Codeine Addiction & Misuse
Misusing codeine puts users at risk of several consequences, including physiological dependence, overdose, and the development of codeine addiction.4 If you or a loved one are struggling with codeine misuse or codeine addiction, educating yourself about the drug can help you make an informed decision about your health. This page will help you learn more about codeine and its addictive potential, the signs of codeine addiction, effects and risks of codeine addiction–including withdrawal, detox, and resources for treating codeine addiction.
What Is Codeine?
Codeine is a prescription opioid that is often used to treat mild to moderate pain and chronic cough.1 Although codeine is a prescription medication, it is possible to misuse it in an effort to “get high” or for uses other than those prescribed by a doctor.2
You likely have heard of opioids and may be wondering how codeine differs from other opioids. Opioids are primarily used to alleviate moderate to severe pain, but some can be used to treat diarrhea and reduce coughing.4 Opioids include substances that are legal, such as prescription medications like codeine and oxycodone, and substances that are illegal, such as heroin.5
Codeine is an opioid commonly prescribed in liquid or pill form to be taken orally. In addition to reducing pain or bodily discomfort, opioids can also produce effects such as a general feeling of happiness, decreased muscle tension, and a sense of calmness.6
An individual has developed an addiction if they can’t control their codeine use and are compulsively taking codeine and seeking it out despite negative effects on their physical health, relationships, and other important areas of life.7 To determine if someone has an opioid use disorder (OUD), the clinical term for opioid addiction, medical providers use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) which provides a list of criteria and guidelines for diagnosing substance use disorders.
To be diagnosed with an OUD, someone must have recurrent opioid use and meet at least 2 of the following 11 criteria within a 12-month period:7
- Using larger amounts of opioids or using opioids more frequently over a longer period of time than initially planned.
- Unsuccessful attempts to reduce or completely stop using opioids.
- Spending a lot of time using opioids or recovering from their effects.
- Having a strong urge or desire to use opioids (also referred to as “cravings”).
- Difficulty fulfilling major life responsibilities, including those related to work, school, family, and home.
- Continuing to use opioids despite the presence of relationship problems with family, friends, and others.
- Giving up enjoyable activities or reduced engagement in activities due to opioid use.
- Using opioids in physically hazardous situations (e.g., driving, or operating machinery).
- Experiencing recurring physical and psychological symptoms that are caused by or made worse by opioid use.
- Building up a tolerance to the drug, meaning that you need to use larger amounts of opioids than previous doses to still feel its effects.
- Experiencing opioid-related withdrawal symptoms or taking opioids to avoid experiencing codeine withdrawal symptoms.
According to the DSM-5, OUD ranges in severity from mild to severe. Meeting a higher number of the criteria means a more severe OUD.7
Is Codeine Addictive?
If you are wondering is codeine addictive, the answer is that codeine is potentially addictive. Codeine, like other prescription opioids, has addictive properties, and anyone with a prescription for an opioid medication has an increased risk of developing an addiction compared to someone who isn’t prescribed opioids.4, 5 When following the guidance of a doctor and taken for a short time, codeine and other opioid medications are generally safe to take.
Misuse of the medication, such as taking the medicine in a way or dose other than prescribed, taking someone else’s codeine prescription, or taking the medicine for reasons other than what it is prescribed for (such as to get high or cope with psychological distress, may increase the risk of developing a codeine addiction.5, 8, 9 An estimated 5.6 million people aged 12 and older met the criteria for an OUD in 2020.3
Side Effects and Risks of Codeine Use
Although codeine is prescribed by doctors and can be safe and effective when taken as directed, there can still be codeine side effects and risks to using it, even when it is used as prescribed. Some potential adverse side effects associated with codeine use include:1, 3, 12
- Drowsiness or sedation.
- Slowed breathing.
Addiction and overdose are also very real risks when using an opioid like codeine.
Anyone who is prescribed opioids is at an increased risk of accidental overdose, and there are increasing concerns about opioid-related overdose deaths, which have grown in recent years. For example, in 2020, there were over 100,000 deaths related to a drug overdose.10 Of those fatal drug overdoses, approximately 78,000 (78%) included an opioid. This is the highest number ever recorded.11 The risk of experiencing a fatal overdose increases with the misuse of opioids.
It is important to know the signs that may indicate an overdose. An overdose is a medical emergency, as it can lead to a person being unable to breathe, which can result in brain damage, coma, or death. A drug called naloxone can reverse the effects of a potentially life-threatening opioid overdose.11
Some signs of overdose include:3
- Shallow, slowed, or stopped breathing.
- Constricted, or “pinpoint,” pupils.
- Loss of consciousness or being unable to wake.
- Cold, clammy skin.
- Choking or gurgling sounds.
- Lips and fingernails turning blue.
Using opioids over an extended period and at higher dosages increases the risks of dependence, overdose, and even the development of an OUD.8
Even when taking codeine as prescribed, a person can become dependent on the medication, meaning if they stop using codeine they will experience codeine withdrawal symptoms. Withdrawal symptoms of codeine are similar to flu symptoms and may include the following:6,7
- depressed mood
- muscle aches and body pain
- increased heart rate and blood pressure
Codeine Withdrawal Timeline
The withdrawal symptoms of codeine and the length of time it takes to withdraw will vary for each individual. Withdrawing from codeine may involve withdrawal symptoms that begin relatively quickly after cutting back or stop use. For short-acting opioids like this, symptoms of codeine withdrawal typically begin 8-24 hours after use.3
How long does codeine withdrawal last? The codeine withdrawal timeline has opioid withdrawal symptoms lasting for 4-10 days.3
Cutting back or stopping the use of codeine may lead to withdrawal as individuals begin to go through detox. As the drug is removed from the body, withdrawal symptoms may cause discomfort. Quitting codeine cold turkey is never advised and a medical detox program is usually necessary to keep individuals comfortable and safe.
While not always necessary, codeine detox can help patients who are dependent on codeine or other substances achieve a substance-free state as comfortably and safely as possible as they go through detox from codeine and possibly experience symptoms of codeine withdrawal. This can help them more easily transition to ongoing codeine addiction treatment in an inpatient or outpatient setting.13, 14
Codeine Addiction Treatment
Although a codeine addiction may feel difficult to overcome, it is a treatable condition. Codeine addiction treatment can take place in a range of settings including detox, inpatient, and outpatient facilities.
Even with the many treatment options available, treatment can look different for everyone. Individualized treatment plans which focus on the needs of the patient are the standard of care for addiction treatment.13 Some common treatments for addiction to codeine include:13, 14, 15, 16
- Behavioral therapies. Behavioral therapies are some of the most commonly used therapies for treating substance use. Behavioral therapies, such as cognitive behavioral therapy, can help people identify and change their thoughts and behaviors surrounding opioid use.
- Medication. Medication can be used to help eliminate or alleviate withdrawal symptoms as well as prevent relapse and reduce cravings for codeine and other opioids.
- Co-occurring disorder evaluation and treatment. Addiction can co-occur with other mental health conditions, like anxiety, depression, and post-traumatic stress disorder (PTSD). Some addiction treatment programs also are equipped to help people manage, treat, and improve symptoms from other conditions as well as OUD.
- Aftercare. Sometimes referred to as continuing care, aftercare refers to the ongoing efforts to promote recovery after patients complete an initial treatment period. Aftercare helps support a patient’s recovery goals and prevent relapse.
Finding Codeine Addiction Treatment
If you or a loved one are struggling, there are several ways to find a codeine addiction treatment center near you:
- Schedule an appointment with your doctor or a mental health practitioner. They can assess your needs and refer you to a codeine rehab program.
- Use an online resource, such as The Substance Abuse and Mental Health Services Administration (SAMHSA) FindTreatment.gov tool.
- Use our rehab directory, which allows you to search for codeine treatment near me, and find different levels of care, and insurance accepted.
- Contact your insurance provider to learn more about in-network options. If you don’t have insurance, you still have options. Ask treatment facilities about grants, loans, and sliding scales.
If you or a loved one are struggling with codeine misuse or addiction, don’t wait to get help. Contact American Addiction Centers (AAC) at to speak to a caring admissions navigator about your rehab options. It’s confidential and free, and there is no obligation to enter treatment.
Find Out If Your Insurance Plan Covers Codeine Rehab
American Addiction Centers provides comprehensive rehab services for those seeking recovery from opioid misuse and opioid use disorder (OUD). To find out if your insurance covers treatment at an American Addiction Centers (AAC) facility, click here or fill out the form below. Your information is kept 100% confidential.