Codeine and alcohol can severely depress the central nervous system when combined, increasing your risk of a deadly overdose.

Codeine is a powerful prescription opioid that’s widely used for pain management. It’s also found in Tylenol 3, which requires a prescription to obtain. Due to its prevalence, it’s important to be conscious of the dangers of combining codeine and alcohol.

Article at a Glance:

Codeine and alcohol are both alcohol and codeine are central nervous system depressants.

Combining codeine and alcohol can lead to dangerous side effects and increase the risk of overdose.

You should avoid drinking within at least 15 hours after taking codeine.

Mixing Alcohol & Codeine

When using a narcotic like codeine, it’s important to follow all warning labels and guidelines outlined by your doctor. This includes not taking codeine along with alcohol, as this can increase the nervous system side effects like drowsiness and lightheadedness. In some cases, the combination can lead to more life-threatening issues like respiratory distress, coma and even death.

Both substances are central nervous system depressants that can seriously impair or alter your mental state, so the utmost care and caution should be taken when using codeine or alcohol. Because of their potential for negative interactions, they should never be taken together.

What Is Codeine?

Codeine is a prescription opioid used as a painkiller and cough suppressant. It is similar in nature to hydrocodone and morphine and can increase a person’s tolerance to pain.

Although it is only available with a doctor’s prescription, codeine can be misused when taken in greater amounts or more frequently than prescribed. Whether you’ve used codeine as prescribed or recreationally, it is important that you never combine it with alcohol, as the two drugs together can have dangerous side effects.

What Are the Risks of Codeine and Alcohol?

Mixing codeine and alcohol can cause a variety of health risks. On its own, codeine can cause drowsiness, nausea, constipation and rash. These side effects are also present in combination products containing codeine, like codeine with promethazine, a medication that can be prescribed for cough and cold symptoms, or codeine with acetaminophen, which can be prescribed for mild-to-moderate pain.

When used in conjunction with alcohol, however, these side effects can be exacerbated, and other more dangerous reactions may occur. This occurs because of a drug interaction between codeine and alcohol, as they are both central nervous system depressants.

Some side effects of mixing alcohol and codeine include:

  • Drowsiness
  • Dizziness
  • Lightheaded feelings
  • Difficulty concentrating
  • Fainting
  • Impaired judgment and thinking
  • Slowed breathing
  • Low blood pressure
  • Coma
  • Death

Taking Codeine After Alcohol

It is best to avoid codeine if you have been drinking alcohol. Although your liver can remove about one drink an hourfrom your body, this rate can vary, meaning that it can be hard to know when it is safe to take a dose of codeine.

Drinking After Taking Codeine

If you have taken a dose of codeine, it is best to avoid alcohol until the codeine is out of your body. Although the effects of codeine wear off in four to six hours, the drug itself can stay in your system for much longer. The half-life of codeine, or how long it takes half a dose to leave your system, is three hours.

Because it generally takes five half-lives for a drug to leave your body, this means you can still have codeine in your system for up to 15 hours after a dose.

Codeine and Alcohol High

Some people may combine codeine with alcohol because they don’t realize the dangers, but other people might do it purposely to get high. Because both substances are central nervous system depressants, they have an additive effect on the body.

For this reason, some people may take them together to intensify the effects of both codeine and alcohol. This high can be made even more dangerous when other central nervous system depressants are combined with codeine and alcohol.

Can You Overdose on Alcohol & Codeine?

Because both alcohol and codeine are central nervous system depressants, it is possible to have a deadly overdosewhen using them together. Avoiding alcohol while taking codeine can decrease your risk of overdose and death as a result of the combination.

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

It is important to note that although the opioid reversal agent naloxone (Narcan) can reverse an opioid overdose, it does not work on alcohol poisoning. If you suspect someone is overdosing on codeine and alcohol, you should give Narcan but always follow up with a call to 911.

Treatment for Codeine and Alcohol

If you or someone you know has an unhealthy relationship with alcohol, codeine or both, help is just a phone call away. The Recovery Village offers treatment programs for a wide variety of substance use disorders and co-occurring mental health disorders.

At The Recovery Village, treatment typically begins with medical detox, a monitored approach that helps you transition away from codeine and alcohol before moving into an inpatient or outpatient program. All levels of care are distinctly designed with you in mind, meaning no two plans of care are exactly the same as you move towards a codeine and alcohol-free life.

If you fear that combining codeine and alcohol has elevated to addictive behavior, contact The Recovery Village to get in touch with a caring intake coordinator who will help you identify the best care program for your unique situation.

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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

Hallare, Jericho; Gerriets, Valerie. “Half Life.” StatPearls, October 6, 2020. Accessed May 8, 2021. “Codeine.” October 30, 2020. Accessed May 8, 2021. “Drug Interaction Report: Codeine and Ethanol.” Accessed May 8, 2021. “Promethazine VC with Codeine.” March 1, 2021. Accessed May 8, 2021. “Tylenol with Codeine #3.” February 5, 2021. Accessed May 8, 2021.

U.S. National Library of Medicine. “Blood Alcohol Level.” December 3, 2020. 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.