Woman attempting to make a positive codeine identification

Have you ever been prescribed codeine to treat a cough? 

Years ago, codeine was a popular medication for suppressing cough and treating pain. However, as potential risks emerged, the Food and Drug Administration stepped in and regulated the substance. As of 2018, all medicines containing codeine are no longer available without a prescription. 

So, why did a medication once sold over-the-counter suddenly require a prescription? The FDA reported that exposure to opioid medications can lead to future substance use problems in some individuals. Given the opioid epidemic, the FDA recommended that alternative medications be considered before giving codeine, and that codeine should not be used to treat pain or cough in children under 12. 

In Yavapai County, over 150,000 opioid prescriptions were written in 2023, including codeine-containing products. While prescription opioids can be beneficial in treating pain, they must be carefully managed. To help you stay informed, let’s learn more about codeine identification, the different forms of this medication, and what they look like. 

The Things You Need to Know About Codeine

Codeine is an opioid pain reliever used to treat mild to moderately severe pain, such as pain from injury, surgery, or chronic conditions. It can also be used to reduce coughing. The medication can be prescribed on its own or in combination with other medications, such as acetaminophen or aspirin. While codeine can be effective at managing pain and suppressing cough, it’s important to understand the potential risks and side effects. 

Codeine acts on the opioid receptors in the brain. It produces a wide range of responses, such as feelings of pain relief, relaxation, and contentment. Due to these pleasurable effects, some people turn to codeine as a coping mechanism for chronic pain or mental health problems. It can also be used recreationally for its pleasant effects. While codeine is not as strong as other opioids like morphine or oxycodone, it can still lead to dependency.  

Identifying Codeine 

To ensure proper use and avoid potential misuse, it’s important to know how to identify codeine, whether in pill form, liquid, or as part of a combination medication. In ideal situations, codeine is prescribed by a doctor and kept in a labeled prescription bottle. However, since this medication can be misused, it’s important to know how to identify it away from a labeled prescription bottle. 

It’s also important to be aware of lean, also known as “purple drank.” This illicit substance is made from a combination of codeine cough syrup, soda, and hard candy, and occasionally alcohol and the antihistamine promethazine. While people of all ages use lean, it’s most common among teens and young adults due to its sweet taste and references in modern culture. 

Where Does Codeine Come From?

Codeine is an opioid alkaloid derived from the opium poppy plant, Papaver somniferum. It is one of the naturally occurring alkaloids found in the opium poppy, which also contains several other alkaloids such as morphine. 

Opium is harvested from a poppy plant by making incisions in the seed pods, causing a milky latex to ooze out. It’s here that the latex is dried and processed to extract the various alkaloids. However, a more modern method of harvesting codeine is the industrial poppy straw process of extracting alkaloids from the mature dried plant. All opium and poppy straw used for pharmaceutical products are then imported into the U.S. from legitimate sources in regulated countries.

Woman with arms crossed looking concerned while sitting on couch

Ways to Identify the Different Forms of Codeine 

Codeine is marketed in tablets and syrups. It is often available as a combination product with NSAIDs for treating pain or cough. Tylenol 3 and Tylenol 4 are two common examples. Codeine is also available in immediate-release tablets and extended-release tablets. 

Codeine has a distinct appearance depending on its formation, manufacturer, and other factors. Here are some of the ways you can identify the medication: 

By Appearance

Codeine pills or tablets can vary in appearance depending on the manufacturer and dosage. However, these pills or tablets are typically small and round, and they’re often white, off-white, or colored. They have imprints that indicate the dosage and manufacturer, such as a code or logo. Codeine can also be found in a liquid cough syrup, where it’s clear or slightly colored and with a thick, syrupy consistency. 

By Prescription Label 

If you receive codeine through a prescription, the label should clearly indicate that the medication contains codeine. The label will also include the dosage (e.g., 15mg, 30mg) and instructions for use. 

Imprint Codes 

Most prescription medications, including codeine tablets, have unique imprint codes on them. These codes can contain numbers, symbols, and/or letters that identify the type of medication, its strength, and the manufacturer. If you see an imprint, you can use an online resource or a pill identifier to verify the medication. 

By Smell and Taste 

It is possible to identify codeine by smell or taste when it’s in its liquid form. It has a distinctive bitter taste, but most cough medicines are flavored to mask the bitterness. The smell might be slightly medicinal or sweetened, depending on the formulation. 

Understanding Codeine Addiction

A codeine use disorder is a type of opioid use disorder that can develop in someone who uses codeine, particularly over an extended period of time or in higher doses than prescribed. It is characterized by the compulsive use of codeine despite negative consequences and involves both a physical dependence on the substance and a psychological craving for its effects. This happens over time, as the brain can become reliant on the pleasurable effects, such as pain relief, euphoria, and relaxation. 

The cycle of codeine use disorder often begins innocently when a person is prescribed the medication to treat pain or suppress coughing. With repeated use, individuals may develop tolerance, meaning they need higher doses to achieve the same effects. This escalation can increase the risk of codeine use disorder. If the person tries to stop or cut back, they may experience distressing withdrawal symptoms and mental cravings. 

Fortunately, you can lower the risk of codeine use disorder by using the medication as prescribed by a healthcare provider, not increasing the dose without medical advice, and not using the medication longer than necessary. Healthcare providers should also closely monitor their patients to catch early signs of misuse. 

Side Effects of Codeine

Codeine, like other opioids, can cause a wide range of side effects. Some may be mild, while others can be severe. Some common side effects include: 

  • Drowsiness. Codeine often causes drowsiness or sedation, which can impair your ability to concentrate or operate machinery. This includes driving.
  • Dizinessiness. You may feel lightheaded or dizzy, particularly when standing up too quickly.
  • Constipation. Codeine can slow down bowel movements, leading to severe constipation. It’s often recommended to take a stool softener with an opioid like codeine. 
  • Nausea and vomiting. Codeine can upset the stomach leading to nausea or vomiting. 
  • Dry mouth. Codeine may reduce saliva production, leading to dry mouth. 
  • Itching or rash. Some people can develop a rash when taking codeine, though it’s usually mild.
  • Sweating. Increased sweating is another common side effect of codeine.

Less common side effects include headaches, mood changes, blurred vision, urinary retention, and confusion. There are some serious side effects to be aware of such as respiratory depression, low blood pressure, severe allergic reactions, seizures, hallucinations, and the risk of dependency. It’s also possible to experience interactions with other medications such as alcohol, benzodiazepines, and certain sleep medications. 

Group therapy session with supportive members

Getting Treatment for Codeine Addiction in Prescott, AZ

Codeine addiction rehab involves several interventions to help individuals gradually taper off the medication, manage withdrawal symptoms, and address the underlying issues contributing to codeine use. The process starts with detoxification, which is where the body is gently weaned off the substance. Detox helps manage withdrawal symptoms and prevents potentially dangerous complications. 

Medication-assisted treatment involves the use of several different medications—buprenorphine, naltrexone, methadone— to reduce cravings, manage withdrawal symptoms, and block the effects of opioids. Behavioral therapies are also an important piece to the puzzle, as they help individuals recognize and change negative patterns and behaviors associated with codeine use. Other effective treatment options include support groups, family therapy, life skills, and aftercare. 

Wolf Creek Recovery offers personalized treatment services for individuals experiencing codeine use disorder. With behavioral therapies, medication management, and outdoor therapy, we’re able to help our clients create a new life that is filled with fun and adventure. Our staff is also in recovery, so you will always have someone to relate to. To build a life you love, contact Wolf Creek Recovery at 833-732-8202

FAQs About Codeine Identification

What should you do if you find codeine?

If you find codeine, try to determine who it belongs to. Avoid handling it excessively, especially if you’re not sure if it’s in its original container. Also, make sure that it’s out of reach of children and pets. If you can’t find its owner, dispose of the medication safely. Most communities have drug take-back programs. 

What are some common hiding places for codeine?

Codeine can sometimes be hidden intentionally to avoid detection. Some common hiding spots include personal belongings (e.g., purses, backpacks, bags), dresser drawers, closets, pillows and pillowcases, medicine cabinets, and under mattresses. Vehicles are other popular hiding spots, specifically, glove compartments, center consoles, under seats, and in trunks. 

How can I make a positive identification of codeine?

Codeine is available in tablets and syrups, and is often combined with other medications like Tylenol. The tablets are usually small and round, with imprints on one or both sides indicating the dosage and/or manufacturer. Syrups are clear or slightly colored and can be added to soda and candy to create a drink called lean.