It often starts quietly. A prescription for a nagging cough or to manage pain after a procedure. Codeine can feel like a helpful solution, a way to get through the day. But sometimes, the line between relief and reliance begins to blur. If you’re reading this, you might be worried that this medication has started to take up too much space in your life, or in the life of someone you love. You might be feeling confused, scared, or alone, wondering how something prescribed by a doctor could lead to this point. Please know that what you’re feeling is valid, and you’ve come to a place of understanding and support. This isn’t about judgment; it’s about getting clarity and finding a path forward.
What is codeine addiction?
Codeine is a prescription opioid medication, most commonly used to treat mild to moderate pain or to suppress a cough. While it’s less potent than other opioids, its potential for misuse and addiction is very real. When you take codeine, your body converts a portion of it into morphine, which then binds to opioid receptors in your brain. This process blocks pain signals and can create a short-lived feeling of euphoria or well-being.
So, is codeine addictive? Yes. With repeated use, your brain adapts. This leads to tolerance, where you need to take more of the drug to get the same effect you once did. As tolerance builds, physical dependence can set in. This doesn’t mean you have an addiction, but it does mean your body has adjusted to the presence of codeine and will experience withdrawal symptoms if you stop suddenly.
Addiction, or substance use disorder, is the next step, where using the drug becomes a compulsive need, even when it’s causing harm to your health, relationships, or daily life. It’s when you continue to seek out and use codeine despite the negative consequences, feeling like you’ve lost control over your use. The journey from a simple prescription to a full-blown codeine addiction is a gradual one, but it can happen more easily than many people think.
What are the signs and symptoms of codeine addiction?
Recognizing a codeine addiction can be difficult, both in yourself and in others. The signs are often subtle at first and can be mistaken for other issues. However, when you know what to look for, the patterns become clearer. The symptoms generally fall into three categories: physical, psychological, and behavioral.
Physical Signs:
- Constant drowsiness or sedation
- Constricted or “pinpoint” pupils
- Nausea and vomiting
- Chronic constipation
- Itching or flushed skin
- Slowed breathing rate
- Poor coordination or slurred speech
Psychological Signs:
- Unexplained mood swings, from euphoria to irritability
- Increased anxiety or depression
- Difficulty concentrating or feeling confused
- Apathy or a loss of motivation
- Defensiveness when asked about codeine use
Behavioral Signs:
- “Doctor shopping,” or visiting multiple doctors to get prescriptions
- Isolating from family and friends
- Losing interest in hobbies and activities once enjoyed
- Financial troubles or borrowing money without a clear reason
- Neglecting responsibilities at work, school, or home
- Secretive behavior around medication use
If you recognize a combination of these signs, it may be time to seek help. It’s not about placing blame, but about acknowledging that a problem exists so that healing can begin.
Side effects
Even when taken as prescribed, codeine can cause a range of immediate side effects. It’s important to be aware of these, as they can impact your ability to function safely. Common side effects include:
- Dizziness and lightheadedness
- Nausea and vomiting
- Sedation or feeling unusually sleepy
- Shortness of breath
- Dry mouth
Long-term effects of codeine
When codeine misuse continues over a long period, the risks become much more severe. Chronic use can lead to serious health consequences that affect your entire body. Prolonged constipation can cause significant bowel damage. Because codeine is often combined with other medications like acetaminophen, there is a high risk of severe liver damage or failure with excessive use. One of the most dangerous long-term effects is respiratory depression, where breathing becomes dangerously slow and shallow, which can lead to brain damage or death. Furthermore, ongoing codeine abuse often worsens or triggers co-occurring mental health conditions like major depression and anxiety disorders.
You can overcome addiction. Reach out to discover:
What are the causes of codeine addiction?
There is no single reason why one person develops an addiction while another doesn’t. It’s a complex disease that stems from a combination of factors. Understanding these can help explain how a codeine addiction takes hold. Genetics plays a significant role; if you have a family history of substance use disorder, your own risk is higher.
Environmental factors are also critical. Growing up in a stressful or chaotic environment, experiencing trauma, or facing intense peer pressure can make someone more vulnerable. For many, the path to addiction begins with a legitimate prescription for pain. As the body builds a tolerance, a person might start taking more than prescribed just to manage their pain, unknowingly starting a cycle of dependence.
Psychological factors, such as co-occurring mental health conditions like depression, anxiety, or PTSD, are also major contributors. People may turn to codeine to self-medicate emotional pain, creating a dangerous link between the drug and relief. At its core, addiction alters the brain’s chemistry. Opioids like codeine hijack the reward system, flooding it with dopamine and teaching the brain to prioritize the drug above all else, which reinforces compulsive drug-seeking behavior.
The dangers of codeine addiction and abuse
Beyond the physical and psychological symptoms, codeine abuse carries life-threatening dangers. The most immediate and severe risk is an overdose. This happens when the amount of codeine overwhelms the body’s ability to handle it, leading to respiratory depression, where breathing slows down or stops completely. The risk of a fatal overdose skyrockets when codeine is mixed with other central nervous system depressants, such as alcohol, benzodiazepines (like Xanax or Valium), or other opioids. Combining these substances can amplify their effects, quickly leading to a medical emergency.
Even if an overdose is not fatal, it can cause permanent brain damage due to a lack of oxygen. Long-term abuse also wears on the body, leading to organ damage, chronic health issues, and a decline in mental health. The cycle of misuse and withdrawal can feel impossible to escape alone, but compassionate and professional help is available. Recognizing the dangers of mixing codeine and alcohol or other substances is the first step toward preventing a tragedy.
Signs of codeine overdose
A codeine overdose is a critical medical emergency that requires immediate help. If you suspect someone is overdosing, call 911 right away. Do not wait. The key signs to watch for include:
- Slow, shallow, or stopped breathing
- Constricted, pinpoint pupils
- Limp body and unresponsiveness
- Pale, cool, or clammy skin
- Blue or purple lips and fingernails
- Loss of consciousness or being unable to wake up
- Gurgling or choking sounds
Symptoms of codeine withdrawal
When someone with a physical dependence on codeine stops using it, their body goes through withdrawal. While typically not life-threatening, the symptoms can be intensely uncomfortable and are often a major reason people find it so hard to quit on their own. Common withdrawal symptoms include:
- Muscle aches and pains
- Anxiety, agitation, and irritability
- Insomnia and restlessness
- Excessive sweating and yawning
- Runny nose and watery eyes
- Nausea, vomiting, and diarrhea
- Abdominal cramping
Free Insurance Check
Our rehab center accepts most insurance plans.
Check if your insurance will cover the cost of treatment by filling out our confidential insurance form. We accept most insurance plans.
Codeine drug rehab treatment
Taking the step to seek professional treatment is the most effective way to overcome codeine addiction and build a foundation for lasting recovery. The journey often begins with a safe, medically supervised detox to manage withdrawal symptoms, but the real work starts with therapy and support. At Red Ribbon Recovery Indiana, we focus on what comes next. We offer flexible and powerful outpatient care programs that allow you to heal while maintaining your daily responsibilities. Our services include outpatient (OP), intensive outpatient (IOP), and partial hospitalization (PHP) programs, providing structured support without requiring you to live at a facility.
Our approach is built on the Red Ribbon Recovery Model, which uses evidence-based therapies like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) to help you understand the root causes of your addiction and develop healthy coping skills. We also provide dedicated dual diagnosis support for those struggling with co-occurring mental health conditions like anxiety or depression. Whether you’re in Indiana or need help from afar through our telehealth options, we’re here to guide you. If you want to better understand the process, learn more about how rehab works and what to expect on your journey to recovery.
Rehab might feel like a big step, but remember why you're here—you’re looking for a way forward. We can help.
Are you ready to get help?
Recovery from codeine addiction is not just possible; it’s a reality for so many people who took the brave first step to ask for help. Reaching out is a sign of incredible strength. You don’t have to carry this burden alone any longer. Understanding the signs and risks of codeine use is the first step, but the next one, seeking support, is what truly changes everything. Compassionate, effective treatment is available, and a healthier, more fulfilling life is waiting for you.
If you or someone you care about is struggling, please don’t wait. Your journey to recovery can start today with a confidential call to our team at (317) 707-9848. Let us at Red Ribbon Recovery Indiana help you find your path forward. You can also contact us to take the first step toward healing.
We are here to help you or a loved one find addiction treatment near you.
Admitting you have a substance abuse problem and asking for help is not always easy. If you or a loved one are struggling with drug addiction, alcohol addiction or another substance use disorder, help is available. Call SAMHSA’s National Helpline at (317) 707-9848 to learn about resources in your area or reach out to our team for personalized treatment.
Frequently Asked Questions About Detox
What is codeine?
Codeine is a prescription opioid medicine prescribed by a doctor to treat mild to moderate pain or to suppress a cough. It’s often found in combination with other medications, like acetaminophen, and is considered a less potent opioid compared to drugs like morphine.
It works by altering how your brain and body perceive pain signals. Because of its effects on the brain, it has the potential for misuse and should only be taken exactly as your doctor directs.
How is codeine used?
Codeine is typically taken by mouth as a tablet, capsule, or liquid syrup. A doctor determines the correct dose and timing to manage symptoms like pain or a severe cough. It’s very important to follow the prescribed directions exactly and not to use it for a longer time than recommended.
Misusing this medicine, such as taking a larger dose for its euphoric effects, significantly increases the risk of developing a physical dependence and addiction.
What makes codeine addictive?
Codeine is addictive because of its effect on the brain’s reward system. When you take this medicine, your body converts some of it into morphine. This morphine attaches to opioid receptors in your brain, which blocks pain signals and can produce a temporary feeling of well-being or euphoria.
Over time, your brain can start to associate codeine with this powerful, positive feeling. It may begin to rely on the drug to feel normal, which leads to tolerance and cravings. This cycle is what makes the drug addictive and can cause a person to feel a compulsive need to continue using it.
What's the difference between codeine abuse and addiction?
Codeine abuse means using the medicine in any way other than how a doctor prescribed it. This could include taking a higher dose, using it for non-medical reasons like feeling high, or taking a prescription that belongs to someone else. It’s a pattern of misuse that can have dangerous effects.
Addiction, also called a substance use disorder, is a chronic disease. It involves a compulsive need to seek out and use the drug, even when you know it’s causing harm. A person with an addiction often feels they’ve lost control and will continue using despite negative impacts on their health and relationships.
Reviews
Sources
- National Center for Biotechnology Information. (02-28-2024). Codeine – StatPearls – NCBI Bookshelf. StatPearls Publishing.
- MedlinePlus. (10-15-2025). Codeine: MedlinePlus Drug Information. National Library of Medicine.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (09-24-2025). Home | SAMHSA – Substance Abuse and Mental Health Services …. SAMHSA.
- U.S. Food and Drug Administration (FDA). (04-20-2017). FDA restricts use of prescription codeine pain and cough medicines. FDA.
- National Institute on Drug Abuse (NIDA). (06-01-2021). Prescription Opioids DrugFacts. NIDA.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Locating Data on Risk Factors for Opioid Overdose. [PDF] Locating Data on Risk Factors for Opioid Overdose – SAMHSA. SAMHSA.
- National Center for Biotechnology Information. (01-17-2024). Opioid Use Disorder: Evaluation and Management – StatPearls. StatPearls Publishing.
- National Center for Biotechnology Information. (07-10-2023). The Opioid Epidemic: A Review of the Contributing Factors … – NIH. National Center for Biotechnology Information.
- Columbia University Irving Medical Center. (07-22-2016). Significant Pain Increases the Risk of Opioid Addiction by 41 Percent. Columbia University.
- Centers for Disease Control and Prevention (CDC). (11-04-2022). CDC Clinical Practice Guideline for Prescribing Opioids for Pain. CDC.
- National Center for Biotechnology Information. (11-18-2016). THE NEUROBIOLOGY OF SUBSTANCE USE, MISUSE, AND … – NCBI. National Academy of Sciences.
- National Center for Biotechnology Information. The Neuroscience of Drug Reward and Addiction – PMC. National Center for Biotechnology Information.
- Rockefeller University. (04-18-2024). Newly discovered brain pathway sheds light on addiction – News. Rockefeller University.
- MedlinePlus. (05-04-2024). Opiate and opioid withdrawal: MedlinePlus Medical Encyclopedia. National Library of Medicine.
- National Center for Biotechnology Information. (01-22-2025). Opioid Toxicity – StatPearls – NCBI Bookshelf. StatPearls Publishing.
- National Center for Biotechnology Information. (01-01-2009). Clinical Guidelines for Withdrawal Management and Treatment of …. National Center for Biotechnology Information.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (02-02-2024). Substance Use Disorders – Statutes, Regulations, and Guidelines. SAMHSA.
- National Center for Biotechnology Information. (01-01-1996). Chapter 5—Specialized Substance Abuse Treatment Programs – NCBI. National Academy Press.
- Substance Abuse and Mental Health Services Administration (SAMHSA). (08-25-2025). Medications for Substance Use Disorders. SAMHSA.
- American Society of Addiction Medicine (ASAM). (07-29-2021). About the ASAM Criteria. ASAM.
- Centers for Disease Control and Prevention (CDC). (04-25-2024). Treatment of Substance Use Disorders | Overdose Prevention. CDC.
- U.S. Department of Health and Human Services. (10-01-2021). Addiction – Healthy People 2030. Office of Disease Prevention and Health Promotion.
- National Center for Biotechnology Information. (02-19-2023). Efficacy of Cognitive Behavioral Therapy for Alcohol and Other Drug …. National Center for Biotechnology Information.
- National Center for Biotechnology Information. (01-01-2003). Evidence-based practices for substance use disorders – PMC – NIH. National Center for Biotechnology Information.
- National Association of Addiction Treatment Providers (NAATP). Addiction Treatment Methods | Evidence-Based Practices. NAATP.
- MedlinePlus. (12-20-2023). Dual Diagnosis. National Library of Medicine.
- National Center for Biotechnology Information. (07-01-2004). Dual diagnosis capability in mental health and addiction treatment …. National Center for Biotechnology Information.
- Substance Abuse and Mental Health Services Administration (SAMHSA). [PDF] Starting the conversation Guide. SAMHSA.
- Substance Abuse and Mental Health Services Administration (SAMHSA). [PDF] Alcohol and Drug Addiction Happens in the Best of Families…and It …. SAMHSA.
- National Center for Biotechnology Information. (01-01-1997). The Impact of Substance Use Disorders on Families and Children. National Center for Biotechnology Information.
About the content
Written by: Carli Simmonds. Carli Simmonds holds a Master of Arts in Community Health Psychology from Northeastern University. From a young age, she witnessed the challenges her community faced with substance abuse, addiction, and mental health challenges, inspiring her dedication to the field.
Medical reviewed by: Jodi Tarantino, LICSW. Jodi Tarantino is an experienced, licensed Independent Clinical Social Worker (LICSW) and Program Director with over 20 years of experience in Behavioral Healthcare. Also reviewed by the RRR Editorial team.
Red Ribbon Recovery is committed to delivering transparent, up-to-date, and medically accurate information. All content is carefully written and reviewed by experienced professionals to ensure clarity and reliability. During the editorial and medical review process, our team fact-checks information using reputable sources. Our goal is to create content that is informative, easy to understand and helpful to our visitors.
