Codeine is a name that is fairly well-known when it comes to surgery or general talk about powerful drugs. This powerful narcotic is often used in pain management and is cautiously prescribed for short periods of time.

For many people suffering from pain following a medical operation, proper codeine use that is monitored by a doctor can be very helpful. Postoperative pain can affect some people more than others and make daily life more difficult.

Narcotics such as codeine often receive a poor reputation for being highly addictive and a gateway to dependency and the complications that come from a lifestyle of habitual illicit drug use. It is true that some people may have a difficult time coming off a powerful narcotic like codeine, but there are a variety of reasons why dependency and addiction happen.

Codeine alone is not the sole reason people develop an addiction to the drug. Instead, it is a combination of the feeling the drug provides, mental health, and other variables in life, like the environment and the availability of supportive relationships with other people.

Of course, ignoring the fact that some people do struggle with codeine misuse will not help them seek help or improve their life. A codeine overdose can happen and can be very dangerous. Learning how to recognize and treat a codeine overdose will allow more people to understand how to best help a victim of an overdose or simply learn more about the potential consequences of codeine misuse.

What Is Codeine?

Codeine is an opioid pain reliever that is often prescribed to treat mild to moderate pain. For example, some people might receive a prescription order for codeine after they get their wisdom teeth removed. Codeine typically comes in a pill form that patients swallow. The Drug Enforcement Administration (DEA) labels codeine as a Schedule II, III, or V drug, which means it has a high potential for being misused. The particular designation for codeine varies depending on whether or not the codeine is mixed with other substances in that category. This includes stimulants like amphetamine and methamphetamine.

The negative connotation around codeine is often due to that pesky word “opioid.” Opioids are a specific group that includes a variety of both licit and illicit drugs. Other opioids include heroin, fentanyl, and other run-of-the-mill prescription pain relievers like Vicodin®, OxyContin®, or morphine.

Many of these substances can be used in relation to pain management and can cause euphoric feelings upon use. Unfortunately, all of these substances, just like many other drugs, have the potential to be misused by deviating from prescription dosage instructions, altering the method of taking the prescription, or taking the prescription drug when it is no longer needed for nonmedical purposes.

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Common side effects of codeine include:

  • Feelings of euphoria
  • Drowsiness
  • Light-headedness
  • Nausea
  • Sweating
  • Shortness of breath

As is a possibility with any medication, more adverse effects of codeine could include an allergic reaction.

Patients who are taking codeine for pain management should maintain regular contact with their doctor. The longer an individual takes codeine, the higher the chance is of developing a tolerance to the drug. This can make it difficult to come off the drug or feel the same effects, so patients should be properly weaned off the prescription if necessary by their doctor.

Other Uses For Codeine: Acetaminophen, Promethazine

Although codeine is most known for being prescribed as a pain reliever following surgery, it can also be mixed in combination with other drugs such as acetaminophen and promethazine. Acetaminophen is a drug that’s more commonly known by its brand name: Tylenol®.

Tylenol with codeine is known as Tylenol #3, a stronger pain reliever than just Tylenol. This medication requires a prescription and the doctor will determine the dosage based on a patient’s needs. For example, a doctor could prescribe Tylenol #3 for a woman who regularly experiences very painful menstrual cramps.

Codeine can also be used as a powerful cough suppressor in a cough syrup called promethazine. Promethazine with codeine can treat severe coughing that is caused by a respiratory illness.

Symptoms And How Your Body Reacts To An Overdose

A codeine overdose often happens when a person uses the drug for nonmedical reasons. Unfortunately, as we know, opioids are widely misused across the country.

The National Institute on Drug Abuse states that based on 2018 data, 128 people die every day due to opioid overdoses. Approximately 21 to 29 percent of patients who receive an opioid prescription for pain management will misuse the drug.

Opioids like codeine can affect parts of the brain that regulate the ability to breathe. That’s why a potential side effect of codeine includes shortness of breath and difficulty breathing. The World Health Organization (WHO) identifies a combination of three signs and symptoms that indicate an opioid overdose.

These include the following or a combination of the following:

  • Pinpoint pupils (shrunken pupils that look like a small dot)
  • Unconsciousness
  • Difficulty breathing

The WHO also lists several factors that increase the risk of an opioid overdose. Many of these risk factors are related to the manner of use and the deviation from prescription instructions.

  • Struggling with an opioid use disorder
  • Using opioids through injection
  • Returning to opioid use following a period of abstinence such as a detox program
  • Misusing prescription opioids without medical supervision
  • Taking a high prescription dose
  • Combining opioids with other substances such as alcohol, benzodiazepines, or barbiturates
  • Comorbidity (co-occurring medical conditions like lung disease, HIV, or mental illness)

How To Care For And Deal With A Codeine Overdose Emergency

Although the statistics concerning the frequency of overdoses and overdose deaths are grim, death after a codeine overdose (or any opioid overdose) is preventable with timely actions and medical support.

A drug called naloxone is often used as an antidote to opioid overdoses by reversing the effects of an overdose. However, naloxone needs to be administered within a certain time frame following the overdose. If done properly and in time, lives can be saved from an overdose.

The WHO also explains that naloxone has basically no effect if administered to a person who has not taken opioids, opening the possibility of use to individuals who may not be able to respond or communicate to others that they have overdosed or taken something.

Currently, healthcare professionals are the ones who have the most access to naloxone. The WHO states that some countries also have limited access even in medical settings like ambulances. However, there seems to be a growing movement in some countries to offer the general public greater access to naloxone. 

According to the WHO “Several countries (Australia, Canada, Italy, the United Kingdom of Great Britain and Northern Ireland, and Ukraine) have recently introduced naloxone as over-the-counter medication and have also started proactive dissemination in communities.” The move to increase access to naloxone can have a great impact on saving lives from overdose in many countries across the globe.

In order to get someone the proper attention they need for a codeine overdose, someone first has to witness the overdose. The people most likely to witness an overdose include those who struggle with codeine use and friends and family of an individual who regularly uses.

If you come across someone who you believe is suffering from the effects of an overdose, call 911 and tell them what you observe in the person, such as any difficulties in breathing. When emergency services arrive, be sure to tell the personnel if you know what substance or combination of substances the person was using. Sometimes, treatment can differ based on the cocktail combinations, since drugs interact differently with one another and can require a particular medication for treatment.

Of course, the ultimate prevention of overdose is getting treatment for opioid and codeine dependency and addiction. Getting treatment will not only allow a person to live a healthier life but will improve their quality of life.

Vertava Health understands the complexity of opioid use and the consequences it can have in daily life. We’re here to provide comprehensive, individualized codeine addiction treatment for all our patients. Get started on living out your best future today. Contact us at (615) 208-2941.

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Frequently Asked Questions

How much codeine does it take to overdose?

There is no fixed amount of codeine that it takes a person to overdose because it will largely depend on the person. If a person already has developed a tolerance to the drug, then it will take a lot more of the drug to overdose than a person with no tolerance.

A general good practice is to follow prescription codeine instructions and dosages. Contact your doctor with any questions about the dosage.

What happens if you overdose on codeine?

If you overdose on codeine, you might experience pinpoint pupils, a condition where your pupils shrink. You might also have difficulty breathing and becoming unconscious. Codeine overdoses can be treated with a drug called naloxone if emergency services are contacted and the drug is administered in a timely fashion.

How many Tylenol #3 pills with codeine does it take to overdose?

Tylenol #3 is handy for those who need a stronger pain medication than normal Tylenol. However, the risk of overdose is present if too much medication is taken. Again, there is no fixed amount of codeine that it takes a person to overdose because it will depend on the person. People with a tolerance to the drug will need greater quantities to overdose.

To avoid overdose, follow prescription codeine instructions and dosages. Don’t use the medication if you don’t need it and contact your doctor with any questions about the dosage.