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Codeine and promethazine are the two active ingredients in an often prescribed cough syrup medicine known as Phenergan with Codeine. In general, cough syrups are formulated to treat symptoms involving cough and congestion, but the stronger varieties employ added agents that may bring on unintended side effects.
As a natural derivative of opium, codeine comes with a high risk for abuse and addiction, whereas promethazine acts as an antihistamine agent. Promethazine carries no abuse or addiction potential; however, it can produce sedative-like effects that feed into codeine’s addiction potential.
In effect, codeine-promethazine addiction develops out its interactions with codeine in cases where cough syrup is used for recreational purposes. Understanding how codeine and promethazine addiction take shape can help you in spotting signs of a growing addiction problem.
Call our helpline at 800-291-1732 (Who Answers?) for more information on codeine-promethazine addiction rehab programs.
Codeine-Promethazine Addiction Risks
Commonly referred to as “Purple Drank,” promethazine and codeine abuse has become a popular practice among teenagers and young adults. According to the U. S. Department of Justice, the effects of this combination resemble those of other forms of opiate abuse, producing feelings of euphoria and sedation that can easily pave the way for a a full-blown addiction to develop.
In effect, promethazine’s reinforcing effects can actually speed up the rate at which addiction develops compared to just taking codeine by itself.
Signs to Watch For
Increasing Dosage Amounts

The codeine-promethazine combination is abused for its euphoric and sedative effects.
The brain easily integrates codeine (in any form) within its chemical processes as codeine shares a similar chemical makeup with the brain’s neurotransmitter materials. According to Columbia University, these conditions give rise to increasing brain tolerance levels.
This means, someone who abuses cough syrup on a regular basis will have to keep increasing his or her dosage amounts in order to experience the desired intensity or “high” effects from the drug. Rising tolerance levels play an active role in a developing codeine-promethazine addiction problem.
Physical Dependence
Codeine-promethazine cough syrup effects not only interfere with the brain’s chemical environment, but also alter the brain’s chemical system over time. In effect, an altered chemical environment breeds imbalances that compromise the brain’s ability to regulate bodily functions as normal. In the process, a state of physical dependence starts to take shape.
With a growing physical dependence comes withdrawal episodes that bring on distressing physical and emotional symptoms. These symptoms may take the form of:
- Profuse sweating
- Problems sleeping
- Depression
- Anxiousness
- Lack of energy
- Restlessness
For most people, the temptation to take more cough syrup becomes overwhelming, which greatly increases codeine-promethazine addiction risks.
Psychological Dependence
Whereas physical dependence affects the body’s physical systems, psychological dependence targets the workings of the mind. With regular cough syrup use, growing brain chemical imbalances soon disrupt the areas of the brain that regulate thinking, emotions and behavior.
Once a psychological dependence takes hold, a codeine-promethazine addiction is at work. In this state, a person has come to believe he or she needs the drug to cope with daily life. Compulsive drug-seeking and drug-using behaviors are key signs of addiction.
For help with finding a treatment program that can help you overcome codeine-promethazine abuse, call our helpline at 800-291-1732 (Who Answers?) to speak with one of our addiction counselors.
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