Prescription drug abuse is on the rise in the United States. According to the American Society of Addiction Medicine, 20.5 million Americans had a substance use disorder in 2015, and two million of those people had a substance use disorder involving a prescription pain reliever, such as codeine.
Codeine is one of the most widely abused drugs among young people because it’s relatively easy to access and it causes a desirable euphoric feeling. Additionally, codeine has been highly publicized in pop culture over the past several years, leading young adults to see codeine misuse as “cool.”
Using codeine to get high is often referred to as leaning on syrup. When used recreationally, it’s most often mixed with soda in what’s known as sizzurp or syrup. Other street names for codeine include lean or purple drank (Codeine and Promethazine Cough Syrup), Cody, schoolboy, and T-three’s (Tylenol #3 with codeine).
Codeine is found in prescription-strength cough syrups or in combination formulations with over-the-counter analgesics, such as acetaminophen (Tylenol No.3). It’s also available in the form of caplets and tablets. Codeine is most commonly used for pain relief and for cough suppression. The effects of codeine are short-term and last approximately four to six hours.
As a schedule II drug, codeine has a high potential for abuse, which may lead to severe psychological or physical dependence. When combined with other drugs, such as Tylenol, codeine is considered a schedule III drug.
Codeine has a relatively short elimination half-life, which refers to how long it takes for half of a single dose of a drug to leave the body. The half-life of codeine is around three to four hours, which means that an entire dose of codeine will normally leave your system in approximately 16 hours or less.
With that being said, various metabolites of codeine, such as morphine-3-glucuronide and codeine-6-glucuronide, have a longer half-life than codeine itself. This means that it may take up to 24 hours to completely clear codeine and its metabolites from your system.
It’s important to understand that how long it takes codeine to leave your system varies from person to person. There are a variety of factors that influence how long codeine stays in your system after your last dose.
Some of these variables include:
- Body mass
- Body fat
- Liver/kidney function
Since codeine belongs to the opioid family of drugs, it can be detected via drug tests – even on standard five-panel drug tests. How long codeine is detectable depends on the type of drug test.
- Urine tests can detect codeinefor 24 to 48 hours.
- Blood tests should be taken within 30 minutes to one hour after the last dose to hit the peak plasma time, however, they can detect codeine for up to 24 hours.
- Hair tests can detect codeine within two to three weeks and for up to 90 days.
- Saliva tests can detect codeine for up to four days.
When used as directed by a doctor, codeine is a relatively safe way to treat minor pain or control coughs. However, codeine is an addictive drug and can be dangerous in high doses. Codeine acts as a depressant to the central nervous system, which leads individuals to experience:
- Feelings of relaxation
- Slowed heart rate
Codeine addiction can sometimes be difficult to detect since many people start by taking codeine under medical supervision and are unaware they’re developing a dependency to the drug. The way codeine use progresses to addiction varies between individuals, but a few key characteristics that many people with a substance use disorder will exhibit include:
- Preoccupation with getting more codeine
- Compulsive usage
If a loved one is exhibiting these behaviors, they may be suffering from a codeine use disorder:
- Being secretive about their activities or whereabouts
- Changes in behavior or social circle
- Lack of energy or motivation
- Making risky decisions when using codeine
- Not being able to stop using codeine
- No longer going to work or fulfilling social obligations, family matters, and other responsibilities
Physical symptoms of codeine abuse or addiction include:
- Loss of appetite.
- Weight loss.
- Nausea and vomiting.
- Less interest in previously enjoyed activities.
- Cold sweats.
- Poor physical coordination.
- Mood swings.
- Changes in sleeping patterns.
Abusing or taking more than the recommended dosage of codeine can lead to overdose. Even a single misuse can be fatal, but those who are suffering from a substance use disorder are even more at risk of overdosing.
The most common cause of death from a codeine overdose is respiratory failure. However, there are several non-fatal consequences of a codeine overdose, including:
- Brain injury
- Liver failure
- Kidney failure
- Pulmonary edema
- Breakdown of skeletal muscles
Symptoms of a codeine overdose include:
- Blueish colored fingernails and lips.
- Slowed, shallowed, or no breathing.
- Cold, clammy skin.
- Loss of consciousness
- Low blood pressure
- Muscle twitches
- Tiny pupils
- Weak pulse
If you see someone experiencing any of the signs of a codeine overdose, call 911 immediately.
If you or someone you know is struggling with a codeine use disorder, it’s easy to feel lost, hopeless, or overwhelmed. There are a variety of treatment options available, including counseling or therapy, medication-assisted therapy, Narcotics Anonymous, outpatient treatment programs, and inpatient treatment programs.
There’s no one-size-fits-all solution when it comes to treatment for codeine addiction, and it comes down to what’s best for you and your situation. Before you choose a treatment plan, it’s often beneficial to reach out to a friend, family member, doctor, therapist, or other trusted individual.
Remember: Even when all hope seems lost, help is available. All you need to do is ask.
How To Taper off Codeine
The Recovery Village aims to improve the quality of life for people struggling with 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 providers.