Understanding How Promethazine Works
When thinking about prescription drug addiction, our minds immediately jump to opioids or heavy tranquilizers. But substances like promethazine, which are often found in prescription cough medication, can be just as potent and addictive. How promethazine works impacts its effects on the body and its ability to cause dependence and addiction.
Many accessible and seemingly harmless medications can carry hidden risks. Promethazine is a medication that is often prescribed to treat allergies, motion sickness and severe nausea. It can help you relax, sleep and relieve symptoms of nausea through severe sedation. It basically works to calm down your nervous system when you are feeling sick with allergies or a cold.
While the medication has a legitimate medical purpose, that does not mean it is without risk. The rising rates of promethazine addiction have turned into a serious public health concern. It is often viewed simply as a cough or allergy medication. But its hidden dangers are frequently underestimated.
More on Promethazine. How Promethazine Works.
Promethazine is a synthetic medication that belongs to a class of drugs called phenothiazines. It is an H1 receptor antagonist. It blocks histamine, a substance released by your body during an allergic reaction. It can also alter the actions of dopamine and acetylcholine in the brain, which works to stop the messages in the brain that make you feel like you need to vomit.
Compared to other antihistamine medications like loratadine and cetirizine, promethazine crosses the blood-brain barrier easily and can trigger feelings of intense sedation. The medication’s ability to easily and intensely depress the central nervous system is what can be considered a high potential for drug abuse.
Promethazine is FDA-approved to treat the following conditions:
- Allergic reactions. It is a first-generation antihistamine that can treat seasonal allergies and allergic conjunctivitis.
- Nausea and vomiting. It is often used to control nausea and vomiting associated with anesthesia or reactions to chemotherapy.
- Motion sickness. It can help ease symptoms of motion sickness.
- Sedation. Because it is a first-generation antihistamine that crosses the blood-brain barrier, it can provide intense sedation.
Common Side Effects of Promethazine
- Drowsiness and sleepiness – helps to with pain control because it regulates wakefulness
- Changes in blood pressure
- Reduced white blood cell count
- Can cause breathing issues
- Can increase excitability
- Can cause abnormal bodily movements
Is Promethazine habit-forming?
In a study published by the National Library of Medicine, researchers found evidence of promethazine non-medical use. Because it is not a controlled substance, it can be easier for those who abuse drugs to get hold of. Although the addictive potential of promethazine is much lower compared to other drugs, when it is combined with other substances like alcohol, the risks of dependence increase.
Promethazine abuse is frequent in those who have other co-existing addictions. It is often misused with opioids, making the user more prone to overdose. It is also a commonly abused drug among those who have a drug injection addiction.
The deep relaxation and sleep-inducing effects of promethazine can easily lead individuals to develop a psychological addiction to the drug to sleep or calm down. What can begin as taking an extra dose of promethazine to get a good night’s rest can quickly turn into full-blown abuse. When a person becomes psychologically addicted, they will develop sedative-hypnotic drug-seeking behaviors.
Signs of promethazine abuse include:
- Doctor shopping in order to obtain multiple prescriptions
- Faking or exaggerating symptoms in order to obtain more of the medication
- Stealing medication from family members
- Experiencing anxiety or panic when your medication supply is low
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The long-term impact of Promethazine Abuse
Even when used as prescribed and alone, promethazine in high doses over a prolonged period of time can alter brain chemistry. Users can develop phenothiazine dependence symptoms as the body begins adapting to the presence of this sedative. It can build a tolerance and require users to consume larger amounts in order to achieve the same effects.
Medical professionals are becoming more and more concerned about the long-term impact of sedative misuse, such as with promethazine. Prolonged abuse of promethazine can depress brain activity, leading to constant brain fog, memory impairment and slowed reaction times. It can also impact cognitive functioning, such as diminishing problem-solving skills.
Over time, the constant heavy sedation can begin to mask underlying mental health disorders like depression, which can make the condition worse.
Other long-term effects of promethazine use include:
- Respiratory depression caused by depression of the central nervous system. Individuals experience slowed or shallow breathing, shortness of breath or feeling faint.
- Risks of seizures.
- Uncontrolled repetitive body movements, muscle spasms or muscle stiffness are common and also linked to depression of the central nervous system.
- Cognitive impairment
- Cardiovascular issues like high blood pressure
- Liver damage
- Hallucinations, confusion and psychosis
- Insomnia
- Blurred or double vision
- Impacts the body’s ability to regulate inflammation, alertness and pain control
- Motion sickness. Although the medication is often used to help treat and manage motion sickness, in some cases it can cause dizziness and drowsiness often associated with the condition.
- Can cause physical and psychological dependence that easily leads to addiction. This is especially true in chronic pain patients who use the medication to help manage their chronic conditions.
Dangerous Drug combinations that include Promethazine
Promethazine abuse has become just as common as abuse of other central nervous system depressants. In some cases, it has been popularized through modern pop culture and music, where you see artists promoting recreational consumption of “lean” or “purple drank.” Some rap and hip hop artists glorify the consumption of “lean” in their lyrics. This only adds to the popularity and false acceptance of this drug.
This concoction that creates “lean” usually consists of prescription promethazine-codeine cough syrup, a sugary soda and even hard candies added for extra flavoring. Some cocktails also include other antihistamines, opioids and alcohol. Promethazine acts as an amplifier for the codeine to create a euphoria and a heavily sedated high.
Mixing promethazine with opioids is dangerous. Both substances slow down the central nervous system, which produces respiratory depression, which in turn increases the risk of overdose. Breathing can be slowed down to the point where a person can stop breathing. This is when it becomes a medical emergency.
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Treatment for Substance Use Disorder
Promethazine addiction is a dangerous and often overlooked epidemic that is just as serious as an addiction to illicit drugs. Because it starts with a legitimate prescription, the line between therapeutic use and abuse can easily be blurred. How promethazine works in the central nervous system can create severe sedation to the point of a life-threatening medical emergency.
Mixing promethazine with other substances makes the user more prone to developing an addiction. Being able to recognize the signs of abuse and understand the dangers of long-term use can help prevent the risks of this drug.
Professional behavioral health programs like Hotel California by the Sea provide tools, resources and support for those with a substance addiction to promethazine. We offer treatment at all levels of care including detox, residential, PHP and IOP. We utilize evidence-based methods such as CBT, DBT and group therapy. Hotel California by the Sea is dedicated to helping clients achieve their goals in sobriety and overcome their addiction.
References:
https://www.ncbi.nlm.nih.gov/books/NBK544361
https://my.clevelandclinic.org/health/drugs/19812-promethazine-tablets
https://www.medicalnewstoday.com/articles/promethazine-oral-tablet
https://www.addictioncenter.com/drugs/promethazine-addiction-abuse
https://www.rehabtoday.com/is-promethazine-addictive
