Codeine vs Hydrocodone: Effects, Risks & Treatment for Opioid Addiction

Understanding Codeine vs Hydrocodone

What Is Codeine?

Codeine is an analgesic prescription opioid derived from poppy plants. 

It is one of many prescription-controlled substances that relieve pain without causing users to lose consciousness.

How Is Codeine Prescribed?

Coedine is prescribed by a healthcare provider who follows strict legal guidelines. 

It is commonly prescribed for short-term mild or moderate pain relief or cough suppression.

What Are Common Brand Names and Combinations Containing Codeine?

Codeine is rarely prescribed as a standalone medication and is instead found in combination with other products and pain relievers such as acetaminophen, chlorpheniramine, aspirin, and guaifenesin.

Common brand names for formulations containing codeine include:

• Robitussin-AC
• Empirin with Codeine
• Tylenol with Codeine

What Is Hydrocodone?

Hydrocodone is an analgesic opioid pain medication used to treat more severe pain. 

It is a semi-synthetic opioid.

Hydrocodone is an FDA Schedule II controlled substance, meaning that it carries a higher risk of physical dependence and substance abuse.

How Is Hydrocodone Prescribed?

Hydrocodone is prescribed by a medical professional and is one of multiple prescription opioids used to treat severe pain. 

It can be prescribed as an immediate-release or an extended-release, depending on the patient’s unique needs.

What Are Common Brand Names and Combinations Containing Hydrocodone?

Similar to codeine, hydrocodone is prescribed combined with other drugs, such as acetaminophen, antihistamines, and non-steroidal anti-inflammatory drugs (NSAIDs).

Common brand names for hydrocodone combinations include:

• Norco
• Vicodin
• Vicoprofen (ibuprofen and hydrocodone)
• Azdone (aspirin and hydrocodone)

Hydrocodone is also prescribed in a pure form with extended-release, brand names include Hysingla ER and Zohydro ER.

Is Codeine as Strong as Hydrocodone?

No, hydrocodone is significantly stronger than codeine. 

Hydrocodone is a partially synthetic opioid that is derived from codeine and is approximately six times stronger than codeine. Due to its potency as a stronger opioid, it has a high potential for abuse and addiction.

Effects on the Brain and Body

How Do Codeine and Hydrocodone Act on Opioid Receptors?

Both codeine and hydrocodone act on opioid receptors as full agonists. 

Full agonists bind completely to a receptor. Hydrocodone and codeine specifically impact the nervous system and alter how the brain perceives pain. As a result, both drugs are analgesics, blocking pain while an individual remains conscious.

How Does Each Drug Affect the Central Nervous System?

Codeine and hydrocodone bind to receptors in the brain and spinal cord that dampen or depress communication between brain cells.

Both drugs act on the same receptors, but hydrocodone decreases activity more intensely compared to codeine because it binds more tightly to receptors.

Impacts of decreased communication include reduced pain, cough suppression, respiratory depression, drowsiness, sedation, and euphoria. Additionally, both drugs can cause nausea or vomiting.

Do These Drugs Affect Respiratory Function and Risk of Respiratory Depression?

Yes, these drugs cause respiratory depression. 

The respiratory control centers in the brain are affected by both codeine and hydrocodone, causing a person’s breathing rate to decrease.

Is Codeine More Euphoric Than Hydrocodone?

No, hydrocodone is more powerful.

As a stronger opiate, hydrocodone causes more intense effects, including more euphoria, when compared to codeine.

Short-Term Side Effects: Codeine vs Hydrocodone

What Are Common Short-Term Side Effects of Codeine?

The most common short-term side effects of codeine include nausea, vomiting, constipation, lightheadedness, and dizziness. 

Because codeine slows the nervous system, these side effects often occur quickly.

What Are Common Short-Term Side Effects of Hydrocodone?

Short-term side effects of hydrocodone include dry mouth, severe nausea, vomiting, and severe constipation.

Hydrocodone is a stronger opioid and therefore causes more severe side effects.

Additional side effects include sedation, dizziness, muscle weakness, and headaches. Due to hydrocodone’s suppression of the nervous system, it can also cause severe respiratory depression.

How Do Drug Interactions Increase Risk?

When an individual takes multiple drugs, it increases the risk of severe side effects by causing an additive effect or interrupting drug metabolism.

If an individual takes multiple drugs that bind to the same receptors or to receptors in the same part of the brain, this amplifies the effects and makes it difficult for the brain to monitor and balance activity.

For example, opioid pain medications taken alongside benzodiazepines, like Xanax, greatly increase the risk of severe side effects.

Additionally, certain drugs alter how other drugs are metabolized, causing the body to be unable to break down and clear the opioid out of a person’s system. This causes an accumulation, leading to a toxic level and an increased risk of an overdose.

Long-Term Side Effects of Codeine vs Hydrocodone

What Are the Chronic Health Risks Associated With Long-Term Use?

Long-term use of codeine or hydrocodone changes the structures in the body and brain, increasing the risk of addiction, hormonal disruption, mental health conditions, and organ and gastrointestinal problems. 

Both codeine and hydrocodone interact with multiple systems in the body. Long-term use of opioid painkillers causes changes to these systems, often structural and functional changes that do not go away after ceasing use of the medication.

How Do Long-Term Effects Differ Between Codeine And Hydrocodone?

While codeine and hydrocodone can both cause severe chronic health issues, hydrocodone is significantly more potent, causing a higher risk of severe long-term side effects.

Additionally, the increased severity of hydrocodone increases toxicity, which increases the risk of liver strain and addiction.

Can Prolonged Use Cause Hormonal or Cognitive Changes?

Yes, long-term use of either hydrocodone or codeine can cause hormonal and cognitive changes. 

Due to the direct impact on the brain, prolonged use impacts the release and balance of hormones in the body, resulting in long-term hormonal imbalances.

Additionally, prolonged use causes volume loss in the brain and decreases connections between brain cells, reducing cognitive capacity. Common cognitive changes include memory degradation, decreased attention, brain fog, and desensitization to pleasure.

Signs of a Developing Addiction

What Behavioral Signs Indicate Emerging Opioid Addiction?

Behavioral signs of opioid addiction include isolation, secretive behaviors, unexplained financial challenges, and drug-seeking behaviors. 

When an individual is struggling with an opioid addiction, they commonly want to stop using but are unable to do so. This results in secretive behavior, isolation, and strain on individuals and their loved ones.

What Physical and Psychological Symptoms Signal Dependence?

Physical and psychological signs of opioid dependence include sedation, flu-like symptoms, mood swings, and neglect of important obligations. 

Due to the impact of opioids, dependence is commonly seen through the oscillation that occurs when someone is using or not using a drug.

When they are dependent, they experience withdrawal symptoms, which result in anxiety, depression, and aggression. However, as they use the substance again, they will show physical and psychological changes such as increased euphoria.

When Should a Healthcare Provider Be Notified About Problematic Use?

If you believe you have a problem with drugs, it is important to contact a healthcare provider.

Working with a healthcare provider at a recovery center is the best way to resolve substance abuse and dependence.

If you or your loved one is struggling with opioid abuse or dependence, early intervention is important. Seeking medical advice can help you know what kind of addiction treatment to seek.

Overdose Risks of Codeine vs Hydrocodone

How Do Overdose Signs Differ Between Codeine and Hydrocodone?

While many overdose signs are similar between codeine and hydrocodone, hydrocodone is faster acting, causing a rapid escalation. 

Signs of overdose with hydrocodone include cold, clammy skin, skeletal muscle twitching, and seizures. Alternatively, signs of a codeine overdose include flushing, hives, respiratory depression, and acute renal retention.

Which Factors Increase Overdose Risk With These Opioids?

Usage habits, physical health, genetic traits, and the interplay between substances impact the risk of an overdose. 

Individuals who use more volume and frequency are at a higher risk of overdose. Certain individuals are more at risk for an overdose due to genetics or other health issues that impact their body’s capacity to metabolize either opioid. The use of other substances, such as other depressants or stimulants, also greatly increases the risk of overdose.

When Should a Person Seek Emergency Care for Suspected Overdose?

If any sign of potential overdose is present, it’s imperative to seek emergency care right away.

Seeking emergency care early is important. If you suspect that you or someone you love is overdosing, early medical attention can protect you from long-term damage caused by an overdose.

Understanding Withdrawal Symptoms: Codeine vs Hydrocodone

What Are Typical Withdrawal Symptoms for Codeine?

Typical withdrawal symptoms from codeine include a runny nose, fever, chills, sweating, and muscle aches.

Additional withdrawal symptoms include anxiety, gastrointestinal irritation, and irritability.

What Are Typical Withdrawal Symptoms for Hydrocodone?

Hydrocodone withdrawal symptoms typically include hot and cold flushes, sweating, shaking, and disrupted sleep.

Similar to codeine withdrawal, flu-like symptoms such as a runny nose, fever, chills, sweating, and muscle aches are also common.

How Long Do Withdrawal Symptoms Usually Last?

Initial symptoms last for a few days, generally dissipating after a couple of weeks. 

However, cravings and psychological opioid withdrawal symptoms commonly continue for months or longer.

Finding Treatment for Opioid Addiction

What Is the Role of Medically Supervised Detox in Opioid Treatment?

Medically supervised detox allows individuals to go through the withdrawal process after ceasing opioid use with the support of medical supervision. 

While many experience mild withdrawal symptoms, opioid withdrawal can sometimes be severe. Medically supervised detox protects individuals from short-term and long-term complications related to more severe complications.

When offered as a precursor to other treatment options, medically supervised detox acts as the first step of addiction treatment and long-term recovery.

How Does Medication-Assisted Treatment Help in Treating Opioid Addiction?

Medication-assisted treatment (MAT) is a treatment option that utilizes medication to support recovery from opioid addiction. 

MAT is the use of FDA-approved medication to manage withdrawal symptoms and cravings and is commonly used in medically supervised detox. Antidepressants and other medications can also be used to treat co-occurring mental health disorders during treatment.

At Wellbridge, we offer innovative and evidence-based treatments, including MAT. The withdrawal experience varies for each person, and we offer flexible care that addresses each individual’s unique needs.

What Evidence-Based Therapies Support Recovery?

Evidence-based therapies for opioid addiction commonly include MAT, behavioral therapies, and psychoeducation. 

At Wellbridge, we offer a blend of evidence-based therapies and holistic treatments, incorporating both into each individual’s opioid treatment program.

Our treatment programs rely on research-backed therapies, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), that help individuals build skills to support long-term recovery and wellness.

What Are the Levels of Care Available?

Wellbridge offers detox and residential treatment for opioid addiction. 

Detox and residential care are the most common levels of care for opioid addiction treatment, including treatment for codeine, hydrocodone, and oxycodone. We also provide referrals for ongoing care through outpatient programs.

How Do Providers Determine the Right Level of Treatment for an Individual?

Prescribers consider the individual’s need for support, immediate risk of health and safety challenges, available support at home, and ability to engage in care.

At Wellbridge, we offer a thorough assessment process to ensure every individual receives the right level of care and support. We know that each patient has a unique set of needs, and we provide a structured entrance process that helps each individual receive care that provides lasting results.

Helping Loved Ones Following Treatment

How Can Family Members Support Recovery and Prevent Relapse?

Family support is extremely important in preventing relapse and supporting the recovery process.

We offer a comprehensive family program and encourage family involvement in treatment. Family members can engage in treatment through psychoeducation, which helps them learn more about addiction and co-occurring disorders that their loved one is struggling with.

Additionally, family programs can incorporate family therapy to supplement the treatment program as a whole.

What Are Practical Steps for Managing Medication Safety at Home?

Managing medication safely at home involves working with a healthcare provider who can provide ongoing check-ins and structure.

At home, medication storage systems, medication security, and proper disposal help support the safe use of medications. Maintaining an inventory of medications at home and organizing them in a pill organizer and/or a locked cabinet can also help ensure that no one in the household abuses medication.

When Should Loved Ones Seek Professional Support or Family Therapy?

If your mental health is affected by your loved one’s addiction, professional support and family therapy can help you develop coping skills, boundaries, and effective communication skills.

FAQs

How much codeine is in Tylenol 3 vs hydrocodone?

Tylenol 3 contains codeine phosphate and does not contain hydrocodone. 

Combinations that contain hydrocodone include Vicodin or Norco.

Can I take codeine and hydrocodone together?

No, codeine and hydrocodone should never be taken together. 

Both medications impact the nervous system, causing communication to slow down. Taking both drugs simultaneously will have a compounding effect.

Major medical risks of taking codeine and hydrocodone together include severe respiratory depression, sedation, liver failure, cardiovascular strain, and overdose.

How much codeine is equal to hydrocodone?

Hydrocodone is significantly stronger, meaning that taking less hydrocodone by weight creates a similar level of pain relief.

It is estimated that hydrocodone is about six times stronger than codeine.

Working with a medical professional is the best way to ensure that an individual receives the proper medication at the right dose for their unique needs.

Why do doctors not like prescribing codeine?

Many doctors prefer to prescribe a different medication due to the effects of codeine being unpredictable. 

Due to its unpredictable effects and its strict therapeutic maximum that doctors can prescribe, many doctors prefer alternatives. There are many safer and more predictable alternatives available, causing many doctors to steer away from prescribing codeine in most cases.

Can opioids cause anemia?

While anemia is rarely a direct side effect, it can be worsened by opioids. 

Chronic opioid use or abuse impacts multiple systems in the body and can indirectly cause anemia or worsen it. Indirect causes of anemia include gastrointestinal bleeding, malnutrition, and immune suppression.

Additionally, illicit opioids are often contaminated by heavy metals or other substances that can increase the risk of developing anemia.

Anemia symptoms include fatigue, muscle weakness, shortness of breath, pale skin, cold extremities, and dizziness.

At Wellbridge, we understand the challenges associated with opioid addiction. We offer a unique blend of evidence-based treatments and holistic care, offering care for adults, including specialized programs for first responders and healthcare workers. Our treatment programs offer individualized care on Long Island, NY. If you or someone you love is struggling with an opioid addiction, do not wait to seek help.