Codeine drug abuse used to be a much bigger problem in the United States because at one time it was available without a prescription. Overseas, codeine drug abuse continues because it is still sold over-the-counter in some cough syrups or pain medication formulations. Because it is still fairly easy to get in other countries, online pharmacies are able to ship it to people in the states.
Codeine Drug Abuse: What is codeine?
Codeine is a narcotic prescription drug in the opiate class. It is used as a pain killer, cough suppressant, as an antidiarrheal, to lower blood pressure, as an antianxiety drug, and as a sedative. Codeine is available by itself or in formulations with other drugs, such as acetaminophen.
Codeine is known as a prodrug, so it must be broken down by the liver in order to be active. In the liver, it is broken down into morphine. This limits the routes of administration options in codeine drug abuse. Codeine will not be active if it is used intravenously or through nasal insufflation. It must be taken orally to achieve the “high.”
Codeine Drug Abuse: Side effects
Codeine drug abuse produces a feeling of euphoria, which is the reason it is abused in the first place. This is the “high” felt by abusers. However, it also can have adverse effects like drowsiness, constipation, itching, nausea, vomiting, dry mouth, pinpoint pupils, light-headedness, urinary retention, and depression. Serious side effects include anaphylaxis, seizure, and respiratory depression.
Codeine Drug Abuse: Dependence and Withdrawal
Codeine drug abuse often results in physical dependence. Over time, prolonged codeine use causes the nerve cells in the brain to function abnormally. They stop producing natural painkilling chemicals. Even people who are taking codeine as directed run the risk of experiencing withdrawal if they discontinue use abruptly. Patients prescribed codeine should always be weaned off the drug when possible.
The severity of codeine withdrawal depends on the dose of codeine that you were taking and the duration of use. Some common withdrawal symptoms include: shivering, nausea, vomiting, anxiety, muscle aches, hot and cold flashes, and diarrhea. It is important to note that withdrawal from codeine is not life-threatening, but it is extremely uncomfortable.
Codeine drug abuse: Krokodil
Codeine drug abuse also plays a part in the illicit manufacture of the drug known on the streets as “Krokodil.” Krokodil, or desomorphine, is a derivative of morphine that is 8 to 10 times more potent. It can be manufactured illicitly from codeine and other easily obtained products, like red phosphorus and gasoline. However, desomorphine manufactured this way is highly impure and contains toxic and corrosive byproducts.
Krokodil attracted a lot of attention in Russia in 2010 after illicit manufacture of the drug started increasing. Pictures of junkies began circulating the web, showing the severe tissue damage and gangrene that can result from the use of the drug, sometimes requiring limb amputation. There is so much tissue damage associated with the use of this drug that addicts are estimated to have a life expectancy of 1-2 years.