Codeine is an opioid drug that is commonly found in different amounts in a wide range of prescription medications, from cough syrups to painkillers. When taken as prescribed, dependence upon codeine is rare among those who do not exhibit any other risk factors or issues with addiction, but those who abuse the drug risk developing not only a physical dependency but a psychological addiction to the substance as well.

Using codeine for any non-medicinal purpose is the definition of codeine abuse. The development of an addiction to the substance or moving on to taking more addictive opiates is a major concern, but so too is the possibility of overdose on this drug.

It’s not an issue to take lightly. According to Medline Plus, an estimated nine percent of Americans have abused opiate drugs like codeine. Due to an increased rate in opiate prescriptions for pain management, the number of opiate overdose deaths across the country has skyrocketed in recent years.

If your loved one abuses codeine and is in need of treatment, we’re here to help. At Black Bear Lodge, we offer a range of substance abuse and treatment options for those ready to learn how to live drug-free. Contact us at the phone number listed above now.

Codeine Abuse and Dependence


Codeine may be prescribed in the form of cough syrup to those who are struggling with cold and flu symptoms or in pill form for pain management. Though cough syrup containing codeine is rarely sold on the street, the pills are not hard to access on the black market.

Sometimes, it is through a prescription for a legitimate purpose that someone develops a dependence or predilection for abusing the drug. In other cases, codeine is one of many substances used by an opiate addict to maintain an addiction and stave off withdrawal symptoms.

Codeine is not as strong as other opiate drugs, like morphine, but it has the same properties so in large amounts it can create all the same analgesic and euphoria-inducing effects – and be just as prone to cause an addiction or overdose in your loved one.

‘Sizzurp’

Sizzurp” is a slang term often heard in popular music to refer to a drink that combines cough syrup containing codeine, promethazine, soda, and sometimes hard candy. Since the late 1990s, this has been a trend among young people, one glorified by a number of younger hip hop stars, and over the years, the devastating effects of drinking this mixture have been widely publicized.

Promethazine is a medication that has sedative effects much like codeine. When the two drugs are combined, it can be overwhelming to the user, causing the central nervous system to slow down or even stop. When “sizzurp” is combined with alcohol, the chances of overdose rise significantly.

This particular combination of codeine has been associated with the deaths of a number of hip hop artists in recent years.


How can you tell if your loved one is under the influence of codeine? Often, they will:

  • Appear more peaceful and content than usual (e.g., sedated)
  • Be fatigued
  • Have enlarged pupils
  • Have glassy eyes
  • Be unable to carry on a conversation or stay focused
  • Appear to be high
  • Be nauseous
  • Seem confused

Taken in large doses, codeine may cause your loved one to nod out or periodically fall asleep in the middle of conversations. The National Institute on Drug Abuse (NIDA) also reports that those who use codeine may experience weakness, itching, constipation and more.

Withdrawal Symptoms

One of the major signs of addiction to a drug like codeine is the withdrawal symptoms that will inevitably strike when the patient has developed a physical dependence upon the drug but has not been able to maintain a steady level of the substance in the body for a period of time. These symptoms will occur whether or not the patient actively chooses to stop taking the pills, and for some, staving off these withdrawal symptoms can become a singular occupation that drives their addiction.

Opiate withdrawal symptoms can include:

  • Anxiety
  • Profuse sweating
  • Watery eyes
  • Sleep disruption
  • Runny nose
  • Agitation
  • Muscle and bone pain
  • Cramping and diarrhea
  • Nausea and vomiting
  • Chills and/or goose bumps

Symptoms can begin with a few hours of the last codeine dose taken, peak within 36 to 72 hours, and last for up to a week or more. Everyone’s experience with opiate withdrawal symptoms will vary; not everyone will experience all the symptoms listed above or experience them intensely. Others could experience medical emergency due to opiate withdrawal symptoms, especially if there are underlying physical or medical concerns.

Codeine Abuse and Deafness

A study published in the Journal of Otolaryngology Head and Neck Surgery found that severe to profound hearing loss might be caused by abuse of narcotic-acetaminophen combination medications – like cough syrups that contain both codeine and acetaminophen. It’s yet another reason that use of the drug can be harmful to patients who regularly abuse cough syrup containing codeine.

Recovery From Codeine Abuse and Addiction: Timeline

Step by step, it takes time to overcome dependence upon an overwhelmingly addictive drug like codeine. It’s important to note that one cannot force movement from one step to the next without risking the sabotage of the entire process.

Though everyone’s situation is unique and the following may be altered by a number of different issues, in general, the timeline of recovery from prescription abuse and addiction is as follows:

  1. Stabilization. The first step in treatment is for the patient to stabilize both mentally and physically. Because those struggling with opiate addiction will experience significant withdrawal symptoms when they stop taking the drug, addressing those withdrawal symptoms and mental distress is of primary concern.
  2. Therapeutic evaluation. Once stabilized, the patient’s treatment can then turn to the identification of all issues that contributed to the development of the addiction to codeine. It may be a chronic pain problem in those who were first prescribed the drug for ongoing pain management, or it may be issues of stress, trauma or other mental health disorders that trigger cravings. Whether physical or mental, all issues related to codeine abuse must be addressed during treatment.
  3. Intensive therapy. Therapeutic intervention designed to address the personal needs of each patient is recommended. This should be founded on a wide range of traditional therapies like personal therapy, group therapy, family therapy, 12-Step meetings and others. Additionally, a number of alternative therapies should round out the program; options include outdoors and adventure therapy, sports therapy, psychodrama, art therapy, dance therapy and many more.
  4. Holistic treatment. There are a number of wellness treatments available that have been shown to positively influence progress during addiction treatment and aid patients in remaining clean and sober for the long term. These can include such options as nutritional therapy, yoga, meditation and others.
  5. Practical assistance. Often life’s stressors can contribute to relapse in recovery, which is why it is important to do everything possible to give patients all the tools necessary to mitigate and manage these stressors as they arise. This will vary from patient to patient but can include such assistance as legal help or referrals, job training, parenting classes, resume assistance and more.
  6. Treatment for co-occurring disorders. If any serious mental health disorders like schizophrenia, bipolar disorder, borderline personality disorder and others were identified during the evaluation phase of treatment, it will be necessary to provide intensive treatment for this issue as well during addiction rehab. Because substance abuse and mental health disorders are often deeply entwined, it is rarely effective to treat first one issue then the other; Dual Diagnosis treatment is almost always recommended.
  7. Ongoing assessment. Throughout the course of treatment, progress will occur at varying rates on different fronts. Patients will need to have regular check-ins with a case manager or counselor in order to identify the progress made and adjust treatment goals accordingly, updating their treatment plan to ensure that their needs are continually being met.
  8. Aftercare. Continued treatments and therapeutic intervention are recommended for at least a year or more after rehab is complete. This continued engagement with recovery could ensure that the principles learned in treatment become lifestyle choices as the patient rebuilds a new life in sobriety.

Street Names for Codeine

  • Cody
  • Co-D
  • Captain Cody
  • Schoolboy
  • Sizzurp

Learn More About Opiate Addiction Treatment Options for Your Loved One Today

There are a number of options for the treatment of dependence upon codeine. Some of these include medications. Buprenorphine, methadone and others may be able to aid in the stabilization process during the first stages of treatment in some cases. However, these medications are not recommended for use in all cases and are not a complete treatment by themselves.

Detox is only the first stage in a comprehensive codeine addiction treatment program. The real work comes through the therapy that follows as the patient learns how to manage cravings and handle triggers to use while rebuilding a life based on balance and wellness.

You can find out more about codeine treatment options waiting for your loved one here at Black Bear Lodge today – simply pick up the phone. We’re standing by to take your call.