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As an opiate, codeine can be addictive despite being a common prescription and over-the-counter medication.
Codeine causes brain abnormalities when it is used frequently. Changes in the brain’s pleasure and pain centres cause a physical dependence. This compulsive need to take opiates passes after a few weeks of not taking them.
However, cravings and compulsion to take opiates persist and can be triggered by mental health problems, social pressure and psychological conditioning.
Yes, you can get addicted to co-codamol. As an opioid, codeine is addictive, although it is classed as lower risk. Stronger opioids such as heroin and oxycodone are at higher risk because they cause physical dependence more quickly and consistently.
The issue with codeine is that it is more widespread and offered on prescription. Many people who take codeine are not aware of how addictive it is. Trusting in their doctor, many of those who use codeine for pain or sleep eventually become addicted.
Codeine is less addictive than other opioids because it is weaker. Morphine, for example, is more than ten times as potent as codeine.
How addictive it is, however, varies based on the individual and their circumstances. For example, if a person is prone to addictive behaviour, has mental health issues or misuses their prescription, they are much more likely to experience a codeine addiction.
Sticking to your prescription or pharmacist’s advice is the best way to avoid developing a problem with codeine. The risk of becoming addicted increases from just 8% for people taking their medication correctly to 25% for people who misuse their prescription codeine.
Also, avoid mixing codeine with other addictive substances, particularly alcohol or other recreational drugs. Increasing your level of intoxication makes you more likely to become addicted. This happens because the greater the dopamine is, the more your body will crave the substance.
Recognising the signs and symptoms of codeine addiction can help as well. If you feel the urge to take increasing amounts of codeine, are taking it despite no pain or illness, consider pharmacy shopping to get more than the recommended codeine or are mixing it to increase the effects, you may be at risk.
This is a temporary state but still a very difficult one. The symptoms and discomfort can lead people to relapse into taking codeine again.
Nausea is a common side effect of stopping codeine, along with vomiting, chills and fever. You may also feel like you have flu with a runny nose and aches and pains.
Pain is also a common experience when you stop taking codeine. Even if the issue you started taking codeine for has completely healed, it may have changed your reaction to normal levels of pain.
Hypersensitivity to pain is quite common in people with opioid addiction. It should only last a maximum of 1-2 months after you stop taking codeine entirely.
Many people are able to overcome a temporary physical addiction to codeine with willpower and help from their doctor. The issue arises for people who are dependent psychologically as well.
This can be for long-term pain relief from an injury or illness that cannot be prevented. It can be very challenging to live with chronic pain, and it wears people down mentally. Pain can lead you to believe that you cannot live without codeine.
Codeine can be prescribed for and used illegally as a sleep aid. It can increase sleepiness and may even cause drowsiness for a few days. This wears off, however, and you will need increasing doses to get the same effect. This is risky, especially if you become dependent on codeine to sleep, and you may suffer chronic insomnia when you stop taking it. This is compounded if your sleep problems are linked to pain management.
Using addictive substances such as opioids like codeine to self-medicate the pain of mental illness is unfortunately common. It is not prescribed as an antidepressant or anti-anxiety medication, but many people self-medicate with codeine.
Codeine can ease some of the symptoms of depression and anxiety, but only temporarily. In the long term, it makes mental health problems worse by adding physical and mental dependency to your problems.
Long-term codeine use can itself be depressing. Studies suggest that up to 70% of people who take codeine for more than six months suffer from depression. The results suggest that taking it over longer periods may cause low mood.
Pain management is one of the most common uses of codeine, particularly on prescription in the UK. Trauma is often linked to chronic pain, whether it is from an accident, conflict or a serious illness.
This may be a contributing factor in such high numbers of codeine users suffering depression and addiction. People with trauma are more likely to fall victim to addiction and mental health problems.
The most recent reports from the UK NHS show 188 deaths a year from codeine poisoning in 2022. Although this is a small reduction from previous years, it is still very high for a drug offered widely on prescription.
One of the biggest dangers of codeine is how easy it is to obtain. You can buy codeine over the counter in low doses in the UK. It is also commonly prescribed for post-operative pain, injuries and severe coughs. Fortunately, recent law changes have made it prescription only in high doses that might cause euphoria or drowsiness. A warning has also been added to the packaging that it can be addictive to increase awareness in patients.
Sources
https://pubmed.ncbi.nlm.nih.gov/10440467/Long-term codeine use is associated with depressive symptoms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/The Neurobiology of Opioid Dependence
https://www.ncbi.nlm.nih.gov/books/NBK526029/ Codeine
