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You would not believe how easy it is to get codeine in the UK! Even if you’ve never heard of codeine before, it doesn’t take more than 5 minutes of online searching to find out that you can legally buy an opioid from a pharmacy –without a prescription, mind you– in a variety of forms to suit your individual tastes and preferences. Telegram, an incredibly popular and wide-reaching social chat app, has entire groups dedicated to discussing and supplying codeine illegally, some with several hundred members. It really is a golden age for those looking for ‘Captain Cody’, ‘Lean’, ‘Sizzrup’, or ‘Purple Drank’.
So what’s the big deal? If doctors freely prescribe it and you can buy it without a prescription, why care? After all, codeine is widely recognised as an effective analgesic (painkiller) by healthcare professionals around the world – finally bringing relief where other remedies have failed.
The big deal is that codeine is addictive and habit-forming. While this is true for many legitimate drugs and medicines prescribed by healthcare workers in the UK, codeine, along with other drugs in the opioid family, stands head and shoulders above most prescription drugs when looking at exactly how addictive it is. The other side of this big deal coin is the harm caused by habitual codeine abuse. Depression, liver and kidney damage, pain, and seizures are but a few of the side effects that the unlucky patient –originally looking for pain relief– could experience.
When a substance is this addictive, this available, and this harmful on a personal and societal level, understanding why people become addicted to codeine, the long-term effects of codeine abuse, and knowing where to seek help can make all the difference to you or a vulnerable loved one.
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Codeine, the most commonly taken opioid medication, is indicated specifically for the treatment of chronic pain but is also used to treat persistent dry coughs, restless leg syndrome, and even as a palliative treatment for persistent diarrhoea. Healthcare providers typically do not resort to codeine or other opioids as the first line of treatment because of how addictive they are; however, they are considered a viable option when other non-opioid treatments have failed. It’s often prescribed as an analgesic to cancer patients, as well as to patients suffering from back pain, fibromyalgia, osteoarthritis, and headaches (Peechakara et al.).
An important caveat when discussing why people use codeine is to remember that it’s part of the opioid family of drugs. Taking doses larger than prescribed or combining codeine with other drugs or alcohol can induce a euphoric high. While not everyone who purchases codeine-containing medications such as co-codamol (codeine and paracetamol), co-codaprin (codeine and aspirin), or solpadeine (codeine and ibuprofen) is necessarily trying to get high, the fact that these medications are available without a prescription certainly doesn’t deter those looking for a high.
The long-term effects of continued codeine abuse should be considered alongside the long-term effects of whatever medication it’s packaged with. A patient who’s been abusing co-codamol for an extended period of time will suffer the effects of both the codeine and the paracetamol and will likely experience kidney damage caused by the latter. Similarly, co-codaprin users might experience dizziness or confusion due to the aspirin content (Goldrich et al.), while long-term solpadeine abusers could expect impaired hearing and an increased risk of heart attack caused by ibuprofen toxicity (“Ibuprofen”).
Long-term codeine abuse, regardless of the form in which it’s taken, is associated with a wide range of serious and morbid effects, including death. This is an increasingly serious problem in the UK specifically, as a study published in 2023 found we had the world’s highest opioid consumption rate in 2019, and that opiate-related poisoning deaths had increased by 388% since 1993 in England and Wales (Roberts and Richards).
When discussing the effects of long-term drug abuse, it’s important to look beyond just the effects it has on one’s physical health. Those suffering from substance use disorder (SUD) often experience dramatic and life-changing effects in terms of their behaviour, interpersonal relationships, and psychological well-being.
Behavioural symptoms
Cognitive & psychological symptoms
Physical symptoms
Opioids are notoriously difficult to quit. The withdrawal symptoms are often extremely severe, painful, and uncomfortable, and can set in within a few hours after the last use. You can learn more about general drug withdrawal symptoms and mechanisms here, or read our article on codeine addiction signs, withdrawal symptoms, and timelines.
Because of these painful and uncomfortable associations with codeine withdrawal, many are hesitant to even attempt quitting, despite being aware of the harm that it’s causing. In these cases, an intervention might be the best chance to get someone to give detox and rehab a chance. Professional intervention services from experienced addiction specialists can help families and friends avoid the many potential pitfalls of a botched intervention, and Gladstones Clinic highly recommends reading up on the subject or seeking professional help if you are considering an intervention for a loved one.
Once the decision to end codeine abuse has been made, the patient effectively has two options: go through detox and rehab in a specialised drug rehab facility, or do a home detox and join a support network. While both are viable options, patients in rehab facilities have a significantly better chance of going through detox without relapsing. Rehab facilities almost always have registered physicians on standby who can prescribe medications such as methadone, buprenorphine, clonidine, or other medications that ease the pain of withdrawal symptoms (Srivastava et al.). While these drugs might be prescribed to someone attempting a home detox, their highly addictive nature (and the black-market value of these drugs) makes physicians hesitant to prescribe them in an outpatient setting.
Opioid withdrawal symptoms typically last for about 8 days, although this can vary from person to person. After the physical withdrawal symptoms have subsided, the patient can enter the primary care phase, which usually lasts for 3 or 4 weeks (Perez). This typically comprises group therapy, psychiatric counselling, cognitive behavioural therapy (CBT), relapse prevention education, and family therapy where required. Depending on the facility, other services that could help the patient rejoin society might include life skills training and community engagement programmes.
Gladstones Clinic Drug and Alcohol Rehabilitation Centres have more than two decades of experience helping people from all walks of life overcome opioid and other drug addictions. Our skilled and experienced addiction specialists offer compassionate and understanding care in our well-suited residential care facilities located in London and the Cotswolds. We take a holistic and integrative approach to dealing with addiction, using nothing but modern, evidence-based techniques and therapies to identify and address each patient’s root causes of addiction.
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If you or a loved one are struggling with codeine addiction, please feel free to contact us sooner rather than later. We will gladly talk you through the services that we offer, clearly explain what to expect from the detox and rehab processes, and answer any of your questions confidentially and obligation-free.
