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No Opioid is Benign, Not Even Codeine

Dr. Jeffrey Berman, MD By October 31, 2018

Codeine is a seems like an innocent opioid. Doctors prescribe the drug to people who suffer from mild amounts of pain. They also prescribe it as a cough syrup to treat severe colds or respiratory issues like bronchitis. The drug affects the patient by blocking pain they are experiencing as a result of being ill, and also weakens the symptoms of the illness. When it is administered it is often combined with acetaminophen, aspirin, or ibuprofen. This practice increases the potency of the prescription without having to increase the dosage. Not having to increase the amount of opioid in someone’s system is good, but even these additives can cause serious medical problems of their own when taken against guidelines.

Codeine is a fast acting drug. It lasts about two hours before the more potent effects of codeine begin to weaken in the body. Though codeine seems like no big deal, opioids feed into one another. As tolerance builds and the user plateaus they seek out more potent opioids and can eventually lead all the way to the deadly opioid, fentanyl. Doctors must take responsibility for doing due diligence and being clear with patients about the gravity of opioid addiction and also clear that codeine will easily lead them down that path.

 

Codeine Side Effects

Some of the side effects of Codeine are:

  • Itching
  • Drowsiness
  • Constipation
  • Nausea
  • Vomiting
  • Dry Mouth
  • Miosis
  • Orthostatic Hypotension
  • Urinary Retention
  • Euphoria
  • Dysphoria
  • Coughing

 

Rare side effects:

  • Anaphylaxis
  • Seizure
  • Acute pancreatitis
  • Respiratory depression

 

Possible long-term effects of codeine usage

  • A lesser libido or sex drive
  • Persistent apathy
  • Memory Loss

 

Decoding the Opioid Epidemic

Everyday the headlines show us the severity of the opioid epidemic in New Jersey, and throughout the United States. Opioids have snuck up on the human race and are slaying large swaths of our population. The World Health Organization explains that the problem of opioid addiction is a top killer throughout the world today. An astounding 74% of people who died from drug related problems in 2015 suffered from death due to some form of opioid related medical complications be it via fatal overdose or complications due to long term use of the drugs, such as heart failure, or pulmonary complications. According to the World Health Organization “Roughly 450,000 people died as a result of drug use in 2015. Of those deaths, about 160 thousands were directly associated with drug use disorders and about 118 thousands with opioid use disorders.” In 2016 the number of drug related deaths in the world skyrocketed to a disturbing 190 thousand. (http://www.who.int/substance_abuse/information-sheet/en/)

 

What Are Opioids and Opiates? Is there a difference?

Both “opiate” and “opioid are used to talk about the epidemic going in the world.  The media isn’t always clear what the difference is between the two words.

 

What are Opiates

An “opiate” is a narcotic analgesic drug found in nature in an opium poppy. It is the purest form of the drug and is often utilized to make synthetic versions that mimic the effects of the natural drug.  

Some common forms of opiates that come from the poppy plant include:

  • Opium
  • Heroin
  • Codeine
  • Thebaine
  • Morphine

 

What are Opioids: “Opioid” is a term that covers both the pure form of the intoxicant, opiates, as well as the synthetic forms.

 

Some common forms of opioids include:

  • Hydrocodone
  • Oxycodone, OxyContin, Percocet, or Percodan
  • Hydromorphone, or Dilaudid
  • Duragesic, or fentanyl

 

The Effect Opioids Have on The Body

Discovery InstituteOpioids bind to the opioid receptors in the brain. These receptors include the limbic system, the brainstem, and also the spinal cord. When opioids attach themselves to these centers in the brain, it changes the way that pain affects the body, the pleasure center and the reward center are also affected, thus giving the nervous system a completely new way of working within the body.

 

  • The Spinal Cord – This is one of the places opioids go to lessen pain.  The spinal cord is part of the nervous system. The nervous system takes in messages that the body puts out from different organs and other systems of the body. It filters through the messages, and delivers them to the brain.
  • The Brainstem –  The brainstem is the control center for a body’s automatic functions.  The brainstem controls the vital actions in the body such as breathing, the mechanism of their heart beat, among other important actions. When opioids affect the brainstem it slows down and does the work of reducing the experience of pain for the user.
  • The Limbic System – The limbic system is a collection of the amygdala, hippocampus, thalamus, hypothalamus, basal ganglia, and cingulate gyru. These parts of the body come together to make the system in the body that filters incoming messages from outside of the body. The system plays an important role in the banking of memories. It helps the body by interpreting body language, voice inflection and more. When an opioid affects these receptors they cause relaxation from anxiety, pleasure, and a sense of contentment.

 

Signs & Symptoms that someone is suffering from an opioid addiction

  • Dehydration
  • Constipation
  • Upset Stomach
  • Vomiting
  • Depression
  • Sedation
  • Dizziness
  • Growing tolerance
  • Higher likelihood of infectious disease
  • Chemical dependence
  • Respiratory depression
  • Overdose
  • Death

 

Withdrawal symptoms that someone may suffer when going through opioid detox

  • Sweating
  • Anxiety
  • Panic attacks
  • Muscle pain
  • Bone pain
  • Insomnia
  • Flu like symptoms
  • Stomach aches
  • Difficulty regulating body temperature
  • Serious cravings

 

The good news is that there is hope for those who suffer from an addiction to opioids. Discovery Institute, the best New Jersey rehab offers comprehensive addiction treatment. New Jersey detox facilities like Discovery Institute can offer support in the form of qualified therapists and medical professionals. Call us today to learn more.

Article Reviewed by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.

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