Why is Codeine Addictive?

What Is Codeine?

Codeine is an everyday painkiller that you can buy over the counter. It can also be prescribed by a doctor if you have had an injury, or following surgery, and is often prescribed for diarrhoea.

It works by binding to receptors in the brain and this blocks feelings of pain from the body reaching the brain. This makes you feel relaxed and happy, chilled and pain-free. 

Codeine usually comes in pill form (between 15mg and 60mg) but can be found in liquid or as an injection. It is often combined with other painkillers such as paracetamol (together this is packaged as Co-Codamol), or ibuprofen (sold as Nurofen Plus). It is also found in cough syrup.

You might think an over-the-counter painkiller is harmless, but codeine is highly addictive and is often misused and abused.

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So Why is Codeine Addictive?

Codeine travels through your bloodstream and into the brain where it attaches to receptors which trigger chemical changes that flood your system with feelings of pleasure. When you’re in pain, this means you no longer ache or hurt. If you’re not in pain but using codeine recreationally, it can make you feel more relaxed and take the edge off any worries or negative feelings.

However, once the relief wears off and the pain comes back, you’re often left craving more. It doesn’t take long before you need more and more to achieve the same feelings. When you try and stop, you experience withdrawal symptoms so you take more codeine.

This is the spiral of addiction and you need help. At Smarmore Castle we have successfully treated many people with codeine addictions, so rest assured you’re not alone.

What Are the Risks of Taking Codeine?

When using opiates like codeine, sticking to the prescribed or recommended dose is important if you want to avoid addiction or overdose. However, both can still happen accidentally. For example, you might not know that codeine is in cough syrup, so if you take that alongside some codeine painkillers, you’re taking more than your recommended dose. 

It can be difficult to understand that an everyday medicine that you’ve been prescribed by your doctor can do you harm, but if you are having repeat prescriptions or taking it without checking in with your GP, you may raise your risk of becoming dependent. 

As codeine blocks pain and makes you feel good, you might feel that you can’t cope without it. One user describes codeine as a ‘companion….It feels like it has its arms around you.’ This nice feeling is hard to let go of, and this is why you become addicted.

It’s not just your own body you can damage with codeine. Breastfeeding women who exceed the recommended dose of codeine can affect their babies’ central nervous systems, which slows down the newborns’ vital functions.

Can You Mix Codeine with Alcohol?

You might think nothing of having a glass of wine while taking a codeine prescription, especially if you always drink responsibly. However, both substances target the same areas in your brain aimed at relaxing you and taken together have double the effect.

So you may feel excessively drowsy, your thought processes might slow down so you slur and are confused, your reflexes may be slower, which can make you a danger to drive and your breathing may slow down to dangerous levels. 

Mixing codeine with alcohol also increases the risk of side effects.

How Do You Know You Have a Codeine Addiction?

Addiction creeps up on you and there isn’t one definitive moment that takes you from safe use to addiction. You might also ignore signs that you are dependent on codeine, maybe because you didn’t think you could become addicted.

If you are buying more and more codeine, and visiting different pharmacists to hide the amount you’re purchasing, this is a sign of addiction. Similarly, if you’re asking your GP for a larger prescription (maybe exaggerating your pain in order to persuade them), visiting different doctors or asking friends if they have any codeine to spare, you are showing signs of an addiction.

Taking codeine ‘just in case’ the pain comes back, is another example of substance misuse. 

If you feel drowsy, confused, struggle to concentrate, feel agitated and irritable and codeine is dominating your thoughts, you have an addiction. You are not in control of codeine, it is now in control of you.

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The Immediate Side Effects of Codeine

Codeine works quickly so while it will take the edge off your pain in 30 to 60 minutes, you can also experience some instant side effects. These include:

  • Feeling excessively drowsy
  • Stomach ache
  • Headache
  • Sweating
  • Muscle ache
  • Feeling dizzy
  • Nausea and vomiting
  • Changes in vision
  • Hallucinations
  • Loss of coordination
  • Laboured breathing

Long-term Side Effects of Codeine

If you abuse codeine over a long period of time you risk causing significant damage to your vital organs as well as developing chronic mental health issues. Long-term side effects include:

  • Liver damage
  • Kidney damage
  • Chronic pain
  • Seizures
  • Depression
  • Confusion and delirium
  • Slow breathing to the point it stops
  • Coma

Codeine Abuse and Misuse

You might be misusing codeine without realising it. Maybe you’re taking a pill slightly before you’re due your next dose because your pain is creeping back. Perhaps you’re continuing to take codeine even after your doctor has suggested you move to a weaker painkiller because codeine is the only thing that works.

Codeine is also misused intentionally. It is an essential ingredient in a homemade concoction called ‘lean’ (which also goes by various other names including ‘purple drank’, ‘sip sip’ and ‘purp’). As well as codeine, it includes cough syrup (which also contains codeine) and either alcohol or a soft fizzy drink such as Sprite.

Glamorised by hip-hop artists, lean is popular with young people. This is despite it being an ‘extraordinarily dangerous’ cocktail, the abuse of which is on the rise. It might sound harmless, but abusing codeine in this way is highly addictive and can be fatal.

How to Help Teenagers with a Codeine Addiction?

Teenagers and young people are at risk of codeine addiction in part due to the attraction of ‘lean’, which is promoted heavily on social media. 

Instagram is full of hashtags such as #Siplean and #Sizzurp on posts of fun cartoon characters and hip-hop artists showing off their enviable lifestyles. It’s easy to see how adolescents and young people are encouraged to take this codeine-based cocktail. 

Parents and adults need to be aware of the dangers of lean. If you can, check a teen’s social media to see if they’re looking at lean-related content. Learn the slang terms so you can read between the lines. Keep your eye out for cough syrup, packets of codeine and cans of fizzy pop in the house (as on their own they may not raise suspicion).

Talk to them and explain your concerns. Maybe there’s a reason they’ve turned to this drug. Are they being bullied at school? Taking it to impress someone? Worried about exams? Talk to their teachers so they’re informed and know what to look out for, and speak to their GP too. The Talk to Frank website is dedicated to tackling substance use and abuse in young people.

If the young person is over 18, they can access a personalised addiction treatment programme from a rehab centre such as Smarmore Castle. It’s best to nip substance abuse in the bud at an early age as drug addiction can go on to wreck an entire life.

The Difference Between Codeine Abuse and Addiction

Substance abuse is when you take drugs intentionally to get high whereas with codeine you can find you have an addiction despite thinking there was no harm in taking a common painkiller, or simply following a prescription.

Codeine addiction is often not your fault and for this reason, you may struggle to recognise you have a dependency and struggle to accept treatment.

Even if you do realise you need help, you might be too embarrassed to ask for it. At Smarmore Castle, we have successfully treated thousands of people from all walks of life, at our discreet centre tucked away in the Irish countryside.

why is codeine addictive

Codeine Allergy Symptoms

In rare cases, you may develop an allergy to codeine and if you do, it is important you stop taking it immediately, as it can be dangerous and even fatal. If you’ve been prescribed codeine, speak to your doctor about an alternative.

The main signs of an allergy are slow and laboured breathing and a rash on the skin. If you see someone develop this you need to call emergency services immediately. If they already have a diagnosed allergy and have taken codeine accidentally, they may need an injection from an Epi-pen.

Codeine allergy has been known to trigger anaphylactic shock

Codeine Withdrawal Symptoms

If you’ve developed a dependency on codeine and you try and stop taking it, you may well experience unpleasant physical and mental withdrawal symptoms. They can make you feel ill and usually result in you reaching for the codeine again. This is the spiral of addiction. 

Withdrawal symptoms from codeine include:

  • Feeling anxious and irritable
  • Insomnia
  • Runny nose
  • Muscle aches
  • Loss of appetite
  • Nausea and vomiting
  • Diarrhoea
  • Feeling cold/goosebumps on skin 

Drug addiction treatment at a rehab centre such as Smarmore Castle keeps you safe while you experience these symptoms. At the same time you are offered therapy to ensure that when you have completed detox, you can avoid future triggers and stay addiction-free for good. 

Signs and Symptoms of Codeine Overdose

You might think you can’t overdose on a drug that’s available over the counter but you can, especially if you are mixing it with other medicines, or alcohol. If you are taking codeine you need to be able to recognise signs and symptoms of overdose so you can get help quickly.

 Signs of a codeine overdose include:

  • Blueish lips and fingernails
  • Cold and clammy skin
  • Slow breathing
  • Feeling drowsy
  • Confusion
  • Feeling lightheaded and dizzy
  • Muscle twitching
  • Nausea and vomiting
  • Constipation
  • Coma

 It is possible to die from a codeine overdose so you need help before it’s too late. 

How Many People Die from Codeine in the Uk?

Codeine-related deaths in the UK increased by almost 25% in 2020, the last year that records were available. In that year 212 people died from codeine, up from 167 in 2019. This figure is more than double the number in 1993 when 91 people died. 

The rise in prescriptions and the ease with which codeine can be obtained
(you can order it online from the hidden part of the internet known as the ‘dark web’ without even leaving your house), are some of the reasons for this spike.

Codeine may be a common painkiller but it can be dangerous when misused, and even fatal. 

If you think you have a codeine addiction or are worried about a loved one, call Smarmore Castle today on 0141 214 5111 for free non-judgmental advice.

Frequently Asked Questions

What Are the Causes of Codeine Addiction?

You may have been prescribed codeine as a painkiller and then developed a dependency, or maybe you bought it over the counter and became addicted to its fast-acting pain relief. Physical dependence and tolerance can happen very quickly. 

What Are the Signs of Codeine Abuse?

Codeine abuse looks like Taking a higher dose of than required or recommended, codeine before your next dose is due and taking it in increasingly larger amounts. 

What Is the Treatment for Codeine Addiction?

Combining detox and therapy at a residential rehab clinic gives you the best chance of staying clean and maintaining long-term sobriety. 


  1. Kinnaird E, Kimergård A, Jennings S, et al, (2019), From Pain Treatments to Opioid Dependence: A Qualitative Study of the Environmental Influence on Codeine Use in UK Adults, BMJ Open: 9

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