Codeine
cody · co-codamol · lean ingredient
What does current UK evidence show?
Codeine contributes to the wider opioid mortality and dependence picture. Public sources do not currently establish a new UK-wide illicit-market shift.
Overview
Identity, legal classification, form and pharmacological context
- Drug category
- Opioids · Medicines
- Common names
- cody, co-codamol, lean ingredient
- Typical forms
- Principally tablets, capsules and oral liquids, including combination products containing paracetamol or ibuprofen
- Routes
- Usually swallowed as an oral medicine
- UK legal classification
- Class BClass A if prepared for administration by injection. Codeine is generally Schedule 2, while qualifying low-strength preparations may be Schedule 5; medicine schedules are distinct from MDA class.Check government source ↗
- Concise pharmacology
- Acts primarily at opioid receptors, producing analgesia, sedation and respiratory depression.
Main harms
Concise clinical and polydrug picture
Reduced consciousness and slowed or stopped breathing are the principal overdose risks.
Dependence, constipation, endocrine effects and repeated overdose risk can develop.
Withdrawal can include agitation, pain, diarrhoea, vomiting, insomnia and intense craving.
Benzodiazepines, alcohol, gabapentinoids and other sedatives increase respiratory-depression risk.
Taking more than directed can cause opioid toxicity; combination products can also cause severe paracetamol or ibuprofen harm.
Current intelligence status
Assessment, confidence and direction
Codeine contributes to the wider opioid mortality and dependence picture. Public sources do not currently establish a new UK-wide illicit-market shift.
Reason: Credible but partial sources support a constrained assessment; the direction or reach cannot be generalised across the UK.
Principal source limits: Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation. Treatment contact reflects recorded service need and access in England, not population prevalence.
Geography and reference periods are given in each linked source card below. The rating is an editorial evidence judgement, not a probability, clinical risk score or TD priority.The assessment reflects the latest linked evidence and is not a universal severity rating.
Operational implications
Evidence-supported prompts for professional response
Include medicine sources, combination-product toxicity and dependence in assessment rather than focusing only on illicit opioids.
Record substance, sold identity, route, frequency and combinations; review overdose and withdrawal needs.
Prioritise airway and breathing, give naloxone for suspected opioid overdose and continue supportive care.
Triangulate treatment, mortality, testing, hospital and frontline evidence before assigning a local trend.
Related intelligence
Continue into connected platform evidence
Sources & limitations
Direct evidence links, reference periods and status
Deaths related to drug poisoning in England and Wales: 2025 registrations
Published4 Nov 2026Reference period2025 registrations; 2024 occurrences
Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation.Adult substance misuse treatment statistics
Published04 Dec 2025Reference periodEngland · 2024–25
Treatment contact reflects recorded service need and access in England, not population prevalence.Codeine: a medicine for pain
PublishedCurrent online guidanceReference periodMedicine use, side effects and stopping
Product and patient circumstances determine appropriate dosing and tapering.