What are the health effects of recreational codeine use?

Dear Reader, 

It’s great that you’re considering the effects of codeine on your body. Research shows that the at-home processes of extracting codeine from pills aren’t always all that effective. This means that large amounts of other substances can remain. In the case of Tylenol-3's, codeine is combined with acetaminophen (also called paracetamol) so you could end up feeling the effects of codeine, acetaminophen, or both. It also means that some effects can sneak up on you—for example, acetaminophen can carry a significant risk of liver problems. Keep reading to learn about some other side effects of codeine consumption and how you might be able to avoid them. 

What is codeine? 

Codeine is an opioid pain-relieving medication. It can be found on its own as well as in combination with a variety of other medications in the pain relief family. Codeine can come in the form of pills or liquid such as cough medicine. Depending on its use and form, codeine is usually taken every four to six hours through the duration of your sickness or until a medical professional adjusts your dose based on your pain levels. Often, these medications require a prescription from a medical professional due to their high rate of misuse and dependence.  

What are the short- and long-term side effects of codeine usage?  

Codeine can have a wide variety of side effects. In the short term, you might feel sick after taking the drug, and experience nausea or vomiting. If you’ve been using codeine for a while, your body may have become used to it, and you might be less likely to have this reaction. Other short-term effects may include constipation, difficulty breathing, drowsiness, and dizziness—because of this, it’s usually best to avoid tasks like driving while using codeine.  

Some of these effects, like constipation or difficulty breathing, can become long-lasting with repeated use. Other long-term effects that may arise can include sexual dysfunction and infertility. If you happen to consume acetaminophen along with the codeine from Tylenol-3 pills, it may put you at a higher risk of liver problems. This can manifest as side effects such as loss of appetite or discoloration (yellowing) of your skin.  

What are signs of codeine overdose? 

While some of the side effects mentioned may seem relatively minor, others might be signs of an overdose. These signs include: 

• difficulty breathing  
• dark urine  
• blue lips or fingernails  
• irregular pupils 
• yellow skin 
• nausea and vomiting 

If you or someone you know is experiencing these symptoms, it is recommended that you call for help immediately.  

When should you consider reaching out to a doctor? 

There are some side effects that could be signs of concerning health impacts. Some of these include things like muscle spasms, hallucinations, discoloration of stool, loss of appetite. If you experience these symptoms, or if other side effects worsen or become long lasting, consider seeking out a health care provider. 

Are there safer ways to consume codeine? 

Due to the risks that come with codeine usage, it’s usually recommended to limit your use to when you’re around other, sober people you trust—like family, friends, or roommates. To be extra safe, consider basic overdose training for yourself and others in your life or household so someone can be prepared to handle the situation if it arises.  

In addition to overdose training, there are plenty of other harm-reduction tactics you may choose to try. For example, if you use any kind of equipment to extract codeine from Tylenol-3 pills, cleaning it regularly can help ensure it remains sterile. Consider reviewing other medications you might be taking, to make sure they won’t interact negatively with the codeine. For example, it’s not considered safe to consume more than four grams of acetaminophen within 24 hours. 

Using codeine can be risky and can come with any number of side effects—so asking questions and doing research is a great way to stay safe.