Codeine is a narcotic that can be used for mild-to-moderate pain but also carries a risk of abuse, dependence and addiction.

If you take codeine, it is important to know the effects and risks of the medication. This is true if you have a prescription for the drug or whether you take codeine illicitly. Knowing how the medication works, as well as its risks, can help you and your loved ones stay safe.

Codeine Pill Identifier

Codeine pills are available in immediate-release oral tablets. They come in 15 mg, 30 mg, and 60 mg strengths.

How Should Codeine Be Used?

Codeine should only ever be taken as prescribed by your doctor. It should not be taken more often or in greater quantities than your doctor instructs.

Codeine is a prescription narcotic pain reliever that’s classified as an opioid. Codeine is a comparatively weak opioidand is the active ingredient in many combination medications used to treat mild-to-moderate pain and coughing. Some of these combination prescriptions include promethazine with codeine and acetaminophen with codeine. Codeine is also available as a single agent in pill form.

Codeine-containing products are all controlled substances and can range from Schedule II (most addictive) to Schedule V (least addictive) depending on the product. Codeine pills are listed as a Schedule II substance.

As with other opioids, codeine pain pills and syrup work by blocking pain responses and, as a result, it also suppresses cough reflexes. Codeine is converted to morphine by the liver.

Can You Get High From Codeine?

Codeine pills can cause a person to get high. When someone takes an opioid such as codeine, the drug binds to mu-opioid receptors in their brain, triggering the brain’s reward circuit through the central nervous system and eliciting feelings of euphoria and a positive rush.

Unfortunately, getting high on codeine can come with serious consequences. People who use codeine to get high can become addicted to the drug. In some cases, they may end up moving on to stronger prescription opioids or illicit street drugs like heroin to continue getting the effects they desire.

How Much Codeine Does It Take To Get High?

How much codeine it takes to get high depends on many factors, including the person’s genetic makeup.

Codeine is broken down into morphine in the liver thanks to an enzyme called CYP2D6. However, due to genetics, this enzyme does not work equally in different people. Some may have more active CYP2D6 than other people, meaning that they are very sensitive to codeine and are therefore at a high risk of overdose even at normal doses of the drug.

Conversely, other people have less active CYP2D6, meaning that codeine does not break down easily in their bodies and they might not get high at all. For this reason, it is hard to predict how codeine will affect you, especially if you have not taken the drug before.

What Are the Side Effects of Codeine Pills?

Codeine has similar side effects to many other opioids. Its side effects include:

  • Dizziness
  • Drowsiness
  • Slow heartbeat
  • Itching
  • Constipation
  • Nausea and vomiting
  • Blurred vision
  • Slowed breathing

Slowed breathing from too much codeine can be particularly dangerous. Slowed breathing, in addition, to pinpoint pupils and clammy skin, are signs that a codeine overdose may be occurring. If you suspect someone is overdosing on codeine, you should immediately give the opioid reversal agent naloxone (Narcan) if it is available and call 911. You will not get in trouble for saving someone’s life by seeking help.

Codeine combination products can pose an additional overdose risk, so consider if there are any other ingredients in the codeine product. For example, codeine is often combined with acetaminophen. Acetaminophen is a pain reliever available over-the-counter, and it is generally considered safe unless taken in large doses. In large doses, acetaminophen can cause liver damage, which can be fatal.

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Editor – Rob Alston
Rob Alston has traveled around Australia, Japan, Europe, and America as a writer and editor for industries including personal wellness and recovery. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
Sources “Promethazine VC with Codeine.” March 1, 2021. Accessed May 8, 2021. “Tylenol with Codeine #3.” February 5, 2021. Accessed May 8, 2021. “Codeine.” October 30, 2020. Accessed May 8, 2021.

National Institute of Diabetes and Digestive and Kidney Diseases. “Acetaminophen.” January 28, 2016. Accessed May 8, 2021.

Drug Enforcement Administration. “Controlled Substances.” April 2, 2020. Accessed May 8, 2021.

American Academy of Family Physicians. “Opioid Conversion Table.” Accessed May 8, 2021.

Pratt, VM; Scott, SA; Pirmohamed, M.; et al. “Codeine Therapy and CYP2D6 Genotype.” March 30, 2021. Accessed May 8, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.