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Twelve-step programs — In an American survey of treatment providers from three separate institutions (the National Association of Alcoholism and Drug Abuse…
Ecstasy is a synthetic drug chemically similar to hallucinogens and stimulants. It has a similar structure as methamphetamines and is a derivative of amphetamines. Ecstasy alters an individual’s mood and perception and also produces feelings of extreme pleasure, increased energy, distorted time and sensory perception, and emotional warmth.
Ecstasy used to be a legal medication. It was developed in 1912, by the Merck pharmaceutical company. The original form of the medication was called “MDMA”, and in 1953 it was used by the US Army in psychological warfare testing. In 1960, “MDMA” was used as a psychotherapy medication to lower inhibitions, and by the 1970’s it was being used as a party drug.
In the 1980s MDMA was the most popular drug for weekend parties. In 1984, it was sold under the brand name of “Ecstasy”, and in 1985 it was banned due to safety concerns.
According to the National Institutes of Health:
MDMA was initially popular in the nightclub scene and at all-night dance parties (“raves”), but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly. People who use MDMA usually take it as a capsule or tablet, though some swallow it in liquid form or snort the powder. The popular nickname Molly (slang for “molecular”) often refers to the supposedly “pure” crystalline powder form of MDMA, usually sold in capsules. However, people who purchase powder or capsules sold as Molly often actually get other drugs such as synthetic cathinones (“bath salts”) instead. Some people take MDMA in combination with other drugs such as alcohol or marijuana.
Ecstasy usually comes in the form of a pill, but it can also be injected or taken as a liquid; the liquid form of the drug is called GHB. GHB is a central nervous system depressant, and it is a very dangerous form of the drug. There have been many instances where GHB has been unknowingly slipped into people’s drinks. They are then lured away from their original location and will wake up the next day without having any recollection of what happened to them.
What Are the Street Names for Ecstasy?
Ecstasy has many different street names. The Drug Enforcement Administration (DEA) has many alternative ecstasy names listed in their database because drug dealers often change the street names to try and confuse law enforcement.
Known as a party drug, ecstasy comes in pill or powder form; the pill has a variety of logos and colors. The street names put together by the DEA include:
Adam
Beans
Biscuit
Clarity
Disco Biscuit
E
Eve
Hug Drug
Lover’s Speed
MDMA
Peace
STP
X
XTC
Molly
There are also some other street names of ecstasy: Cadillac, California Sunrise, Essence, Elephants, Love Drug, Love Pill, Molly, Roll, Scooby snacks, Snowball, and XE.
Side Effects of Ecstasy Use
Ecstasy affects three different chemicals in the brain, dopamine, serotonin, and norepinephrine. Its effects can give the individual a greater sense of well-being, emotional warmth, enhanced sensory perception, and increased empathy towards others. Some of the side effects of the drug can include:
Anxiety
Depression
Confusion
Attention problems
Decreased libido
Irritability
Insomnia
Reduced appetite
Memory problems
Impulsiveness
The onset of Ecstasy is about 45 minutes after a dose is taken, and the duration is usually between three to six hours.
Dangers of Ecstasy Abuse
Just like a lot of heroin, cocaine, and other substances in this country are being mixed with fentanyl, Ecstasy can also have a lot of additives. A person may purchase a pill that they believe to be pure Molly, but much of the time it is mixed with cocaine, methamphetamine, ketamine, bath salts, and/or over-the-counter cough medicine. You do not know what you are buying these days, and any of these substances can be extremely dangerous especially when mixed with MDMA.
Treatment for Ecstasy Addiction
If you or someone you love is struggling with an addiction, our addiction specialists are available around the clock to assist you. Recreate Life Counseling provides cutting edge addiction treatment. We tailor our programs to meet the individual needs of each person suffering from addiction. We offer a variety of different treatment programs to help recreate your life and get you on the road to a lasting recovery.
FAQ
How long does Ecstasy stay in your system?
Ecstasy can be detected in blood for 1 to 2 days & in Urine for 2 to 4 days after taking it.
The euphoric effects of crack cocaine hit rapidly and intensely, making it one of the most addictive stimulant drugs. Unlike powder cocaine, a white powder that is typically snorted, crack cocaine is a freebase form that is smoked, leading to an immediate and powerful high.
Crack cocaine is a highly potent stimulant that impacts the central nervous system, producing an intense but short-lived high. This powerful stimulant is derived from South America, where coca leaves are processed into powdered cocaine before being converted into crack. When smoked, the drug enters the bloodstream almost instantly, creating a rapid dopamine surge that results in extreme euphoria, increased energy, and heightened confidence.
However, this intensity comes at a cost. The high from crack cocaine typically lasts only 5 to 15 minutes, followed by an abrupt and severe crash that leaves users feeling anxious, irritable, and desperate to use again. The effects of cocaine use are further complicated by the production of cocaethylene, a toxic byproduct that forms when cocaine is combined with alcohol, significantly increasing the risk of overdose and cardiovascular issues.
So, how long does a crack cocaine high last, and what factors influence its duration? The answer depends on dosage, frequency of use, tolerance, metabolism, and the presence of other substances like opioids or alcohol. While the high itself is fleeting, the long-term consequences—both physical and psychological—can be devastating.
In this article, we’ll explore the effects of cocaine, the duration of its high, the crash that follows, and the serious risks associated with crack cocaine use, while also offering hope for those seeking recovery.
How Crack Cocaine Affects the Brain
Crack cocaine is a powerful central nervous system stimulant that rapidly affects dopamine levels in the brain. Dopamine is a neurotransmitter associated with pleasure, motivation, and reward. Under normal conditions, dopamine is released and then reabsorbed by neurons, regulating mood and behavior. However, when crack cocaine is smoked, it prevents dopamine reabsorption, leading to an intense surge of euphoria.
Unlike powder cocaine, which is often snorted and absorbed more slowly, crack cocaine enters the bloodstream almost instantly through the lungs, reaching the brain within seconds. This rapid dopamine spike creates a powerful but extremely short-lived high, reinforcing compulsive use and addiction as the brain quickly craves more of the drug.
Immediate Effects of a Crack Cocaine High
Once smoked, crack cocaine delivers an almost instantaneous rush, leading to:
Euphoria & Intense Pleasure – Users feel an overwhelming sense of well-being and confidence.
Increased Energy & Alertness – A sudden boost in physical energy and mental focus.
Heightened Sensory Perception – Colors may seem brighter, sounds more intense.
Decreased Appetite – Users may go hours without feeling hungry.
Temporary Reduction in Fatigue – Feelings of exhaustion are replaced with alertness.
However, this high is fleeting, and users often experience a rapid and severe crash as dopamine levels plummet. This crash can lead to intense cravings, anxiety, paranoia, and depression, which often trigger repeated use and binge cycles.
How Long Do the Effects of Crack Cocaine Last?
The onset and duration of cocaine vary and depend solely on how the drug is ingested. Let’s take a look at the different ways it’s ingested and how long the high lasts.
Method of Use
Onset of Effects
Duration of High
Injecting Cocaine (IV use)
10-15 seconds
15-30 minutes
Snorting Cocaine (Powdered Cocaine)
1-3 minutes
30-60 minutes
Gumming Cocaine (Oral/Buccal Use)
1-3 minutes
45-90 minutes
Smoking Crack Cocaine
10-15 seconds
5-15 minutes
The methods that get cocaine into your system or bloodstream faster allow the drug to wear off faster. The high euphoria that one gets from smoking crack cocaine comes on very hard and very fast making it one of the most, psychologically addicting drugs. Once the high wears off, the drug leaves you craving more and more of it. A lot of times you will hear people say that they continue to smoke crack cocaine, trying to achieve that initial high and euphoria that they got when they took that first hit, and they are never able to obtain it.
Crack Cocaine vs. Powder Cocaine: Duration & Intensity
Form of Cocaine
Onset of Effects
Peak High
Total Duration
Crack Cocaine (Smoked)
10-15 seconds
1-5 minutes
5-15 minutes
Powder Cocaine (Snorted)
1-3 minutes
15-30 minutes
30-60 minutes
Powder Cocaine (Injected)
Immediate
5-10 minutes
20-45 minutes
Key Differences:
Crack cocaine produces a much faster, more intense high but lasts for a significantly shorter time.
Powder cocaine (snorted) has a slower onset but lasts longer (up to an hour).
The rapid crash of crack cocaine leads to a stronger compulsive need to redose, increasing addiction risk.
Understanding the short-lived but intense nature of a crack cocaine high is crucial for recognizing the dangers of repeated use, addiction, and long-term consequences.
Factors Influencing the Duration of the High
The length and intensity of a crack cocaine high depend on dosage, method of use, metabolism, frequency of use, and purity.
Dosage: Larger doses create a more intense high but do not prolong it. Instead, they worsen the crash by rapidly depleting dopamine.
Route of Administration: Smoking vs Snorting vs Injecting
Smoking (Crack Cocaine) – Reaches the brain in seconds, with a 5-15 minute high.
Injecting (Powder Cocaine) – Immediate effect, 20-45 minutes high, but higher risk of overdose.
Smoking crack leads to the most intense and addictive cycle due to its rapid onset and short duration.
Metabolism: How the Body Processes Crack Cocaine
Body fat & weight – Higher fat content slows metabolism.
Liver function – A healthy liver clears the drug faster.
Genetics – Some metabolize cocaine quicker, shortening its effects.
Frequency of Use: Tolerance Reduces Duration
Repeated use builds tolerance, meaning:
The same dose produces a weaker high.
Users increase dosage to feel the same effect.
Highs become shorter, leading to binge use.
Purity of the Drug: Adulterants Matter
Pure crack creates a stronger, immediate high.
Adulterated crack (cut with baking soda, talcum, or fentanyl) may weaken or increase risks.
Crack cocaine produces an intense but short-lived high, with factors like dosage, tolerance, metabolism, and purity influencing its effects. Would you like me to refine this further?
The Crash Following the High
The crash that follows a crack cocaine high is often as intense as the high itself—only in the opposite direction. As the drug quickly leaves the system, users experience severe dysphoria, anxiety, depression, fatigue, and intense cravings. Many also report feeling irritable, restless, and emotionally unstable, struggling to regain a sense of normalcy.
This crash occurs because crack cocaine depletes dopamine and other neurotransmitters at an extreme rate. During the high, the brain is flooded with dopamine, creating euphoria and heightened energy. However, once the drug wears off, dopamine levels plummet, leaving the user in a state of emotional and physical exhaustion. Without sufficient dopamine, the brain struggles to regulate mood and motivation, contributing to severe depressive symptoms and an overwhelming urge to use again.
The intensity of the crash often drives compulsive use, leading users to take more crack to escape the discomfort. This binge-crash cycle can quickly spiral into addiction, as the brain becomes increasingly dependent on the drug to function. Over time, repeated crashes worsen mental health, increasing the risk of chronic anxiety, depression, paranoia, and cognitive impairment. Some long-term users develop persistent mood disorders and struggle with emotional regulation even after stopping the drug.
Breaking free from this cycle requires professional intervention and support, as the psychological grip of crack cocaine can be just as challenging as its physical effects. Seeking treatment can help restore brain chemistry, stabilize mood, and rebuild a healthier, addiction-free life.
Short-Term Side Effects of Crack Cocaine
The short-term effects occur immediately after smoking crack and can last anywhere from 5 to 15 minutes before the crash begins. These include:
Euphoria & Intense Pleasure – A powerful but short-lived sense of well-being.
Increased Heart Rate & Blood Pressure – A spike in cardiovascular activity, increasing the risk of heart attack or stroke.
Dilated Pupils & Increased Body Temperature – A sign of central nervous system overstimulation.
Enhanced Energy & Alertness – A sudden boost in energy and mental focus.
Loss of Appetite & Weight Loss – Crack suppresses hunger, leading to rapid weight loss.
Shortness of Breath & Chest Pain – Crack smoking irritates the lungs and can cause respiratory distress.
Heightened Anxiety & Paranoia – Some users experience intense nervousness or paranoia shortly after smoking.
Compulsive Drug-Seeking Behavior – The short high leads to binge use, increasing addiction risk.
Severe Risks
Cocaine Overdose – Can cause seizures, heart failure, or stroke.
Risk of Sudden Death – Even first-time use can lead to fatal cardiovascular collapse.
Long-Term Side Effects of Crack Cocaine
Long-term effects of crack cocaine use has serious health consequences affecting nearly every system in the body.
Physical Health Problems
Cardiovascular Damage – Chronic use weakens the heart, creates high blood pressure, damages blood vessels, and increases the risk of stroke, heart attack, and aneurysm.
Lung & Respiratory Issues – Chronic cough, lung infections, and respiratory failure due to repeated smoking.
Neurological Damage – Crack alters brain structure, leading to memory loss, reduced cognitive function, and decision-making difficulties.
Severe Weight Loss & Malnutrition – Prolonged use leads to muscle wasting and severe malnutrition.
Hepatitis & Infections – Crack cocaine users who share pipes or needles have a higher risk of hepatitis and other infections.
Mental Health Effects
Paranoia & Hallucinations – Long-term use can cause cocaine-induced psychosis, leading to severe paranoia, delusions, and auditory hallucinations.
Severe Depression & Anxiety – Chronic use depletes dopamine, making it difficult for users to feel pleasure without the drug.
Emotional Instability – Users may experience violent mood swings, aggression, or suicidal thoughts.
Social & Economic Consequences
Addiction & Substance Use Disorder – Crack cocaine has one of the highest addiction potentials, leading to compulsive use and dependency.
Financial Ruin – Addiction often leads to job loss, financial instability, and legal issues.
Legal Consequences – Crack cocaine possession can lead to arrests, incarceration, and long-term legal problems.
Damaged Relationships – Addiction often results in estranged family relationships, loss of trust, and isolation.
Crack Cocaine Withdrawal Symptoms
Crack cocaine withdrawal is primarily psychological rather than physical, but it can be intensely distressing and lead to severe cravings and emotional instability. The withdrawal process varies depending on duration of use, frequency, and dosage, but most users experience several key symptoms after stopping use.
Psychological Symptoms
Intense Cravings – A powerful urge to use crack again, often leading to relapse.
Severe Anxiety & Restlessness – Users feel extreme nervousness, agitation, and paranoia.
Depression & Suicidal Thoughts – Dopamine depletion leads to persistent sadness, hopelessness, and emotional numbness.
Irritability & Mood Swings – Users may experience uncontrollable anger and frustration.
Hallucinations & Paranoia – Some users experience cocaine-induced psychosis, causing delusions and paranoia even when sober.
Physical Symptoms
Fatigue & Extreme Lethargy – The body crashes after overstimulation, leading to severe exhaustion.
Increased Appetite & Weight Gain – Users may binge eat as metabolism stabilizes.
Body Aches & Muscle Pain – Aches and discomfort are common.
Headaches – Often caused by dopamine imbalances and dehydration.
Insomnia or Excessive Sleeping – Users either struggle to sleep or sleep for long hours as the body recovers.
Cognitive Symptoms
Difficulty Concentrating – Brain fog and slowed cognitive function are common.
Memory Issues – Users may experience short-term memory loss or difficulty processing information.
Psychological symptoms improve, but occasional cravings persist.
Months 1-3
Post-Acute Withdrawal Syndrome (PAWS) – Ongoing mood swings, depression, and cravings may continue.
Why Withdrawal Is So Intense
Crack cocaine creates a rapid surge of dopamine, but after stopping use, the brain struggles to produce dopamine naturally. This dopamine crash leads to prolonged feelings of emptiness, sadness, and cravings, making recovery difficult without professional support.
Treatment and Recovery
Despite its powerful grip, crack cocaine addiction is a serious form of substance abuse, but effective addiction treatment is available. Recovery requires professional healthcare intervention, as willpower alone is often not enough to overcome the intense cravings and psychological dependence. Treatment programs, including inpatient and outpatient options, provide structured support to help individuals regain control of their lives.
Behavioral therapies, such as Cognitive Behavioral Therapy (CBT), counseling, and support groups, play a crucial role in helping individuals rewire their thought patterns and develop healthier coping mechanisms. These treatment options are essential for addressing both the physical and psychological aspects of drug addiction.
Medical detox and structured rehabilitation programs—whether in an inpatient setting for intensive care or through outpatient treatment for flexible support—can help manage withdrawal symptoms and reduce the risk of relapse. Ongoing therapy and peer support groups, such as Narcotics Anonymous (NA), offer continued guidance to help individuals maintain long-term sobriety and rebuild their lives.
If you or a loved one is struggling with drug abuse, help is available. Seeking professional treatment can provide the tools and support needed to break free from addiction and reclaim a healthier, more fulfilling life.
Getting Treatment for Crack Cocaine Addiction
The intense yet short-lived high of crack cocaine is followed by a severe crash, leading to overwhelming cravings, anxiety, and depression. This cycle fuels its highly addictive nature, making it one of the most dangerous and difficult substances to quit. The physical and psychological toll of crack cocaine use can be devastating, but recovery is possible with the right support.
If you or a loved one is struggling with crack cocaine addiction, you are not alone. At Recreate Life Counseling, our addiction specialists are available 24/7 to provide evidence-based treatment and guide you toward a lasting recovery. Take the first step today—call us now and start your journey to a healthier, drug-free life.
The programs of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are 12 Step programs. Twelve-step programs are organizations that were created for recovery from substance abuse. The first twelve-step program that was created is Alcoholics Anonymous; it was created in the 1930s.
The 12 Steps were created to establish guidelines to help those that were struggling with alcoholism overcome their addiction to alcohol. Because the 12-steps and program helped so many people in its early years, today there are a lot of 12-step programs available for several different addictions and compulsive behaviors.
Is There a 13th Step in Narcotics Anonymous or Alcoholics Anonymous?
The “13th Step” is not officially part of any 12-step program. The definition of “13th stepping” is when an individual who has over a year of sobriety attempts to develop a sexual relationship with someone who is brand new in recovery, or who has less than a year of sobriety. When you join a 12-step program, you are strongly advised against starting a relationship of any kind for at least the first year of your recovery.
The Dangers of 13th Stepping
Starting a relationship of any kind, especially a sexual relationship, when you are new in recovery can be dangerous for several reasons. Here is a list of some of those reasons.
When you are new in recovery, you are very vulnerable. For someone, that has been in recovery, to take advantage of a newcomer is exploitative.
Starting a new relationship, especially a sexual relationship, can distract you from sustaining recovery.
If the relationship doesn’t work out, the potential for relapse is there, and this gives the newcomer justification to relapse.
It can drive new members away. This is a betrayal of trust.
13th-stepping can damage the reputation of the program and individual meeting groups.
It can make a newcomer feel very unsafe and like they can’t trust the program or anyone in it.
The act of 13th Stepping is detrimental to anyone that is involved. It is detrimental to the program and specific meeting groups.
How Do You Protect Yourself from 13th Stepping?
There are several ways to protect yourself from 13th Stepping. Here are some things you can do:
It is best to stick with a sponsor of the same sex if you are heterosexual and of the opposite sex if you are homosexual.
If any sponsor in the program makes sexual advances towards you, it is very important to end the relationship immediately. Sponsors are there to help support you and give you advice only. Any other behavior can be damaging to the newcomer.
Newcomers’ priority should be their sobriety, so any sexual relationships should be avoided in the first year of recovery. Sexual relationships put the newcomer at too much risk.
Flirting is normal to an extent, but if the flirtatious behavior is making the newcomer feel uncomfortable, they should immediately talk with their sponsor about it. Their sponsor will be able to give them advice on how to deal with the behavior.
The only time it is acceptable to have a sexual relationship with another member of the program is when both parties are secure in their recovery and both have at least a year of sobriety under their belts. Sometimes even a year of sobriety isn’t enough depending on where each party is in their recovery.
AA meetings and groups, on the whole, are safe, but if you attend a meeting and notice any unethical behavior, it would be best to find a new meeting to attend. People in recovery are far from perfect; no one is perfect, but if you witness this type of behavior, especially right off the bat, it would be in your best interest to get away from it immediately.
Effective Treatment for Substance Use Disorders
If you or someone you love is struggling with addiction, our addiction specialists are available around the clock to assist you. Recreate Life Counseling offers evidence-based addiction treatment to get you to a lasting recovery. What are you waiting for? Call us today!
One of the main components of every 12-step method of addiction recovery is “coming to believe in a power greater than yourself.” Unfortunately, many men and women who could greatly benefit from a 12-step program allow this component to deter them entirely, generally because they believe this entails becoming religious or coming to believe in and put faith in a God. On the contrary, the phrase “higher power” encourages spirituality and the fostering of a spiritual connection – there is nothing religious about it. The step itself reads, “Came to believe that a power greater than ourselves could restore us to sanity.” This is the 2nd step of Alcoholics Anonymous, and it explores spirituality as well as the definition of insanity.
When you enter addiction recovery, you will begin to further understand the meaning of insanity, which is doing the same thing over and over and expecting different results. What better describes active addiction than this definition of insanity? Those who are inactive addiction will use their drug of choice over and over again despite negative consequences, repeatedly telling themselves, “This time will be different,” or, “I’ll be able to control my intake this time around, I just know it.” Of course, this is never the case.
Time and time again those who are struggling with active addiction will make the same mistake. How do they pull themselves out of that trite old rut and overcome addiction? Well, they certainly cannot do it without help – and this is what “higher power” means. It means understanding that left to your own devices you will not be able to overcome addiction; that you will require some outside help, whatever that may look like to your specific case.
How to Choose a Power Greater Than Yourself
How do you go about choosing a power greater than yourself? We have outlined several simple steps – take a look.
First, do not put too much pressure on yourself. There is no “right way” to go about this. Over time you will begin to develop a clearer picture of what the phrase “higher power” means to you. In the meantime, choose something that you do not understand, like the ocean, or something that you know has helped you, like the program of Alcoholics Anonymous.
Practice prayer and meditation daily. This will further help you bolster your spiritual connection and will help you discover who or what your higher power is over time.
Ask around. Ask other men and women who have years of sobriety under their belts who or what they look to when they think of a power greater than themselves. There is no shame in asking for advice or guidance.
Choose something to work with initially, even if it seems silly to you. Many people will choose a doorknob as their higher power as a sort of placeholder until they can further explore their spirituality. The most important thing is that you recognize that addiction is out of your control and that your life has become unmanageable.
Recreate Life Counseling and the Twelve Steps
At Recreate Life Counseling, we passionately believe that spirituality is a fundamental component of every successful long-term recovery program. We also believe that working through the 12 steps of Alcoholics Anonymous or Narcotics Anonymous is an important part of every aftercare program; those who work through the 12 steps are far more likely to maintain long-term sobriety after treatment. Recreate Life Counseling offers an individualized and comprehensive treatment program for individuals who are suffering at the hands of substance abuse disorders of all types and severities. To learn more about our program of recovery, give us a call today. We look forward to speaking with you soon.
“Made direct amends to such people wherever possible, except when to do so would injure them or others”; the 9th step of the Twelve Steps of Alcoholics Anonymous (AA). By now you have made it through the first 8 steps, congratulations, you have almost made it! There are some important things you must know and do to successfully make 9th step amends.
To work the 12 steps effectively, specifically step nine, you should have a sponsor or someone that has already worked the steps to help you and more importantly be there to support you. Do not try to attempt to work step nine without a sponsor, therapist, or spiritual advisor. Your sponsor can help walk you through this by asking you about your goals in making amends, how you plan to do it, and when. This person should have already worked on step nine, so they understand what it takes and can help guide you through it.
What Does Making Amends Mean?
Amends is a compensation for a loss, injury, or damage of any kind. Some of the steps you take to make amends include:
Make a list of the harm or damage you have caused.
Be willing to repair it.
Admit you’re wrongdoings.
Figure out the best way to repair the damage.
Be patient about gaining the other person’s trust back.
Before you start working step nine, you must have already completed step eight. Step eight says “Made a list of all the people we have harmed and became willing to make amends to them all.” You cannot work the 9th step effectively without doing step eight first.
Types of Twelve-Step Amends
In 12-step recovery programs like Alcoholics Anonymous (AA), making amends is a crucial part of the healing process, as outlined in the steps of AA. There are three main kinds of amends in a 12-step program: direct amends, indirect amends, and living amends.
Direct amends involve taking responsibility for your actions by directly confronting the person you’ve harmed, as emphasized in Twelve Steps and Twelve Traditions.
Indirect amends focus on repairing the damage in a way that doesn’t involve direct confrontation, such as helping others or making restitution in a different form.
Living amends are about demonstrating long-term change. This type of amends involves committing to a new way of life, showing others through your actions that you’ve moved beyond your past destructive behaviors.
In the 12-step program, making these amends is a core part of recovery, helping to rebuild trust and personal accountability, which are key aspects of the 12-step recovery process.
Direct Amends in Recovery
Making direct amends could be a simple “I’m sorry, and I’m working hard to change my life around and make sure it never happens again.” Sometimes it could be repaying money that you owe or promising to pay along with an apology and the assurance that you are working hard to change your ways.
However, it’s not always a good idea to make direct amends, that’s why the second half of the step says “except when to do so would injure them or others.” If the harm you have done is so severe that it could cause more problems, then no matter how good your intentions are, it’s probably best that you don’t make direct amends. It’s possible that the other person is unaware of the harm you have caused them, and making direct amends would make them aware and hurt them badly.
Another instance where making direct amends may not be a good idea is if admitting your wrongs could jeopardize your freedom, which could hurt your loved ones. However, if after talking with your sponsor you decide to proceed anyway, make sure you have spoken to your family especially if you are the head of the household or primary source of income. You don’t want to do more harm than good. Also, it may not be a good idea to make direct amends if it could potentially stir something up.
Indirect Amends And Living Amends
Sometimes an indirect or living amends is the best you can do. Of course, if you can make direct amends you should do so; this is why having a sponsor or advisor to help give you direction is so important. If you aren’t able to make direct amends, then you can volunteer your time or help someone else out. Making amends is more than just an apology, it’s changing your life around and changing your ways; eliminating the destructive behaviors that were once part of your life.
Step nine is one of the scariest steps but isn’t as difficult as we make it out to be. Most people are going to be receptive. Not everyone will be, but that’s not something you can’t worry about. You’ve done your part and attempted to make amends; this is your recovery, not theirs. For a lot of people, step nine is key on the road to recovery. It is a change for the better!
Conclusion
If you or someone you love is struggling with active addiction or substance abuse, our specialists are available around the clock to assist you. At Recreate Life Counseling, we offer both inpatient and outpatient programs, with evidence-based addiction treatment designed to support every stage of the recovery process. Whether you’re dealing with alcohol addiction or another form of substance use, we are here to help you on your recovery journey.
Our comprehensive approach includes recovery support services, counseling, and resources for making a sincere apology and working through the amends process. We help individuals address past wrongs while guiding them through a complete addiction recovery plan.
Don’t wait to start your new life. Call our helpline today to learn more about how we can assist you in finding peace, restoring your mental health, and building a connection to a support group or higher power as outlined in programs like the Big Book.
Codeine is an opioid pain reliever and widely used analgesics, commonly used for mild to moderate pain and cough suppression. However, its availability varies by region due to concerns over misuse, addiction, and health risks.
Previously available over-the-counter (OTC) in Australia, low-dose codeine products were made prescription-only to curb opioid misuse and dependence. This decision was driven by the risk of addiction, respiratory depression, and other serious side effects, especially for individuals with conditions like asthma or COPD.
While codeine can be effective for both chronic pain and acute pain relief, its prescription-only status highlights the importance of responsible use under a healthcare provider’s supervision.
This article explores the regulatory status of OTC codeine, the use of codeine for pain management, and the availability of codeine-containing combination analgesics and other codeine-containing products.
Can You Buy Codeine Over-the-Counter in the USA?
No, you cannot buy codeine over-the-counter (OTC) in the United States. Codeine is a controlled substance due to its potential for misuse, addiction, and dependence. It is classified as a Schedule II, III, or V drug, depending on its formulation and combination with other medications. This restriction applies to all codeine-containing products, including some cough syrups.
Codeine’s Legal Classification in the U.S.:
Schedule II – Pure codeine (highly restricted, requires a prescription).
Schedule III – Codeine combined with non-narcotic drugs (e.g., acetaminophen or aspirin), available by prescription.
Schedule V – Low-dose codeine cough syrups, available with a prescription in most states but may be obtained OTC in limited states with pharmacist approval.
Can You Get Codeine Cough Syrup Without a Prescription?
Some states previously allowed the sale of low-dose codeine-containing cough syrups (Schedule V) over-the-counter, but most states now require a prescription. Even where OTC sales were permitted, restrictions were in place due to concerns about the use of codeine and its potential for abuse.
In states where OTC purchase is permitted, you must:
Speak with a pharmacist before purchase.
Show a valid ID proving you are 18 or older.
Have your purchase recorded in a database to prevent misuse.
However, due to the opioid epidemic, most states have restricted or eliminated OTC sales of codeine cough syrup altogether.
Where Can You Buy Codeine in the U.S.?
Codeine is only available through a prescription from a licensed healthcare provider and can be obtained at pharmacies when prescribed for pain relief or cough suppression.
Why Is Codeine Restricted?
Risk of Addiction & Dependence – Codeine is an opioid that can cause physical dependence with prolonged use.
Potential for Abuse – Misuse of codeine-based cough syrups has led to the illegal production of “lean” or “purple drank.”
Side Effects & Overdose Risk – High doses can cause respiratory depression, drowsiness, and even fatal overdose.
Alternatives to Codeine for Cough & Pain Relief
If you need an OTC alternative for pain or cough relief, consider:
Dextromethorphan (DXM) – A non-opioid cough suppressant available in OTC syrups.
Guaifenesin – A common expectorant that helps clear mucus.
Acetaminophen or Ibuprofen – For mild to moderate pain management. Also known as non-steroidal anti-inflammatory medicines (NSAIDs).
Where can you buy Codeine Over-the-Counter (OTC) outside of the USA?
In the United States, codeine is a controlled substance and is only available by prescription due to its high potential for addiction. Strict regulations have been implemented to prevent misuse. However, in other parts of the world, low-dose over-the-counter codeine is still available over-the-counter (OTC) under specific conditions.
In the United Kingdom and some European countries, codeine can be purchased in small doses from pharmacies without a prescription. It is commonly found in codeine-containing combination analgesics such as Co-Codamol (codeine + paracetamol), Co-Codaprin (codeine + aspirin), and Nurofen Plus (codeine + ibuprofen). Additionally, codeine cough syrups (linctus) are available for treating dry cough. These codeine-containing medicines are subject to regulations.
The availability of OTC codeine varies by country:
Australia & New Zealand – Previously available OTC, but now restricted to prescription-only due to concerns about misuse and addiction.
Canada – Some provinces allow low-dose codeine-containing medications to be sold without a prescription, but buyers must consult a pharmacist and meet certain criteria.
Ireland & South Africa – Codeine is still available over-the-counter, but only in limited amounts and in combination medications.
Despite its accessibility in some regions, codeine is highly addictive, and misuse can lead to dependence and withdrawal symptoms. If you or a loved one has a history of substance abuse, alcohol addiction, or mental health disorders, the risk of codeine misuse increases. Always consult a healthcare professional before using codeine-containing products to ensure safe and responsible use.
Side Effects of Codeine Abuse
Codeine abuse can lead to serious physical, psychological, and long-term health risks. As an opioid, codeine affects the central nervous system, slowing down vital functions and creating a high risk of dependence and addiction.
Short-Term Side Effects of Codeine Abuse
Even at lower doses, codeine misuse can cause:
Drowsiness & Sedation – Extreme fatigue, sluggishness, and mental fog.
Euphoria & Relaxation – A temporary sense of well-being that leads to addiction.
Nausea & Vomiting – Common side effects, especially with high doses.
Constipation – Opioids slow digestion, causing severe gastrointestinal discomfort.
Dizziness & Low Blood Pressure – Increased risk of fainting and lightheadedness.
Respiratory Depression – Slowed breathing, which can lead to oxygen deprivation.
Itching & Skin Rash – Some users experience histamine reactions.
Blurred Vision & Impaired Coordination – Increased risk of accidents and falls.
High doses can lead to overdose, causing severe breathing problems, unconsciousness, and death.
Long-Term Effects of Codeine Abuse
Chronic codeine abuse can lead to serious health complications, including:
Physical Dependence & Addiction – The body adapts to codeine, leading to withdrawal symptoms when stopping use.
Liver & Kidney Damage – Many codeine medications contain acetaminophen, which can cause organ failure when taken in large amounts.
Chronic Constipation & Gastrointestinal Issues – Long-term use can lead to bowel obstruction and severe digestive problems.
Cognitive Impairment – Prolonged use affects memory, focus, and mental clarity.
Mood Disorders – Depression, anxiety, and irritability are common with long-term abuse.
Increased Risk of Infections – Opioid misuse weakens the immune system, increasing vulnerability to illnesses.
Social & Financial Consequences – Job loss, legal troubles, and strained relationships are common among individuals struggling with opioid addiction.
Withdrawal Symptoms of Codeine Abuse
If you have been prescribed or have purchased codeine or any related codeine-containing products over the counter for pain or a cough, and you believe you may be dependent or addicted to it, you may experience some withdrawal symptoms. Withdrawal symptoms may come in two phases. The early phase occurs within a few hours of your last dose, and other symptoms may occur later as your body readjusts to working without codeine.
Early Symptoms of Codeine Withdrawal
Feeling irritable or anxious
Trouble sleeping
Teary eyes
Runny nose
Sweating
Yawning
Muscle aches
Faster heartbeat
Late Symptoms of Codeine Withdrawal
Loss of appetite
Nausea and vomiting
Stomach cramps
Diarrhea
Enlarged pupils
Chills or goosebumps
Treatment for Codeine Addiction
Withdrawal symptoms can last for a week or may persist for up to months (as Post-Acute Withdrawal Syndrome) after you stop taking Codeine recreationally. If you or someone you love is addicted to Codeine, please contact one of our Recreate Life Counseling addiction specialists. Health professionals are available to talk to you confidentially, 24 hours a day and 7 days a week. Let Recreate Life Counseling get you the help you deserve and primary care intervention today for a full recovery from Codeine dependency.
FAQ
Can You Overdose on Codeine?
Yes, you can overdose on codeine, and it can be life-threatening. As an opioid analgesic and antitussive, codeine affects the central nervous system, slowing breathing and heart rate, which can lead to respiratory depression, coma, or death in high doses. Overdose risk increases when codeine is misused, taken in excessive amounts, or combined with other depressants like alcohol or benzodiazepines.
How Does Codeine Overdose Occur?
Overdose can happen when codeine is:
Taken in high doses to enhance its effects.
Combined with other central nervous system depressants, increasing the risk of respiratory failure.
Used improperly due to self-prescribing outside of a doctor’s guidelines.
Misused in high-prevalence settings where access to prescription-only medicine regulations are poorly enforced.
The pharmacological effects of codeine involve conversion into morphine by the liver enzyme CYP2D6. Some individuals metabolize codeine too quickly, leading to dangerously high levels of morphine in the bloodstream, increasing toxicity risks.
Symptoms of Codeine Overdose
Recognizing the signs of overdose is crucial for public health awareness. Symptoms include:
Severe drowsiness or unconsciousness
Slow, weak, or stopped breathing
Cold, clammy skin
Bluish lips or fingernails (cyanosis)
Extreme confusion or delirium
Low blood pressure and weak pulse
If an overdose is suspected, immediate medical intervention is critical. Call emergency services (911 or local equivalent) and administer naloxone (if available) to reverse opioid toxicity.
Codeine Overdose & Public Health Regulations
Due to rising codeine misuse and overdose prevalence, many countries, including Australia, the UK, and Canada, have implemented rescheduling and upscheduling policies. In 2018, the Therapeutic Goods Administration (TGA) and the Australian Department of Health made codeine a prescription-only medicine, removing OTC access in community pharmacies to reduce overdose risks.
Research from PubMed and DOI-indexed studies suggests that upscheduling has helped curb misuse, but prescribing practices still play a role in patient safety. Nielsen S. and Van Hout have published significant research on codeine dependency and the effectiveness of policy changes.
Conclusion
Yes, codeine overdose is possible, and it is a serious public health concern. Misuse and self-medication are dangerous, and only healthcare professionals should prescribe codeine-based medications. If you or someone you know is struggling with opioid misuse, seek help from medical professionals or addiction treatment programs.
Codeine and dihydrocodeine are two commonly prescribed opioid medications with similar uses but notable differences in their pharmacology and effects. Understanding these distinctions is crucial for healthcare professionals and patients alike.
Codeine is a Food and Drug Administration (FDA) approved opioid analgesic medication that is naturally occurring and found in the poppy plant that is typically prescribed for things such as a severe cough and is used to relieve the symptoms of mild to moderate pain. When codeine is used for treating pain, it acts by changing the way your nervous system and brain respond to that pain.
It’s main difference when it comes to Chemical Composition and Derivatives is that Codeine is a naturally occurring alkaloid derived from the opium poppy plant and is chemically classified as an opiate, while Dihydrocodeine (DHC), which is also derived from the opium poppy plant, DHC is a semi-synthetic derivative of codeine, structurally similar but with some differences in its effects.
On the other hand, when it comes to potency and analgesic effect, DHC is generally considered to be more potent than codeine, providing stronger analgesic effects at equivalent doses.
Furthermore, when it comes to metabolism and pharmacokinetics, toth codeine and DHC undergo hepatic metabolism, primarily via the CYP2D6 enzyme pathway. However, DHC is metabolized more efficiently than codeine. Also, Codeine is metabolized into morphine via CYP2D6, which contributes significantly to its analgesic effects.
DHC is metabolized into dihydromorphine, which also contributes to its analgesic properties.
What is Dihydrocodeine?
Dihydrocodeine is also an opioid analgesic medication, but it is semi-synthetic. While it is structurally similar and related to codeine, and they also have the same activity and effects, it is twice as strong as codeine and has a higher euphoric impact on the person taking it, as well as a higher risk of dependence and abuse. Dihydrocodeine was developed in the hopes of finding a more effective and better alternative to codeine.
Dihydrocodeine is also used for the treatment of cough, used as a pain medication, and also is used for the treatment for dyspnea (difficult breathing). Also, unlike Codeine, which is generally only found in couch syrup form, dihydrocodeine can be found in more forms such as tablets, solutions, elixirs, and other oral forms. In some countries, dihydrocodeine can also be found as an injectable that is used for intramuscular and deep subcutaneous administration. This is unlike codeine, which cannot be injected due to the risk of anaphylaxis or pulmonary edema, along with a potential large histamine release.
Formulations:
Combination Formulations:
Codeine is often formulated in combination with other medications, such as paracetamol (acetaminophen) or ibuprofen, to enhance its analgesic effects.
DHC may also be found in combination formulations with other analgesics or non-opioid medications.
The big difference: Dihydrocodeine is semi-synthetic and almost twice as strong as Codeine.
Similarities Between Codeine and Dihydrocodeine
While most of the differences between codeine and dihydrocodeine are primarily within the structure of the two substances, it is important to talk about the biggest similarity between the two. That is their risk of abuse and addiction. While these two substances may not be the most potent when taken as prescribed, if they are taken in excess and more often than needed, you risk the possibility of addiction.
After all, both substances are still opioids, which have a very high likelihood of misuse and physical dependence, like most pain relievers. Not only is abuse and addiction to these two substances possible, but it also can act as a gateway to stronger opioid use like stronger prescription medications or illegal street drugs such as heroin.
How Does Codeine Help with Coughs?
When it is prescribed for a cough, it works by decreasing the activity in that particular part of the brain that causes coughing. Compared to other opioid medication options, codeine is thought to have pretty low potency and is not generally used for pain treatment due to there being better options available. While codeine is normally found in the form of cough syrup because it is most prescribed for that, it can also be found in tablet form.
Basically, it has two main uses:
Pain Management – Both codeine and DHC are used for pain relief, ranging from mild to moderate pain. However, DHC is often preferred for cases of moderate to severe pain due to its increased potency.
Antitussive Properties – Codeine is commonly used as an antitussive (cough suppressant), particularly in over-the-counter cough medications. DHC may also possess antitussive properties, although it is less commonly utilized for this purpose.
There are also prescribing considerations when taking codeine:
Individual Variability – Due to genetic variability in the CYP2D6 enzyme, some individuals may metabolize codeine and DHC differently, leading to variations in efficacy and side effects.
Patient-Specific Factors – Prescribing decisions should consider factors such as the patient’s pain severity, medical history, concomitant medications, and risk of opioid misuse.
Aside from the prescribing consideration, users or patients may experience the following side effects and adverse effects, especially if they take more than what is prescribed.
It’s common Side Effects for both codeine and DHC can cause side effects such as drowsiness, constipation, dry mouth, and sedation.
When it comes to respiratory depression and toxicity, high doses of both medications can lead to respiratory depression, a potentially life-threatening side effect, while toxicity risk increases with higher doses and prolonged use.
Meanwhile, if the user experiences an abrupt cessation of either medication, it can lead to withdrawal symptoms, including anxiety, insomnia, sweating, and gastrointestinal disturbances.
Conclusion
In conclusion, while codeine and dihydrocodeine share similarities in their opioid properties and therapeutic uses, there are notable differences in potency, metabolism, and side effect profiles. Healthcare professionals must consider these factors when prescribing these medications for pain management and cough suppression, taking into account individual patient needs and safety concerns.
Treatment for Codeine Abuse
We at Recreate Life Counseling understand the seriousness of drug dependence and abuse, no matter what the substance is, and we believe your addiction must be treated as soon as possible. We focus on treating addiction with a combination of effective treatments, predominantly focusing on group and individual therapy.
If you or someone you love has been struggling with substance abuse or addiction, please feel free to give us a call today. We will discuss treatment options and do our best to point you in the right direction. Now is the time to turn your life around. Let us help you do it.
When an individual takes two prescription medications at the same time, it is considered polydrug abuse. Polydrug abuse is extremely dangerous, seeing as many drugs interact with one another in a variety of adverse ways. When it comes to Percocet and Xanax, combining the two is exceptionally unsafe, and can often prove to be life-threatening. Percocet is a potent pain medication – an opioid narcotic.
Xanax is a prescription tranquilizer – a medication used to treat severe symptoms of anxiety-related disorders. Combining these two drugs leads to central nervous system depression and slowed breathing, which can ultimately lead to respiratory depression, coma, and death. Medical professionals will never prescribe these two medications at the same time because the potentially fatal interactions are well-known.
Still, some individuals take both medications at one time to enhance the “high” that drug abuse provides. Individually, Xanax abuse and Percocet abuse are very dangerous and will require intensive professional treatment. Those who combine the two medications are at greater risk of an overdose every single time they use, and professional intervention will need to occur right away to prevent accidental death. If you or someone you love has been struggling with polydrug abuse of any kind, call Recreate Life Counseling today. We will help get you started on your journey of addiction recovery.
More on Percocet Addiction
Percocet is a medication consisting of a combination of oxycodone, a potent opioid narcotic, and acetaminophen, an over-the-counter pain reliever. If you believe that you or someone close to you has been struggling with an addiction to Percocet, there are several signs and symptoms to keep an eye out for. These include (but are not limited to):
Gastrointestinal issues, usually marked by extreme and persistent constipation.
Insomnia and other sleep-related issues.
Mood swings, often marked by long periods of significant depression.
Profuse sweating.
Respiratory depression and difficulties breathing.
Low blood pressure.
Issues with coordination and concentration.
Those struggling with an addiction to Percocet, Xanax, or both will often engage in certain behavioral symptoms of addiction as well. One of the predominant symptoms is doctor shopping, which refers to making appointments with multiple doctors in an attempt to get a larger quantity of the medication in question.
More on Xanax Addiction
Xanax is a potent prescription benzodiazepine, one that is widely prescribed and responsible for a significant amount of overdose-related deaths on an annual basis. It was reported that in the year 2015 alone, there were over 8,000 deaths in the US that were directly linked to benzodiazepine abuse. The majority of men and women that acquire this drug will not receive a prescription but instead receive the medication from a close friend or relative (55% of all users, in fact). On the other hand, only 17.3 percent of American adults who abuse Xanax originally received the prescription from a medical professional.
In the year 2013, there were over 50 million Xanax prescriptions written nationwide. This drug is frequently abused and readily accessible. In many cases, an individual will begin to abuse Xanax, develop a physical tolerance, and then begin combining this drug with other prescription medications like Percocet. Again, combining Xanax and Percocet increases the risk of overdose and several other health-related complications.
Get the Help You Need
Recreate Life Counseling is dedicated to helping men and women of all ages overcome Percocet and Xanax addiction and go on to lead happy and fulfilling lives. We understand that those who have been struggling with polydrug abuse will require a more intensive level of care. Abusing two drugs at one time does excessive damage to the mind and the body. Fortunately, our comprehensive recovery program caters to those who have been grappling with addictive disorders of all severities. To learn more, simply pick up the phone and give us a call.
Both PCP and ketamine are considered club drugs, generally used in a social setting like parties or nightclubs. Both of the drugs are psychoactive substances, meaning that they affect the way that users behave and think. They can alter perceptions of reality, and cause physical changes like increased blood pressure and spiked heart rate. Individually, the drugs are dangerous – when taken together, they can be lethal.
PCP is the street name for the drug phencyclidine, which is a white powder that is typically dissolved in liquid. Most individuals who use PCP will snort it, though it can also be added to a nicotine product (like a cigarette) and smoked. In severe cases of PCP abuse, the drug might be intravenously injected. Because PCP is so potent, those that abuse the drug consistently (even for a relatively short length of time) put themselves at great risk of lasting psychological and physical consequences. Those that take this specific drug often get into trouble with the law, seeing as it causes extremely erratic behavior, severe visual and auditory hallucinations and a distorted perception of the world.
Physiological Effects of Ketamine and PCP
Ketamine was first developed for medical uses, just like PCP. However, it was quickly determined that PCP was far too dangerous, so Ketamine was developed as an alternative – it was originally used as an anesthetic during surgical procedures. The two drugs are structured very similarly, and they cause similar effects. Recreational use of either drug is likely to cause the following side effects:
Feelings of detachment.
Slurring of speech and an inability to form complete sentences.
Severe mood swings, usually marked by extreme agitation.
Involuntary twitching of the muscles (and involuntary movements of the eyes).
Hallucinations.
Anxiety and panic attacks.
Violent behaviors.
Profuse sweating.
Shallow breathing and respiratory depression.
Those who combine the drugs and take them in high doses are liable to experience nausea, vomiting, a loss of balance, vision loss, coma, and suicidal tendencies. While many people believe that potent party drugs like ketamine and PCP are generally taken infrequently and in small doses (in very specific settings), both drugs are highly addictive. There is a widespread stigma surrounding hallucinogenic drugs and addiction, and widespread misinformation continues to keep this stigma alive.
Many individuals struggle with physical and psychological dependencies on both PCP and ketamine. Both drugs are illegal and are classified as Schedule II and Schedule III substances (respectively), meaning they have the potential to be habit-forming.
The National Household Survey on Drug Abuse reported that around 6 million Americans over the age of 12 had experimented with PCP at least one time during their lives. Rates of use were shockingly high amongst youth and young adults. More than 3 percent of American high school seniors admitting to using the drug within the past year. It was also reported that hospital visits related to PCP use increased around 400 percent between 2005 and 2011. As far as ketamine goes, rates of abuse are somewhat lower – but they’re still significant. It was reported in 2015 that 3 million Americans over the age of 12 had used ketamine at least once during their lifetimes.
Ketamine and PCP Polydrug Addiction Treatment
Dissociative drugs like ketamine and PCP are habit-forming and produce serious side effects when taken alone – when mixing ketamine and PCP, the effects are often life-threatening. If you have been mixing chemical substances of any kind or if you have been struggling with an addiction to PCP, ketamine or both drugs, professional help must be sought immediately. For more information on our program of drug addiction recovery, give us a call today. We are here to help.
