Although available as a prescription in the UK, codeine is one of the most addictive drugs and can have a negative impact on an individual’s life if misused. Here, we look at codeine in more detail as well as signs of a codeine addiction and how long codeine stays in your system. Remember, if you are concerned about your own use or someone you care abouts use, it is important to get professional help.

What is Codeine?

Codeine is a prescription opiate analgesic medication – derived from the poppy plant – and is often used to treat pain following an operation or injury. Codeine is often used when over the counter painkillers – such as paracetamol, ibuprofen and aspirin – have not worked.

Codeine can also be used to treat coughs in some circumstances, and due to its constipation effects, it can be used to treat diarrhoea. Codeine is often in tablet form, but can also be provided in capsule, oral solution, suspensions and syrups.

Classified as a class B drug in the UK, possession of codeine requires a prescription – although lower-strength codeine can be purchased from a pharmacy without a prescription. Lower strength over-the-counter codeine comes mixed with paracetamol (co-codamol), aspirin (co-codaprin), or ibuprofen (Nurofen Plus).

Codeine has the potential to be addictive – producing cravings and the psychological desire to keep taking it. Often addiction can start when withdrawal symptoms begin after codeine use ceases – which can often lead to individuals seeking codeine illegally.

Withdrawal symptoms following codeine withdrawal include: nervous tremors, anxiety, yawning, sweating, runny nose, sleep disturbances, nausea, diarrhoea, goose-bumps, restlessness, abdominal cramps, and muscle spasms.

How Long Does Codeine Stay in Your System?

After taking a dose of codeine, it can take up to an hour to feel the effects of the drug – which include pain relief, as well as sometimes relaxation, drowsiness, confusion, nausea, itchiness and constipation. Pain and cough relief is typically felt for about three or four hours – which is why codeine is often prescribed for use multiple times per day.

Codeine has a short half-life – which is half the time it takes for the body to break down and excrete half of one dose. After codeine enters the bloodstream, the liver breaks it down into metabolites – which are substances found as the body breaks the drug down.

The half-life of codeine is about three hours – however codeine’s metabolites have longer half-lives, which can provide cough and pain relief after codeine has been broken down.

A variety of factors impact how long codeine stays in your system, including:

● Dosage consumed – higher doses will require more time to process.
● Frequency of drug use – frequent usage of codeine can lead to an excess of metabolites (substances the liver breaks the drug down into), meaning it takes longer for the body to excrete the drug.
● Duration of codeine use – regular use of codeine over a long period of time can lead to more metabolites in your system compared to short-term codeine use.
● Age, weight, activity level, and metabolism – as metabolisms vary between people, some may process codeine faster than others. Often individuals who are elderly, overweight, or have any condition that compromises their metabolisms may take longer to clear the drug from their body.

Metabolism of Codeine

Codeine is metabolised by the liver, which results in the production of metabolites – which is what the liver breaks codeine down into. Although the main organ involved in metabolising codeine is the liver, the organ primarily tasked with excretion of substances is the kidneys.

Codeine is converted into metabolites by the liver, with 50-70% of codeine converted into codeine-6-glucuronide, 10-15% converted to norcodeine, and up to 15% converted to morphine.

Codeine and its metabolites are excreted in the urine, via the kidneys. Approximately 90% of the total dose of codeine is excreted by the kidneys, with the majority of the excretion found in the urine within six-hours of ingestion.

Codeine Addiction and Withdrawal

Addiction is a disorder of the brain’s reward system where the user is compelled to engage in rewarding behaviours despite the awareness of the negative consequences. Over time, repeated exposure to addictive substances can change the levels of chemicals in the brain.

Codeine has the potential for addiction due to some of its pleasant side effects – such as relaxation and euphoria. Users may enjoy these side effects and seek to repeat that feeling, thus becoming addicted to the drug.

When someone engages in a rewarding behaviour, such as taking codeine, their levels of dopamine (the reward chemical) in the brain increases, which makes them feel good. Higher levels of dopamine drive the affected person to continually recreate the positive feelings that result from the higher levels of dopamine, reinforcing the addiction to the drug to avoid the drop in dopamine and the associated negative feelings.

Codeine is also physically addictive – long-term users often feel the need to take codeine to avoid withdrawal symptoms, which include:

● Nervous tremors
● Anxiety
● Yawning
● Sweating
● Runny nose
● Sleep disturbances
● Nausea
● Diarrhoea
● Restlessness
● Abdominal cramps
● Muscle spasms.

Causes of withdrawal symptoms from codeine include tolerance, dependence and addiction. With continued use of codeine, the body needs higher doses to produce the same pain relief and euphoric effects – making the usual dose less effective on the body. Tolerance is affected by genetics, how long you take codeine for, dosage and behaviour.

As you become tolerant to the effects of codeine, your cells begin to rely on the drug in order to prevent withdrawal symptoms – this is called dependence. Dependence is what leads to withdrawal symptoms if codeine use is stopped abruptly. A sign of dependence is the need to take codeine to prevent withdrawal symptoms.

Dependence can occur if codeine is taken for more than a few weeks or if higher than prescribed doses are taken – although it is possible to develop codeine dependence even if the drug is taken as prescribed by a doctor.

Addiction often follows dependence and involves craving the drug and having compulsions to seek out ways to take the drug. Addiction also changes the way your brain works – leading you to use a drug despite being aware of the negative consequences.

Dependence and addiction both cause withdrawal symptoms when the drug is stopped, but dependence stems from long-term exposure to a drug, with mild to severe withdrawal symptoms.

Codeine Addiction Test

Codeine can be detected in the body through a variety of methods, depending on the testing method – including in urine, blood, saliva and hair. The time that codeine is detectable in a drug test depends on the type of test and other factors – including:

● Dosage
● How long codeine has been taken for
● Age
● Weight
● Liver and kidney function
● Genetics
● Other medication taken

Codeine and its metabolites can be detected for one to three days in a urine test. Urine testing is the most common type of drug testing as it doesn’t require any specialist equipment and is non-invasive. Codeine can be detected in blood tests for two to four hours – with the time frame being short due to the short half-life of codeine.

Blood testing is a more invasive and costly method for detecting drugs such as codeine, so is often only used in medical centres. Codeine can be detected in saliva for approximately seven-hours, but this method of testing is challenging due to a variety of factors – including sensitivity of equipment used, dose taken and individual differences.

Codeine can be detected in hair for up to 10-weeks after just one dosage of the drug. This method demonstrates that an individual has consumed codeine but does not show how often they take the drug – and cannot be relied on to show addiction.

How We Can Help

Codeine addiction is a very serious condition that will soon take a toll on physical and mental health as well as careers, finances and relationships. However, there is support out there and with the right treatment for codeine addiction you can get back onto the right path. That’s exactly what the team at Step 1 Recovery have been helping individuals to do for many years – learn more about our private drug rehab.

Whether you have any questions about codeine addiction, are worried about yourself or a loved one, the team at Step 1 are always here. We offer codeine rehab to help you get back on track. Get in touch via phone, email or message today on +44 (0) 800 012 6006.