By Alice || Edited by Go Ask Alice Editorial Team || Last edited May 16, 2024
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Alice! Health Promotion. "What are the health effects of recreational codeine use?." Go Ask Alice!, Columbia University, 16 May. 2024, https://goaskalice.columbia.edu/answered-questions/what-are-health-effects-recreational-codeine-use. Accessed 23, Jun. 2024.

Alice! Health Promotion. (2024, May 16). What are the health effects of recreational codeine use?. Go Ask Alice!, https://goaskalice.columbia.edu/answered-questions/what-are-health-effects-recreational-codeine-use.

Dear Alice,

I like to use codeine occaisionally (once or twice a week at most) to help me relax and feel a minor high. Typically, I'll take about 90 to 150mg per session (100 to 200mg per week on average). Sometimes I take Tylenol-3's, and sometimes I extract the codeine from these pills and drink it pure. What are the potential health side-effects of this usage, both short- and long-term?

Thanks!

Dear Reader,  

Let's start with some basic information: Codeine is part of the family of opioid drugs and can be made from the opium poppy flower or produced synthetically. Opioids like codeine and morphine are commonly prescribed for mild to moderate pain relief but can also be used to induce feelings of intense pleasure and relaxation, as you may have experienced. Higher doses can lower heart rate and blood pressure, cause disorientation, convulsions, hallucinations, coma, and even death. It’s important to keep in mind that opioids like codeine have the potential to be highly addictive, possess certain short-term and long-term health effects, and may also be illegal if taken without a prescription.  

Since you’re taking codeine recreationally as opposed to by prescription guidelines, it’s harder to predict what harmful effects you may experience. The typical prescribed dosage of codeine often depends on your height, weight, age, administration method, and the strength of the medication you have. Taking codeine with another medication, like acetaminophen—Tylenol-3—, could lead to different effects. With acetaminophen alone, taking more than 4,000 milligrams a day increases the risk of liver damage, which could cause you to need a liver transplant or lead to death. In combination with codeine, it’s possible that you may experience very serious breathing problems within 24 to 72 hours. Codeine and acetaminophen together are especially dangerous if you have another health condition like asthma, chronic obstructive pulmonary disease (COPD), a head injury, a brain tumor, or any injury that increases pressure in your brain. There are also possible interactions with antidepressants, cold medications, medications used to treat certain mental illnesses, certain antifungal medications, benzodiazepines, certain medications for HIV, and sedatives, to name a few.  

While codeine use may result some short-lived positive effects such as pain relief, euphoria, relaxation, other more negative short-term affects may occur such as: 

  • Mood changes 
  • Impaired coordination or vision 
  • Nausea and vomiting 
  • Constipation or diarrhea 

Other more long-term effects of codeine use can include: 

  • Difficulty concentrating and sleeping 
  • Difficulty urinating 
  • Severe constipation 
  • Addiction 

Other more serious side effects that may appear in either the short- or long-term could include: 

  • Tremors 
  • Seizures 
  • Low blood pressure or slow heartbeat 
  • Rash or hives 
  • Hallucinations  
  • Difficulty breathing 
  • Liver damage 
  • Internal bleeding 
  • Kidney failure 
  • Heart attack or death 

If you experience any of these, it would be best to contact a health care provider immediately.  

Another issue that may contribute to the short- and long-term effects of use is the extraction method you mentioned. Unfortunately, attempting to extract opioids from medications to make them more drinkable is often associated with codeine addiction, might be toxic, and could be fatal.  

Since codeine can be habit-forming, use isn't recommended in large doses, over long periods, or without speaking with a health care professional first. People who do become addicted to codeine could experience withdrawal symptoms when they’re no longer using the substance.  

Withdrawal symptoms may include: 

  • Restlessness 
  • Irritability 
  • Sweating 
  • Chills 
  • Stomach cramps 
  • Muscle aches 
  • Difficulty falling asleep or staying awake 

When trying to discover whether codeine may be having any negative effects on your health, you might consider some thinking through some questions. Are you experiencing any of these symptoms when you aren't using codeine? If so, it may be a sign that you’re experiencing withdrawal symptoms. Have you noticed any need to increase the amount of codeine needed to reach the desired effect or to fight off withdrawal symptoms? If that’s the case, and you answered yes to the former question, these symptoms could indicate tolerance (needing more substance to produce the sought-after feelings), which may lead to a cycle of addiction.  

If getting relaxed and feeling a small high is what you’re after when taking codeine, you might consider ways to do that without codeine. You might look for alternative ways to release endorphins. Yoga, running, and many other forms of exercise, as well as (safer) sex, can all be safer and healthier ways to rev up your natural production of endorphins. These can all help to produce feelings of intense pleasure and peace—without the risks of using addictive substances. If you have concerns about your codeine use, you may consider visiting a health care provider and kudos to you for seeking out more information to inform future health-related decisions. 

Additional Relevant Topics:

Substance Use and Recovery
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