Codeine Cough Syrups: Side Effects and Addiction Risks


Codeine cough syrups have a dual nature - while they're commonly prescribed for cough and pain, they hold hidden risks for misuse. Explore the risks here.

When it comes to codeine cough syrups, it can be difficult to strike a balance between therapeutic use and the awareness of potential misuse. These syrups, while effective for certain conditions, can lead down a path of dependency if not managed carefully. 

If you’ve been prescribed codeine, and especially if you have a history of substance use, it’s important to know the potential side effects and risks for misuse – including dependence and addiction. 

Learn more, and call The Forge Recovery Center today if you or a loved one are struggling with codeine addiction. Our team of treatment experts are here to help.

What Is Codeine?

Codeine is a commonly prescribed opiate that’s primarily used in the medical field for its efficacy as both a cough suppressant and a pain reliever. As an opioid, it works by interacting with the body’s central nervous system to reduce the urge to cough and to alleviate discomfort. 

Key Functions of Codeine:

  • Cough Suppression: Codeine reduces cough reflexes by acting on the brain's area responsible for triggering coughs, helping to manage symptoms of severe coughs.

  • Pain Relief: It binds to opioid receptors in the brain and alters the perception of pain, and is commonly used to manage mild to severe pain.

  • Combined Use: Often combined with other analgesics like acetaminophen or ibuprofen to enhance pain relief effects without increasing opioid intake.

While codeine is effective when used as prescribed and for short periods, it’s important to be aware of the risks – especially if you have a history of substance abuse. It’s always advised that you consult your healthcare provider to craft a plan that avoids risking misuse. 

Why Are Codeine Cough Syrups Frequently Misused? 

Codeine cough syrups are frequently misused due to their ability to produce euphoric effects. When codeine is ingested, it’s metabolized into morphine by the liver, which then triggers the release of neurotransmitters that produce feelings of pleasure and well-being. This euphoria is often sought after by individuals looking for an escape from physical, emotional, or psychological pain.

Factors That Influence Codeine Cough Syrup Misuse:

  • Accessibility: As a prescribed medication, codeine cough syrup is often more accessible than other controlled substances, leading to its misuse.

  • Perceived Safety: Being a prescription medication, some individuals mistakenly believe that codeine cough syrup is safer than other illicit drugs, underestimating its potential for addiction.

  • Recreational Use: In some social circles, the recreational use of codeine cough syrup, often mixed with sodas or candies in concoctions known as "purple drank" or "sizzurp," has been popularized by media and music, adding to its appeal among youth.

  • Self-Medication: Individuals suffering from untreated mental health issues might misuse codeine cough syrups to alleviate symptoms like anxiety or depression.

The Dangers of Addiction and Dependence

Codeine, like other opioids, has a high potential for addiction and dependence. Regular use, even as prescribed, can lead to the body developing a tolerance, necessitating higher doses to achieve the same effects, and ultimately leading to physical dependence.

How Codeine Misuse Leads to Dependence and Addiction:

  • Tolerance Development: Over time, regular use of codeine can lead the body to require more of the drug to feel its effects, setting a foundation for addiction.

  • Physical Dependence: The body may become so used to the presence of codeine that it functions "normally" only when the drug is in the system, leading to withdrawal symptoms if usage is reduced or stopped.

  • Psychological Dependence: Cravings for the effects of codeine can become a significant psychological challenge, making it difficult to stop using the substance.

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Interaction with Other Substances

Mixing codeine with other substances can lead to dangerous and even life-threatening complications, highlighting the importance of using it responsibly under medical supervision. Some common combinations to be aware and steer clear of include:

  • Alcohol: Combining codeine with alcohol can enhance the sedative effects of both, potentially leading to severe respiratory depression, coma, or death.

  • Benzodiazepines: Like alcohol, mixing benzodiazepines with codeine can significantly increase the risk of respiratory depression, profound sedation, or overdose.

  • Other Opioids: Using codeine in conjunction with other opioids compounds the risks associated with each, increasing the likelihood of overdose and heightened side effects.

Challenges of Quitting Codeine

Quitting codeine can be particularly challenging for those already in recovery from substance abuse, as the withdrawal process can trigger a relapse into other addictive behaviors. Withdrawal symptoms, as well as emotional struggles, are likely to arise as well. Here’s a deeper look into the challenges of tapering off codeine cough syrups:

  • Withdrawal Symptoms: Symptoms can include severe flu-like symptoms, mood swings, insomnia, and cravings, which are often difficult to manage without medical help.

  • Emotional and Psychological Stress: The stress of withdrawal can exacerbate underlying mental health conditions or lead to new anxiety and depression, complicating the recovery process.

  • Relapse Risk: The discomfort of withdrawal and the intense cravings for codeine can often lead to relapse, especially for those without a strong support system or who are in a non-conducive environment for recovery.

Health Risks and Side Effects of Codeine Cough Syrup

Codeine cough syrup, while effective for certain medical conditions, carries both short-term side effects and long-term consequences if abused. These effects can range from nausea, vomiting, and disorientation in the short-term to dependency, addiction, and liver damage if misused. Let’s explore these risks and effects on a deeper level:

Short-Term Side Effects of Codeine Use:

  • Drowsiness and Sedation: Codeine often causes significant drowsiness, which can impair your ability to perform daily activities safely.

  • Nausea and Vomiting: A common reaction, especially in those new to its use or when taken in high doses.

  • Constipation: Opioids like codeine reduce gut motility, leading to this uncomfortable digestive issue.

  • Confusion and Disorientation: Higher doses can affect cognitive function, making it difficult to think clearly.

Long-Term Health Risks Associated with Prolonged Use or Abuse:

  • Dependency and Addiction: Long-term use can lead to physical dependence and addiction, as the body becomes accustomed to the drug’s presence.

  • Respiratory Depression: Chronic use can impair respiratory function, particularly in high doses, which is potentially life-threatening.

  • Liver Damage: Especially when codeine is combined with other medications like acetaminophen, prolonged use can lead to liver damage or failure.

  • Decreased Libido and Hormonal Dysfunction: Opioids are known to disrupt normal hormonal production, which can affect sexual function and overall hormonal health.

Impact of Codeine on Mental Health and Recovery Processes:

  • Mood Changes: Users may experience mood swings ranging from euphoria to severe depression.

  • Anxiety and Paranoia: Some individuals may develop anxiety or paranoia as side effects of codeine use.

  • Impact on Recovery: For those in recovery from drug and alcohol abuse, codeine use can trigger a relapse or make it difficult to maintain sobriety due to its addictive nature and the mental health challenges it poses.

As you can see, misusing codeine can lead to a vicious cycle of withdrawal and long-term health risks. Attempting to quit without medical supervision can also be dangerous, as opioid withdrawal is a serious condition with often debilitating symptoms. For these reasons, seeking out professional help in your healthcare provider or a trusted treatment center is a crucial first step in recovery. 

The Forge Recovery Center’s opioid addiction program, for example, can refer you to a reputable detox center, before taking you into our community and treating you with a combination of therapy and medication if needed. But the first step is recognizing the need for professional support.

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Codeine Abuse Treatment & Recovery

Treating codeine addiction should be a guided, supportive process designed to help you reclaim control over your life. However, treatment doesn’t start until you recognize your need for help and seek out a fitting professional. By intervening early, you can receive treatment before your condition worsens. After contacting your healthcare provider or a trusted treatment center, the process will likely start with an initial assessment before moving onto detoxification:

Step-by-Step Recovery Process:

  • Detoxification (Detox): This initial phase involves safely withdrawing from codeine under medical supervision. The Forge Recovery Center can connect you to a reputable detox center within our network. 

  • Inpatient Care: Inpatient treatment provides 24/7 monitoring in a residential setting, and is typically offered for severe cases that require a more intensive approach. 

  • Outpatient Care: Outpatient care allows you to live your life alongside treatment, and is considered a more flexible option than inpatient care. You’ll live at home and work or go to school as usual, all while attending your weekly therapy sessions. 

  • Aftercare: Recovery doesn’t end with rehab, and ongoing support plays a big role in maintaining sobriety. Aftercare includes continued therapy sessions and support groups, which are vital for long-term recovery.

What You Can Expect

  • Individual Therapy: Tailored counseling that helps you understand your addiction patterns.

  • Group Therapy: Sharing experiences and recovery strategies with peers facing similar challenges.

  • Family and Couples Therapy: These programs help repair and strengthen personal relationships, providing a crucial support network.

  • Education on Triggers and Patterns: Our programs emphasize learning about addiction as a disease, recognizing personal triggers, and developing strategies to avoid relapse.

  • Specialized Treatments: For those addicted to codeine-based concoctions like lean or purple drank, our treatments address the unique challenges posed by these substances.

At The Forge Recovery Center, we understand the journey to recovery can be daunting, but you don't have to face it alone. We’re here to help you every step of the way, ensuring you have the tools and support necessary to overcome addiction and lead a healthier, substance-free life.

Codeine Cough Syrups Are Addictive; Call The Forge Recovery Center for Support!

Understanding the risks associated with codeine cough syrups is important for anyone who’s prescribed it, and especially if you have a history of substance use. But if you’ve already reached the point of dependence, seeking help is the priority. At The Forge Recovery Center, we offer a team of treatment professionals – alongside a range of evidence-based therapies – to guide your recovery journey, and are here to lend a hand. Call us today and we’ll craft a comprehensive plan that leads you toward a healthier, substance-free life.

Are You Struggling with Mental Health or Addiction?

We Can Help. Call Us Now!

CALL: 877-839-1772

Written by


The Forge Recovery Center

Reviewed by

jeremy-arztJeremy Arzt

Chief Clinical Officer

June 28, 2024

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