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A serious crisis is occurring in the U.S. when it comes to opioid abuse. Opioids are responsible for thousands of deaths each year, and it’s important for individuals to understand what these drugs are and what their effects can be before they are prescribed to them. The following provides an overview of two opioids in particular: codeine and hydrocodone.
|Drug Class||Natural opioid||Semi-synthetic opioid|
|Drug Schedule||Schedule II to Schedule V, depending on the product||Schedule II|
|Dosage||Can vary; a sample dose is 15 to 30 mg every 4 hours as needed||Can vary; a sample dose is 10 mg every 12 hours|
|Side Effects||Constipation, nausea, and sedation||Constipation, nausea, and sedation|
|Warnings||Carries an FDA Black Box Warning for addiction, overdose, and drug interactions with central nervous system depressants||Carries an FDA Black Box Warning for addiction, overdose, drug interactions with central nervous system depressants, and a warning against drinking alcohol with the long-acting form of the drug|
|Drug Interactions||Avoid with other central nervous system depressants, including benzodiazepines||Avoid with other central nervous system depressants, including benzodiazepine|
Codeine is a prescription opioid that’s used to treat pain and as a cough suppressant. It is a natural opioid derived from morphine. Among opioids, it’s considered relatively mild, but it still carries a risk of abuse, addiction and overdose.
Codeine is often combined with other medications such as Tylenol to create combination formulations that more effectively relieve pain or cough.
Codeine is a narcotic that converts to morphine in the user’s body. It binds to opioid receptors in the brain, which changes how the person experiences pain. It increases the person’s tolerance to pain, but it doesn’t necessarily alleviate pain.
Common codeine side effects can include dizziness, lightheadedness, nausea, vomiting and sedation.
Hydrocodone is also classified as an opioid pain reliever that binds to certain central nervous system receptors. If high doses are taken, it can cause weak or shallow breathing as well as other side effects.
Hydrocodone is considered a semi-synthetic opioid, which means it’s partially man-made. The drug is intended for pain ranging from moderate to severe. Hydrocodone is also sometimes used as an antitussive, meaning it can treat a cough.
Hydrocodone is often used in combination drugs such as Vicodin and Lortab, which include both hydrocodone and acetaminophen. It’s also available in controlled-release versions for more around-the-clock pain relief.
Neither hydrocodone nor codeine is objectively “better” than the other. That said, each drug has a role for which it may be a better choice. As a more potent opioid, hydrocodone may work better for severe pain. As a less potent opioid, codeine may work effectively and more safely for moderate pain and cough.
Codeine is not in hydrocodone. Each drug is a chemically distinct opioid.
The primary differences between codeine vs. hydrocodone include the potency of hydrocodone being stronger than that of codeine and the fact that hydrocodone is available as an extended-release medication.
Both have many of the same risks and side effects, so if you’re prescribed either, you should follow your doctor’s instructions.
No, hydrocodone does not contain codeine. Hydrocodone is a distinct and separate opioid from codeine.
Codeine and hydrocodone have many similarities:
A risk of abuse and addiction exists with both codeine and hydrocodone. However, these risks may be more significant with hydrocodone since it’s considered more potent than codeine.
Both codeine and hydrocodone can cause physical dependence. This occurs when someone’s brain and body become used to the presence of these drugs. When you are physically dependent on a drug, you will go through uncomfortable withdrawal symptoms if you suddenly stop taking them.
If a doctor has prescribed codeine or hydrocodone and the patient wishes to stop, they will usually put patients on a tapering-down schedule where they use less and less until they stop completely to lessen or prevent withdrawal symptoms from occurring. If a person struggles with codeine or hydrocodone addiction, a medical detox program followed by inpatient rehab may be the best option to come off the medication.
Opioid withdrawal symptoms are similar in codeine and hydrocodone and include:
Despite their similarities, codeine and hydrocodone have many differences:
The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.