Codeine, The Opiate Opioid That No One Is Talking About

Codeine is a seemingly innocent opioid that doctors frequently prescribe to people who suffer from mild to medium amounts of pain. Physicians also prescribe it as a way to treat severe bouts of diarrhea. However the most common usage of codeine is when a doctor prescribes the drug in the form of a cough syrup to treat severe respiratory issues such as bronchitis. The medicine affects the patient who is suffering from a cough by blocking any pain they are experiencing as a result of the illness, and as a cough suppressant to weaken the symptoms of the illness.

When the drug is administered this way in it’s legal, prescription form it is often combined with acetaminophen, aspirin, or ibuprofen as a way to increase the potency of the prescription without having to increase the dosage of the opioid and therefore also the cost of the prescription. Decreasing the amount of opioid in someone’s system is always a good thing, however even these types of over the counter pain medications like acetaminophen, aspirin, and ibuprofen can all cause serious medical problems of their own when they are misused or overused. Ibuprofen can cause kidney failure. Acetaminophen has been known to cause liver failure in startling numbers of people because it is often marketed as a completely safe over the counter solution to pain, and it is used as an additive in many different kinds of medications – so sometimes people don’t really realize how much of the substance they are consuming.

However, even if they did realize how much of the medication they were taking,  is likely because of its false reputation as being completely safe, that they would not think of it as a problem. Aspirin is a blood thinning medication and as such can be problematic for those who suffer from blood diseases as well as troublesome to the liver when used in access. When used in codeine, it is important that a patient limit the amount of these medications they take in addition to the codeine prescription so as to keep their organs safe. If a patient has questions in regards to this matter, they should call their physician.

Like most opioids, codeine is a fairly fast acting substance and lasts about two hours until the more potent effects of codeine begin to weaken and dissipate in the user’s body. Though codeine seems innocent, given the frequency with which the drug is prescribed for illnesses as common as bronchitis, it is an opioid and opioids are never innocuous. They feed into one another on a long chain of destructive substances that someone struggling with a chemical dependency to opioids travels through as their tolerance builds and they plateau on each drug. Something that seems as safe as codeine can eventually lead someone all the way to the very deadly substance of fentanyl. Because of this doctors are responsible for doing their due diligence and explaining to their patients the gravity of an opioid addiction and that codeine is not a drug to be trifled with. They should also warn about use of codeine while a person who has had a baby is breastfeeding. The drug could be dangerous for the child because the medication can find its way through the person’s breast milk and then cause the infant to have opioid toxicity.

Codeine Side Effects

Some of the side effects of Codeine are:

  • Itching
  • Drowsiness
  • Constipation
  • Nausea
  • Vomiting
  • Dry Mouth
  • Miosis

 

  • Orthostatic Hypotension
  • Urinary Retention
  • Euphoria
  • Dysphoria
  • Coughing

 

Rare side effects:

  • Anaphylaxis
  • Seizure
  • Acute pancreatitis
  • Respiratory depression

 

Possible long-term effects of codeine usage

  • A lesser libido or sex drive
  • Persistent apathy
  • Memory Loss

 

Decoding the Opioid Epidemic

Everyday the headlines indicate the severity of the opioid problem that we have in Florida, the United States, and throughout the whole world. Opioids seem to have snuck up on the human race and are ravaging our population. As the World Health Organization explains, the problem of opioid addiction is one of the top killers of our world population throughout the world. An astounding 74% of people who died from drug related problems in 2015 suffered from death due to some form of opioid related medical complications be it via fatal overdose or complications due to long term use of the drugs, such as heart failure, or pulmonary complications. According to the World Health Organization “Roughly 450,000 people died as a result of drug use in 2015. Of those deaths, about 160 thousands were directly associated with drug use disorders and about 118 thousands with opioid use disorders.” In 2016 the number of drug related deaths in the world skyrocketed to a disturbing 190 thousand. (https://www.who.int/substance_abuse/information-sheet/en/)

 

What Are Opioids and Opiates? Is there a difference?

 

The words opiate and opioid are both words that are used in the media to describe substances that are killing people in hordes. But it is sometimes unclear what if any is the difference between the drugs that lie under the two different categories. It is complicated by the fact that there are even more people talking about opioids these days. As they make it into the media and politicians talk about the substances more and more, the waters between the two categories become even more muddied. This is further complicated by how uneducated the general public is in terms of drugs and intoxicating substances in general. Unfortunately the education included in programs such as the Dare program still left many ignorant to the facts about different drugs and did very little to equip the general public both in Florida as well as the wider United States about how to deal with drug addiction, chemical dependency, and overdose. This is quite obvious due to the growing number of fatalities. Telling someone to “just say no” doesn’t account for prescription medications given by a licensed medical physician.  

 

What are Opiates

“Opiate” are a narcotic analgesic drug found in nature in its purest form. The opium poppy plant makes a pure form of the drug and that pure form is often used to create more synthetic drugs that are included in the opioid category.

 

Some common forms of opiates that come from the poppy plant include:

  • Opium
  • Heroin
  • Codeine
  • Thebaine
  • Morphine

 

What are Opioids: “Opioid” is a term that covers both opiates and opioids. Opiates, as already discussed above, are the natural form of the opioid drug. The label “opioid” includes both opiates, as well as the synthetic version of the drug that mimics the effects of natural opiates on the body.

 

Some common forms of opioids include:

  • Hydrocodone
  • Oxycodone, OxyContin, Percocet, or Percodan
  • Hydromorphone, or Dilaudid
  • Duragesic, or fentanyl

 

The Effect Opioids Have on The Body

Regardless of if the drug is natural or synthetic, opioids both bind to the opioid receptors of the brain. These receptors include the limbic system, the brainstem, and the spinal cord. When the opioid attaches itself to these centers of the brain, it changes the way that the pain center, the pleasure center and the reward or addiction center all act, thus giving the nervous system an overhaul in the way it effects and controls the body.

 

  • The Spinal Cord – The spinal cord is one of the places an opioid goes to cause the person struggling with addiction to have a lessened amount of pain while their bodies are under the influence of the drug. The spinal cord is the part of the nervous system that intakes messages made by sensations that the body experiences from other parts of the body, filters through the messages, and delivers the right messages to the brain. When an opioid blocks the message receptor it makes it difficult for messages of pain to get through to the brain, effectively stalling or halting all together the experience of pain from the consciousness of the person under the influence of the drug. Knowing this, it is easy to see why someone would become addicted to the drug. There are a lot of people in Florida and throughout the world who suffer from chronic pain due to illnesses such as Fibromyalgia, or an injury that causes chronic pain, among others.
  • The Brainstem –  The brainstem is a person’s control center for their automatic systems in the body. This means the brainstem controls many vital actions in the body includes breathing, the mechanism of their heart beating, among other very important actions. When opioids are affecting the brainstem it slows these mechanisms down and does the work of, like the spinal cord, reducing the experience of pain for the person taking the drug.
  • The Limbic System – The limbic system includes the amygdala, hippocampus, thalamus, hypothalamus, basal ganglia, and cingulate gyru. These parts of the body all come together to create the system in the body that is the place that a person filters incoming messages that come from outside of the body. They all add up to a system that is the emotion center of the body – telling the brain how to react to those messages. It plays a vital role in the banking of memories. Most animals have a limbic system. This is why sometimes dogs appear to smile. It is likely that they actually are smiling as they enjoy an activity or happily enjoy good pet. It is obvious that the limbic system is an evolutionary imperative as we use these filters as a way to understand our surroundings for interpersonal experiences as well as to understand cues of danger from others, intentions and motivations. It does this by interpreting body language, voice inflection etc. When an opioid covers these receptors they create relaxation from anxiety, pleasure, and a sense of contentment. Again, plenty of reasons here for someone to experience a deep addiction very quickly. The world is full of people who suffer from anxiety. Over half of drug addicts suffer from some type of dual diagnosis, or co-occurring mental health disorder like generalized anxiety disorder. This drug relaxes some of those symptoms for those who desperately need a respite.

Here is a non-comprehensive list of some of the symptoms someone may experience due to an opioid addiction:

  • Dehydration
  • Constipation
  • Upset Stomach
  • Vomiting
  • Depression
  • Sedation
  • Dizziness
  • Growing tolerance
  • Higher likelihood of infectious disease
  • Chemical dependence
  • Respiratory depression
  • Overdose
  • Death

 

Here is a list of just a few of the withdrawal symptoms that someone who is addicted to opioids may experience when they go through detoxification:

  • Sweating
  • Anxiety
  • Panic attacks
  • Muscle pain
  • Bone pain
  • Insomnia
  • Flu like symptoms
  • Stomach aches
  • Difficulty regulating body temperature
  • Serious cravings

 

The most difficult side effect of using opioids is the way it skyrockets tolerance at such a speed that it often can take a user by storm. Over and over again the user will need more opioids administered to their body one way or another, to satisfy their body’s chemical dependency Their tolerance grows out of the codeine, the prescription vicodin, or even the heroin if they survive on the opioids that long. They may not even realize how serious their addiction has become until they are playing with the fire of fentanyl and seeing the headlines with what could be their fate. Hundreds of thousands of deaths by the fatal opioid drugs. These days are scary ones for those suffering from opioid drug addiction. But there is actually hope in the spotlight. More and more states like Florida are creating legislation surrounding the regulation of prescription opioids.

 

Thousands of people every year encounter opioids for the first time through a mild prescription such as codeine cough syrup, or a pain medication that includes codeine or oxycodone, or some other innocuous seeming medication. If someone is predisposed to drug abuse due to genetics, traumatic experiences they have experienced in the past, or even due to a co-occurring mental health disorder, this can be a real problem and can lure them very quickly into a deep opioid addiction. They may also encounter opioids via another drug they are already addicted to. It is not uncommon for someone to cut a drug with heroin or fentanyl. Prince, Michael Jackson and other celebrities have been in the spotlight due to their untimely deaths which both included a consumption of many kinds of different substances including the deadly fentanyl.

Codeine May Lead to These Stronger Opioids

Prescription opioids such as oxycodone, hydrocodone, etc. are generally prescribed by medical doctors for medium to severe states of discomfort. They, like other opioids, cover the pain receptors and block the pain messages from even reaching the brain.

Oxycodone has become one of the most commonly prescribed pain pills in Florida and across the nation.  Because the drug is so widely prescribed it is also easily accessible on the street. This narcotic analgesic is especially popular in Florida and the sunshine state is one of the easiest places in the country to get the drug illicitly among other prescription drugs that end up on the street. According to CNN’s fact sheet on opioids , “The number of opioid prescriptions dispensed by doctors steadily increased from 112 million prescriptions in 1992 to a peak of 282 million in 2012, according to the market research firm IMS Health. The number of prescriptions dispensed has since declined, falling to 236 million in 2016.” Because these drugs are so easily accessible in Florida it isn’t hard to see why around 6 thousand citizens of the state of Florida die every year due to an opioid related death. That means that more than 16 people a day who succumb to the drug and are lost to our communities in the state. The only solution to the problem is to make treatment as readily available, or even more optimally, more available to the general public than opioids are.

 

Heroin is, like all opioids, a narcotic analgesic that was once used in medical situations until it  was then banned in the 1930’s. It alters the mental state of the person using the drug. The user is usually looking for a sense of contentment and calm. The drug lasts about 4 to 5 hours in a user’s system. The drug usually comes in a powder form and in a spectrum of color from pure white to a murky brown color, depending on what the drug is cut with. Dealers cut the drug in order to stretch it and make more money. This can cause all sorts of problems because the drug can be cut with such substances such as laundry detergent, rat poison, fentanyl – another startlingly potent form of opioid, baking soda, caffeine, flour, and talcum powder. Heroin is highly addictive itself, but by the time four out of five people make it to taking heroin, they have come to the drug already chemically dependent upon a lesser potent form of the same type of substance, such as codeine. Because of this, it doesn’t matter to them that their heroin may be cut with rat poison because they already desperately need to find a way to feed their addiction. The addiction that they very likely came to via a prescription opioid medication.

Consuming heroin is done in many different ways. Heroin is the drug that many people have focused on up until recently, when it comes to talking about opioids. But even though fentanyl is the opioid most people are talking about these days, heroin is still a menacing presence in our communities. If the ways in which heroin is cut with substances such as rat poison the weren’t dangerous enough, the way people take the drug also can have serious medical consequences.

 

Common ways people consume heroin:

  • Some users snort the powder via their nasal passages like someone may do with cocaine. They do this because the nasal membrane can absorb the intoxicant very quickly. Unfortunately snorting heroin can cause severe problems with the respiratory system. This method is becoming a more common place way to take heroin because it relieves the person of the visible track marks that injecting the drug create.

 

  • Some users smoke heroin. This method also causes respiratory problems, deteriorating vital pulmonary tissue. Using heroin this way, also removes the visible sign of use, track marks, created by injection.

 

  • Some heroin users still inject the drug. When someone thinks of a heroin user, this is the most common method of intake. People inject the drug via their veins or into their muscle. This is where the visible track marks come from making it easy for any observer to guess what the person’s addiction is. Using heroin this way can cause severe cardiovascular issues such as blockages in the blood vessels or collapsed veins.

 

The United States Center for Disease Control and Prevention reports that  “In 2016, nearly 948,000 people in the United States (12-years old or older) reported using heroin in the past year, which is an estimated rate of 0.4 per 100 persons.  And in 2015, 81,326 emergency department visits occurred for unintentional, heroin-related poisonings in America, which is an estimated rate of almost 26 per 100,000 people.” (https://www.cdc.gov/drugoverdose/data/heroin.html)

 

Even though many people die from heroin addiction via either long term effects or via a fatal overdose, some do live on and make it to using fentanyl, an opioid that is said to be 50 times the potency of heroin, if not one hundred times as potent. Without the heartbreaking consequences of a drug overdose, eventually like many of them did after getting exposed to codeine or hydrocodone, or oxycodone via a prescription, the person may plateau on heroin, or even experience fentanyl by it being cut into their heroin stash, and then require a stronger drug to satisfy their bodies insistent cravings.

 

Fentanyl is a drug that is taking the world by storm these days. Though it has been on the medical drug scene since the 1960’s, it is just recently coming into a more public space given the celebrity deaths that it has helped cause. It was first used as an anesthetic for surgical purposes, to help “put someone under” during serious surgeries. LIke so many other drugs have, Fentanyl went from a drug used almost exclusively by the medical community to one that was highly available on the street as soon as it was put into a form that was easily administered outside of a hospital setting. The drug became a patch and by the 1990’s fentanyl was ubiquitous and being prescribed for major pain to be administered in the hospital, yes, but also in doctors offices, in clinics, and in someone’s home. When accessibility is high, medications such as fentanyl become highly problematic and deadly. Cut to modern day, and the world has an opioid epidemic on its hands of epic proportions because these days not only is the transdermal patch available to the public via prescription and the street, but the drug also comes in forms of lollipop, nasal spray, and pill form.

 

Even though fentanyl is used for surgical purposes and pharmaceutically, the real problem, like with any drug, is when someone goes off script and uses the drug illicitly. This opioid is more powerful of a drug than most people have encountered before and often people highly underestimate its effects.

 

“Most of the increases in fentanyl deaths over the last three years do not involve prescription fentanyl but are related to illicitly-made fentanyl that is being mixed with or sold as heroin—with or without the users’ knowledge and increasing as counterfeit pills. In July 2016, the Drug Enforcement Administration (DEA) issued a new nationwide report indicating hundreds of thousands of counterfeit prescription pills have been entering the U.S. drug market since 2014, some containing deadly amounts of fentanyl and fentanyl analogs. The current fentanyl crisis continues to expand in size and scope across the United States”

(https://www.cdc.gov/drugoverdose/data/fentanyl-le-reports.html)

 

When illicitly used fentanyl is intensely deadly. The drug is so deadly in fact that the state of Nebraska recently threw off it’s stall in death roe activity in order to try out the drug as a method for state sanctioned death sentences. For a long time the drugs used for this purpose, not only in nebraska, but around the country have been derided by human rights organizations because they tortured the inmate before they died, or didn’t end in death at all. Fentanyl did the job.

 

Treatment For Opioid Addiction with The Best Drug Rehabs in South Florida Recovery Centers

Treatment is really the best hope for someone sliding from codeine to oxycodone or hydrocodone, or worse to heroin and fentanyl or anywhere in between.

 

At FHE Health South Florida detox center, we have a team of highly trained medical staff and therapists who will be there every step of the way for each patient, as they move from medically supervised detoxification to personalized rehab treatment, through to relapse preventative aftercare where the person will continue a less intensive treatment and likely an outpatient treatment to maintain a state of active recovery, or remission for their addiction. Contact us today to finally be free of these dangerous substances. 

 

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