Codeine

Codeine is a type of medicine that helps with pain, coughing, and diarrhea. It comes from the sap of a special flower called the opium poppy. Doctors often give it to help with mild to moderate pain.

People can take codeine by mouth, and it usually starts working in about half an hour. It can make some people feel sleepy. It is important to be careful with codeine because it can be misused.

Codeine was first found in 1832. It is not recommended for children because it may not be safe for them. It is listed as an important medicine by the World Health Organization because many people need it.

Medical uses

Codeine is used to help with pain, especially after dental surgery. It can also help stop coughing and treat diarrhea. It is not recommended for children under 12 years old because of possible side effects.

Codeine can be found in different medicines, sometimes mixed with other ingredients. It is important to use it only as a doctor says.

Side effects

Codeine can make you feel sleepy or cause digestion problems. Other effects might include itching, feeling sick, dry mouth, or changes in vision. In rare cases, it can cause serious reactions like breathing problems.

People who use codeine for a long time might feel weaker or have trouble remembering things. Some might also feel very attached to the medicine and feel bad if they stop using it suddenly. It’s important to reduce use slowly with help from a healthcare professional.

Codeine can pass into breast milk, so special care is needed when breastfeeding.

In 2012, health experts in the United States warned that young children under six years old could have serious problems after taking certain medicines with codeine, especially after surgery.

Pharmacology

Codeine is a type of opioid that helps reduce pain by affecting special receptors in the brain. It is not very strong on its own, but the body changes it into a stronger substance called morphine, which helps with pain relief.

The body changes codeine into morphine in the liver. This process can vary from person to person. Some people change codeine into morphine faster, which can cause problems. Because of this, doctors are careful when prescribing codeine.

Chemistry

Codeine can be taken directly from opium, but most of it is made from a substance called morphine. This process is called O-methylation and was first done in the late 20th century.

Codeine has been used to help make other pain-relieving medicines, such as hydrocodone, oxycodone, and dihydrocodeine. However, these medicines are now usually made from other parts of the opium plant, not from codeine.

History

Codeine, also called 3-methylmorphine, is a natural substance found in the opium poppy, Papaver somniferum var. album. People have used the opium poppy for thousands of years to help with pain, coughing, and diarrhea, as well as to help them feel sleepy. The opium poppy contains several important substances, including morphine, codeine, and papaverine.

Codeine makes up about 1% to 3% of the opium taken from the unripe pods of the opium poppy. The name codeine comes from an Ancient Greek word, κώδεια (kṓdeia), meaning "poppy head." Codeine was first separated from opium in 1832 in France by a scientist named Pierre Robiquet. Since then, scientists have learned more about its chemical makeup and how it works in the body. Codeine and similar substances were once used to help treat diabetes, but we now have better ways to manage that condition.

Society and culture

Codeine is one of the most commonly used medicines for pain relief around the world.

Names

Codeine is often found in medicines as codeine sulfate or codeine phosphate. It has many different forms and names depending on where you live.

Recreational use

Some people use codeine when they cannot get their usual medicines. It can also be mixed with other medicines or soft drinks.

Detection

Doctors can test for codeine in a person’s blood, urine, or other body fluids.

Legal status

Laws about codeine differ around the world. In many countries, you need a prescription to buy stronger forms of codeine. Some places allow weaker forms to be sold without a prescription, but rules are changing.

Australia

In Australia, you need a prescription for codeine medicines since February 2018.

Canada

In Canada, low-dose codeine medicines can be sold without a prescription if mixed with other ingredients. However, rules changed in 2020 to make all codeine medicines prescription-only.

Denmark

In Denmark, you can buy weaker codeine medicines without a prescription.

Estonia

Estonia used to allow weaker codeine medicines without a prescription, but this changed in 2023.

Ethiopia

In Ethiopia, codeine is banned because it can be dangerous for some people.

France

France started requiring prescriptions for codeine medicines in 2017.

Greece

In Greece, codeine is illegal without a prescription.

Hong Kong

Hong Kong has strict rules about codeine. You need a prescription to buy it.

India

In India, you need a prescription for codeine medicines. Some cough syrups with codeine have been banned since 2016.

Ireland

Ireland allows weaker codeine medicines without a prescription, but you must ask a pharmacist for them.

Italy

In Italy, you need a prescription for codeine tablets or mixtures.

Japan

Japan allows adults to buy weaker codeine medicines without a prescription, up to certain amounts per day.

Latvia

Latvia allows weaker codeine medicines without a prescription.

Nigeria

Nigeria planned to ban cough syrups with codeine in 2018.

South Africa

South Africa allows codeine medicines to be sold without a prescription.

United Arab Emirates

The UAE has very strict rules about codeine. You need a special prescription.

United Kingdom

In the UK, stronger codeine medicines need a prescription. Weaker forms mixed with other medicines can be sold in pharmacies without a prescription.

United States

In the US, codeine is controlled by law. Stronger forms for pain relief need a prescription. Cough syrups with codeine are also controlled, depending on their strength.

Veterinary use

Codeine is not recommended for dogs and cats to help with pain. This is because it does not work well when taken by mouth and there is no proof that it works better than other pain medicines for these animals.