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, and it can work better when mixed with other medicines.

People can take codeine by mouth, and it usually starts working in about half an hour. It can make some people feel sleepy or sick to their stomachs. It is important to be careful with codeine because it can be misused and might lead to serious health problems.

Codeine was first found in 1832. Even though it can help with certain problems, 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. However, 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 to help with pain better. It is important to use it only as directed by a doctor.

Side effects

Codeine can cause some unwanted effects, such as feeling sleepy and having trouble with digestion. Other effects might include itching, feeling sick, dry mouth, or changes in vision. In rare cases, it can cause serious reactions like breathing problems or seizures.

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 experience uncomfortable symptoms if they stop using it suddenly. It’s important to reduce use slowly and 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 works by affecting special receptors in the brain to help reduce pain. 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, and this process can vary from person to person. Some people change codeine into morphine much faster, which can cause too much morphine to build up and lead to serious problems. Because of this, doctors are careful when prescribing codeine, especially for people who might change it very quickly.

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 known as 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 because of its helpful properties for pain, coughing, and diarrhea, as well as its sleepy-making effects. 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, especially if they are addicted to stronger drugs. It can also be mixed with other medicines or soft drinks for recreational purposes.

Detection

Doctors can test for codeine in a person’s blood, urine, or other body fluids to see if they have been using it or to investigate poisoning cases.

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 to make these prescription-only to prevent misuse.

Australia

In Australia, you need a prescription for codeine medicines since February 2018. Stronger forms are tightly controlled.

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. Some areas, like Manitoba, started this earlier, and saw big drops in sales.

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, about 30% of people process codeine unusually fast, which can be dangerous. Because of this, codeine is banned there.

France

France started requiring prescriptions for codeine medicines in 2017.

Greece

In Greece, codeine is illegal without a prescription, even if prescribed elsewhere.

Hong Kong

Hong Kong has strict rules about codeine. You need a prescription to buy it, and selling it without one can lead to heavy fines or jail time.

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. Stronger forms need a prescription.

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 because of concerns about misuse.

South Africa

South Africa allows codeine medicines to be sold without a prescription, though some pharmacies may ask for your name and address.

United Arab Emirates

The UAE has very strict rules about codeine. You need a special prescription, and breaking these rules can lead to deportation or jail time.

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, but cough syrups with codeine are now prescription-only. Possessing codeine without a prescription can be a crime unless it is mixed with other ingredients in specific ways.

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. Some states have even stricter rules.

Veterinary use

Codeine is not suggested for use in 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.