Codeine

Drug Source

Codeine is found in opium in concentrations between %0.1 and %2. Because of the small concentration found in nature, most codeine found in medical products is synthesized from morphine via the methylation of the hydroxyl group found on the second non-aromatic ring.

Trade Name

There are no commercial name for products containing only codeine in US. Found under common name of codeine. Canada does have a codeine only syrup available under Paveral. Mainly found in combination products.

Street Name

T-three's (Tylenol #3 w/ codeine), schoolboy, cough syrup

Medical Uses

• relief of mild to moderate pain
• relief of non-productive cough
• relief of diarrhea

Drug Combinations

Sold under many name brand products, the most popular being the Tylenol with Codeine series, the number on the tablet corresponds to the amount of codeine and caffeine found in the each tablet.

Tylenol #1 w/ codeine - 8 mg codeine, 15 mg caffeine

Tylenol #2 w/ codeine - 15 mg codeine, 15 mg caffeine

Tylenol #3 w/ codeine - 30 mg codeine, 30 mg caffeine

Tylenol #4 w/ codeine - 60 mg codeine, no caffeine

note: all tablets contain same amount of acetaminophen (300 mg)

Fiorinal (aspirin, caffeine, barbital, codeine)

Many other brand name product combinations.

Physical Appearance

Tylenol w/ codeine series are imprinted with number on one side and other side is Tylenol label(McNeil).

Controlled Substance Status

As a single product codeine is a schedule II controlled substance in the US. When combined with other non-controlled substance, and depending on amount per dose unit, codeine combined products range from schedule III to V.

Canada has OTC codeine products available if product has no more than 8 mg of codeine per unit dose. Some US areas may have codeine preps available OTC, but usually require release form.

As an interesting fact, a travelers handbook noted that Greece has banned codeine in that country (no idea on what it's status is now) so be careful when traveling there. Codeine is also restricted in South Africa. Laws on codeine may vary greatly from one country to another, so travelers who use codeine should be advised to check local laws before departing.

Dosage

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Medical

Pain relief : 30mg - 220mg oral or equivalent dose SC or IM

Diarrhea relief : 10mg - 20mg orally

Cough suppressant : 5mg - 15mg orally

Nonmedical

Doses can range from 30mg up to 400mg. LD50 for codeine is 800mg in a average nontolerant person. At doses of > 250mg adverse effects tend to arise, including intense itching, flushed skin, dizziness, sedation, nausea and vomiting

Routes Of Administration

Usually taken orally but can be injected IM or SC. The IV route is not recommended as reactions such as facial swelling, pulmonary edema and convulsions can occur.

Short Term Use

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CNS, Behavioral, Subjective:

Effects begin at 30mg and tend to mimic those of morphine, except sedation and euphoria are less intense.

Respiratory:

same as morphine but less intense.

Gastrointestinal:

same as morphine but nausea and vomiting are less common and constipation less severe.

Other:

alleocodone is a schedule II drug, and when combined with other non-controlled drugs, is found from schedule III-IV. 

Dosage

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Medical

as a cough suppressant 5mg - 10mg

for pain relief 10mg - 30mg

Nonmedical

doses are similar to those for pain relief

Routes Of Administration

Usually taken orally but can be inject via three routes. Unknown if hydrocodone can be sniffed or smoked. Sniffing is likely possible.

Short Term Use

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CNS, Behavioral, Subjective:

Has similar effects as morphine but less sedation and euphoria

Respiratory:

Less depression than morphine.

Gastrointestinal:

Less likely to cause nausea and vomiting than morphine.

Other:

Hydrocodone is a weaker opioid than morphine but still a effective opioid with similar potency to oxycodone. It should also be noted that acetaminophen (Tylenol) has been found to have effects on the liver and kidneys when used in large doses or over long periods of time. Therefore, anyone taking any of the common pills including acetaminophen should be careful to monitor the dosage of that component of their medication.

Duration

3 - 4 hours

Dependency Potential

moderately low, much less potential than morphine