Syrups with codeine: types, effect, when prescribed

When are codeine syrups prescribed?

Medicines of the codeine group are used for the following pathologies:

• Throat diseases that cause debilitating coughing attacks: laryngitis, pharyngitis, tonsillitis;
• Pneumonia;
• Bronchitis;
• Whooping cough.

Syrups affect the centers of the brain responsible for cough impulses. At night, the cough becomes especially intense and causes insomnia. Codeine helps control severe cough impulses.

Despite this, syrups of these groups are prescribed in extreme cases, since the content of the narcotic drug requires strict adherence to the dosage.

Conclusion

Codeine is an opioid analgesic with psychostimulant properties. Serves as a starting material for the synthesis of other opioid analgesics with a more pronounced narcotic effect. Abuse of codeine-containing drugs causes a persistent psychophysiological craving, which leads to polydrug addiction, overdose, and secondary infection, which inevitably leads to death. To save the life of a drug addict, it is necessary to promptly recognize the signs of drug addiction, undergo examination and begin treatment. Complex therapy using medications, the help of psychologists, psychotherapists allows you to cope with addiction, minimizing the likelihood of relapse.

Contraindications

The cough medicine has an extensive list of contraindications. It is necessary to refrain from consuming codeine-containing syrups without a doctor’s prescription: otherwise, the risk of severe adverse reactions increases. Syrups are contraindicated in the following conditions:

• Pregnancy and lactation;
• Bronchial asthma;
• Individual intolerance to components;
• Respiratory failure;
• State of alcoholic intoxication;
• Epilepsy;
• Heart rhythm disturbances;
• Hypocoagulable state;
• Acute kidney and liver diseases.

Before prescribing the syrup, the attending physician carefully examines the patient’s medical history and life history. If a person has no contraindications for use, the doctor writes a prescription to purchase syrup at the pharmacy.

Treatment and how to cure

Treatment for codeineism must be carried out in a psychiatric or specialized drug treatment clinic.

Therapy for any addiction is a complex, multi-stage, long-term individual process. First of all, it depends on the patient himself - his clear awareness of the presence of the disease and a strong desire to be cured. Therefore, it is important not only drug treatment, but also psychotherapeutic treatment. One without the other will not bring the desired result.

Drug therapy

Medicines used for drug therapy can be divided into three groups:

• Psychotropic drugs used in psychiatry and narcology - antidepressants (imipramine, clomipramine, trazodone), antipsychotics (clozapine, neurolepromazine, perphenazine), anticonvulsants (carbamazepine, lamictal).
• Specific medications used only in narcology are drugs that are antidotes or drug antagonists; in the case of codeine, these are naloxone and naltrexone.
• Systemic or somatic drugs that are prescribed in therapy and narcology - nootropics (piracetam, cavinton, aminalon), hepatotropes (ursosan, heptral, hepa-merz).

Psychotherapy

Psychotherapeutic treatment occurs in two directions: individual and group therapy. Each of the areas includes:

• Psychological adaptation – getting used to living in new conditions of sobriety.
• Psychological counseling – assistance in resolving problems and making decisions regarding all areas of a new life.
• Psychological correction is the formation of the necessary psychological qualities to maintain adaptation to new living conditions.
• Occupational therapy - developing the skill to work, increasing motivation for work, an adequate feeling of being a full-fledged member of society - significant, useful and valuable.
• Environmental therapy, art therapy, autogenic training, social rehabilitation work are other ways to restore the individual socially and psychophysiologically.

Outpatient or home treatment

Dependence on any psychoactive drug is treated only in a hospital under the supervision of specialists. If it were possible to recover at home, following the doctor's testimony, then drug addiction would not be such a common disease.

To send a patient home for treatment, you need to be confident in his firm decision to quit. But even the person himself cannot be sure of this. Once at home, the drug addict will begin to mechanically look for reasons and opportunities to use a new dose.

What is the effect of codeine syrup?

The use of drugs containing codeine leads to a side effect - euphoria. Drug addicts use drugs of this group as a substitute for opioid drugs.

As a result of long-term use of narcotic syrups, severe drug addiction develops, and internal organs are rapidly destroyed.

Rehabilitation

Rehabilitation of codeine addicts should take place in a hospital. Withdrawal in such patients can be with withdrawal, like in heroin addicts. Codeine is highly addictive. Therefore, dependent people require constant work with a psychologist. In addition, resocialization and work with codependent people play an important role in the rehabilitation of such people.

What does rehabilitation include:

• cleansing the body;
• relief from withdrawal symptoms;
• treatment of concomitant diseases that arose while taking codeine-containing drugs;
• social rehabilitation;
• work with a psychologist and group rehabilitation;
• resocialization and return to society.

Remember that there is no recovery from drug addiction. A person can go into a phase of stable remission. But the risk that a person will want to use again always remains. Therefore, the more correctly the rehabilitation is carried out, the lower the risk of failure after treatment.

If during the rehabilitation process you use distraction therapy with a religious bias, the result will be better than rehabilitation without a religious component.

Taken from the dissertation: “Resocialization of drug addicts: socio-psychological aspects” by Kutyanova I.P.

Types of codeine-containing cough medications

There are several analogues of codeine-containing medications, differing from each other in the form of application. There are syrups, drops and tablets containing codeine.

Cough syrup with codeine

In addition to the active substance, syrups contain additional components to enhance the effect of codeine, as well as flavoring additives that facilitate application. This form of the drug is often used for pediatric patients because they are easy to use and do not have a tart aftertaste.

Codeine cough tablets

Soviet drugs containing codeine are often produced in tablet form. These medications include Tedein, Codelac and Terpinkod. The use of tablets in a dose exceeding the therapeutic one causes short-term euphoria, and then severe opioid dependence.

Cough drops with codeine

Codeline-containing drops include Codelac Neo. The drops often contain ethyl alcohol, and therefore their use is strictly contraindicated for people with alcohol addiction tendencies.

Effect on the body

The mechanism of action of codeine is based on the stimulation of opiate receptors located in the central nervous system and in peripheral organs, as well as inhibition of the cough center. In the intestines, where there are also opiate receptors, smooth muscle tone and peristalsis decrease. The sphincters, on the contrary, spasm. As a result, codeine has an analgesic and antitussive effect. Since the analgesia from codeine is less pronounced, it is used mainly for dry cough. Due to spasm of the sphincters, codeine is also effective for diarrhea.

What syrups contain codeine?

The following medications are used to treat coughs, but drug addicts often obtain them through illegal means for recreational use. This means that if packages of codeine-containing drugs are found on a person without special indications, drug addiction can be suspected.

Promethazine

Promethazine is an antitussive, analgesic and antihistamine. The substance is produced in the form of syrup, has a depressant effect, and in combination with third-party ingredients has an antitussive effect.

Codelac

Codelac includes several main components that determine the therapeutic effect:

• Thermopsis - increased bronchial secretion;
• Licorice – anti-inflammatory effect;
• Thyme – relief of spasms;
• Sodium bicarbonate – decreases mucus viscosity.

Codelac phyto

The drug has a mucolytic, analgesic, expectorant and anti-inflammatory effect. The syrup contains herbal components that have a powerful therapeutic effect in combination with codeine.

Kofex

In addition to codeine, the syrup contains chlorpheniramine, which has an antihistamine effect. This reduces the likelihood of allergic reactions as a result of other syrup components entering the body.

Tussamag

The substance helps relieve cough impulses during pneumonia and bronchitis, and eliminate pain. Tussamag is involved in suppressing the growth and development of pathogenic fungi and bacteria.

Neo-codion

In addition to anti-inflammatory, antitussive and analgesic properties, Neo-codion contains a complex of vitamin substances involved in strengthening the immune system.

Glycodin

Glycodin

- syrup with antitussive effect. The use of Glycodin, like other codeine-containing drugs, is strictly under the supervision of a doctor. Otherwise, there is a risk of developing severe dependence, uncontrolled increase in dosage and a state of drug intoxication.

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Chemical and toxicological study of biological samples

Codeine is metabolized in the body in three ways:

• Binding to glucuronic acid - excreted in urine as a glucuronide;
• O-demethylation – morphine is formed;
• N-demethylation – narcodeine is formed.

There are no rapid tests for determining codeine. Therefore, tests are used to determine specific antibodies to morphine. Immunochemical analysis is considered a preliminary study. Therefore, biological samples are sent for laboratory diagnostics.

Brands and manufacturers of express tests:

• ImmunoChrome – Morphine – Express – strips for one-step determination of metabolites in urine. MED-EXPRESS-DIAGNOSTICS company (Russia);
• Narcochek - tablet test - system for determining metabolites in urine. I&D Diagnostics Company (Canada);
• Vivacek is a rapid test for determining morphine and its metabolites in the blood. Manufacturer USA.

Express tests do not determine the concentration of a substance, so it is only possible to establish the fact of drug addiction.

Chemical and toxicological analysis in the laboratory is carried out in two stages. The first is preliminary testing of the sample. More often, a urine sample is used for testing, since traces of the drug are present for a longer time. The second stage is confirmatory. The gas chromatography method is considered the most reliable and accurate.

Various laboratory identification methods can distinguish codeine from morphine. Morphine and codeine are similar structural alkaloids, therefore they give a number of positive reactions to the same reagents. But at the same time, codeine does not give a positive reaction with ferric chloride and potassium hexacyanoferrate. Codeine can also be distinguished from morphine by light absorption in the infrared region of the spectrum.

Kramarenko V. F. Toxicological chemistry / Kramarenko V. F.

Gas chromatography allows you to study any biological samples. It is impossible to deceive a chemical-toxicological study.

Enhanced poisoning therapy

7,500 pcs.

Dropper volume 1500 ml
• Visit of a narcologist
• Patient examination
• Consultation with a narcologist
• Detoxification
• Doctor's orders
• Medicines for 3 days
• Monitoring the patient's condition

Order service

During therapy with codeine-containing drugs, the doctor constantly monitors the patient. If adverse reactions or signs of addiction develop, the specialist reduces the dosage or discontinues the drug. Self-administration of syrups, even in small doses, can lead to the development of severe pathologies, as well as drug addiction.

Working with codependents

Codependent people are relatives, parents, husband or wife. Such people suffer first of all together with the dependent person. Therefore, they can be both the cause of a new breakdown and a reason to stop using.

Codependents must be able to recognize attempts at new use and know how to prevent them. It is believed that close people do not believe or do not see the problem until the last moment. The task is to teach them not only to see the problem of drug addiction in their loved ones, but to tell them how to overcome it.

Harm of syrups containing codeine

Self-administration of syrups with codeine leads to the following consequences:

• Development of acute cardiovascular pathologies
  : hypertensive crisis, heart attack, stroke, ischemia. Often, these conditions occur during use with a latent form of cardiovascular disease, or as a result of ignoring individual contraindications;
• Severe drug addiction

  . Codeine is a derivative of morphine from the group of opioid drugs. This means that long-term use without a prescription leads to the development of drug addiction. Often, after recreational drug use, a strong craving for psychoactive substances develops. After consuming syrup, a person becomes interested in drugs of other groups;

• Liver dysfunction

  . Due to hepatotoxicity, the drug promotes the destruction of liver cells. Delay in seeking medical help can lead to diseases such as liver failure, cirrhosis, hepatitis and even death.

The use of codeine syrups can be the beginning of severe drug addiction. A person is looking for ways to acquire the drug through illegal means. Over time, resistance develops: to achieve the desired effect, the dosage of the drug is increased. Complete degradation of personality occurs, loss of previous social connections, overdose and death.

How addiction is formed

Addiction to the use of codeine develops in approximately the same way as any other drug addiction.

1. At the first stage, irregular, episodic use occurs. There are no changes in the body yet. And there are no symptoms of addiction.
2. The second stage of addiction is characterized by the onset of the disease codeineism. The drug is being taken more and more often, while euphoria and the first symptoms of use (itching, redness of the skin) are felt less and less. Doses begin to increase. Mental dependence appears, the realization that psychological comfort will come only during drug intoxication. At the same time, the attraction to alcohol is replaced by disgust.
3. After about six months, withdrawal symptoms begin to appear, in which dyspeptic disorders predominate. And over time, withdrawal syndrome is accompanied by too much weakness and depression. Long-time codeine addicts are usually withdrawn, exhausted and embittered.

Overdose

Taking an increased dose causes an overdose. In this condition the following is observed:

• Drowsiness
• Confusion
• Disorientation in space
• Lethargy
• Excessive sweating
• Tremor of limbs
• Decreased blood pressure
• Convulsive manifestations
• Digestive problems

Sometimes epileptic seizures and fainting occur. If the patient is not treated in a timely manner, he will suffer coma or death.

Interaction[ | ]

Strengthens the inhibitory effect of ethanol on the speed of psychomotor reactions. With the simultaneous use of ethanol, muscle relaxants, as well as drugs that depress the central nervous system, increased sedation, suppression of the respiratory center and depression of the central nervous system are possible. When taken simultaneously with other opioid analgesics, it increases the risk of depression of the central nervous system, respiration, and decreased blood pressure. Enhances the effects of antihypertensive and antipsychotic drugs (neuroleptics), anxiolytics (tranquilizers), barbiturates and drugs for general anesthesia. Naloxone and naltrexone are specific antagonists. Naloxone reduces the effect of opioid analgesics, as well as the respiratory and central nervous system depression they cause; Large doses may be required to reverse the effects of butorphanol, nalbuphine and pentazocine, which were prescribed to eliminate the unwanted effects of other opioids; may accelerate the onset of symptoms of “withdrawal syndrome” due to drug addiction. Naltrexone accelerates the appearance of symptoms of “withdrawal syndrome” against the background of drug addiction (symptoms can appear as early as 5 minutes after administration of the drug, continue for 48 hours, are characterized by persistence and difficulty in eliminating them); reduces the effect of opioid analgesics (analgesic, antidiarrheal, antitussive); does not affect symptoms caused by histamine reaction. Medicines with anticholinergic activity, antidiarrheal drugs (including loperamide) increase the risk of constipation, including intestinal obstruction, urinary retention and central nervous system depression. Buprenorphine (including previous therapy) reduces the effect of other opioid analgesics; against the background of the use of high doses of mu-opioid receptor agonists, it reduces respiratory depression, and against the background of the use of low doses of mu- or kappa-opioid receptor agonists, it increases. Caution should be used simultaneously with MAO inhibitors due to possible overexcitation or inhibition with the occurrence of hyper- or hypotensive crises (initially, to assess the effect of interaction, the dose should be reduced to 1/4 of the recommended). Reduces the effect of metoclopramide.

Signs of use

At the first stage of drug addiction, it is difficult for relatives and loved ones to recognize the problem. The drug addict does not notice her, and also cunningly hides from the family. Codeine withdrawal is an alarming signal for relatives. Outwardly, it looks like a severe alcohol hangover. Relatives do not see the problems that are artificially hidden by drug addicts.

Gradually, as the disease progresses, signs of addiction become more noticeable. Relatives begin to sound the alarm. The best way out of the stalemate is to contact the specialists of the RC Svoboda.

You can recognize a drug addict who takes Codeine by the manifestations of changes in habitual behavior:

• euphoria alternating with periods of detachment;
• violation of movement coordination;
• real-time loss;
• constriction of the pupils;
• respiratory depression;
• a feeling of constant drowsiness, which is eliminated after the drug is removed from the human body.

Withdrawal from Codeine is noticeable to others. When signs appear, the patient needs medical attention. Doctors' assistance can be provided at home, as well as in the hospital.

Dosage

Based on the patient’s well-being, 15 to 60 mg of the substance is prescribed to relieve pain; re-taking the dose is recommended after 3 hours. Codeine containing drugs are taken 30 mg 4 times a day to eliminate diarrhea. To eliminate cough, it is enough to take 10-20 mg 4 times a day. The maximum dosage per day for an adult should not exceed 120 mg of the substance.

Children: to relieve pain and as an antidiarrheal agent, 0.5 mg/kg is prescribed up to 6 times a day.

When coughing:

When administered intramuscularly or subcutaneously, the dosage remains the same as when administered orally.

Codeine ban - is the drug banned in Russia?

The Federal Service for Control of Narcotic Substances found that codeine drugs have become the cause of the growth of “pharmacy drug addiction.” On June 1, 2012, a law was passed banning the over-the-counter sale of drugs containing codeine. However, this led to the fact that patients had to look for analogues of the drug in order to be cured. And enterprising drug manufacturers began to purchase codeine in countries where it is not prohibited. But in 2013 the law was repealed.

Physical properties[ | ]

The base of ein is colorless crystals or white crystalline powder, odorless and bitter taste. It erodes in the air. Solubility in water: 1:120 at 25 degrees; 1:60 at 80 degrees and 1:17 at 100 degrees. In alcohol 1:9.5. Poorly soluble in diethyl ether (1:50). It dissolves best in chloroform (1:0.5, according to other sources 1:1), which is often used to extract the latter of ein-containing substrates; solubility in benzene is 1:10. Practically insoluble in petroleum ether and alkali solutions, except ammonia. Aqueous and alcohol solutions have an alkaline reaction. From wet diethyl ether, ein crystallizes as monohydrate[9] (C18H21NO3•H2O) with a melting point of 155 °C.

Consequences

Regular use of codeine medications has a negative effect on the body and disrupts the normal functioning of internal organs. The harm from taking a pharmaceutical drug also depends on why it was used.

Taking codeine for pleasure can cause a number of unpleasant symptoms:

• Allergy, in the form of swelling, vomiting or bronchospasm
• Atrophy
• Anemia
• Gastrointestinal diseases
• Problems with the cardiovascular system
• Exacerbation of chronic diseases
• Decreased libido, problems with potency
• Infertility is also common
• Depressive states
• Insomnia or sleepwalking