Codeine is an opioid also used as a cough suppressant. It is a commonly abused drug, and regular use can result in tolerance, dependence, and addiction. Possible long-term consequences of codeine misuse include frequent oversedation, overdose, chronic constipation, sexual dysfunction, reduced sex drive, and irregular menstrual cycles. Codeine can be detected for up to two days in urine, nearly one day in saliva, and ten weeks in hair.
What Is Codeine?
Codeine is a prescription analgesic medication used to treat mild-moderate pain and suppress cough. In its many forms, codeine is available as a capsule, tablet, oral solutions, syrups, and suspensions. When used as a cough suppressant, codeine is included in a few different combination products, including Robitussin AC, Cheratussin AC, Guiatuss AC, and others.
Codeine is frequently abused for its ability to induce relaxation and euphoria at high doses. People who misuse the drug may attempt to crush, snort, chew, or inject the tablets. A common means of abuse is to mix codeine with soda and hard candy (a mixture known as sizzurp, purple drank, or lean) and marijuana or alcohol as well.
The approximate detection times for codeine are as follows:
- Codeine can be detected in the urine for up to 48 hours after their last drug use, but may be identified for up to 1 week in chronic users.
- It can be found in saliva for 21 hours after last use.
- It can be identified for up to 10 weeks in hair follicle tests.
In addition to the drug test being used, the detectability of codeine in anyone’s system depends on the following:
- Age or sex (male vs. female)
- Urine pH levels and concentration
- Kidney or liver dysfunction
- How much codeine the individuals used before the test, and when they used
- How long the person has been using or abusing codeine
How Is Codeine Metabolized in the Body?
Codeine is broken down by the liver, which results in the production of metabolites, including codeine-6-glucuronide, norcodeine, and morphine. Except for the latter, these metabolites are inactive, meaning they do not induce any drug effects of their own.
Codeine and its metabolites are expelled in the urine. Many urine tests can identify codeine and its metabolites, including morphine, norcodeine, and hydrocodone. Codeine’s half-life is between 2.5-3 hours. Half-life is the amount of time needed for half of a dose of a substance to be eliminated from an individual’s system.
Repeated abuse of codeine can result in addiction—a chronic, relapsing condition in which an individual continues codeine use despite harmful effects on their personal life and health. Long-term effects of codeine abuse include the following:
- Chronic constipation
- Reduced sex drive
- Irregular menstruation cycles in women
- Muscle tension and twitches
- Tolerance, in which the individual needs to use ever-increasing amounts of the drug to get the desired effect
Extended use of codeine can also lead to physical dependence and unpleasant withdrawal symptoms when the person stops using, including cravings, abdominal cramps, runny nose, muscle and joint aches, fever, chills, sweating, restlessness, depression, and irritability.
Codeine abuse can also result in overdose, and this risk is greatly increased when using it with alcohol, sedatives, or other opioids. Overdoses can be lethal due to the drug’s effects on the central nervous system, leading to respiratory arrest and cardiovascular dysfunction.
Potential signs of an overdose include the following:
- Constricted pupils
- Extreme drowsiness
- Limpness in extremities
- Cold and clammy skin
- Cyanosis (bluish skin)
- Severe respiratory depression
- Respiratory arrest
- Low blood pressure
- Slow pulse rate
- Cardiac arrest
An overdose requires immediate medical attention. Please call 911 immediately if you observe these signs in a person who has been using codeine or another intoxicating substance.
Treating Codeine Addiction
A person who has become dependent on codeine will typically need some form of professional treatment to recover. It can be challenging to discontinue use by one’s self.
For persons who have been abusing codeine for an extended period, supervised medical detox is recommended. During this process, the person can receive medications to relieve withdrawal symptoms, manage cravings, and receive medical care should any complications arise.
After detox, it is recommended that individuals continue their recovery work with the help of an addiction rehab program. Many substance rehab programs, such as those offered by Just Believe Detox and Just Believe Recovery, combine psychotherapy with medications and provide individual and group therapy meetings to help people find the roots of their addiction so they can finally break free from it.