Codeine Addiction: The Causes, Symptoms and Side Effects
Codeine is one of the most commonly used painkillers in the UK. It is found in everything from everyday headache tablets to over-the-counter cough syrups, which can make it seem pretty harmless. However, just because codeine is widely used doesn’t mean it is without risk. Codeine addiction can build quietly, making it hard to spot until the effects start to spill into everyday life.
What is codeine?
Codeine is a type of opiate medication used for pain relief, calming coughs, and sometimes managing diarrhoea. It is often combined with other drugs like paracetamol or ibuprofen and is typically taken as a tablet or liquid. Hospitals might use it in suppository form or as an injection for more severe cases. Stronger doses of codeine need a prescription, but some weaker versions are still sold over the counter in the UK.
What is codeine addiction?
Codeine addiction is a type of opiate addiction where you find yourself relying on codeine even though part of you wants to stop. Codeine addiction sometimes begins with chasing the calming effects, sometimes after a legitimate prescription for pain. Whatever the starting point, prescription drug addiction to codeine is a serious and potentially fatal condition. However, codeine addiction is treatable and recognising the problem is the first step toward getting help through codeine detox and rehab.
How does codeine addiction develop?
Codeine addiction can develop from recreational codeine abuse or self-medication, but as explained above, it very often starts with innocent prescription use. In either case, you can grow tolerant of its effects incredibly quickly. What this means is that you have to take more codeine pills for pain, to get high or to sedate yourself.
When you start to realise that one pill isn’t quite doing the job anymore, you take two. Then three. Suddenly, often without you realising it, you are taking codeine to avoid the withdrawal symptoms that hit when you miss a dose. This is called physical dependence, and it opens the floodgates for ever-escalating codeine abuse.
Full-blown codeine addiction is both a physical and psychological dependence. As well as avoiding withdrawal symptoms, you may also come to feel like you need codeine for stress, anxiety or getting through everyday life. Once you reach this point, stopping can seem impossible and often is without professional codeine rehab and detox.
Codeine addiction factsheet
- Codeine is the most commonly prescribed opioid/opiate in the UK.
- Opioids like codeine contributed to 2,551 drug-poisoning deaths in England & Wales during 2023 (a 12.8% rise from the previous year).
- Pure codeine and higher-strength formulations are prescription-only, while low-dose products combined with other painkillers are available over the counter at pharmacies. High-dose cough syrups containing codeine were reclassified as prescription-only in 2024 due to concerns over codeine dependence.
- Under UK law, codeine is a Class B controlled substance but rises to a Class A in its pure injectable form.
- Around 2% of global substance detox and rehab centre admissions are linked to codeine addiction.
How to spot the signs of codeine addiction?
Because codeine is so easy to get and often starts off with a simple prescription, recognising codeine addiction symptoms is not always easy. A lot of people try to downplay or hide their codeine abuse, even convincing themselves that everything is okay. But there are some telltale signs of codeine addiction which can point to the truth:
- No longer taking codeine for pain, but because you want it or feel like you need it to get through the day.
- The need to get more codeine taking over your daily life and finances.
- Putting off responsibilities because codeine feels more urgent.
- Loved ones asking if everything is okay and lying about the reality.
- Getting codeine through dishonest or risky means.
- Wanting to stop using codeine but finding it scary or impossible.
Crucially, these aren’t things to be ashamed of. They are signals pointing you towards the need for professional prescription drug addiction treatment.
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Who is most at risk of codeine addiction?
The chemical effects of codeine are inherently habit-forming, but that doesn’t mean you will necessarily become addicted to it. What makes the difference often comes down to a mix of personal history, mental health and what’s happening around you. You might be more at risk if:
- Addiction or substance use is part of your family background.
- You have been using codeine as a way to escape emotional pain or mental health issues.
- You grew up in a household or area where substance use was normalised. Getting hold of codeine is easy for you.
- You tend to be highly anxious, impulsive or emotionally reactive.
- You’re carrying heavy stress with no real outlet for relief.
All of these factors matter, both when codeine is prescribed and when an effective opiate addiction treatment plan is being built.
What are the most dangerous codeine side effects and addiction risks?
When codeine use spirals into addiction or misuse, it can quietly cause serious harm. It’s not always easy to see these dangers coming, but knowing what to look out for could help you stay safe or take that first step towards recovery:
Codeine overdose
Mental health struggles
If you already live with anxiety or depression, codeine can make those feelings worse. It can also throw your emotions off balance, leading to mood swings, a lack of motivation or chronic confusion.
Constipation and stomach issues
Codeine often causes constipation, which might sound minor but can lead to painful digestive problems if it continues. As well as codeine constipation, you may also get constant stomach cramps or feel nauseous all the time.
Liver damage
Your liver works hard to filter codeine out of your body. When there’s too much codeine, especially if you’re also taking paracetamol, your liver can become overwhelmed and serious, lasting damage can occur.
Finding help if you have a codeine addiction
If you’re stuck in a cycle with codeine and don’t know how to get out, know that you’re not alone and you’re not beyond help. At Providence Projects, we can help you make a change. Our treatment pathway will allow you to receive the support you deserve not only when you start your treatment at our facilities, but also far beyond your completion of treatment, helping you achieve and maintain long-term recovery.
Contact us when you’re ready.
Reach out to our expert support team 24 hours a day
Start the Codeine Rehabilitation Process Today
Finding the best addiction treatment is vital for long-term recovery success. Our friendly and compassionate team will hold your hand through the process until you learn to love yourself again.
Frequently Asked Questions
How is codeine addiction screened?
Screening for codeine addiction usually starts with a conversation. A doctor or addiction specialist may ask questions about your codeine use, including how often you take it, why you started, and whether you’ve noticed any changes in your health, mood or behaviour. They may also use tools like the DSM-5 criteria for substance use disorders, which look at patterns like cravings, tolerance and impact on your daily life. You may also be asked to take a urine or blood test to check for codeine in your system or see how your body is responding to withdrawal.
How to prevent a codeine addiction?
The best way to avoid codeine addiction is to take it exactly as your doctor tells you and only for as long as it’s needed. If you’re prescribed codeine, don’t increase your dosage on your own and be honest with your doctor if it’s not working or if you’re starting to rely on it emotionally. If you’ve been using it for a while, don’t stop suddenly without support and speak to a medical professional about tapering safely. For over-the-counter products, check the labels carefully and don’t use them for more than a few days in a row.
Is codeine safe during pregnancy?
Codeine is not usually recommended during pregnancy unless there is a very clear medical reason and it’s prescribed at the lowest possible dose for the shortest time. Taking codeine while pregnant can affect the baby, especially if it’s used in high doses or over a long period. It may lead to withdrawal symptoms in newborns or problems with breathing if taken near delivery. If you’re pregnant or trying to become pregnant and are using codeine, it’s important to speak to your doctor right away. They can help you find safer alternatives and support you properly.
(Click here to see works cited)
- medRxiv. “Sales of over the counter (OTC) codeine-containing products in the United Kingdom: a retrospective observational study.” medRxiv, 24 November 2023, https://www.medrxiv.org/content/10.1101/2023.11.23.23298967v1.full – Accessed 12 July 2025.
- Peechakara BV, Tharp JG, Eriator II, et al. Codeine. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526029/
- Jani, Meghna et al. “Time trends and prescribing patterns of opioid drugs in UK primary care patients with non-cancer pain: A retrospective cohort study.” PLoS medicine vol. 17,10 e1003270. 15 Oct. 2020, doi:10.1371/journal.pmed.1003270
- UK-Rehab. “Codeine Addiction & Abuse | UK Rehab.” UK-Rehab, https://www.uk-rehab.com/opiate-addiction/codeine/ – Accessed 12 July 2025.
- Carter, Alan, and Zawn Villines. “Codeine withdrawal: Symptoms, timeline, causes, and treatments.” Medical News Today, 9 May 2022, https://www.medicalnewstoday.com/articles/326849#causes – Accessed 12 July 2025.
- NHS. “Codeine: medicine to treat pain and diarrhoea.” NHS, https://www.nhs.uk/medicines/codeine/ – Accessed 12 July 2025.