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Codeine Addiction & Abuse

Written by Erica Weiman

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

Medically Reviewed

Up to Date

This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.

Last Updated - 6/17/2022

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America is currently in the middle of an epidemic, and opioids are at the center of the crisis. Codeine is an opioid pain medication that treats mild to moderate pain, and it can also be combined with other medications to treat cough. Because codeine is less potent than other opiates, people may falsely believe they can’t become addicted to it.

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What Is Codeine Used For?

Codeine is a prescription opioid used to treat cough and pain. Codeine fights pain by attaching to mu-opioid receptors in your brain. The drug prevents cough by acting on the brain’s medulla, which is responsible for the cough reflex. Because codeine is an opioid, it carries a risk of addiction, abuse and dependence despite its benefits.

How Long Does Codeine Last?

Codeine typically starts to work within 15 to 30 minutes after a dose is taken. When taken for pain, codeine’s peak effects occur within two hours and can last for 4–6 hours. In contrast, when taken for cough, codeine’s peak effects occur within 1–4 hours and may last for 4 hours.

Codeine Dosage

Codeine is taken by mouth, but comes in various forms, including an oral solution, tablets and capsules. Codeine dosages can also vary, depending on the exact product and whether the codeine is combined with other substances.

Numerous codeine products exist, including but not limited to:

  • Acetaminophen 120 mg and codeine phosphate 12 mg per 5 mL oral solution
  • Acetaminophen 300 mg and codeine 15 mg, 30 mg, or 60 mg tablets
  • Guaifenesin 100 mg and codeine 6.3 mg or 10 mg per 5 mL oral solution
  • Codeine 30 mg, Acetaminophen 300 mg, Butalbital 50 mg, and caffeine 40 mg tablets

Is Codeine Addictive?

As a controlled substance, codeine carries a risk of abuse, addiction and dependence. However, codeine scheduling varies widely depending on the product and amount prescribed. Some codeine products are Schedule II, meaning they carry a high risk of addiction, while others are Schedule III or V, meaning they carry a lower risk of addiction.

Codeine Side Effects

Codeine, like all drugs, carries the risk of side effects. Some common codeine side effects include:

  • Drowsiness
  • Lightheadedness
  • Dizziness
  • Sedation
  • Nausea or vomiting
  • Sweating
  • Abdominal pain
  • Dry mouth
  • Constipation
  • Flushing of the skin
  • Itching
  • Rash

Codeine and Alcohol

Combining codeine and alcohol can be dangerous. Codeine’s side effects include drowsiness, nausea, constipation and rash, which are also present in combination products that contain codeine.

These side effects can worsen due to the drug interaction between codeine and alcohol, and this combination may cause other more dangerous reactions. Because they are both central nervous system depressants, the side effects of combining alcohol and codeine include:

  • Drowsiness
  • Dizziness
  • Lightheadedness
  • Problems concentrating
  • Fainting
  • Impaired judgment and thinking
  • Slowed breathing
  • Low blood pressure
  • Coma
  • Death

It is also important to consider that many codeine products contain other ingredients, like acetaminophen, which can lead to potentially fatal liver toxicity when mixed with alcohol.

Codeine Overdose

Despite being a relatively weak opioid, codeine can cause a fatal overdose. The amount of codeine it takes to overdose depends on genetics. Codeine is broken down into morphine by an enzyme in the liver called CYP2D6, an enzyme that is far more active in some people than in others. As a result, codeine may be more or less potent than expected, depending on the person.

A codeine overdose is a medical emergency. If you suspect someone has overdosed on codeine, administer naloxone, or Narcan, if possible and call 911 immediately.

Codeine overdose symptoms include:

  • Small, or pinpoint, pupils
  • Falling asleep
  • Loss of consciousness
  • Slow or shallow breathing
  • Choking or gurgling sounds
  • Limp muscles
  • Pale, blue, clammy or cold skin

Codeine Withdrawal

If you use codeine on a regular basis, your body becomes physically dependent on the substance as it begins to expect its presence. If you suddenly stop taking it, you are likely to experience codeine withdrawal symptoms within eight hours of the last dose of codeine. These symptoms can range from mild to severe, and may last up to 10 days.

Codeine Withdrawal Symptoms

Codeine withdrawal symptoms are similar to those of other opioids and include:

  • Runny nose
  • Headaches
  • Nausea and vomiting
  • Fever
  • Achiness
  • Abdominal cramps
  • Weakness
  • Chills
  • Diarrhea
  • Fear or anxiety
  • Agitation
  • Sweating

Codeine Detox

Quitting codeine cold-turkey can lead to uncontrolled withdrawal symptoms. This is difficult for many people and may lead to relapse if the withdrawal symptoms or cravings are too much to bear. For this reason, medical detox can be an effective, safe option. In medical detox, you are admitted to an inpatient detox unit and monitored round-the-clock by doctors and nurses. At The Recovery Village Ridgefield’s 16-bed detox facility outside Portland, Oregon, you have access to nutritional counseling and treatment for co-occurring disorders like anxiety or depression.

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Codeine Addiction Treatment

A codeine use disorder is a disease that needs to be treated, just like diabetes or cancer, for example. The most important thing to keep in mind about any drug or alcohol addiction is that recovery is possible. Help is available if you reach out. Our specialists at The Recovery Village Ridgefield know what you’re going through and are committed to providing the care you deserve.

The Recovery Village Ridgefield is a treatment center that offers a full continuum of care for codeine treatment, including detox, residential and outpatient treatment programs. Convenient to the cities of Seattle, Washington and Eugene, Oregon, our facility is tucked away in the Cascade Mountains, providing the ideal location for healing. If you are considering treatment for your codeine addiction, reach out to us today. Let us help you discover your path to recovery.


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