Mixing Codeine and Alcohol: Risks and Dangers

Published On: October 13, 2023

As part of the opiate group of medications, Codeine is a substance most often used to numb both moderate and severe pain. By interfering with the passage of pain signals to the brain, it provides individuals with temporary relief.

Codeine is most often used to treat intense discomfort following an injury, but it can also be a long-term solution when weaker painkillers are ineffective. It can also prove useful for easing anxiety and stress, as well as for treating diarrhoea.

The drug is available in several forms, including both as a tablet which you swallow and a liquid which is injected. Injections should only be carried out in a hospital.

Does Codeine Have Side Effects?

A woman taking a white pill

Codeine is available in the UK via prescription. The use of the drug must be monitored due to the prevalence of several unwanted effects. These can vary greatly in their severity and threat to well-being, and individuals can experience their combination.

Some of the most common side effects include:

  • Stomach complications, primarily resulting in constipation
  • Drowsiness and falling asleep
  • Nausea and vomiting
  • Muddled thoughts and confusion
  • Disorientation and dizziness
  • Headaches
  • Dry mouth

Some of the more dangerous side effects include muscle stiffness and low blood pressure. These tend to impact 1 in 100 people, and those who do experience them need to seek medical help immediately.

Using Codeine and Alcohol Together – What Are The Dangers?

alcohol damages liver

Codeine should not be consumed alongside alcohol. This includes both codeine in its state as well as medications which include codeine [1].

The reason for this is that the mixing of these substances can create several dangerous effects.

1. Overdose

One of the greatest risks of mixing codeine and alcohol is overdose. Consuming these substances at the same time increases the chances of their effects overwhelming the body, in turn enhancing the risk of overdose.

Overloading the body with these substances can spark several dangers, several of which can pose a threat to life. These include:

  • Poor blood circulation, resulting in bluish skin or lips
  • Chest pains/heart palpitations
  • Irregular heartbeat
  • Drowsiness and loss of consciousness
  • Unresponsiveness or poor coordination
  • Shallow breathing

While not all of these symptoms pose an immediate threat to life, they can have a knock-on effect which can put vulnerable people in incredible danger. Individuals will health conditions may suffer more easily, and those who drive may fall asleep at the wheel.

2. Respiratory depression

As well as overdose, one of the most dangerous consequences of mixing codeine and alcohol is the impact it can have on how we breathe. Consuming these substances together can disrupt the passage of oxygen around the body, causing respiratory depression.

When this happens, an individual experiences irregular breathing, which interrupts the provision of oxygen to the brain and body. In the short term, this might cause difficulty breathing and a lack of energy.

In the long term, however, much greater dangers lie. Oxygen deprivation can lead to some of the body’s major organs losing their functionality, including the brain. As a result, an individual may be fatally at risk.

Cardiorespiratory arrest (induced by respiratory depression) is one of the primary causes of death in opiate users [2].

3. Liver damage

Abusing alcohol already poses a great threat to the functionality and long-term health of the liver. It is the primary organ for processing alcohol, but adding codeine to the equation only intensifies this problem.

Mixing codeine with alcohol increases the demand put on the liver, quickening its fatigue and damage. This pressure on the liver can also lead to knock-on damage to other organs, such as the kidneys.

4. Other effects

In addition to the problems listed above, mixing codeine and alcohol can spark individual effects as well. These can include:

  • Low blood pressure
  • Difficulty thinking clearly
  • Drowsiness and loss of consciousness
  • Headaches
  • Poor coordination and disorientation
  • Slipping into a coma

In What Way Is Mixing Codeine And Alcohol Desirable?

packets of pills

With all of these dangers being present for those who mix codeine and alcohol, it is understandable to question why individuals do it. However, it is important to understand that a variety of motivations can lead individuals to this behaviour.

Using different substances at the same time strengthens their individual effects, usually producing a more immersive and pleasurable high.

Individuals can desire this greater sensation for many reasons [3]:

  • To combat worsening physical or mental health
  • To maintain compliance with a group of friends
  • To overcome tolerance build-up
  • To satisfy curiosity about substance mixing
  • To rebel against parents or institutions who have outlawed substance use

I’ve Taken Alcohol And Codeine – What Should I Do?

Woman looking sad

For those who regularly use codeine and alcohol, learning about the risks of mixing can trigger a desire to quit. However, in many situations, individuals cannot simply cut out such regular behaviour from their routine. So what options are available?

First and foremost, speak to a doctor or GP. Outline your situation, and they will be able to offer you advice as to what treatment options you can access. They will also be able to take into consideration the physical toll your mixing has taken.

If you have consumed a lot of codeine and alcohol and are concerned that you may overdose, contact emergency services. Explain what has happened and wait while they make their way to you. Ensure you are in a safe and accessible place.

Identifying When An Addiction Has Developed

Two people holding hands across a table

If an individual regularly consumes codeine and alcohol together, it may be because they have developed an addiction.

The combination of these substances can have an intensifying effect on their benefits, but doing this a lot can suggest an unhealthy dependence.

But how can you determine whether an individual has an addiction or whether they are simply being reckless with their substance use?

Although substance use disorders can be difficult to spot, there are several warning signs which indicate unhealthy consumption:

  • Using codeine and alcohol together on a regular or daily basis
  • Using higher quantities of codeine and alcohol over time
  • Being secretive about using codeine and alcohol so much
  • Using codeine and alcohol without social cause
  • Losing interest in hobbies and interests outside of substance use
  • Obsessing over acquiring codeine and alcohol
  • Prioritising codeine and alcohol over work/school
  • Falling into financial hardship to pay for codeine and alcohol

Although many of these signs can be difficult to identify in an individual’s everyday behaviour – especially since they will likely be very good at hiding their codeine and alcohol use – there is one large sign of addiction which is easier to spot: withdrawal.

If an individual becomes unwell whenever they are without codeine and alcohol, or they show great effort or anxiety when trying to avoid becoming completely sober, they are likely dependent on the substances.

Getting Treatment For Codeine And/Or Alcohol Dependency

A woman smiling at another, holding a smart device

If an individual is identified to be struggling with codeine and/or alcohol dependency, they will require addiction rehab to make a full recovery.

Despite the stigma around substance abuse, it is perfectly possible to achieve sobriety again via treatment.

Addiction rehab is not an especially confusing or daunting medical process. Instead, it is an organised series of stages which transport individuals first to physical sobriety and then onto mental and emotional sobriety as well.

Stage 1: achieving physical sobriety

With many substance abuse conditions, the body has usually become dependent upon the substance in question. Especially with alcohol, the body can become so reliant that it cannot function when sober, and withdrawal symptoms spark if the substance is taken away.

To help individuals relieve this unhealthy relationship between their body and codeine/alcohol, rehab utilises detox. During this treatment, doctors monitor a gradual reduction in substance use until the body is completely sober.

This slow and steady response is designed to help the body re-establish independence without triggering drastic withdrawal symptoms. To help with this, benzodiazepines can be provided to offer relief from withdrawal which threatens both progress and well-being.

Stage 2: achieving psychological sobriety

While not all substances produce a physical dependence over time, all addictions are comprised of some form of mental dependency. With such consistent usage, individuals come to believe that they cannot live without codeine and alcohol.

Therapy is used at this stage of rehab. It works to help individuals understand why they have such an unhealthy perception of substance use, identifying the triggers which exist in their everyday life and encourage dependence.

These triggers can range from unmanageable emotions to irresponsible friends, but no matter the nature of a trigger, therapy works to equip individuals with healthy ways of managing them.

Stage 3: sustaining sobriety

When the body and mind have been cleared of their dependence on codeine and alcohol, it comes time to prepare them for the world post-rehab.

Leaving treatment is a big step, and many individuals find it challenging to readjust to their everyday life and face the triggers they have been protected from throughout rehab. Relapse is incredibly normal, but there is no harm in trying to prevent it.

Before the end of rehab, individuals are equipped with skills and techniques for recognising triggers and handling them in a way which does not require them to slip back into substance use.

Get In Touch With Rehab 4 Alcoholism

Two women hugging

If you have more concerns about the mixing of codeine and alcohol or simply have questions about getting addiction support, reach out to us at Rehab 4 Alcoholism.

Our team are waiting to offer you the advice and information to help you start your road to recovery. If you need us, don’t hesitate to give us a call at 0800 111 4108.


[1] https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173639/

[3] https://adf.org.au/insights/why-do-people-use-alcohol-and-other-drugs/

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