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The codeine alkaloid is found in opium; however, most codeine used in the United States is derived from morphine. It is available in prescription form for the management of moderate pain, and it is used as a cough suppressant.

CodeineCodeine produces less respiratory depression and sedation when compared to morphine. It is most commonly taken orally. It is also used in combination with other drugs; a common prescription for codeine is Tylenol with Codeine.

Codeine is available in prescription forms but is also obtainable on the black market. It is a painkiller, one of the most commonly abused prescription drugs. Codeine is sometimes used as a recreational drug.  Some recreational users purchase codeine from multiple pharmacies. It can also be purchased on the streets as an illegal prescription painkiller as are so many prescription drugs today. Recreational users like this drug for its euphoric effects.

Common Side Effects Of This Drug

Some common adverse effects of codeine are drowsiness and constipation.  A serious side effect is respiratory depression.  Codeine was used often in young patients who had tonsillectomies.  This practice has been stopped more recently because of the effects of respiratory depression, especially in children. It should never be taken along with alcohol.  Serious side effects or death can result when combined with alcohol.

Addiction on Trend

Several current hip-hop artists and pop stars are often seen carrying a white styrofoam cup during public appearances and general outings. What exactly is reported to be in those cups? It is a concoction called “Sizzurp.” It is also the concoction that brought one rap artist to the hospital twice in 2013, reportedly for seizures resulting from his addiction to his favorite beverage.

Sizzurp, “Texas Tea,” “Purple Drank” and even “Water” are street and pop culture names used for a dangerous mix of codeine-rich cough syrup and carbonated beverages such as Mountain Dew or 7-Up. Some users mix the syrup with fruit punch or their favorite juice. Some consumers even add Jolly Rancher candies to the drink, to sweeten and add flavor.

Touted as the drink of choice for hardened drug dealers because it produces effects similar to drugs such as heroin, it is surprising that celebrities, who have so much going for them, would consider consumption of the codeine drink, despite knowing it can seriously harm or even kill them quickly. Even more surprising are the stars’ decision to try the beverage after hearing it mentioned in the lyrics of another rapper’s music. Pimp C was the performer of those lyrics and died in 2007 as the result of a codeine overdose.

So why do some celebrities remain so devoted to Sizzurp, despite death of a friend due to the same substance, and after several renowned artists have come so close to debilitation and even death? The answer lies in the concoction’s primary active ingredient, prescription strength codeine, which is easily acquired in comparison to other opiates and is equally addictive and habit-forming.

Primarily used for treatment of pain, codeine is a narcotic medication derived from the opium poppy plant, the same origin as heroin. It is generally prescribed for treatment of minor to severe pain, by licensed practitioners. Under street names like “T-threes,” “Doors & Fours,” “Coties” and “Schoolboy,” codeine is one of the most over-prescribed drugs on the market and is used by 33 million Americans each year, according to the National Survey on Drug Use and Health by the Substance Abuse and Mental Health Services Administration.

While codeine is an effective solution for pain and is safe when used as prescribed by a physician, many men and women start using the drug long term. Sometimes this is derived from actual need to fight physical pain. Other times, abuse stems from the desire to numb emotional or mental pain, as codeine produces a calming, relaxing, euphoric sense of peace, stemming from its morphine-like qualities. It is unfortunate that mainstream pop culture so clearly touts Sizzurp and other variations as being an acceptable beverage on the hip hop scene. Certainly, top level and highly visible stars’ repeated mention and public use of the codeine drink influences others to use, just as some claim in the press they were originally enticed by their friend Pimp C.

Long-term use of codeine is highly detrimental to the physical, psychological and relational/social well-being of the user. Codeine seriously impacts the nervous system, thus wreaking havoc on the entire body and life of the abuser.

Some of the consequences of abuse are:

  • Nausea
  • Blurred Vision
  • Liver Damage
  • Kidney Damage
  • Respiratory Depression
  • Stomach Damage
  • Tremors
  • Seizures
  • Cardiovascular Problems
  • Disorientation and Confusion
  • Impaired Cognition
  • Irritability and Moodiness
  • Anxiety
  • Hallucinations
  • Depression
  • Broken Relationships
  • Social Isolation and Division
  • Death

The signs of addiction can occur even as part of short-term overuse. In as little as five days of abuse, codeine can prove detrimental and addictive.

Some of those signs of a problem are:

  • Loss of Appetite
  • Itchy Skin
  • Excessive Drowsiness and Sleeping
  • Fatigue
  • Bluish Coloration of Nails and Lips
  • Dizziness and Nausea
  • Social Withdrawal
  • Uncontrollable Twitching
  • Heightened Interest in Money (to support the addiction)

Codeine withdrawal is not necessarily easier to endure than withdrawal on more major street drugs, such as heroin. Many of the withdrawal symptoms are the same as those experienced by heroin and other opiates. While most of the symptoms pass with days of discontinuation of use, many recovering addicts do not feel normal or fully physically recovered for months.

Some of the most common withdrawal issues are:

  • Digestive Problems
  • Nausea and Vomiting
  • Dehydration
  • Weakness
  • Sweating
  • Fever
  • Headaches
  • Muscle Pain
  • Insomnia


Whether derived from prescription overuse in a more raw form, or through popular use as Sizzurp or Texas Tea – is relatively treatable. But, it is often difficult to entice abusers into treatment, particularly when use is so accepted within popular culture. Unlike many drugs like heroin, Sizzurp codeine abuse is spotlighted in music, video and through celebrity imagery as being on trend and even fashionable. Regularly prescribed codeine is also not considered within the media as being a major abuse concern, whereas Vicodin and other, more known painkillers are repeatedly mentioned as big threats to society. These are social and cultural hurdles that must be overcome. As things are today, in regard to its overuse and long-term abuse, codeine will continue to become a drug of choice. That is, until an unfortunate and equally visible loss is suffered, at the hand of this quietly addictive, fashionable opiate.

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