considering codeine side effects and addiction:

  • Codeine is an addictive opioid pain medication
  • Short-term side effects are caused by the slowing of nerve signals that codeine causes
  • Long-term side effects can include dependence and addiction
  • Codeine is a common “gateway drug” that leads to the use of stronger drugs
  • There are several different treatment options for overcoming a codeine addiction

Contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how professional addiction treatment can put you on the path to a healthier future.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.