Codeine and Alcohol: What Are the Dangers?

If you have been prescribed codeine to treat an injury or chronic pain, you might not be aware that it shouldn’t be mixed with alcohol. 

Codeine and alcohol are both central nervous system depressants, so combining them will exaggerate the effects of both. Both alcohol and codeine are also addictive, a risk that may increase if you take them together. 

In this article, we will take a look at the health risks associated with mixing alcohol and codeine, how the two affect the body, and why combining them could lead to addiction. We’ll also look at what you should do if you have taken them together and how to treat dependence on alcohol and codeine. 

Codeine & Alcohol Summary

  • Codeine is one of the most common opioid narcotics in the world and is used to treat injuries and chronic pain
  • Alcohol is one of the most used drugs in the world 
  • Both codeine and alcohol are addictive
  • Mixing codeine and alcohol can result in a range of side effects including headaches, memory loss, and poor judgement. 
  • Long-term, mixing codeine and alcohol can lead to liver damage, depression, and immune system problems. 
  • Mixing codeine and alcohol can also put you at greater risk of experiencing addiction, overdose, and death 
  • Warning signs of addiction include losing interest in hobbies, prioritising codeine and alcohol over everything else, and experiencing cravings and withdrawal symptoms
  • If you have mixed codeine and alcohol and are experiencing symptoms it’s important to get medical help right away 
  • To beat a codeine and alcohol addiction you will need to go through a medical detox
  • After you have detoxed, treatment options include support groups and therapy as either an inpatient or an outpatient

Mixing Codeine & Alcohol — Side Effects & Risks 

Codeine, one of the most commonly used opioid narcotics in the world, is used to help with pain following operations, and injuries and to treat chronic pain where other forms of medication no longer work. 

It is usually prescribed in tablet form, though it is available as a cough syrup to treat coughs too. Codeine is a short-acting analgesic and after taking it, in most cases, the effects will wear off after a few hours. 

It works in the central nervous system and brain and stops them from passing on pain signals. Along with dulling or stopping the pain, it can also reduce the stress and anxiety associated with severe or long-lasting paint. 

Codeine can be helpful in certain situations, but it is worth remembering that it is an addictive drug. While you are taking it on prescription, it’s vital that you only take as much as you have been prescribed by your doctor. If you take more of it or take it more frequently, you could suffer a range of side effects and even accidentally overdose. In certain cases this can be fatal; codeine-related deaths have increased by almost 25% in 2021, reaching a record high. 

Meanwhile, alcohol is among one of the most used drugs around the world, largely because of its availability, the fact it’s legal, and the important role it plays in many cultures around the world. Despite its popularity, it is associated with a range of negative health outcomes and, like codeine, also has the capacity for addiction. 

Because of its ubiquitous nature, many people end up drinking while taking codeine despite warnings not to. Unfortunately, this is not a good idea. Not only are they both addictive, but when combined together the effects of each become even more pronounced. 

Effects & Dangers of Combining Codeine & Alcohol 

Alcohol is commonly consumed here in the UK. The research found that 24% of adults in England and Scotland regularly drink over the low-risk guidelines and in England, there are around 602,391 dependent drinkers (82% of whom are not currently in treatment). 

Codeine is also a commonly used painkiller in the UK. It is widely accessible; it is one of the most commonly prescribed opioids and can be bought over the counter in lower doses. 

Considering how common both codeine and alcohol are, it is not surprising that sometimes they are mixed together. This may be done unintentionally or deliberately, in order to create a specific high. 

Due to the manner in which each substance affects the brain, the high or intoxication that is experienced when combining them is more intense than when using just one. Codeine lowers the user’s perception of pain while increasing feelings of pleasure. 

When combined with alcohol, this feeling is exacerbated which can feel enjoyable and even euphoric. However, codeine is not meant to be consumed in large quantities or combined with alcohol, and doing so can cause a number of issues especially if this abuse takes place over a long time period. While mixing the two can create a high, it can also be quite unpleasant. Codeine is an opiate, and both codeine and alcohol are depressants, so taking them together emphasises the depressant and sedative effects of both.

Whether combined intentionally or not, it is not a good idea to mix the two. Consuming alcohol while taking codeine, particularly if you have a prescription strength form, can cause a number of unpleasant health issues. Combining codeine and alcohol could cause the following side effects:

  • Dizziness 
  • Drowsiness 
  • Lightheaded
  • Headaches 
  • Fainting 
  • Lethargy and fatigue 
  • Euphoria 
  • Agitation 
  • Poor concentration 
  • Poor coordination 
  • Poor judgement 
  • Delayed reaction 
  • Memory loss 
  • Nausea
  • Slowed breathing 
  • Slowed respiratory rate
  • Low blood pressure
  • Reduced inhibitions

In some cases, it can also lead to coma, brain injury, and death. 

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How Does Codeine & Alcohol Affect the Body? 

Codeine is an opioid, so part of its effect is to lower the perception of pain while increasing feelings of pleasure. When taken with alcohol, these effects can become exaggerated. 

This is because although they work in different areas of the brain, codeine binds to opioid receptors and alcohol affects the GABA receptors – both drugs meddle with your neurotransmitters, including dopamine and serotonin.

These neurotransmitters impact your mood, so it makes sense that when they are more available the person will feel happier. Unfortunately, as the effects wear off, the sudden reduction in these neurotransmitters can actually make you feel worse and you may experience depression. 

This can lead to your reward system, which is fuelled by dopamine, wanting you to replicate the same feelings again, which can lead to you seeking out more codeine and alcohol. Over time, this can lead to addiction. Once addicted, you will need more of the substances to experience the same initial pleasurable feelings, and eventually, simply to function. 

In the long term, abusing codeine and alcohol could result in the following health issues: 

  • Liver damage
  • Kidney damage
  • Heightened sensitivity to pain
  • Acute pancreatitis
  • Depression 
  • Muscle spasms 
  • Respiratory depression
  • Nerve damage 
  • Immune system problems 
  • Coma
  • Seizure
  • Death

One of the most major and potentially fatal effects of mixing codeine with alcohol is the risk of severe respiratory depression that can happen. This causes irregular breathing, which limits the amount of oxygen that gets to your brain. Starved of oxygen, this can cause long-term damage to major organs and can result in death. 

If you become addicted to codeine and alcohol you will also be at greater risk of overdosing. This can leave you with life-limiting health complications. Signs of a codeine overdose include: 

  1. Blue lips 
  2. Muscle weakness
  3. Clammy skin
  4. Breathlessness 
  5. Lethargy 
  6. Small pupils
  7. Slow pulse
  8. Low blood pressure
  9. Itching
  10. Stomach pain 
  11. Slurring 
  12. Nausea
  13. Drowsiness
  14. Unconsciousness
  15. Coma

Overdosing on codeine and alcohol can also be fatal. 

A Slippery Slope?  

Once you understand how both codeine and alcohol work, it’s not difficult to see how an addiction can form without intention. 

Whether you have accidentally mixed codeine and alcohol without realising the dangers of doing so or deliberately mixed them to achieve a specific high, it is easy for this to lead to health problems and potential addiction. 

You can avoid ending up with addiction by staying vigilant to the early warning signs of an addiction, which may include: 

  • Losing interest in other activities 
  • Apathy
  • Difficulty experiencing contentment 
  • Being secretive about codeine and alcohol use  
  • Cravings 

If these early warning signs are not addressed through treatment, the addiction will become more entrenched. This could look like this: 

  • Prioritising codeine and alcohol over the rest of their life 
  • Mixing codeine and alcohol despite experiencing negative health impacts 
  • Becoming defensive about their use 
  • Requiring higher doses 
  • Intense cravings 
  • Withdrawal symptoms

In addition to these signs of serious addiction, you may experience some of the long-term symptoms of codeine and alcohol problems mentioned earlier, such as depression, muscle spasms, or seizures. 

If you notice the early warning signs, it is easier to get a handle on the situation. However even if you’re in the later stages of addiction, it’s important to remember that it is never too late to get help. 

With the right support in place, it is possible to overcome an addiction to codeine and alcohol. 

What Should You Do If You Have to Take Codeine & Alcohol 

If you have a prescription for codeine, it’s important to read all of the literature that comes with it and speak with your healthcare provider about any queries. If you have any questions, please call our 24-hour Helpline.

  • If You Have Unintentionally Mixed a Small Amount of Alcohol With Codeine

    If you have been prescribed codeine for a condition or injury, you may not have been aware that you aren’t supposed to consume alcohol for the duration of the time you’re on codeine. Or perhaps you thought that the codeine was out of your system, so had a glass of beer or wine.

    In this situation, the main thing to do is stay calm and reassure yourself. Unless you are experiencing systems, you should be OK. In this scenario, monitor yourself for any symptoms, and if you experience any contact medical help immediately.

  • If You Have Mixed Codeine and Alcohol on a Few Occasions

    Perhaps you have accidentally been combining codeine and alcohol for a while, without realising that doing so can cause damage to your health. If this is you, again, monitor yourself for any symptoms and get help at the first sign of any.

    It’s also important to stop mixing codeine and alcohol altogether going forward. If you find this difficult, you may have developed tolerance or addiction and you may need to undergo a detox.

  • If You Mix Codeine and Alcohol Frequently

    If you are intentionally combining codeine and alcohol because you enjoy the sensations it produces, you need to come to terms with the fact that you may be facing an addiction. While the feelings created from mixing these two substances together might be fleetingly enjoyable, you are putting your health at risk by doing so.

  • If You Have Mixed Codeine and Alcohol and Are Experiencing Symptoms

    If you are experiencing any of the side effects outlined in the overdose section above, it’s important to call 999 and seek urgent medical care.

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What Is The Safest Way to Treat Alcohol & Codeine Dependence? 

If you have developed a dependence on alcohol and codeine, this means you have a physical dependence on the combined substances. This means that you’ve developed tolerance and will experience withdrawal if you try to stop. While you might have a physical dependence without being addicted, addiction usually quickly follows dependence. 

Addiction is hallmarked by biochemical changes in the brain which make the substance the main priority for the person experiencing addiction. This is in spite of any negative health impacts they are experiencing. It’s often easier and quicker to form an addiction when you’re using more than one substance, as is the case with a codeine and alcohol addiction. 

Because codeine and alcohol both work in a similar way, when they’re used together for a while you will develop a cross-tolerance to them. 

If you’re currently dealing with multiple addictions, like an addiction to both codeine and alcohol, it is likely that you would benefit from a nuanced treatment program. This might feature treatment to tackle both addictions and their underlying causes, along with any other mental or physical health issues. Treatment options can include: 

Codeine & Alcohol Detox 

The first step to beating your codeine and alcohol addiction will involve detoxing from both substances. To do this, you’ll gradually reduce the doses of both as this is both safer and easier to tolerate. Throughout the withdrawal process, your symptoms can be managed with medication and experienced staff who can help guide you through the process. Because of the intensity of this, medical detox is best done in a professional, clinical treatment centre like Castle Craig.


Detoxing from alcohol and codeine is the first step. Once it is out of your system, you will need to understand the underlying causes of your addiction. This will help you come to terms with these issues, develop healthy coping mechanisms, and ultimately avoid relapsing.

Doing all of this as an inpatient at a residential treatment centre has numerous benefits, not least because it removes you from the environment where the addiction started and takes any triggers away. You will also have 24/7 access to support, along with a range of treatment options including therapy, support groups, and holistic treatments.


Attending a treatment centre as an inpatient is not always viable for everyone, so attending as an outpatient can be a good backup option. You can access the same treatment but will remain based at home. Because it is less intensive, this form of treatment is usually longer and can last several months or up to a year.

If you think outpatient treatment is right for you then check out our sister clinic CATCH Recovery for online or in-person outpatient addiction treatment.

Support Groups 

Once you have detoxed and begun to understand where your addiction has come from, a support group can be a very useful setting. You can hear from people going through similar experiences and learn how they have maintained sobriety.


During therapy, you will work with a mental health professional to better understand the issues that led to your addiction and develop some coping mechanisms to help you avoid resorting back to this destructive behaviour in the future.

Codeine &  Alcohol FAQs

  • Can You Drink Alcohol With Ibuprofen and Codeine?

    You should avoid drinking alcohol when you are taking any medication with codeine in it. Both substances are central nervous system depressants that can cause brain fog, impaired judgement and poor coordination.

  • Can I Have Alcohol With Tylenol With Codeine?

    If you are taking any medication that has codeine in it, avoid drinking alcohol for the duration. Both codeine and alcohol are central nervous system depressants that can cause issues like fatigue, dizziness and delayed reactions.

  • What Medication Can You Not Drink Alcohol With?

    You should avoid alcohol with many medications, including codeine. If in doubt, read the literature that came with your medication or contact your healthcare provider.


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