Codeine Cough Syrup: Abuse & Treatment

Codeine is an opioid painkiller used for the treatment of mild and moderate pain. Codeine is also available in isolation and in combination with other medicines like Solpadol. You can also find codeine in some cough and cold medicines. This is typically the source of codeine in lean drinks.

The effects of codeine are similar to the effects of other addictive opioids, from oxycodone to heroin. Lean contains up to 25 times the recommended dose of codeine. Effects take hold within 30 to 40 minutes, peaking within an hour or two. The lean high lasts for four to six hours.

Promethazine is an antihistamine used to alleviate the symptoms of hay fever, eye inflammation, and allergic reactions. Promethazine works by inhibiting the effects of histamine in the body.

When combined with alcohol or other CNS depressants, promethazine will intensify the effects of those substances, causing extreme drowsiness.

The alcohol contained in many versions of lean drink triggers the usual effects associated with alcohol, while at the same time magnifying the effects of the other lean ingredients.

If lean is made using DXM, this can trigger effects similar to ketamine and PCP in high doses, a phenomenon known as robotripping. The result is a potentially dissociative experience like with out-of-body hallucinations.

Several studies have reported the misuse of cough syrups containing promethazine and codeine due to its euphoric and tranquilizing effects.

The ingredients of lean trigger increased production of dopamine in the reward system of the brain.

Codeine, like all opioids, can be addictive when used long-term or when abused.

Is it an Opioid?

Codeine is both an opioid and an opiate.

CDC (Centers for Disease Control and Prevention) outlines the difference between these two terms as follows:

• Opiates: natural opioids like codeine, morphine, and heroin. These chemical compounds are extracted from the sap and fibers of opium poppies.

• Opioids: an umbrella term used for all opioids, whether natural, semi-synthetic, or synthetic. These chemical compounds are not typically derived from plant matter. Most opioids are made in laboratories (synthesized).

Codeine is an opiate specifically, and part of the opioid family. According to NIDA (National Institute on Drug Abuse), codeine binds to the mu-opioid receptor in the brain. Once ingested, codeine is converted into morphine in the body, helping with pain relief.

Codeine Cough Syrup Side Effects

The main component of codeine cough syrup is a mild narcotic, meaning it is often targeted by those seeking a rewarding high.

Since many codeine-based cough syrups no longer contain alcohol, beverages like lean (codeine cough syrup) are often mixed with alcoholic drinks. Some cough syrups also contain DXM (dextromethorphan) or promethazine, both potentially intoxicating substances.

Codeine cough syrup and associated syrups contain:

• Codeine

• Alcohol

• Other depressants of the CNS (central nervous system)

The combination of these substances and the way in which they act on the CNS can trigger a variety of potentially serious side effects. These common side effects include:

• Sedation

• Euphoria

• Impaired coordination

• Dizziness

• Dissociation

• Blurry vision

• Stomach pain and nausea

• Slowed breathing rate and heart rate

• Withdrawal symptoms

• Cravings

• Addiction (opioid use disorder)

• Seizure

Abusing codeine cough syrup long-term can cause the following dangerous effects:

• Memory loss

• Cognitive impairment

• Liver damage

• Behavioral changes

• Epilepsy

• Permanent psychosis

There is also a risk of codeine overdose when using this type of cough syrup. It can lead to a number of serious health effects including respiratory depression to the extent of oxygen deprivation. Mixing alcohol and opioids intensifies the effects of both substances.

The other primary risk of using cough syrups containing codeine is the risk of developing an opioid addiction.

Codeine Addiction

Addiction to opiates like codeine can develop quickly. Opioid use disorder can also be challenging to overcome.

Resultantly, cough syrups containing codeine have been removed from the shelves at pharmacies to be sold over the counter. There are also legal restrictions in the United States limiting the concentration of codeine in certain cough medications. Codeine cough syrups are classified under schedules III to V, according to the formula.

Tolerance to codeine can form rapidly. The rate hinges mainly on your body chemistry and how quickly you metabolize opioids. As the effects of codeine diminish, taking more of the opioid can cause physical dependence to manifest. When this occurs, you will require codeine to function normally and experience withdrawal symptoms in its absence.

The most recent National Survey on Drug Use and Health (NSDUH 2020) shows that 2.6 million U.S. adults developed an opioid use disorder like codeine addiction in 2020. Among those, 805,000 engaged with professional treatment.

If you are ready to commit to recovery from codeine cough syrup addiction, we can help you from detox to discharge and beyond here at Renaissance Recovery Center.