Codeine is an opioid medication that doctors might prescribe to treat mild-to-moderate pain. It may be combined with other medicines for pain, such as aspirin or acetaminophen. Like all medications, codeine has the potential to cause side effects. Codeine also has the potential to lead to tolerance and abuse.
The most common side effects of codeine affect more than 10 percent of people who use the medication, and they include drowsiness and constipation, according to Medscape. With proper use, these side effects typically go away.
There are other potential short-term side effects, according to the Mayo Clinic.
There are also long-term effects of codeine to be aware of. Tolerance is possible if someone takes this drug long-term or in amounts higher than normally prescribed. Tolerance can lead to increasing abuse and then addiction to codeine.
Respiratory depression is possible when using codeine, especially among people with pre-existing respiratory issues and the elderly, according to the U.S. Food and Drug Administration.
Respiratory depression is characterized by weak and slow breathing. The various parts of the body are not getting enough oxygen, and blood levels of carbon dioxide start to rise. When related to a drug overdose, this condition can eventually result in respiratory arrest. Respiratory arrest can leave the body without proper pulmonary gas exchange, which could result in potentially irreversible damage to the vital organs in about five minutes, according to Merck Manuals.
Codeine can also cause sphincter of Oddi spasms. This can lead to reduced pancreatic and biliary secretions, increasing the risk of acute pancreatitis.
Pancreatitis is characterized by inflammation of the pancreas. This can cause nausea, weight loss, significant pain, rapid pulse, and fever. If left untreated, this condition can result in multiple complications, according to the Mayo Clinic, such as:
Ready to get Help?
We’re here 24/7. Pick up the phone.
When someone is abusing codeine, they might show certain behavioral and psychological symptoms such as:
They might also experience the short-term and long-term side effects discussed above. It is possible for codeine abuse to cause someone to experience depressive symptoms, according to a study published in the Journal of Clinical Psychopharmacology. Dysphoric moods may accompany the depressive symptoms.
In addition to pancreatic and respiratory problems, codeine abuse might cause other long-term physical effects. These might include liver damage, such as hepatitis, digestive system damage, and kidney damage.
The most serious side effects of codeine include pancreatitis, respiratory failure, digestive system damage, hepatitis C, and kidney damage. All of these require abstaining from codeine and additional medical treatments.
Pancreatitis typically requires someone to stay in the hospital for treatment. Nutrition and fluids are typically provided via a feeding tube or intravenous line since many people can’t digest food temporarily. Antibiotics and pain control are also common.
It is important to seek rehabilitation to stop using codeine. This will help people get through the acute withdrawal phase and aid them in overcoming their addiction.
The majority of people who abuse codeine cannot stop using it without seeking professional help. In some cases, removal of the gallbladder might be necessary, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
If respiratory failure due to codeine abuse is acute, this is considered a medical emergency. The following treatments might be needed:
Hepatitis C may result from codeine abuse. People might require antiviral medications to treat the infection. For both hepatitis C and other codeine-related liver damage, a liver transplant might be considered in the most severe cases.
Kidney damage may require medications or dialysis to treat it.
A kidney transplant could be needed in the most severe cases.
Substance abuse can cause several issues with the digestive system.
The types of damage might include ischemic colitis or enterocolitis.
It is also possible for substance abuse to increase the risk of digestive system cancers, according to research published in Acta Chirurgica Lugoslavica.
Any person taking codeine needs to exercise caution. This medication poses the potential for abuse and addiction.
Always use it exactly as prescribed and only according to your doctor’s instructions. If the medicine causes adverse effects or you start to develop tolerance, alert your doctor immediately.
Codeine that contains under 90 milligrams per dose is classified as a Schedule II drug, according to the U.S. Drug Enforcement Agency. This medication is most often prescribed in tablet form with dosage strengths that include 15 mg (milligrams), 30 mg, and 60 mg. It also comes in liquid and capsule form.
On average, codeine is prescribed to be taken every four hours, according to MedlinePlus. Doctors may give a less frequent dosing schedule, so it is essential that people read the label before they take this medicine.
The exact mechanism of action of codeine is unknown. However, it is believed that its pain-relieving effects come from the fact that it converts to morphine in the body, according to the U.S. Food and Drug Administration. This medicine acts on the central nervous system to cause pain relief. Other effects on the central nervous system include euphoria, relaxation, and reduced anxiety.
The cough-suppressing effects are also due to this medication’s effect on the central nervous system. Several codeine ingredient options that might be used include:
Codeine might be combined with other medications. These may include carisoprodol, promethazine, acetaminophen, and aspirin.
Controlled Substance Schedules. U.S. Drug Enforcement Agency. Retrieved from https://www.deadiversion.usdoj.gov/schedules/
Acetaminophen and Codeine. MedlinePlus. Retrieved December 2018 from https://medlineplus.gov/druginfo/meds/a601005.html
Highlights of Prescribing Information. U.S. Food and Drug Administration. Retrieved December 2018 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/022402s006lbl.pdf
Codeine. Drug Bank. Retrieved December 2018 from https://www.drugbank.ca/drugs/DB00318
Codeine. Medscape. Retrieved December 2018 from https://reference.medscape.com/drug/codeine-343310#4
Codeine (Oral Route). Mayo Clinic. Retrieved December 2018 from https://www.mayoclinic.org/drugs-supplements/codeine-oral-route/side-effects/drg-20074022
Overview of Respiratory Arrest. Merck Manuals. Retrieved from https://www.merckmanuals.com/professional/critical-care-medicine/respiratory-arrest/overview-of-respiratory-arrest
Pancreatitis. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/pancreatitis/symptoms-causes/syc-20360227
(August 1999) Long-Term Codeine Use is Associated with Depressive Symptoms. Journal of Clinical Psychopharmacology. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10440467
Treatment of Pancreatitis. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved December 2018 from https://www.niddk.nih.gov/health-information/digestive-diseases/pancreatitis/treatment
Respiratory Failure. MedlinePlus. Retrieved December 2018 from https://medlineplus.gov/respiratoryfailure.html
(2008) Digestive System Damage Caused by Substance Abuse. Acta Chirurgica Lugoslavica. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19069706