It’s time to talk about Codeine Addiction – SA’s silent dependence | Stepaway Blog
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It’s time to talk about Codeine Addiction – SA’s silent dependence

What is Codeine?

Codeine is a moderately strong opiate drug that is used to manage physical pain as a result of conditions such as arthritis, migraines and severe headaches or to relieve pain after surgeries.

When codeine is broken down by the body it turns into morphine which is a much stronger painkiller from the opioid family and is used in the manufacture of heroin.

Codeine Addiction - SA's silent dependence

Codeine comes in the form of cough mixtures and painkillers with the most commonly abused over the counter medications being Adcodol, Acurate, Lenadol, Betapyn, and Propain. All of which are over the counter medications (OTC) and no prescription is needed.

Additionally, Stilpane, a much stronger painkiller is also often abused, however, Stilpane requires a script from a doctor.

New Legislation but is it effective?

Up until last year September when the law was changed, it was easy to pop into your local pharmacy every week to top-up your codeine stocks with 100 tablets at a time.

However, new legislation now allows you to only refill every 10 days and you are now limited to 40 tablets… However, this doesn’t stop you from going to another pharmacy that very same day to purchase another 40 tablets. This is what we call “pharmacy shopping”.

Depending on how many pharmacy visits you could fit into one day, you could end up with 400 tablets if you visited only 10 pharmacies – and there is nothing stopping you from visiting another 10 pharmacies the very next day.

Each over the counter tablet contains 10mg of codeine, a box of 40 tablets equals 400mg - 10 boxes equal 4000mg… 

Granted, some pharmacies are stricter than others, however, Codeine often comes in the form of over the counter medications and therefore many pharmacies don’t take your details down when you purchase it.

This lack of monitoring creates room for abuse and inevitably addiction.

Codeine Addiction Denial

Many Codeine addictions are formed unintentionally and with devastating effects. A lot of people are unaware of the addictive potential of the drugs and their addictions often go unnoticed by loved ones.

This is because Codeine addiction does not carry the same characteristics as other addictions, there are no physical symptoms and because these drugs are legal it is socially acceptable to use them.

Additionally, most people do not acknowledge that they have a problem as the medications are viewed as safe and legal.

The combined denial of codeine abusers, lack of addicted symptoms and their ability to purchase these drugs without much hassle is cause for much concern.

Codeine Addiction in Schools

Additionally, schools in the Western Cape have reported issues of codeine abuse amongst learners. The legal age for dispensing schedule 1 and 2 medications is 14 years old, making it fairly easy for children to purchase over the counter medications containing Codeine.

Pupils on several occasions have been found drinking a powerful mixture of cough syrup, Sprite (cooldrink) and paracetamol. This mixture, referred to as "Lean", causes feelings of euphoria and when enough is consumed produces the same effects as being very drunk.

In addition to the low legal age issue, parents often don’t monitor the medications in their home which makes it easy for children to abuse them without any suspicion.

Parents and teachers need to inform their children not only of their dangers of abusing illegal drugs but also of the dangers of abusing legal medications. Furthermore, an effort must be made to monitor at-home medications.

Moreover, doctors and pharmacists alike must inform patients of the dangers of misuse and provide alternative drugs. It’s also important to ensure there is proper monitoring of the misuse of these products.

Codeine Addiction and Rehabilitation

People who abuse Codeine are often in denial, however, many people avoid asking for help because they fear being attached to the stigma associated with drug rehabilitation centres.

Before, codeine was used to treat terminal illnesses but the problem emerged when it started being used to treat the common "headache" or other everyday ailments. This has been one of the root causes for the increase in Codeine Addiction.

It is often not your fault for becoming addicted to prescription medications. A lack of patient-centred care, disengaged doctors and incompetent monitoring provide the perfect environment for prescription medication addictions.

Future campaigns must highlight the addictive effects of Codeine. They must also highlight that anyone can become dependent on codeine products when they are used long term or excessively.

Symptoms of Codeine Addiction

Although there are no real physical symptoms of codeine addiction, below is a list of symptoms to look out for.


  • The use of the drugs when there are no symptoms to alleviate.
  • The use of the drugs for longer than prescribed.
  • Visits to multiple pharmacies and doctors to obtain unusually large doses.
  • The mixing the medication with alcohol or illicit drugs.
  • Becoming preoccupied with getting and using the drugs.


Step Away Drug Rehabilitation Centre South Africa

Codeine Addiction Treatment

Codeine withdrawal can be painful and dangerous if not supervised by a medical professional who specialises in Opiate withdrawal.

The severity of withdrawals depends on the quantity and duration of abuse. Withdrawal symptoms may include:


  • insomnia,
  • sweating,
  • dizziness,
  • fatigue,
  • diarrhoea and cramping,
  • and nausea.


We do not recommend detox without medical supervision or an out-patient detox. We strongly suggest in-patient detox with around the clock supervision.

It’s important to understand that Codeine Addiction is nothing to be ashamed of. Taking the first step towards your recovery means that you want to improve your life and you should be proud of it.

It may not be easy but it will be worth it. We’ve been where you are today and we are living proof that you can beat whatever you put your heart and mind to.

For more information about our drug rehabilitation centre or to find out more about intervention for a loved one, please contact us.

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