Codeine Addiction, Abuse and Ways to Recover in Washington State

Codeine abuse remains a serious problem in the State of Washington, as well as elsewhere in the U.S.

This is a drug that can lead to addiction, even though most people view it as being harmless because it is prescribed. But that does not change the fact that it has contributed to the nation’s opioid epidemic. Fortunately, treatment can help those who have become addicted to it.

Even though morphine is three times stronger than codeine, there is still a cause for concern. This drug is made from the opium poppy plant, and it is used to treat pain when combined with Tylenol to make Tylenol 3. Doctors also prescribe it in cough syrup, and it is the primary ingredient in most prescription-strength cough suppressants.

In recent years, codeine has gotten a lot of press because of how it has been abused by young people, primarily. It has been used to make dangerous drinks called Lean, Sizzurp and Purple Drank. We will talk about that more in just a moment.

We know that codeine has been a major player in the opioid crisis in Washington. But what is the scope of the damage that has been done?

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The History of Codeine

Codeine has a long history. This chemical was first isolated in 1832 by a chemist called Pierre Robiquet. 

This drug drew a lot of attention, as it was regarded as one of the safest opiates to ever be discovered.

Ever since its discovery, codeine has been added to most prescription-grade cough medicines. Codeine has the ability to suppress chronic coughing. All opiate compounds have this ability. The reason why most pharmacists and pharmaceutical companies choose to use codeine is because it is the weakest opiate out there and comes with the fewest side effects. 

Codeine was also then added to some prescription opioids to treat mild to moderate pain. It’s important to note that any medications that contain codeine are not usually recommended for children or anyone under the age of 18.

Codeine comes in many different forms and strengths. This opioid is always taken orally. The different forms of codeine available in the US include: 

  • A solution of codeine sulfate with a strength of 30mg/5mL or 15mg/2.5mL
  • A tablet of codeine sulfate with a strength of 15mg, 30mg or 60mg 

The dose and form of codeine prescribed will vary depending on why it is prescribed. Upon being digested, codeine will break down into morphine. Codeine can also be combined with various other chemicals, like acetaminophen or dexphen.

Pop culture has been pushing a new type of drug known as “lean”, “sizzurp” or “purple drank”. Rappers are referencing this drug in many new hit singles, and it’s commonly talked about by celebrities and even actors. 

Nowadays, drugs influence pop culture. Many celebrities talk about drugs in such a casual manner that it feels as if doing drugs is normal. This has led to a surge of addiction rates among young adults and teenagers. 

Lean or purple drank is actually a homemade concoction made from codeine, Sprite and purple Jolly Ranchers. To make this drink, one would mix codeine and Sprite together first. They would then throw several purple Jolly Ranchers into the beverage and wait until they dissolve. 

This codeine beverage will induce mild euphoria and a sense of dissociation. Those who drink this concoction will often lean to one side, which is where the name of the drug comes from. 

Lean is incredibly addictive. More terrifyingly, it’s easy to overdose on this drug. Rap legends, like DJ Screw and Pimp C, have overdosed from this deadly drug. This drug is even more dangerous if it is mixed with other drugs and alcohol. If lean is taken with another depressant, it can lead to rapid cardiac and respiratory depression or failure.

Codeine Addiction

Codeine Addiction Signs and Symptoms

Recognizing the signs and symptoms of a codeine addiction is not easy. Many people are sure that they are not addicted to codeine, but rather using it for recreational purposes. They think that they are merely having fun, and that they don’t have to worry yet. 

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V or DSM 5) uses 11 different criteria to diagnose an addiction. Those who are addicted to codeine will meet two or more of the following criteria: 

  1. Taking codeine in larger amounts or for longer than intended
  2. Wanting to quit using codeine or to take smaller amounts, but being unable to
  3. Craving codeine physically and psychologically
  4. Spending a lot of time obsessing over codeine
  5. Neglecting work, home or school responsibilities because of the drug
  6. Developing withdrawal symptoms which can only be relieved by taking more codeine
  7. Building a tolerance to codeine and needing more of the substance to achieve the desired effects
  8. Continuing to take codeine even when it strains one’s relationships
  9. Continuing to take codeine even when it causes or worsens a physical or psychological problem
  10. Giving up social, recreational or occupational activities in favor of using codeine
  11. Continuing to use codeine even when it puts one in dangerous situations 

Anyone who meets two to three criteria will be diagnosed with a mild codeine addiction. Anyone who meets four or five criteria will be diagnosed with a moderate codeine addiction, and anyone who meets six or more criteria will be diagnosed with a severe addiction. 

Those who are still at a loss as to whether they are addicted to codeine should take our addiction quiz. By answering our questions honestly, one would be able to get a better idea of the severity of his or her addiction. 

Every addict’s story is different. Each person will come to terms with his or her addiction in a different way. Read opioid addiction stories to see how others may have come to the realization that they were addicted to a substance.

Side Effects of Codeine Abuse

Codeine is often found in prescription cough syrup. As cough syrup doesn’t seem dangerous, many people are not aware of the side effects involved with abusing codeine. Some common short-term and long-term side effects of codeine abuse include: 

  • Anhedonia, or an inability to feel pleasure and joy
  • Changes in sleeping patterns and sleep disorders
  • Cold sweats and cold and clammy hands and feet
  • Confusion and mood swings
  • Constipation and other types of bowel dysfunction
  • Depression and suicidal thoughts
  • Irregular heart rhythms or arrhythmia
  • Nausea and vomiting
  • Poor physical coordination
  • Weight loss or a loss of appetite 

Some of the more serious side effects of misusing codeine include permanent brain damage and coma. The intensity and type of side effects that each substance abuser will experience will vary.

A major side effect of abusing codeine is serotonin syndrome. This condition happens when too much serotonin accumulates within a person’s body. Although serotonin is a natural chemical produced by the body, too much serotonin can lead to some pretty serious side effects. In severe cases, serotonin syndrome can be fatal. 

Serotonin syndrome ranges from mild to severe. Some common symptoms of this syndrome include: 

  • Agitation, irritability and restlessness
  • Confusion
  • Diarrhea
  • Dilated pupils
  • Fever
  • Goosebumps and shivering
  • Headaches
  • High blood pressure
  • Irregular heart rate
  • Loss of consciousness
  • Muscle rigidity
  • Poor muscle coordination
  • Rapid heart rate
  • Seizures and tremors 

In general, the milder forms of this syndrome will usually disappear within a day. It’s the more serious forms that need to be addressed by a medical professional. Fortunately, serotonin syndrome is often fairly easy to treat.

Codeine Withdrawal Symptoms

Anyone who is attempting to recover from a codeine addiction will likely experience withdrawal symptoms. This is the brain’s way for overcorrecting the artificial influx of chemicals caused by codeine. This flood of panicked signals will throw the body into complete disarray. Withdrawal symptoms show that the user has developed a chemical and physical dependence on the drugs. 

Codeine withdrawal symptoms can be so overbearing that they cause recovering drug users to relapse. Relapse is common with addiction. It’s vital for those who relapse to know what steps to take next.

Most codeine abusers will not experience all withdrawal symptoms. They will only experience a selection of them. Some of the most common withdrawal symptoms for codeine addiction include: 

  • Abdominal pains
  • Diarrhea or bowel dysfunction
  • Depression and suicidal thoughts
  • Fever
  • Headaches
  • Insomnia and sleep disorders
  • Intense cravings
  • Joint ache and pain
  • Mood swings
  • Muscle pain and aches
  • Nausea and vomiting 

As codeine is a mild opioid, it is not as dangerous as heroin or other strong opioids. Recovering drug users rarely experience life-threatening withdrawals.

The withdrawal timeline for each substance will vary. Codeine withdrawals typically follow the same timeline as other opioid withdrawals. There will be some discrepancies based on factors like:

  • The severity of the abuse, which includes the dosage and frequency of which the substance abuser took codeine
  • The drug user’s own biological makeup, as everyone responds to drugs in a different way
  • Whether the codeine was mixed and consumed with other substances, like alcohol
  • The codeine abuser’s age, weight and body fat percentage
  • The mental and psychological health of the substance abuser

In comparison to other opioids, like heroin, the withdrawal symptoms will usually take longer to appear. Most heavy users will experience their first withdrawal symptoms approximately 12 hours after their last dose. With that said, some drug users only start experiencing withdrawal symptoms two days after their last dose. 

In general, the physical withdrawal symptoms will last anywhere from 7 to 14 days. By the end of the second week, most drug users will not be plagued with any intense withdrawal symptoms. They are only left with psychological withdrawal symptoms, like cravings, anxiety and even depression.

Addiction Treatment for Codeine Addiction

Professional addiction treatment can make a huge difference when it comes to one’s recovery. 

Those who seek addiction treatment services from recovery centers, like Northpoint Seattle, are more likely to achieve their recovery goals. They will have an easier time dealing with cravings, and will also learn crucial recovery skills that help them manage addictive behaviors.

Addiction treatment can take anywhere from a few weeks to several months to complete. It all depends on each individual’s circumstances.

Different rehab centers will have various features to offer. For example, some addiction recovery facilities offer gender-specific treatment while others may specialize in holistic treatment approaches. Some recovery centers may offer additional amenities and services, like spa services and equine therapy. 

Research what each facility has to offer before making a decision. Make sure that the treatment facility chosen has Joint Commission Accreditation. This basically means that it meets a certain standard of care.

When choosing a codeine addiction treatment facility, most people will quickly learn that there are two different types of rehabs: inpatient rehab and outpatient rehab. They differ in the level of care that they can provide. Northpoint Seattle is an outpatient treatment center. Let’s take a look at the differences between the two: 

  • Inpatient treatment programs. Also known as residential treatment programs, inpatient programs will require patients to move into the recovery center for 28 to 90 days. In general, longer addiction treatment lengths have been linked to higher success rates. With inpatient care, patients receive around-the-clock supervision and care. They can reach out for help and support whenever they need it. These patients will also build a strong support network with other patients who are also living at the facility.
  • Outpatient treatment programs. There are many different types of outpatient treatment programs. Some popular options include Partial Hospitalization Programs (PHPs), Intensive Outpatient Programs (IOPs) and standard outpatient programs. Unlike with inpatient care, patients do not live at the treatment facility. Instead, they will travel to the recovery center for treatment whenever they want. Patients can schedule as much treatment as they need. Some patients will receive 6 hours of structured therapy every day while others will only receive several hours of treatment every week. 

Each type of rehab program can offer different pros and cons. As an addiction to codeine is generally considered fairly mild, most drug users can get away with opting for outpatient care.

There are many benefits associated with choosing an outpatient treatment center, like Northpoint Seattle, which is located in Everett, Washington. Let’s take a look at some of the reasons why some codeine addicts will prefer an outpatient program over an inpatient one. 

  • Affordability. In comparison to inpatient treatment, outpatient treatment is a lot more affordable. Patients are able to pay a lot less for outpatient treatment. Also, most health insurance plans are also more likely to offer more coverage for outpatient programs rather than inpatient ones. 
  • Minimal disruptions to one’s school, work or home life. Many people cannot afford to go away for a whole month or more for substance abuse treatment. They may need to continue to work or may not want to disrupt their current lifestyle. Those who opt for outpatient programs are able to get the treatment that they need without changing their schedule up too much.
  • Flexibility. With outpatient care, patients can pick and choose when they would like to receive treatment. They can schedule in treatment whenever they’re free. 
  • Immediate feedback. One of the most difficult parts of recovery is avoiding relapses. To ensure long-term recovery, recovering codeine users must master certain recovery skills. Those who choose outpatient programs can practice the recovery skills that they’ve learned and get immediate feedback on their efficacy.
  • Familial support. Those who have strong familial support can draw on this source of energy with outpatient treatment. These individuals will be able to easily contact family and friends who support their recovery. 

Although outpatient treatment programs require less commitment than inpatient treatment programs, this doesn’t mean that they’re not a good option. Studies show that outpatient treatment programs are just as effective as inpatient ones.

Medical Detox

The first part of almost all addiction treatment programs involves medical detox. Detox involves the use of medications to return chemical levels within the body back to normal. Many different medications can be used to treat a codeine addiction. The type of medication used will depend on the rehab center, as well as the severity of the withdrawal symptoms that patients exhibit. 

Some medications are approved by the Food and Drug Administration (FDA) specifically for treating opioid and opiate withdrawals. Other medications treat specific symptoms. Common medications often used during detox include: 

  • Non-narcotic pain relievers, like acetaminophen or ibuprofen, to treat pain
  • Loperamide or Bismuth subsalicylate to relieve symptoms of diarrhea
  • Hydroxyzine to relieve nausea and anxiety
  • Benzodiazepines like Clonidine and Lofexidine to reduce muscle aches and stomach cramps
  • Naltrexone, methadone or buprenorphine to treat pain and opioid cravings 

It’s important to note that benzodiazepines and opioid medications like naltrexone and methadone are often prescribed sparingly. This is because both types of drugs come with a potential for abuse. Those who misuse or abuse methadone or buprenorphine can develop a secondary addiction. This secondary addiction can be equally as difficult to treat. 

The type and dose of medications prescribed will vary from one patient to another. Most addiction experts recommend inpatient detox because this allows them to monitor each patient’s progress. Addiction specialists can alter the treatment plan if patients recover more quickly or if they react in an unfavorable way to certain medications.

Although codeine is a mild opioid, it’s still possible to overdose on this drug. The amount of codeine that it takes to overdose will vary from one individual to another. Some factors that play a role include one’s tolerance, gender, height and weight. 

In general, most physicians advise taking no more than 360 mg of codeine per day. The estimated dose required for a fatal overdose falls between 500 to 1,000 mg. 

Common codeine overdose symptoms include: 

  • Blue tint on fingernails and lips
  • Cardiac depression or failure
  • Cold and clammy skin
  • Dizziness
  • Excessive drowsiness
  • Fainting
  • Loss of consciousness
  • Respiratory depression or failure 

Those who mix codeine with other substances and drugs will be more likely to overdose. Fortunately, it’s possible to treat a codeine overdose with naloxone, or Narcan. This drug is an antidote capable of reversing the effects of an opioid overdose.

Choosing a Drug Rehab for Codeine Addiction in WA State

It is so important to find a quality addiction treatment center in Washington State. There are hundreds to choose from, according to the SAMHSA treatment locator. But they are not all the same.

The best rehab programs offer clients their own treatment plans. They are smaller in size to allow for better client/staff interactions. Also, it is best to find a program that is accredited by The Joint Commission.

At Northpoint Seattle, we have one of the best outpatient addiction treatment programs in Washington State. We have two locations in Seattle and Bellevue. We meet all of the criteria we mentioned above.

We want our clients to know that we see them as individuals with their own needs. That is why we offer three levels of care. Our clients are assessed and placed in the level that is right for them. The levels are traditional outpatient, intensive outpatient and partial hospitalization.

Learn More About Codeine Abuse, Addiction and Treatment in Washington State

Recovering from an addiction can be difficult; but with the right support, it is possible. At Northpoint Seattle, our staff is dedicated to helping our clients be successful in treatment. We want you to know that you are not alone, and that together, we can work to meet your recovery goals.

Do you have questions about codeine abuse or addiction? Are you interested in learning more about your treatment options in WA State? Please contact us.