Codeine

Category: Medicines

Type

Involuntary and voluntary

Introduction and description

Codeine is the third most prevalent opiate found in opium from Papaver somniferum. 

In unadulterated poppies, codeine is between about 3%-6% or so of the alkaloid content.

It is usually present in raw opium as free alkaloid in addition to codeine meconate, codeine pectinate, and possibly other naturally occurring codeine salts. Pseudocodeine and some other similar alkaloids are found in trace amounts in opium as well. 

The name codeine is derived from the Greek word kodeia for "poppy head."   It is much more prevalent in the Iranian poppy (Papaver bractreatum), and codeine is extracted from this species in some places for use in pharmaceuticals. 

It is extracted and used pharmaceutically for its analgesic and antitussive effects, often in combination with paracetamol, aspirin, NSAIDs and so on.

Demand for codeine exceeds the supply of it naturally.  Most morphine produced for pharmaceutical use around the world, for example a little under 50 per cent of opium licitly (lawfully) produced by the latex method, is actually converted into codeine.  In most countries the usage of codeine (both as end-product and precursor) is at least equal or greater than that of morphine on a weight basis and codeine is by far the most commonly-used opioid in the world.

While strains of poppies have been engineered to produce much higher yields of other opioid pharmaceutical precursors like thebaine, no known strain of P. somniferum will produce more codeine than morphine. The poppy straw process of producing licit opioid alkaloids generally yields more codeine.

Side-effects

The principal side-effect of codeine, whether it is used as a pain reliever or 'recreationally' is addiction. 

I have chosen to put the experiences of a real sufferer as the means of showing what can happen.  The main problem is actually withdrawal - stopping use. 

The body adjusts to the existence of the codeine and effectively reduces the number of pain relief receptors, in order that the signals signifying that something is wrong continue to reach the brain.  Once you stop the codeine, the pain plus a whole load of other symptoms come back with a vengeance.

If we use an analogy, let us suppose you are standing on your dog's tail.  This hurts any dog, the tail is very sensitive, so he bites you to tell you to get off his tail.  You divert him with a plate of delicious warming chicken and for a while he forgets you are still on his tail.  Then he finishes the stew and the pain is worse because you have been on the tail so long, so he bites you a lot harder.

Pain is the body trying to tell you something is wrong.  You need to address the cause - see Healing yourself.

Withdrawal

Overdose

If you overdose as opposed to withdraw from use, you can experience ..........

• Constipation
• Miosis and Visual distortions
• Hypothermia
• Respiratory depression -   pulmonary edema, shortness of breath, pleural effusions - hypoxia
• Itching
• Heart problems - hypertension or hypotension, bradycardia, tachycardia

 The itching shown in the list above as a side effect is probably a result of over stimulation of the immune system and the release of an excess of histamine.

"On Aug, 22, 2014: 2,039 people reported to have side effects when taking Codeine. Among them, 78 people (3.83%) have Death." [eHealthme]

How it works

Why does codeine cause hallucinations, visions and even out of body experiences?  It may be helpful here to have the Model of spiritual experience open for referral.

It may also be helpful to refer to the generic description of How spiritual experience works.

Normal/first dose

If you turn for a moment to the description of Overwhelming fear and terror you will see that all truly major threats eventually cause Endorphins to be released.  In effect, the ingestion or injection of any opioid is like throwing yourself off a cliff without the emotion of fear that precedes it!!    Codeine just happens to have similar though not identical actions to endorphins.....  initially.

Endorphins generate a feeling of total relaxation and by doing this, we have opened the door to the Composer.  The relief acts in much the same way as the Relaxation techniques.   Thus the first use of codeine can be positive, it can indeed promote a feeling of well being.  But this is dangerous, because it can generate a wish to experience the same again, and again, and again...

Overdose

If you have overdosed, any one of the side-effects listed above are capable of  producing hallucinations - particularly hypothermia and hypoxia.

What is actually happening is that the body perceives itself to have encountered a major Threat. Codeine is competing with the body's own pain killers and is masking the fact that something is wrong within the body and deserves attention.

But, it is also clear from the observations that many people who obtain the more overwhelming effects from codeine – hallucinations, visions and so on have obtained them because they have taken the drug in truly overdose proportions and have been poisoned  - see Poisoning.  There have been Near death experiences.

Withdrawal

As I have explained, codeine like all opiates is highly addictive.  If taken regularly, our own endorphin receptors are destroyed to counteract the high amount of the endorphin look alike that appears to be flooding round our system.  If you then stop the codeine, you do not have enough receptors to support your own natural endorphin release.

We have seen some of the side effects of withdrawal above - one of which is depression, which can cause hallucinations. The technical name for this is dysphoria – despondency of a level you can not imagine without having been there – so low you are in an abyss of unfathomable horror.  The hallucinations are not nice.

Furthermore, there may be excruciating pain from only tiny wounds, or from whatever prompted you to take the pain killers in the first place.  Extreme pain is an extremely effective mechanism of producing all sorts of spiritual experiences - including out of body.

References and further reading

EROWID - this LINK takes you to the EROWID experience vault for codeine.

EROWID - this LINK takes you to the list of all experiences on EROWID good and bad.

Codeine addicition help - this LINK takes you to a site providing guidelines, help and advice on codeine addiction.

For a detailed explanation of codeine receptor activity see Codeine receptor bindings.

Observations

One of the really great problems with codeine is that you often are not aware that you may be taking it. 

Codeine is marketed as both a single-ingredient drug and in combination preparations with numerous other apparently harmless pharmaceuticals such as paracetamol and less benign pharmaceuticals.

So, for example, co-codamol which contains codeine and paracetemol is then marketed as   e.g., Paracod, Panadeine, and Paramol.

There is then the Tylenol-with-codeine series, also classified as co-codamols as they contain both paracetemol and codeine.  But it is even more confusing as whilst Tylenol 1 contains acetaminophen and codeine; Tylenol PM is the trademark for a mixture of acetaminophen (paracetamol) and diphenhydramine [which is an antihistamine].

Codeine may be combined with aspirin; and is known then as  co-codaprin.  It can be combined with  ibuprofen and is then known as Nurofen Plus!  After concerns were raised about the addiction risk posed by the codeine content of these medicines (both Nurofen Plus and competing brands which contain codeine), an addiction warning was placed on the boxes in 2009 to warn users the medicine may cause addiction and must only be used for three days.

Codeine may be mixed with phenacetin (Emprazil With Codeine No. 1, 2, 3, and 4), naproxen, indomethacin, diclofenac, and others, as well as more complex mixtures, including such mixtures as aspirin + paracetamol + codeine ± caffeine ± antihistamines and other agents, such as those mentioned above.

Codeine is also found in cough syrups – many for children – often mixed with other active ingredients, and a linctus e.g., Paveral.  

So the opportunities  of overdose, addiction and abuse are quite high, given that these are all over the counter medications.

A whole range of performers have suffered from codeine addiction, see the observations.  One of the most prominent and visible victims of codeine abuse was Howard Hughes.  It may be interesting to know that one side effect of codeine abuse is obsessive compulsive disorder 

I have only one specific observation for Hughes, but have added his biography so that you can see what happened – he suffered the whole gamut of the most unpleasant of the spiritual experiences – frightening visions,  hallucinations, demons….

Related observations

Healing observations

• Healing a benzodiazepine addiction with spiritual ayahuasca treatment 017515
• Integration of Complementary and Alternative Medicine Therapies into Primary-Care Pain Management for Opiate Reduction in a Rural Setting 023461

Hallucination

• Abuse of BRON cough medicine 012136
• Abuse of codeine-containing cough syrups: a report from India 012138
• Acetaminophen and codeine phosphate 012126
• Acetaminophen and hydrocodone bitartrate 012127
• Chronic analgesic induced headaches 012215
• Cochrane review - Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain 012009
• Codeine 012128
• Codeine abuse 024026
• Codeine intoxication in childhood 003661
• Codeine, aspirin, apap formula no. 2. 012132
• Cough mixture abuse 003660
• Fiorinal - eHealthme figures for hallucinations 012206
• High Hitler: how Nazi drug abuse steered the course of history 027403
• Hughes, Howard - The Aviator ending scene , the way of the future 012125
• Migraine, headache and pain killers 005751
• Noodled by narcotics, and seeing how brain compression algorithms at work 014453
• Prescription drug abuse in the US Army 012134
• Purple drank and Lil Wayne 012133
• Qualaquin, Quinine sulphate and Quinine medication use and abuse 024135
• Sudden infant deaths and cough syrup 017476
• Tylenol w/ codeine 012129
• Tylenol with codeine 3 012130
• Tylenol with codeine 4 012131

Wisdom, Inspiration, Divine love & Bliss

• Noodled by narcotics, and seeing how brain compression algorithms at work 014453

Out of time

Near death, Out of time, Out of body, Rebirth

• Visions and out of body from Codeine 003658

In time

Synaesthesia, Pure or enhanced perception, Inter composer communication, Vision, Dream, Perception recall, Exploring group perception

• Danielou, Alain – On drugs you are possessed by the spirit being of the drug 022582
• Fiorinal - eHealthme figures for hallucinations 012206
• Judee Sill - The kiss 002046
• Noodled by narcotics, and seeing how brain compression algorithms at work 014453

Other observations

• Codeine and other drug related deaths in Australia 012137