Codeine is in some of the most common painkillers you’ll find in a pharmacy. Solpadeine, Nurofen Plus, and Maxilief are all available over the counter, and each one contains a mild opioid.
They’re so common that most people wouldn’t think twice about taking a codeine medicine and drinking alcohol on the same day.
But codeine and alcohol both slow your body down. When they’re active in your system at the same time, the effects can be serious, even at low doses.
Codeine is in more medicines than most people realise
If you have ever taken Solpadeine for a headache, Maxilief for period pain, or Solpadol, Codipar or Nurofen Plus for back pain – you’ve taken codeine. These products are available behind the counter at most pharmacies across Ireland. But each contains codeine phosphate – a mild to moderate opioid painkiller – in combination with paracetamol, ibuprofen, or caffeine.
Under Irish law, codeine is a controlled drug. Codeine medicines should:
- Only be sold when the pharmacist thinks it’s necessary
- Only be used when other painkillers (like paracetamol, aspirin, and ibuprofen) haven’t worked
- Be used for the shortest time possible,
- Be used for no longer than three days without seeing a doctor
Could you be mixing codeine and alcohol without knowing it?
Combining alcohol and Solpadeine, Codipar and alcohol, or Solpadol and alcohol can have serious and dangerous effects.
But they can be mixed easily without thinking about it.
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What happens in your body when you mix codeine and alcohol?
Codeine and alcohol are both central nervous system depressants. Your central nervous system controls your breathing, heart rate, and consciousness.
Each substance slows these functions on its own, but when they’re in your body at the same time, they amplify each other and can cause:
- Breathing to slow to dangerous levels
- Heart rate to drop
- Memory loss
- In some cases, loss of consciousness and possible death
Doctors call this respiratory depression. It’s a fatal danger of mixing alcohol and codeine.
Even a normal dose of a painkiller with codeine in it, plus a couple of drinks, can be enough. That’s especially true if you don’t drink or take codeine regularly.
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Short-term effects of mixing codeine and alcohol
If you mix codeine and alcohol, the side effects you’re most likely to notice include:
- Drowsiness or extreme tiredness
- Poor coordination and unsteady movement
- Nausea or vomiting
- Difficulty concentrating or thinking clearly
These side effects can come on quickly, sometimes within an hour of taking both substances. They’re easy to put down to tiredness or having had a drink, which is one reason the combination often goes unnoticed.
For most people, these effects pass. But the line between discomfort and a medical emergency isn’t always clear. Knowing what an overdose looks like can potentially save a life.
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Signs of a codeine and alcohol overdose
A codeine and alcohol overdose is a medical emergency. It can happen even when someone hasn’t drunk excessively or taken what they’d consider a large amount of codeine.
Signs of a codeine overdose include:
- Breathing that is slow, shallow, or has stopped
- Bluish colour in the lips or fingernails
- Pinpoint pupils
- Cold, clammy skin
- Loss of consciousness
- Weak pulse or low blood pressure
If you see any of these signs in yourself or someone else, call 112 immediately. Don’t wait to see if they improve.
Naloxone is a medicine that can reverse an opioid overdose. If you or someone you know takes codeine regularly, ask your GP or pharmacist whether naloxone is something you should have access to.
When does mixing codeine and alcohol become a dependence?
You don’t decide to become dependent on codeine and alcohol. You use them together once, and nothing bad happens, so you do it again. Your body gets used to both substances, and you need a little more to feel the same effect. The medical term for this is tolerance, one of the first signs that a pattern is forming.
Codeine works by blocking pain signals in the brain and easing the stress that comes with pain. Once your body gets used to that relief, you can feel uncomfortable or sick when you stop. This is called withdrawal, and it includes restlessness, nausea, anxiety, and muscle aches when you go without codeine or alcohol. These are signs your body has adapted to their presence.
Once dependent, other signs include:
- Using more than you meant to
- Finding it hard to cut down
- Carrying on even when you know it’s causing problems
“It takes more courage to admit, you know, that you’re not as strong as everyone is saying or thinking that you are, and that actually makes you stronger too. That was the difference this time. I was able to just come out and say I need to do this, I want to get my maintenance and all that sort of stuff, and it was part of that just being willing to do whatever it takes.”
Signs that it may be time to speak to someone
You may recognise some of the following in yourself:
- You’re taking codeine more often than you used to
- You find it difficult to have an evening without a drink
- You feel physically unwell when you haven’t taken either one for a while
- People close to you have noticed changes in your behaviour
- You’ve tried to cut down and found you couldn’t
You can read more about alcohol addiction or codeine addiction to understand
How to get help with codeine and alcohol dependence
It can take time to feel ready to get help, but the dangers of codeine and alcohol dependence increase the longer you wait. Whenever you’re ready, there are a number of options.
Your GP can assess your situation and talk through what support might help. It’s often the simplest place to start.
If you’re dependent on both codeine and alcohol, don’t try to stop both without medical supervision.
- Alcohol withdrawal is dangerous, and it’s one of the few substance withdrawals that can have life-threatening symptoms
- Opioid withdrawal isn’t usually life-threatening, but the anxiety and distress that come with it can be serious
At Smarmore Castle, treatment starts with a medically supervised detox, followed by an assessment that covers any co-occurring mental health conditions. Our residential setting takes you away from the environment where the pattern formed.
Find out more about our treatment approach and the cost of rehab at Smarmore Castle.
If someone in your life is mixing codeine and alcohol
If you’re worried about someone else drinking and using codeine, you’re right to take that seriously. But watching someone you know mix codeine and alcohol without realising the risk can be frightening. You may not be sure whether to say something, or how to bring it up without pushing them away.
At Smarmore Castle, we work with families as well as the person in treatment. If you’re not sure where to start, you can contact our team for a confidential conversation about what you’ve seen and what the options are.
- There were 343 drug poisoning deaths recorded in Ireland in 2022.
- Opioids accounted for two in three of those deaths.
- Almost eight in 10 poisonings involved more than one substance.
Source: https://www.drugsandalcohol.ie/deaths-data/
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Frequently asked questions about mixing codeine and alcohol
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How long after taking codeine can I drink alcohol?
Codeine is absorbed quickly, and its effects typically last four to six hours. As a general guide, you should wait until the codeine has fully cleared your system before drinking alcohol. But factors like your weight, liver function, and how regularly you take codeine can affect this. The safest approach is to speak to your GP or pharmacist before mixing the two, especially if you take codeine on a regular basis.
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What is codeine and alcohol sometimes called?
The combination of codeine cough syrup mixed with a soft drink is sometimes called Lean or Purple Drank. The term became widely known through music and popular culture. It carries the same risks as any other combination of codeine and alcohol, including respiratory depression, loss of consciousness, and overdose.
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Can mixing codeine and alcohol make you feel sick?
Yes. Nausea and vomiting are common when codeine and alcohol are taken together. Both substances irritate the stomach and affect the part of the brain that controls nausea. If you experience repeated vomiting after mixing the two, seek medical advice, as this can be an early sign of overdose.
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Is it safe to take Solpadeine, Solpadol, or Codipar with alcohol?
No. All three products contain codeine. Take any of them with alcohol, and the risk of drowsiness, slowed breathing, and overdose goes up. If you’re unsure whether a painkiller you take contains codeine, check the packaging or ask your pharmacist.
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What are the effects of mixing alcohol, codeine, and cocaine?
The effects of mixing alcohol, codeine, and cocaine are unpredictable and very dangerous. Cocaine is a stimulant, while codeine and alcohol are depressants. The combination puts conflicting demands on your heart and breathing, raising the risk of overdose, cardiac arrest, and death.
