Codeine addiction can often be challenging to detect. People frequently become addicted by accident, usually following treatment for pain. Unfortunately, people believe that because it is a mild opiate with minimal side effects, it is harder or less likely to cause dependence. The versatility of the drug yields numerous illicit forms as well, leading to new problems such as Purple Drank or Lean Addiction.


Although most people are monitored by medical staff during its use, it is not strictly monitored like other opiate-based medications. Doctors often do not distinguish that tolerance or dependency are beginning until addiction has already set in. Many people do not know that their tolerance and dependency are developing either.

Medical professionals are aware of the potential for addiction. It is the main reason why prescriptions for codeine are intended only for short-term usage. Dosage instructions are supposed to be followed strictly. One of the most prominent signs of developing tolerance is the need to take a higher dosage than initially prescribed. Learn more about codeine withdrawal symptoms in our recent study.



Codeine can be the result of either of two methods. First, as previously noted, it can stem from a legitimate medical need. This is the more common type of addiction, and often much more comfortable to address. It is often discovered that tolerance is occurring when people return to their doctor, stating that the medication is not as effective as it was. Addiction has not yet set in.

The second type can occur as intentional misuse. Codeine has been mixed with various other ingredients and sold illegally. Most commonly, the cough syrup is combined with soda or alcohol and hard candy to create a substance called lean or purple drank.

As a recreational drug or party drink, lean is usually extremely addictive. This is often due to the higher amount of cough syrup added to the drink. Additionally, the promethazine found in the cough syrup adds to the effects of codeine, creating more pronounced drowsiness and depressed motor functions that are highly desired by users and lead to a lean addiction.


General potential warning signs of codeine addiction can include a variety of mood, behavioral, psychological, and physical changes. Mood changes include depression, anxiety, and extreme mood changes. The person likely has no previous history with mood issues. An addict may either have a prior history with addiction or no history at all.

Behavioral changes can include sleeping all the time, lack of appetite, an increase in visits to the doctor or hospital, and doctor shopping. An increase in lying about usage and general lack of caring for themselves or others may also occur. In some cases, the addict may even begin stealing prescriptions from other people.

Psychological changes can vary. Hallucination, loss of memory, and emotional shut down are common. Some addicts may also have difficulty determining what is real from what they imagine. This delusional thinking can often cause agitation for the addict.

Numerous physical changes can occur from an addiction to codeine. Blue tinted fingernails and lips may be noticed. An addict may also have pronounced muscle twitches, rashes, and dizziness. In severe cases, seizures and fainting can occur. The addict could also suffer from uncontrollable itchiness, often in the nose area.

Codeine, although not as potent as its counterparts, still poses a risk for dangerous side effects that come with abuse and long-term use. Addicts may suffer from permanent brain damage due to the repeated drop in oxygen getting to the brain. Some addicts may also experience a dangerous reduction in blood pressure and heart rate.


The extent of the addiction is going to influence treatment. Due to its potentially dangerous composition, methods of treatment are designed to make sure that safety is a priority, and the risks of life-threatening withdrawal symptoms are minimized. Initial treatment should only be received at a facility and closely monitored by medical staff.

The first step in a treatment plan is detoxification. During this period, withdrawal symptoms occur. Professionals need to make sure the addict stays hydrated, and vital signs are closely monitored during detox. In many instances, medications are used to help reduce withdrawal symptoms. These medications include buprenorphine, naloxone, methadone, and naltrexone. A combination of these medications is often ideal in reducing the euphoria and reducing cravings for codeine.


Withdrawal symptoms that occur after stopping the use of codeine include headaches, insomnia, fever, nausea or vomiting, and sweating. Dehydration and depression may also occur. Symptoms during withdrawal may differ between people. Each person will go through detoxification and withdrawal differently.

Several factors can influence the withdrawal symptoms a person might experience. The length of time the drug was taken, the amount, and frequency are the main factors. Medical staff must also consider the addict’s medical history and mental health history, including existing conditions and current weight. Addiction of any kind is not discriminatory; it does not have consideration for age, sex, race, or financial status. All these factors will also influence how long the codeine will remain in the person’s system. Generally, a system is clear within 16 hours.

The biggest obstacle for addicts is themselves. For treatment to be successful, the individual must understand that the addiction is real and have a desire to be sober. Without those two elements, together, the odds of successful treatment are minimal. The risk of relapse is high.

Regardless of how the addiction occurred, addicts should seek treatment as soon as possible. Although inpatient care is highly recommended, outpatient care is also beneficial. Outpatient treatment is often suitable following medically assisted detox. Ongoing therapy helps recovering addicts. If the person has other medical conditions, either occurring before the addiction or as a result, outpatient care can also treat these conditions.

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