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Codeine Cough Syrup

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Codeine is a prescription medication in the opioid class.

A Schedule II controlled substance, codeine is typically prescribed to treat mild pain. Codeine is also used as a cough suppressant in the form of promethazine codeine combination medications. Like all substances in this schedule, codeine has a strong potential for abuse and addiction, as well as some medical utility.

People abuse codeine by mixing codeine cough syrups with soda or an alcoholic beverage. This combination is known as lean or lean drug. Cough syrup with codeine is also known as:

  • Purple drank
  • Sizzurp
  • Syrup
  • Lean drug  

Today’s guide outlines the dangers of abusing codeine in any form and highlights how you can reclaim your life from codeine addiction.

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What is Codeine?

Codeine is an opioid and a narcotic analgesic. This prescription medication is generally administered to treat mild and moderate pain.

Codeine is available as a single-ingredient product containing codeine, or as combination product containing codeine with acetaminophen or aspirin for pain relief. Codeine is also an ingredient in some cough and cold medications.

Although codeine is a very effective painkiller, the sustained use of this medication is liable to cause the development of physical dependence and addiction (opioid use disorder). 

If you become physically dependent on codeine or any other opioid, extremely unpleasant withdrawal symptoms will present in its absence.

Codeine Side Effects

The most common side effects of codeine are similar to those of other opioids. These include:

  • Nausea and vomiting
  • Drowsiness
  • Dizziness
  • Headaches
  • Dry mouth
  • Allergic reactions
  • Constipation

Codeine cough syrup combination products known as lean contain:

  • Codeine
  • Alcohol
  • Other CNS depressants 

These substances and their mechanism of action on the central nervous system can induce many side effects, some potentially severe. The most common side effects include: 

  • Euphoria
  • Sedation
  • Dissociation
  • Dizziness
  • Loss of coordination
  • Slowed breathing
  • Reduced heart rate
  • Cravings
  • Withdrawal symptoms
  • Addiction (opioid use disorder)
  • Seizures 

The long-term abuse of codeine cough syrup can trigger these serious adverse side effects. 

  • Cognitive impairment
  • Memory loss
  • Behavioral changes
  • Liver damage
  • Permanent psychosis
  • Epilepsy
  • Opioid overdose

Codeine Addiction and Withdrawal

Opioid use disorder can develop rapidly with the chronic abuse of codeine.

Tolerance to codeine often forms quickly, with the rate of development contingent on your unique body chemistry and the speed at which your body metabolizes opioids. When tolerance builds, codeine becomes less effective.

Many people attempt to combat tolerance to codeine by taking more of the medication, or by taking more frequent doses. This abusive pattern of consumption is likely to provoke the development of dependence. When you become physically dependent on an opioid like codeine, you will need the drug to function normally. In its absence, withdrawal symptoms will present as your system struggles to normalize.

Data from NSDUH 2020 (National Survey on Drug Use and Health) indicates that 2.6 million U.S. over-18s were diagnosed with an opioid use disorder in 2020. Among these people with opioid addictions, 800,000 engaged with professional treatment.

Codeine withdrawal can be intensely uncomfortable, but it is not typically dangerous or life-threatening. Most people detoxing from codeine find that symptoms are similar to the symptoms of a severe cold or flu, usually subsiding within a week or so.

Codeine withdrawal symptoms normally present in two phases.

The first phase of codeine withdrawal usually begins a few hours after the last codeine dose. Early withdrawal symptoms include:

  •  Muscle aches
  • Increased heart rate
  • Sweating
  • Insomnia
  • Yawning
  • Anxiety
  • Irritability
  • Teary eyes
  • Runny nose 

Next, you can expect the following codeine withdrawal symptoms to present after a few days:

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach cramps
  • Appetite loss
  • Chills

Many codeine withdrawal symptoms are the opposite of the regular side effects of this medication. While codeine often causes constipation, for example, codeine withdrawal is associated with episodes of diarrhea.

Most codeine withdrawal symptoms will subside within seven to ten days, although some behavioral symptoms may persist for several months after discontinuing use of codeine.

When you feel that the time is right to initiate your recovery, we can help you achieve this at California Detox in Orange County.

Codeine Rehab at California Detox

While opioids are fiercely addictive, almost all opioid use disorders will respond favorably to treatment with a combination of MAT (medication-assisted treatment) and behavioral interventions like psychotherapy and counseling.

Here at our California drug rehab, we appreciate that all addictions are unique. As such, we provide treatment programs at all levels of American Society of Addiction Medicine’s continuum of care as follows:

  • Outpatient programs
  • Intensive outpatient programs
  • Partial hospitalization programs
  • Inpatient programs (residential rehab)
  • Remote rehab
  • Dual diagnosis treatment programs

Detoxing from opioids can be intensely uncomfortable. Streamline your codeine withdrawal experience by taking advantage of our supervised medical detox program. Codeine detox will address the physical aspect of dependence, preparing you to engage with inpatient or outpatient rehab.

All of our treatment programs will provide you with a personalized treatment plan for opioid addiction, drawing from these evidence-based therapies:

  • Medication-assisted treatment
  • Psychotherapy
  • Group counseling
  • Individual counseling
  • Family therapy
  • Holistic therapy

Once you complete your codeine addiction treatment program, you can either step down to a less intensive form of treatment or transition back into daily living. Your treatment team will equip you with an aftercare plan that includes relapse prevention strategies. When you are ready to commit to recovery from opioid addiction, call California Detox at (949) 694-8305.


Codeine is an opioid. It is also classified as an opiate. CDC (Centers for Disease Control and Prevention) describes opiates as natural opioids like codeine and morphine. These are chemical compounds derived from the seed pods of some opium poppies. CDC describes opioids as an umbrella term for natural opioids, as well as semi-synthetic opioids (heroin) and synthetic opioids (fentanyl). So, codeine is an opiate and part of the opioid classification.

Codeine cough syrup, also known as lean, can induce feelings of euphoria and relaxation, triggering a dreamy and floaty sensation. Lean is not a packaged product, so the makeup and quantities of ingredients often vary significantly.


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