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4 Signs of Codeine Addiction You Probably Didn't Know

By Jacqueline Hensler
Medically Reviewed by Dr. Moe Gelbart, PhD on March 23, 2022
Codeine is a strong drug that can all too easily be misused, even when prescribed. Find out how to spot the signs of someone with an opiate addiction.

Codeine is a prescription opiate medication used to relieve mild to moderate pain. It can be found in some prescription cough syrups and tablets and is prescribed by doctors to ease symptoms such as pain and cough. Codeine provides a feeling of euphoria and relaxation, a reaction that has the potential to lead to misuse. Learn about the three signs of codeine addiction you probably didn’t know. 

Increased tolerance

Similar to other opiates like oxycodone and heroin, codeine is a powerful drug. It’s possible to become addicted to codeine even if you’re taking a prescribed medication combined with a pain reliever. The Drug Enforcement Administration (DEA) labels codeine as a highly addictive substance with a high potential for abuse. 

“Many individuals who misuse or abuse codeine become tolerant to the mild effects of the opiate and begin to abuse stronger opiates to achieve greater highs,” Anton C. Bizzell, MD, president and CEO of The Bizzell Group, tells WebMD Connect to Care.

Interpersonal problems

Addiction to codeine is a serious disorder that can have an accumulating effect physically and personally. “Like any opioid use disorder, codeine use and abuse can lead to adverse health and interpersonal problems,” Bizzell says. “The lesser-known warning signs of a codeine addiction might mean that an individual ignores commitments or responsibilities, unexplained absences, or problems at work or school.” 

Irregular appetite

One of the most common signs of an addiction to codeine is nausea, especially in higher doses. “It’s also a common side effect of withdrawal,” Michael Damioli, LCSW, CSAT, clinical director at Colorado Medication Assisted Recovery, says. “Users are more likely to take even more codeine to alleviate their nausea, worsening their addiction cycle.”

Other signs of a codeine addiction are:

  • Mood swings 
  • Decreased appetite
  • Itching
  • Drowsiness
  • Constipation
  • Abnormal heart rate 
  • Feeling tired and weak
  • Isolating from friends and family

Using other drugs

Codeine has a similar effect on the body as other opioids. According to the National Institute of Health, frequent prescription opiate users who are diagnosed with dependence or abuse are more likely to switch to heroin.

“To put this into perspective, a heavy codeine user can develop a physical dependency on the drug after only three to five days,” Damioli says. “When withdrawal symptoms begin, an individual often uses other substances to ease the withdrawal experience. The theory of ‘cross addiction’ suggests that as an addiction develops, you are more likely to seek out and use other substances.”

Abusing codeine can lead to the abuse of other drugs, such as:

  • Oxycontin
  • Heroin
  • Fentanyl
  • Alcohol
  • Xanax 

An addiction to codeine involves both a physical and mental dependency. A dual approach of medical intervention and behavioral counseling services are recommended to treat a codeine addiction.

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