Codeine is available in tablet form, as a syrup (e.g. as a cough syrup) and as a solution for injection. It is normally swallowed. Some people misusing the medicine prefer to crush up the tablets and snort them, and some may try to inject them. Tablets of codeine can cost between £1 – £2.50 per tablet obtained from illicit sources.

Codeine is an opiate drug used to treat mild to moderate pain. On its own codeine is only available on prescription.

Smaller doses of codeine are in some medicines that can be bought without prescription in pharmacies.

Lower dose codeine is usually combined with other medicines such as paracetamol, ibuprofen or aspirin and are used for treating headache, period pain etc. that has not responded to simpler pain-killers.

Codeine-containing medicines carry warnings on the packs about the risk of addiction and advise that the non-prescription medicines should only be used for up to three days at a time without medical advice.

What are the effects of codeine?

Codeine has similar effects to the other opiates:

• Feelings of warmth and well-being, calm, relaxation and sleepiness.
• Nausea, vomiting, constipation, loss of appetite, drowsiness, confusion, sweating, itching, dry mouth, mood swings and feelings of lethargy.

What are the risks of taking codeine?

Taking codeine does involve risks. Here’s what it could do to you.

• Codeine can lower blood pressure and can suppress normal breathing, and so can increase the risk of respiratory arrest (when you stop breathing altogether). There is more risk of overdose and death if you are mixing too much codeine with other drugs that suppress breathing such as alcohol, benzodiazepines like diazepam (Valium), or other opiate drugs.
• When a higher than recommended dose of codeine is taken in a tablet combined with another type of painkiller (commonly paracetamol, aspirin or ibuprofen), there is a real risk of experiencing the side-effects of these other drugs. And whilst these other drugs may seem harmless in normal doses, they can cause really serious problems in overdose – with risks of kidney failure, liver failure, and of indigestion or bleeding from the stomach, which can be fatal.
• As with other opiates, taking very high does of codeine during pregnancy may lead to withdrawal symptoms in new born babies.

If the codeine has been prescribed as a medicine (alone or mixed with other drugs such as paracetamol or ibuprofen), the purity will be very high and the doses consumed will be predictable. If you are not sure the tablets have come directly from a reputable pharmacy, you cannot be sure what is in them.

Can you get addicted to Codeine?

Yes, like all opiates, codeine is addictive.

Over time it can produce ‘cravings’ and a psychological desire to keep on using.

Tolerance can also build, so that users have to take more just to get the same effects or to avoid an unpleasant withdrawal.

Physical dependence is common in regular users. The withdrawal symptoms include nervous tremors, anxiety, yawning, sweating, runny nose, sleep disturbance, nausea, goose-bumps, restlessness, diarrhoea, abdominal cramps and muscle spasms.

Codeine and the law

• Codeine is a substance controlled under Class B of the Misuse of Drugs Act. That means it’s illegal to have, give away or sell.
• Codeine on its own is only available on prescription, unauthorised possession can get you up to five years in jail and an unlimited fine.
• Supplying someone else, including your friends, can get you up to 14 years and an unlimited fine.

Small amounts of codeine are in some medicines which can be bought without prescription but only in pharmacies. These medicines include cough syrups, and tablets or capsules where the codeine is combined with other medicines, such as paracetamol, ibuprofen or aspirin, for treating headaches, period pain etc. Codeine containing medicines carry warnings on the packs about the risk of addiction and advise that the non-prescription medicines should only be used for up to three days at a time without medical advice.

Did you know?

• A conviction for a drug-related offence could have a serious impact. It can stop you visiting certain countries – for example the United States – and limit the types of jobs you can apply for.
• Like drinking and driving, driving while impaired by codeine is illegal – and you can still be unfit to drive the day after using codeine. You can get a heavy fine, be disqualified from driving or even go to prison.