Codeine is a narcotic or an opioid pain medication. It is most often used to treat pain but can also be used to treat a persistent cough or chronic diarrhea. Codeine is a strong and highly addictive drug, so it should only be taken exactly as prescribed by a doctor. Selling or giving this drug away is illegal.
Although codeine is generally safe when prescribed by a doctor, some people may find its euphoric and pain-relieving effects to be pleasurable, and start abusing it as a result. Others may develop a tolerance to it, and feel the need to take larger or more frequent doses to achieve the same effects. Over time, these behaviors can lead to addiction.
People receive codeine in tablet, liquid, or injection form from a doctor with a prescription, but it is also available in many combination over-the-counter medications that contain lower doses of codeine combined with drugs like aspirin, paracetamol, or ibuprofen.
Many different medicines available in the United States contain codeine, including the following brand names:
- Phenflu CDX
- Phenflu CD
- Maxiflu CD
- Maxiflu CDX
According to SAMHSA’s 2016 National Survey on Drug Use and Health, 18.7 million people (or 6.9 percent of the population) abused prescription drugs like codeine during the past year.
Most people abuse codeine for its pain-relieving and euphoric properties. It is normally only prescribed for short periods of time, but when it is used over a long period of time, a person may develop a tolerance and become addicted.
One a person’s supply is depleted, he or she may attempt to get more codeine by returning to the doctor for another prescription. If that doesn’t work, he or she may resort to illegal methods, such as:
- Stealing another person’s prescription
- Buying prescription codeine from a friend or dealer
- Misusing over-the-counter medications that contain codeine
Codeine abuse can be very dangerous, as this narcotic can severely slow breathing or even stop it completely. When abused in conjunction with alcohol, codeine can also cause serious or deadly side effects.
Although codeine is not as widely abused as other opioids, abuse of this drug often opens the door to opioid addiction involving other harmful substances, such as oxycodone or hydrocodone, which are also highly addictive.
Immediate short-term effects of codeine abuse may include:
- Poor coordination
- Difficulty breathing
- Stomach pain
Long-term effects of codeine abuse may include:
- Uncomfortable withdrawal symptoms (when codeine use is suddenly stopped)
- Increased risk of overdose
Prescription drug abuse is more common among young adults, but many middle-aged or older adults also suffer from prescription opioid use disorders. Common risk factors for prescription drug abuse include:
- Chronic pain
- Younger age (teens or early 20s)
- Past or current substance abuse
- Family history of substance abuse
- Untreated psychiatric disorders
- Social or family environments that encourage misuse of drugs
Even individuals without the above risk factors may become addicted to codeine. If you believe that you or a loved one may be addicted to codeine, the following symptoms may be signs of abuse and/or addiction:
- Getting prescriptions from more than one doctor
- Stealing, selling, or forging fake prescriptions
- Taking higher or more frequent doses than prescribed
- Uncharacteristic mood swings
- Extreme hostility
- Sudden changes in sleeping habits
- Unusual behavior such as extreme excitement, sedation, or talkativeness
- Poor decision-making
Codeine addiction or dependence can be difficult to overcome without medical assistance because the withdrawal symptoms can be very uncomfortable. Medically assisted drug detox programs can provide assistance to overcome addiction and will help clients achieve a stable state of sobriety.
Medically assisted detox is much safer than at-home detox because it provides round-the-clock monitoring and treatment for uncomfortable physical withdrawal symptoms. A detox center can also provide a much more comfortable withdrawal experience because medical staff is trained to recognize and treat the physical symptoms of codeine withdrawal.
Codeine withdrawal may be different for each individual, depending on their personal circumstances and drug abuse history, but withdrawal symptoms typically include:
- Difficulty sleeping
- Muscle aches
- Increased heart rate
- Loss of appetite
A medically assisted drug detox program will focus on treating these symptoms and can help a person withdrawal from codeine in the most comfortable way possible. Full recovery cannot be achieved with detox alone, and any detox program should be followed up with long-term drug rehab.
Codeine withdrawal will vary from person to person, but the worst physical effects typically fade after about a week.
1-4 days after the last dose: Muscle pain, headaches, insomnia, nausea, sweating, diarrhea, and vomiting are common symptoms during the first four days of detox.
5-7 days after the last dose: Most physical symptoms will begin to fade during this time, but psychological symptoms such as depression may begin to occur.
8-30+ days after the last dose: Physical symptoms should have subsided at this point, but individuals may continue to experience depression and cravings for several weeks after codeine detox is complete.
Drug detox is just the first step to overcoming codeine addiction. To achieve long-term recovery from prescription drug abuse and addiction, individuals should enroll in a long-term drug rehab program that consists of behavioral therapy, life skills, relapse prevention, addiction education, and family therapy.
Although addiction treatment outcomes vary depending on individual circumstances, motivation, and level of participation in treatment, the National Institute on Drug Abuse states that long-term drug rehab of 90 days or longer provides the best treatment outcomes.
In drug rehab, clients work with a variety of addiction treatment professionals including licensed counselors, therapists, recovery specialists, and sober peers to work through the values of the 12-step program, adopt effective coping strategies, and learn how to manage triggers and high-risk situations.
A variety of behavioral therapies and evidence-based practices are used in drug rehab to assist individuals who are in addiction recovery. These may vary based on the individual’s needs, but they often include specialized therapies such as:
- Contingency management
- 12-step facilitation therapy
- Music group
- Pet therapy
- Family behavior therapy
- Creative arts therapy
- EMDR therapy
Inpatient Drug Rehab vs. Outpatient Drug Rehab
A person may achieve a full recovery from codeine addiction and abuse with inpatient or outpatient drug rehab. During inpatient rehab, clients required to live on-site at the treatment center while they complete their rehab program. This requires strict adherence to the rehab center’s rules and structured scheduling. Contact with the outside world is somewhat limited, but interaction with family and friends is still allowed. It just must be scheduled.
Outpatient drug rehab consists of a series of group sessions that meet three or more times each week in a secure, clinical location. These group sessions cover the same topics reviewed in an inpatient setting, such as relapse prevention, addiction education, coping skills, and stress management. Outpatient drug rehab may provide more flexibility for clients who cannot commit to 90 days in an inpatient rehab center.
The cost of inpatient or outpatient drug rehab varies depending on the program, the location, and any additional recovery support services the client chooses to enroll in. Many different forms of payment may be used to cover the cost of treatment, such as:
- Medical insurance benefits
- Private loans
- Out-of-pocket payments
- Employee Assistance Programs
Clients may choose to continue their addiction treatment after rehab with the additional support of a sober living or aftercare program. These recovery support services provide varying levels of assistance for individuals who have completed a drug rehab program but would like additional assistance maintaining their sobriety on a long-term basis.
Sober Living Programs
A sober living program serves as a supportive and sober housing option for those who are transitioning from drug rehab to independent life. Transitional living programs are especially beneficial for those who do not have a sober living environment to return to after rehab or who need additional structure to maintain their sobriety.
Sober living residents are required to adhere to the rules and standards set forth by their sober community and they must consistently be working to achieve the requirements of their recovery program.
Sober living houses provide a number of services that are ideal for men and women in recovery. These include:
- Structured daily schedules
- Sober living environment
- Regular drug and alcohol testing
- 12-step program involvement
- Peer support
- Tiered recovery programming (for individuals in various stages of recovery)
- Employment, education, and volunteer assistance
- Family involvement
The cost of a sober living program will vary based on the location, the type of home, and the recovery services offered. Payment is collected from residents on a monthly basis.
Aftercare programs are ideal for alumni who have already completed drug and alcohol rehab and/or a sober living program and would like continued support in their recovery. This type of program provides regular weekly meetings that clients can use as sobriety check-ins. They may also use this time to discuss current issues they are facing in their sobriety.
- Gender-specific treatment
- Evidenced-based treatment
- 12-Step immersion
- 90-day residential treatment
- Family program
- Full continuum of care
- Insurance and private pay
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