Codeine: Ingestion methods

Last modified: Thursday, 25. December 2008 - 10:22 am

Codeine-containing medications are most often taken orally, either in tablet form or as syrup (also called “elixir”). Codeine may also be given by intramuscular (DVI) injection. Intravenous codeine administration is not used because of the risk of causing dangerously low blood pressure (hypotension). Codeine suppositories are given rectally, but usually only in infants and children who have had surgery.

It is difficult, but possible, to extract the codeine from tablet and syrup preparations. This is usually done by people who wish to abuse codeine and need higher doses than could be safely taken when it is combined with other medications. Once extracted, the codeine powder is typically mixed with a liquid of some kind and drunk. Since OTC medicines with codeine contain very small amounts of the drug, large quantities must be purchased in order to be able to extract enough codeine to abuse. This can be expensive and cause suspicion in a single pharmacy.

Codeine is not routinely sold in the United States as an individual drug. It is combined instead with one or more other OTC analgesics or cough suppressants into a single compound medication. Codeine is familiar to most people as an ingredient in a series of analgesic preparations in combination with Tylenol-brand acetaminophen. The number after “Tylenol” designates the amount of codeine in each tablet:

• Tylenol #1 — 8 mg codeine (not marketed in the United States)

• Tylenol #2 — 15 mg codeine

• Tylenol #3 — 30 mg codeine

• Tylenol #4 — 60 mg codeine

All combinations contain 300 mg acetaminophen per tablet. Other pharmaceutical companies produce similar preparations that may have slightly different amounts of acetaminophen, but the number designation and codeine quantity stay constant across brands. Some preparations also include up to 30 mg of caffeine to help counteract drowsiness from the codeine.

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