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Mixing Alcohol and Codeine: Risks and Side Effects


Author: Thomas Roth

Last Updated: 1/16/2022

Codeine and alcohol are a dangerous combination. Alcohol and codeine are also dangerous when consumed alone. For example, alcohol consumed in large quantities can lead to alcohol poisoning, which is an overdose. On the other hand, codeine taken in high doses can result in the loss of consciousness and coma. For these reasons, you should always avoid mixing alcohol and codeine.

What is Codeine?

Codeine is a central nervous system (CNS) depressant that’s used for pain relief. Because of its depressant effect on the nervous system, codeine is known for making people sleepy. Codeine is also an opioid, so it can make individuals feel relaxed, uplifted, and happy. When taken in high doses these effects are more prevalent. However, abusing codeine can also cause negative health problems and even death. For example, taking a dosage of codeine that’s too high can lead to overdose and death.

Doctors prescribe codeine for many different reasons but the most common reasons are pain relief and coughing. While it’s also a type of cough medicine, codeine doesn’t get prescribed for coughing as much as it used to. Instead, it’s mostly used for pain relief and discomfort. Codeine should never be used for coughing, pain, or pleasure without a prescription.

Codeine is also an addicting substance. Individuals who use the medication for pleasure or pain can become addicted to its pleasurable effects. The risk of addiction increases when codeine is taken with substances like alcohol because of alcohol’s addictive qualities. Codeine can create physical addictions and mental addictions, depending on the person and how long the substance is being abused.

While codeine is a helpful medication when used properly, it has a high risk of abuse and dependence. When taking codeine, it’s best to only take the amount prescribed (less if possible) and avoid mixing it with other substances like alcohol.

How Does Codeine Work?

Codeine works by changing the way the brain perceives pain. As an opiate analgesic, it interacts with neurotransmitters in the brain and the central nervous system (CNS). Because pain is controlled by the CNS, codeine’s effects can reduce pain and cause the brain to think there’s no pain. Codeine can be taken orally but there are similar narcotics like morphine that also reduce pain in this way.

Codeine can also cause changes in the brain that lead to altered dopamine and serotonin levels. For this reason, people feel uplifted and happy when taking the medication. Unfortunately, codeine can cause physical and mental addiction because of its pleasurable effects. Additionally, the effects become harder to achieve as tolerance increases. So, the risk of overdose increases the longer someone is addicted.

What are the Side Effects of Mixing Alcohol and Codeine?

As an opioid, codeine has similar side effects as other opioids. Codeine is known for making people feel sleepy and groggy, which is amplified when codeine is mixed with substances like alcohol. There are also some positive effects of codeine like pain relief and improved mood. The intensity of the side effects depends on the dosage of codeine and an individual’s tolerance to the medication.

Some common side effects of codeine are listed below.

  • Trouble with focusing and concentration
  • Feeling dizzy and lightheaded
  • Fatigue and drowsiness 
  • Stomach problems (nausea, vomiting)
  • Diarrhea 
  • Respiratory problems (slow breathing)
  • Sweating 
  • Changes in heart rate
  • Rashes 
  • Itchiness

Mixing codeine with other substances can make these side effects worse and increase the chance of overdose. Symptoms of a codeine overdose include chest discomfort/pain, changes in heart rate, blue skin or lips, and small pupils.

What are the Risks of Mixing Alcohol and Codeine?

When codeine is mixed with substances like alcohol there are many risks. Alcohol and codeine both slow down nerve function, which can cause problems for the central nervous system and several organs. When mixing codeine and alcohol there’s also an increased risk of overdose and death. Another problem is that the combination of alcohol and codeine makes medications like Naltrexone less effective in the event of an overdose. Naltrexone can reverse an overdose from opioids but it doesn’t have the same effect on alcohol. Therefore, the risk of alcohol poisoning is increased. 

Codeine and alcohol also cause other problems for the body. The most notable is that taking codeine with alcohol places more stress on the liver and kidneys. If codeine and alcohol are abused often, this can lead to long-term organ damage. Furthermore, codeine can cause respiratory problems that make it hard to breathe and cut off oxygen from the brain. If this occurs, the risk of death and long-term brain damage is elevated.

Below are the risks of mixing codeine and alcohol.

  • Loss of memory
  • Increased risk of blacking out 
  • Changes in blood pressure
  • Coma, loss of consciousness, death 
  • Reduced motor skills 
  • Headaches
  • Feeling drunker
  • Increased risk of overdose
  • Increased risk of developing alcohol poisoning 

These are only some of the risks that come with mixing codeine and alcohol. The substances should not be mixed, especially in high doses.

What are the Reasons Why Alcohol and Codeine Should Not Be Combined?

Alcohol and codeine should never be combined. If codeine is prescribed by a doctor you should consult with them before consuming alcohol. Codeine that hasn’t been prescribed by a doctor should never be taken or mixed with alcohol. Alcohol and codeine should never be mixed because both substances slow down the central nervous system and place strain on the kidneys. Codeine and alcohol are both depressants, so the effects of both substances are amplified when they’re taken together.

Below are the most important reasons that alcohol and codeine shouldn’t be combined.

  • Increased risk of opioid and alcohol overdose 
  • Amplified side effects of alcohol and codeine 
  • Inability to operate vehicles
  • Increased risk of poor decision-making 
  • The risk of developing mental and physical addictions to alcohol and codeine increase 
  • Overdoses can lead to coma and death

Alcohol and codeine are dangerous substances (alone and combined), so be sure to avoid combining them if possible.

How Long After Taking Codeine Can I Drink Alcohol?

You should wait for at least 12-18 hours after taking codeine to drink alcohol. While the effects of codeine wear off faster (in about 5 hours), the body does not clear until it goes through 5 half-lives. The half-life of codeine is 3 hours, so it takes about 15 hours to make it through 5 half-life cycles. Overall, we recommend waiting until the next day to consume alcohol after taking codeine. Doing so will help you avoid potential problems.

What Should You Not Mix with Codeine?

Codeine is an opioid pain reliever and cough medication. It shouldn’t be mixed with other opioids and cough medicines because that increases the risk of overdose. Codeine should also not be mixed with central nervous system depressants like alcohol because the respiratory and heart rate side effects increase.

Below are substances you should not mix with codeine.

  • Alcohol
  • Cocaine
  • Other opioids 
  • Hallucinogens 
  • Antidepressants 
  • Xanax 
  • Amphetamines

Always consult with your doctor if you have a codeine prescription and plan on mixing the drug with other substances.

How is Alcohol And Codeine Addiction treated?

An alcohol and codeine addiction is treated by a dual-diagnosis rehabilitation center or treatment program. There are inpatient options for this type of drug dependence and outpatient options. Individuals can also choose to attend support groups for Narcotics Anonymous and Alcoholics Anonymous. Both groups use similar methods to treat addiction. Ultimately, someone needs to receive dual-diagnosis treatment for codeine and alcohol addiction.

When someone is addicted to only one substance (alcohol or codeine), however, the treatment methods remain similar. Medications like Naltrexone can be used to make opioids and alcohol less pleasurable and inpatient/outpatient counseling is based on the same principles. Depending on the severity of the addiction, people can also need an alcohol detox or opioid detox.

Alcohol and codeine addictions are serious and even the withdrawal symptoms can be fatal. For this reason, people need to recover from these addictions with medical supervision. With severe cases of alcohol and codeine addiction, partial hospitalization programs are necessary.