Why is Codeine Addictive?

Why is Codeine Addictive?

The use of strong prescription painkillers, particularly opiates, has been the subject of much concern recently. The US has seen what has been described as an ‘epidemic’ of prescription drug abuse and related deaths. The situation in the UK is not so bad, but it is still a serious concern.

A recent Public Health England (PHE) report highlighted that nearly 12 million adults in England were using prescription painkillers. The vast majority were not being misused, but the report concluded that the widespread prescription of drugs, including opioid painkillers like codeine, needed to change.1

These opiates can be addictive and potentially dangerous, especially if misused recreationally or taken outside prescribed guidelines. But what exactly is codeine, and what makes it so addictive?


What is Codeine?

Codeine is a strong painkiller used to treat moderate to severe pain experienced after surgery or an accident. It may also be prescribed if painkillers such as paracetamol, ibuprofen or aspirin are inadequate or have stopped working. It is from the opiate family, including the illegal drug heroin and other prescription drugs such as morphine and oxycodone. It generally comes in the form of tablets, a liquid to swallow or injections that are usually only given in hospitals.

It can also be mixed with other drugs in the form of well-known medicines such as co-codamol (which contains paracetamol), co-codaprin (with aspirin) and Nurofen Plus (with ibuprofen). It works as a painkiller by blocking pain signals from the brain and central nervous system from being sent to the rest of the body. It also lowers the stress and anxiety usually caused by pain.2


What Makes Codeine Addictive?

Opiate or opioid painkillers such as codeine can be addictive even when used as directed by a GP or other medical professional. A recent government report said: “Considerable concern has been raised regarding prescribing rates of opioids in the UK and the awareness of healthcare professionals and patients of the risks of dependence and addiction.” It added that long-term use of opioids could lead to addiction, even when used at “therapeutic doses”.3

The risk of dependency and addiction can increase if the drug is misused. This could involve sourcing the drug illegally, using deception to get more of the drug from your doctor, taking more than the amounts prescribed or using the drug recreationally.

While codeine is not as strong as other opiate painkillers like fentanyl, morphine, and oxycodone (commonly known as Oxynorm and OxyContin), it works similarly. As well as reducing pain by blocking the signals codeine can also cause pleasurable sensations including a sense of euphoria, relaxation and drowsiness. These pleasurable sensations can play a part in developing a psychological dependency on the drug.

Dr Lewis Nelson, a professor of emergency medicine at New York University’s Langone Medical Center, told Live Science: “It would be great if you could dissociate the pain-relieving part of [opioids] from the euphoria-inducing part of [opioids], but you can’t. They’re inextricably linked.”4

At the same time, long-term use of a drug like codeine can see you start to develop a physical dependency. You can build up a tolerance to the drug, meaning you need to use it more and more for the same effect. Your brain and body can also rely on the chemicals provided by the drug beyond its painkilling effects. This means the user can experience a range of withdrawal symptoms if the drug is suddenly removed or drastically reduced. This can make it even more difficult to quit the drug without expert help.

Withdrawal symptoms commonly associated with codeine include:

  • Nervous tremors
  • Anxiety
  • Yawning
  • Sweating
  • Runny nose
  • Sleep disturbance
  • Nausea
  • Diarrhoea
  • Goosebumps
  • Restlessness
  • Abdominal cramps and muscle spasms5


5 Symptoms of Codeine Addiction

Codeine addiction can creep up on you, especially if it started through a legitimate prescription and drug use. Here are some signs to look out for that could suggest you have a problem.

  • Needing more for the same effect – This is a sign of increasing tolerance to the drug
  • Withdrawal symptoms – Experiencing physical and psychological withdrawal symptoms when you do not use the drug is a sign that you are physically dependent on it
  • Feeling anxious about getting more codeine – You might become anxious and preoccupied about getting more codeine. This could lead to you being dishonest with doctors to get more, using other people’s prescriptions or buying the drug illegally
  • Trying and failing to quit or cut down – This could signify that you need professional help to get yourself off the drug
  • Physical and mental symptoms – could include dizziness, mood swings, agitation, disturbed sleep, anxiety, sexual dysfunction and more


What Are the Risks of Codeine Addiction?

Codeine can have a wide range of side effects such as headaches, nausea and confusion. These can affect any user. Still, long-term and heavy use can potentially increase the risks of more serious side effects like low blood pressure and abnormal breathing. There can also be potentially fatal side effects if mixed with other drugs that suppress breathing – including other opiates, alcohol and sedatives like Valium. Heavy use of codeine can lead to overdose.


Help for Prescription Drug Addiction

Codeine addiction can be successfully treated like other forms of prescription drug addiction. You can take different routes, but private drug and alcohol rehab is generally the most effective treatment for serious addiction. This can involve a medically supervised detox to help you deal with the withdrawal symptoms, as well as therapies and other treatments to help you deal with the psychological aspect and develop strategies to avoid relapsing.

If you are worried about your own codeine use or that of a loved one, contact us today and find out how we can help.



  1. https://www.theguardian.com/uk-news/2019/sep/10/addictive-medication-nhs-opioid-crisis-government-study-england
  2. https://www.nhs.uk/medicines/codeine/about-codeine/
  3. https://www.gov.uk/drug-safety-update/opioids-risk-of-dependence-and-addiction
  4. https://www.livescience.com/41174-tramadol.html
  5. https://www.talktofrank.com/drug/codeine#addiction