Codeine
Codeine is used to treat mild to moderate pain and to relieve cough. Codeine is also used to treat diarrhea and diarrhea predominant irritable bowel syndrome, although loperamide, diphenoxylate, paregoric or even laudanum are more frequently used to treat severe diarrhea.
Besides its medical use, codeine can be used as a recreational drug.
Abstract
Codeine is the most widely used, naturally occurring narcotic in medical treatment in the world.Codeine is medically prescribed for the relief of moderate pain and cough suppression. Compared to morphine, codeine produces less analgesia, sedation, and respiratory depression, and is usually taken orally.
[1]
[1]
Street Names
Empirin compound with codeine
Tylenol with codeine
Codeine in cough medicine
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Tylenol with codeine
Codeine in cough medicine
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Brand Names
Fioricet with Codeine
Floricet with Codeine
Phrenilin with Caffeine and Codeine
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Phrenilin with Caffeine and Codeine
[3]
History
Codeine was first isolated from the opium poppy in France in 1832 by a French chemist and pharmacist. His work paved the way for newer, safer codeine-based formulas to treat different ailments. Codeine, available in tablet, injection and cough syrup form, is one of the most prescribed and used opiates in the world and can be taken safely and effectively within the parameters of a prescription. While codeine can be extracted from opium, it is more often synthesized from morphine.
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Pharmacology
Codeine was once considered to be a morphine prodrug, since it was thought that its analgesia was due in large part to its O-demethylation to the much more powerful opiate, morphine. However, more recent research shows that 80% of codeine is conjugated with glucuronic acid to Codeine-6-glucuronide (C6G), which is the metabolite that is most responsible for codeine's analgesia. Only 5% of the dose is O-demethylated to morphine, which in turn is immediately glucuronidated at the 3- and 6-position and excreted renally. A portion of the codeine is N-demethylized to norcodeine. It is less potent than morphine and has a correspondingly lower dependence-liability than morphine.Like all opioids, continued use of codeine induces physical dependence and can be psychologically addictive. However, due to its low potency, the withdrawal symptoms are relatively mild compared to closely related opioids such as hydrocodone and oxycodone. As such, codeine has a lower physical dependence liability than most other opioids.
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Uses
Codeine is used to treat mild to moderate pain and to relieve cough. Codeine is also used to treat diarrhea and diarrhea predominant irritable bowel syndrome, although loperamide, diphenoxylate, paregoric or even laudanum are more frequently used to treat severe diarrhea.
Besides its medical use, codeine can be used as a recreational drug. A heroin addict may use codeine to ward off the effects of a withdrawal.
Besides its medical use, codeine can be used as a recreational drug. A heroin addict may use codeine to ward off the effects of a withdrawal.
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Scheduling
It is a Schedule II controlled substance for pain-relief products containing codeine alone or more than 90 mg per dosage unit. Tablets of codeine in combination with aspirin or acetaminophen (paracetamol/Tylenol) made for pain relief are listed as Schedule III; and cough syrups are Schedule III or V, depending on formula.
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Psychological and physical addiction liabilites
The possible are the psychological and physical addiction liabilites of codeine:
Abdominal cramps
Diarrhea
Vomiting
Intense pain in the body
Tremors
Excessive sweating
Anxiety
Insomnia
Muscle cramps with spasms
Body chills
Goose bumps
Paranoia
Muscle spasms
Agitated and aggressive behavior
Increased heart rate
Hyperactivity
Dilated pupils
Runny nose and eye
Depression
Loss of appetite
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Abdominal cramps
Diarrhea
Vomiting
Intense pain in the body
Tremors
Excessive sweating
Anxiety
Insomnia
Muscle cramps with spasms
Body chills
Goose bumps
Paranoia
Muscle spasms
Agitated and aggressive behavior
Increased heart rate
Hyperactivity
Dilated pupils
Runny nose and eye
Depression
Loss of appetite
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Long term effects
One of the long-term effects of codeine addiction is that characterized by greater dependence on the drug and tolerance to the dosage. Tolerance to a drug means that you must take more and more of the medication to get the same early effect.
After long-term use of codeine, men may also experience a decreased level of testosterone or enlargement of the prostate. Other long-term effects include excessive
sweating, swelling in the arms and legs, and chronic constipation.
Because chronic use leads to tolerance and dependence, you may experience withdrawal symptoms if a prescription is reduced or stopped. These withdrawal symptoms can involve signs of central nervous system hyperactivity and will peak 48 to 72 hours after your last dose. Physical symptoms will be eliminated within a week but it may take longer to erase the psychological addiction.
Because chronic use leads to tolerance and dependence, you may experience withdrawal symptoms if a prescription is reduced or stopped. These withdrawal symptoms can involve signs of central nervous system hyperactivity and will peak 48 to 72 hours after your last dose. Physical symptoms will be eliminated within a week but it may take longer to erase the psychological addiction.
Withdrawal from codeine will begin with anxiety followed by an increased rate of breathing, runny nose, stomach cramps, tearing and sweating. Although withdrawal from oxycodone is distressing it is not fatal.
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Physical effects
The physical effects of codeine are as below:
Pain relief
Sedation
Nausea
Vomiting
Dizziness
Headache
Constipation
Sweating
Insomnia
Urinary retention
Miosis
Euphoria or dysphoria
Sedation
Nausea
Vomiting
Dizziness
Headache
Constipation
Sweating
Insomnia
Urinary retention
Miosis
Euphoria or dysphoria
Withdrawal Effect
Codeine withdrawal symptoms can vary in intensity and may include:
Sweating
Insomnia
Shivering
Shakiness
Diarrhea
Goosebumps
Cravings for hydrocodone
Anxiety
Pain
Nausea
A runny nose.
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Sweating
Insomnia
Shivering
Shakiness
Diarrhea
Goosebumps
Cravings for hydrocodone
Anxiety
Pain
Nausea
A runny nose.
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Pyschological treatment option
The pyschological treatment option for codeine addiction involve:
Detox at addiction treatment centers, followed by counselling. Rehab centers often help addicted patients to learn to overcome the emotional issues that led them to addiction. Rehab also offers important tips and strategies for achieving relapse prevention. The main aim in the treatment for codeine addiction is get rid of the symptoms that cause both physical as well psychological effects.
Medical treatment
The medical options are limited in that case. At times, using drugs that mimic codeine may do the trick. This helps in codeine detox, which will mitigate the pain and discomfort of withdrawal significantly.
Psychological treatment
The psychological treatment is generally carried out at rehab centers. About 10% of addicted patients have been successfully able to overcome this addiction without the rehab centers. The treatment involved detox followed by followed by counselling. Rehab centers provide guidelines, following which one may find it easy in preventing relapse.
Related Drugs
Drugs that have similar effects include:
Heroin
Morphine
Hydrocodone
Fentanyl
Oxycodone
Related Synthetics
Dihydrocodeine
Hydrocodone
Oxycodone
Buprenorphine
Hydrocodone
Oxycodone
Buprenorphine
References
[1] http://www.justice.gov/dea/concern/codeine.html
[2] http://www.enotes.com/codeine-reference/codeine
[3] http://www.drugs.com/ingredient/codeine.html
[4] http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=5710
[5] http://www.drugs.com/monograph/codeine.html
[6] http://www.druglib.com/druginfo/demerol/description_pharmacology/
[7] http://www.deadiversion.usdoj.gov/schedules/index.html
[8] http://www.codeineaddiction.com/
Related Resources
http://www.justice.gov/dea/concern/codeine.html - Click here
http://www.drugs.com/monograph/codeine.html - Click here
http://www.deadiversion.usdoj.gov/schedules/index.html - Click here
Footnotes
| Source Type | Other: |
|---|---|
| Date Published | 10/08/2012 |
| Posting Date | 10/08/2012 |
