In the old days (the 1970s), codeine cough syrup was as easy to buy as aspirin. Today, it's only available as a prescription. But that doesn't stop people who want to get high from getting their hands on it.

Codeine cough syrup addiction is not as prevalent as meth, but it's out there: professional athletes and hip-hop artists keep the narcotic in the press with a concoction called "purple drank".

For some, codeine cough syrup addiction is a serious problem. For others, it's deadly. 

A Codeine Primer
Within the poppy plant, Papaver soniferum, is opium. In opium, codeine is found as an alkaloid in small concentrations of less than 2.5%.

"Codeine is the most widely used, naturally occurring narcotic in medical treatment in the world," says the U.S. Drug Enforcement Agency (DEA). Over 500 tons of opium is imported to the U.S. every year for legitimate medical uses. Codeine is prescribed as a moderate pain reliever and a cough suppressant.

Codeine is the base ingredient in the narcotics dihydrocodeine and hydrocodone  (Vicodin, Lortab, etc.). It's also used in combination with aspirin or acetaminophen (Tylenol with codeine) and in over-the-counter cough suppressants such as Robitussin AC.

And codeine is used in combination with other drugs in prescription cough medicines. One of the most popular combinations is codeine and promethazine, a drug used to treat allergy symptoms such as itching, runny nose and sneezing. This prescription drug is often used in combination with Sprite, 7Up, Mountain Dew and other soft drinks in what's called purple drank.

Codeine Cough Syrup and the Law
Codeine cough syrups are only available with a prescription. And codeine is classified according to its strength in these prescriptions. The U.S. Controlled Substances Act (CAS) categorizes drugs from Schedule I to Schedule V, with Schedule I (LSD, heroin, etc.) having a high potential for abuse.

Codeine and codeine products fall under Schedules II, III, and V. Schedule II drugs have a high potential for abuse and can lead to physical and psychological dependence. Schedule III drugs have a potential for abuse, but it's not as high as Schedule II drugs.

Schedule II
Codeine products with more than 90 milligrams per dosage unit. These require a written prescription. 

Schedule III
Codeine products with not more than 1.8 grams of codeine per 100 milliliters or not more than 90 milligrams (Tylenol with codeine) per dosage unit. These prescriptions can be phoned in.

Schedule V
Codeine products with not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC and Phenergan with Codeine). These cough syrups usually have two other active ingredients.

Abusing Codeine Cough Syrup
Rapper Lil' Wayne admits he has a codeine cough syrup addiction. Former NFL quarterback JaMarcus Russell was arrested for possession of codeine cough syrup. DJ Screw, a popular Houston DJ, overdosed on codeine, as did Rapper Pimp C.

It's called "Purple Drank". And when taken in large doses, it can stop the heart. Purple Drank is a cocktail of prescription cough syrup with promethazine and codeine mixed with a soft drink like Sprite.

To get purple drank, mix a few ounces of promethazine/codeine prescription cough syrup and 8 ounces or more of a lemon-lime soda like Sprite, Sierra Mist or 7Up with Jolly Ranchers or Skittles thrown in for flavor. The purple comes from the syrup dye.

Because both ingredients, codeine and promethazine, are central nervous system depressants, the effects of purple drank can be dangerous and even deadly.

Because of its psychological and physical qualities, codeine cough syrup addiction treatment should be addressed immediately.
Side Effects
Drugs.com lists the following side effects for the combination Promethazine/Codeine:

  • Restless muscles movements in the eyes, tongue, jaw, neck
  • Shallow breathing
  • Slow heartbeat
  • Feeling like you might pass out
  • Confusion, agitation, hallucinations
  • Seizure
  • Urinating less than usual
  • Stiff muscles
  • High fever, sweating
  • Dizziness, drowsiness
  • Feeling restless
  • Insomnia

The New Codeine
For decades, people, especially kids, have been abusing over-the-counter (OTC) cough medicines. When the FDA replaced most OTC codeine products, kids simply found a new product that would give get them high—those with the ingredient dextromethorphan (DXM).

DMX gives users feelings of euphoria and visual and auditory hallucinations.

This cough suppressant is found in over 120 OTC medicines such as Robitussin, Pediacare, Dayquil and Corcidin products, known as the "Triple Cs" because of the CCC printed on them.

According to the DEA, "DXM is not scheduled under the Controlled Substances Act (CSA).  However, the CSA indicated that DXM could be added to the CSA, in the future, through the traditional scheduling process, if warranted."

Summary

It may seem innocuous at first, but a codeine cough syrup addiction can become a serious problem, especially for those in the hip-hop community, where purple drank is promoted. If you are interested in treatment, learn "how to select a treatment center."