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Codeine is a seemingly innocuous cough syrup that can actually cause some serious health risks if used incorrectly. It is commonly mixed with alcohol to create a deadly concoction that can cause serious issues such as damage to your liver or kidneys, heart failure, or even death. In this article, we'll cover why someone would choose to mix codeine and alcohol, the side effects of the mixture, and the long-term effects of extended abuse.
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Codeine is a painkiller similar to Morphine that also suppresses the patient's cough. It is most commonly used to treat patients suffering from pain associated with chronic coughing or a cold. 
Like many other opioid painkillers, it's not necessarily dangerous but is highly addictive when more than the recommended dose is taken. It creates an intense high which can cause an addiction that persists even after the initial pain from illness occurs.
"Codeine" is the scientific name for the painkiller, but there are several different brands of Codeine available. Some examples include Nurofen Plus, Co-Cedorol, Paramol, Solpadine Plus, and Max, and Anadin Extra. 
Alcohol is a depressant that largely affects your nervous system, specifically a neurotransmitter called gamma-Aminobutyric acid. Consuming alcohol dampens that specific neurotransmitter and suppresses your excitability. This is why people largely feel relaxed or become tired after drinking large amounts of alcohol (3).
Codeine, however, is an opioid that binds to the opioid receptors in your nervous system. If taken in large enough doses, the user's breathing and heart rate can begin to slow. Their blood pressure may also drop as well.
While taken separately and in small doses, either drug will most likely affect the body mildly; however, when combined--even at the same dose--, potentiation may occur. This is a process where the effects of two chemicals compound on each other. This causes a much more potent reaction, even if the user is only taking a small amount. 
If someone is taking Codeine or another opioid, they may become drunk faster and more intensely than usual. This makes it a lot easier to overdose even if someone hasn't consumed much alcohol.
Like many opioids, mixing alcohol with Codeine can intensify the high; unfortunately, this is combination can prove to be incredibly deadly. Here's why:
Both alcohol and Codeine cause a sedative effect on the body. When taken together, the user is essentially doubling that effect on their body.
Because of the sedative effect on the body, mixing Codeine and alcohol can severely impact the amount of oxygen circulating through a person's body. While this might not sound like that big of a deal at first, prolonged use can damage the user's liver, cause kidney disease, and even put someone in a coma or kill them.
As is common with addictive substances, a tolerance can form which necessitates higher doses of a drug to achieve a satisfying high. As a user becomes more and more resistant to the drug's effects, they are putting themselves at a higher risk of overdosing.
According to the CDC, alcohol consumption in addition to taking opioids makes up a significant amount of emergency room visits and deaths associated with prescription painkillers.
The patient's stomach will need to be pumped and it's very possible the patient will have a seizure, develop heart problems or brain damage, or their muscles could begin to deteriorate. 
Aside from the aforementioned risk of overdosing, there are other, potentially dangerous, side effects associated with both alcohol and Codeine consumption.
While taking alcohol and Codeine together intensifies the high a user experiences, it also amplifies the side effects associated with either drug. Someone may begin to feel dizzy or lightheaded. They may struggle to concentrate or think, and they might even faint.
Since the combination of Codeine and alcohol can cause dizziness or light-headedness, there is naturally a higher risk of falling which can result in brain injuries or broken bones. If someone chooses to drive, they're at a higher risk of getting into an accident.
Someone may begin to have problems breathing and their heart rate will begin to slow. Similar to heavy alcohol consumption, a person may experience memory loss, drowsiness or fatigue, or have impaired mental functions. Their reaction time and motor skills may be delayed. In extreme situations, a person may faint, fall into a coma, or die.
6. You're at risk of respiratory depression
Another worrying side effect of mixing Codeine and alcohol is respiratory depression. This means the body will have less oxygen circulating through it. This can cause a person to breathe irregularly and will most likely deprive organs with air which, if prolonged for a long enough time, will cause permanent damage.
With how dangerous mixing the two substances are, why in the world would someone choose to take the risk?
Well, even though each drug interacts with different receptors in the brain, both affect the neurotransmitters dopamine and serotonin-- two transmitters that directly correlate with a person's mood. When Codeine and alcohol are mixed together, a person will begin to feel happier than normal.
But once the effects of the drugs wear off, a vicious cycle begins. The brain will begin to feel depressed and the user will most likely begin to crave the high Codeine and alcohol cause. In most situations, this may cause the person to become addicted.
Aside from mixing Codeine with alcohol, it is also often mixed with soft drinks or candy. This concoction is called 'lean' and has been fairly prevalent in the pop culture consciousness since the 1990s where it has been featured in several rap songs.
A significant number of listeners of this music began to take the drug themselves to emulate their favourite artists. This has caused the deaths of numerous rap artists and their listeners.
Even today, lean is a popular drug found at parties. If someone is addicted to lean, they're mixing Codeine either with alcohol or soda and a piece of hard candy. Because opioid abuse can adversely affect the way someone's brain responds to rewards, addiction can happen relatively quickly.
While taking the drug, someone may begin to slouch or lean to one side the more they consume (thus explaining the name).
Someone will typically begin to experience the effects of lean about 30-45 minutes after ingesting the drug. If someone consumes more Codeine, those times may become shorter. Effects can last. up to 4-6 hours and the effects are similar to other dangerous drugs such as heroin or oxycodone.
Aside from the effects on the body that were previously mentioned, abusers of lean may also develop constipation, gain weight, begin to lose their teeth, develop urinary tract infections of vision problems, and hallucinate.
Over time, someone abusing lean will begin to develop a resistance to the substance. After a while, the body will become completely reliant on the opioid and stop producing its own. If abused for a long enough time, the user will stop experiencing a high at all and will simply be taking the drug to feel normal again.
Purple Drank is another slang term for the mixture of alcohol and Codeine. The term is tentatively credited to DJ Screw, a rap artist from Houston who credits his psychedelic genre of rap (title Screw) to the effects he experienced while taking alcohol and codeine. Tragically, DJ Screw died from a purple drank overdose in 2000. 
If someone is taking Codeine and alcohol together, they may have trouble breathing or staying awake. Their lips or nails may have a bluish tint to them and their skin may be a greyish colour if they're having trouble breathing. If they wake up, they may begin to vomit or be unable to speak.
If someone is experiencing any of these symptoms, you should call an ambulance immediately. There is still time to save their life if you act quickly.
While under the influence of Codeine and alcohol, someone may become dizzy, have impaired vision, or have impaired mental functions. Their brain may become foggy and they will have trouble thinking clearly. They may also become drowsy or develop a headache. If they consume enough of the drug, they may have trouble breathing as well.
If someone abused Codeine and alcohol for a long period of time, dependence may develop. After abusing the drug for a long enough time, the user may become unable to get high and will simply be taking the drug to feel somewhat normal.
Kidney and liver damage can also occur as alcohol severely damages your kidney and liver. A person may also experience dental decay or depression and anxiety.
Not everyone taking Codeine is abusing it, so how long should you wait until you drink? It is most likely safe for you to drink about 24 hours after your final dose of Codeine.
You should, however, consult your doctor before consuming any alcohol. They will know the specifics of the medication you're taking and will be able to advise you on when it is safe to consume alcohol.
You should also refrain from taking anything that consumes alcohol, even if you're not drinking it. Certain mouthwashes contain alcohol and should be avoided no matter what if you're taking Codeine. 
If you have never taken Codeine before, one dose will most likely be enough to numb any pain you're feeling; however, as you consume more of the drug, you will need to take more to receive the same effect.
If someone mixes alcohol and Codeine together, they will begin to develop a tolerance to both substances that will remain even if they were to stop taking one of the drugs.
If you find that you need to take more Codeine or alcohol to feel the same affects you used to experience, you may be developing tolerance and you should seek treatment to begin to wean yourself off of the substances. 
If someone is addicted to Codeine and alcohol, they should seek professional help at a rehab centre. A patient can choose to stay at a centre for 24 hours a day or live at home and check in at least once a day for treatment. Either method is incredibly beneficial to the patient and provides them with qualified doctors to treat them and a strong support system to help get through the withdrawal process.
Codeine is classified as a Class B substance meaning you can only acquire it from a doctor or any other person qualified to write you a prescription. If someone chooses to sell it or even give it to a friend without being a medical professional, they can face serious jail time.
Simply possessing Codeine without a valid prescription can net someone up to five years in jail as well as a hefty fine. If a person chooses to give it to someone -even just a friend, they can expect up to 14 years in jail and a fine.
You can even be prosecuted for simply knowing someone is illegally distributing Codeine. If you are a landlord, club, or bar owner, you can be prosecuted for allowing the illegal sale of Codeine on your property.
If you don't want to face the legal ramifications, it's important to keep an eye on what's happening on your property. Similar to driving while drunk, people who drive while high on Codeine can be prosecuted for driving under the influence.
If you or someone you love is abusing Codeine and alcohol, you should attempt to seek medical rehab or therapy. Abuse can cause death or other serious health problems so you should attempt to get help as quickly as possible.
If you are worried about your own health and behaviours, or a loved one's, call us today on 0800 111 41 08.