What is codeine?

Codeine is a strong medication used against pain. It comes from extracts of the poppy plant and belongs to the same family of pain medications as morphine. Other members of this family of products is morphine and pethidine; they are all very powerful pain medication with high addiction potential.

Codeine occurs naturally together with morphine in the milky fluid that is extracted from the seed pods of the poppy plant, but it can also be manufactured in a laboratory. Codeine is a very commonly-used pain medication worldwide and it is usually prescribed for pain that may occur after an operation. It is usually taken orally in the form of a tablet or capsule, but can be taken as an injection in rare cases. The oral form has the longest-lasting effect against pain. In cases where oral codeine is not effective enough, it can be taken with other medication as a combination.

Like most medication in its family, codeine also works against coughs, as it decreases the working of the part of the brain that causes you to cough. It is also effective against diarrhoea, because it decreases the working of the muscles in the intestines. In spite of being effective against cough and diarrhea, codeine is not recommended or prescribed against these two conditions, because it has quite severe side effects and also because it can cause addiction. There are various other medications on the market which are just as effective against cough and against diarrhea, so patients do not have to use codeine.

Some side-effects of codeine include the following:

• addiction (in a very small time period of use)

• drowsiness and sedation

• flushed skin

• decreased blood pressure

• itching

• constricted pupils

• slow and shallow breathing

• low body temperature

• sleep disturbances

• mood changes

• depression

• brady- or tachycardia (slowed or excessively fast heart rate).

Codeine is addictive and for some patients the positive effects may decrease over time, which may mean that they must take higher dosages to have the same positive effects against pain.

Medical use, non-medical use and misuse

Medical use of codeine means that the patient uses the medication for the correct reasons and in the dosage, as prescribed by the doctor or the pharmacist.

Non-medical use or misuse of codeine occurs when the patient uses codeine in dosages that are higher than prescribed or for a time-period that is longer than necessary. Patients sometimes use codeine because it causes similar effects than taking too much alcohol; this is also misuse.

It can also happen that patients misuse codeine by taking two or more codeine or codeine-containing products for different symptoms without realizing it. An example of this is using codeine for pain and a different product for cough; this can lead to overdosing and increases the potential for dependence.

Codeine dependence and addiction

Codeine dependence occurs when the patient is physically or psychologically dependent on codeine after a prolonged period of use; it also includes when a patient relies on codeine for aid and support. Dependence can also be described as a driving need to continue taking the drug to feel pleasure or to prevent or relieve anxiety and tension and to avoid discomfort.

Being addicted to something means that the patient is enslaved by something such as a drug; this enslavement can be so severe that to stop using it may cause severe physical and emotional trauma and damage to the patient. Addiction is characterized by disruptive behavior that may occur when the patient is trying to obtain and use the drug; this behavior can be so bad that it affects the patient’s work, social and family life very negatively.

“What should I do…?”

One of the challenges mentioned by people when faced with suspected codeine misuse, is the question of what to do in such cases. In your case, the only thing you should do, is to refer the patient to the pharmacist immediately