Codeine can be prescribed to treat mild to moderate pain and to suppress the cough reflex. However, some people misuse codeine to get high, which can be addictive.

As the U.S. grapples with an opioid epidemic, there has been a significant discussion surrounding doctors over-prescribing opioid medications. One prescription opioid is codeine. Codeine is a controlled substance, meaning that if you use it without a prescription or in a way other than how it’s prescribed, it’s considered drug abuse and can lead to an addiction.

What Is Codeine Used For?

Codeine can be prescribed to treat pain, usually mild to moderate in severity, and it can also help suppress the cough reflex, so it’s used in cough syrups and medications.

Codeine converts back to morphine when it enters the brain, and then it binds to the central nervous system’s (CNS) opioid receptors. Along with suppressing the sensation of pain, codeine can slow other functionality of the CNS, leading to extreme drowsiness and shallow or stopped breathing.

Misusing or Abusing Codeine

Unfortunately, codeine is sometimes misused to achieve a euphoric high. There is the risk with any opiate or opioid of addiction because these drugs affect certain feel-good brain chemicals in the brain. This can trigger a high and a reward response that the person wants to feel again, which can lead to addiction.

There’s also the risk of having a physical dependence on codeine, meaning when you use it for a period of time, your body becomes used to it. If you stop using it, you will go through a type of shock that’s called withdrawal.

Using codeine in any way other than prescribed by a doctor or described on the product label is considered codeine abuse and can be dangerous. This can include taking more or more frequently than described, mixing the drug with other substances like in lean or purple drank, or crushing and snorting or injecting the drug.

What Is Codeine Prescribed For?

Codeine is prescribed for conditions and illnesses where the associated pain is mild to moderate. As a pain reliever, codeine is considered weaker than most other opioids, so it’s generally not effective for more severe levels of pain. Codeine can also be prescribed for diarrhea.

Codeine is sometimes prescribed as a single-ingredient drug, but it’s also available in combination with other substances such as acetaminophen or aspirin. Codeine-acetaminophen combinations include Tylenol with Codeine. The objective with these combination drugs is greater levels of pain relief.

When Codeine Isn’t Prescribed

Unlike some stronger opioids, codeine is not necessarily useful to treat cancer pain, and it can also have an increased risk of nausea, vomiting or constipation for these patients.

Codeine is not ideal for an acute cough (like with a cold) and is better suited to a chronic cough. Codeine also isn’t supposed to be used for cough suppression in children younger than 12.

Codeine For Pain Dosage

The appropriate codeine dosage can vary based on many factors, including the person’s physiology and the specific formulation. For adults, the typical codeine dose for pain is 15 to 60 mg, which can be taken every four to six hours on an as-needed basis, with a maximum dose of 360 mg.

If you’re taking codeine for pain or a cough, it’s important that you don’t mix it with other CNS depressants, such as sedatives or alcohol. This can cause significant impairment and confusion and depress the nervous system to a dangerous level.

When evaluating codeine dosage guidelines, something else to consider is whether or not it’s combined with another substance. This can impact the level that’s considered safe. For example, if you’re taking codeine for pain and it’s paired with acetaminophen, you have to be extra careful about the amount you take. Too much acetaminophen can cause liver damage, liver failure and death.

Getting Help for Codeine Misuse

If you’re worried you or your loved one is misusing codeine but can’t seem to stop, you may be struggling with a codeine addiction. The Recovery Village is here to help. Our helpful representatives can talk with you about your situation and walk you through the next steps if addiction treatment is necessary. Contact us today to get started.

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more

U.S. National Library of Medicine. “Codeine.” MedlinePlus, December 15, 2020. Accessed August 31, 2021.

U.S. Food and Drug Administration. “FDA Drug Safety Communication: FDA restr[…] breastfeeding women.” March 8, 2018. Accessed August 31, 2021.

U.S. National Library of Medicine. “Acetaminophen.” MedlinePlus, August 23, 2021. Accessed August 31, 2021. “Codeine Sulfate.” August 6, 2020. Accessed August 31, 2021.

American Academy of Family Physicians. “Opioid Conversion Table.” Accessed August 31, 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.