Also called cody, sizzurp, syrup

Understanding Codeine

Codeine is a depressant drug which means that it slows down and interferes with the functioning of the brain and the body. Codeine belongs to a group of drugs known as opioids, in itself it has little effect, however in most people it is converted to morphine in the liver which is how it works as a pain reliever. It is a prescription medicine which is prescribed by doctors to help people with pain management. Products containing codeine may be better known by a range of brand or trade names. 

Generic Name                                      Trade Name

Aspirin and codeine                          Codral Cold & Flu Original®, Aspalgin®

Ibuprofen and codeine                    Nurofen Plus®

Paracetamol and                                 Panadeine Forte®, Panamax Co®

Paracetamol, codeine and             Panalgesic®, Mersyndol®, Mersyndol Forte®

What does it look like?

  • Tablets or capsules
  • Soluble powders
  • Liquids
How is it used?
  • Commonly swallowed
What are the possible short-term effects?

People commonly use codeine for acute or short-term pain management. Some people may also use codeine to feel euphoric, or to feel relaxed. Other short-term effects include:

  • Small pupils
  • Slurred and slow speech
  • Slow breathing
  • Decreased heart rate or palpitations
  • Sweating
  • Cold clammy skin
  • Itchiness
  • Drowsiness
  • Dizziness
  • Confusion
  • Nausea / vomiting
  • Stomach ache
  • Constipation
  • Difficulty urinating

People who inject are at higher risk of additional harms such as:

  • Blood-borne viruses
  • Bacterial and fungal infection
  • Damage to the circulatory system
  • Increased likelihood of overdose

Codeine affects people differently depending on a range of factors including how strong it is, dosage size, whether it is used with other drugs, and the individual characteristics of the person.

What are the possible long-term effects?
  • Constipation
  • Reduced sex drive
  • Irregular periods
  • Ulcers and internal bleeding
  • Liver damage
  • Kidney failure
  • Heart attack
What are the signs of a codeine problem?
  • Spending a great deal of time getting, using, or recovering from the effects 
  • Using in greater amounts, or for longer than originally planned
  • Needing to use more to get the same effect
  • Having cravings, difficulties stopping/reducing use
  • Experiencing withdrawal symptoms
  • Social problems including relationship issues, financial problems, impacts on study or work and legal problems
Thinking about cutting back or stopping?

The best option for people dependent on codeine is opioid treatment which should be discussed with your doctor or local alcohol and drug treatment service. Withdrawal symptoms may be unpleasant, but will lessen over time. Withdrawal symptoms include diarrhoea, stomach and leg cramps, nausea, sweats and chills, increased heart rate, low mood, anxiety, irritability, poor sleep and cravings.

Codeine use and pregnancy

Codeine use may increase the risk of miscarriage, premature delivery, and low birth weight. Regular codeine use throughout pregnancy can cause the new born baby to experience withdrawal symptoms. For people who are concerned about their codeine use while pregnant or breastfeeding, it is important to talk to your doctor or health professional.

What help is available?

Adis 24/7 Alcohol and Drug Support is a 24 hour, 7 day a week confidential support service for people in Queensland with alcohol and other drug concerns, their families and health professionals. 

Talk to us. Anytime, anywhere.

1800 177 833

What should I do in an emergency?

Signs of a codeine overdose may include:

  • Loss of consciousness
  • Very slow breathing and/or gurgling sounds
  • Slow heart rate 
  • Low body temperature
  • Muscle twitching
  • Cold clammy skin
  • Blue lips and fingertips
  • Skin with a blue-ish tinge
  • Vomiting
  • Confusion
  • Drowsiness

If a person has overdosed on codeine call an ambulance on triple zero (000) and if available administer naloxone. If they have stopped breathing commence CPR. If they are breathing normally, place them into the recovery position and wait with the person until the ambulance has arrived.


Naloxone is a drug that can reverse an opioid overdose. It is short acting, and non-addictive.  A new formulation Nyxoid® is given into one nostril, while Narcan® and Prenoxad® is given by injection into the muscles of the thigh of the overdosed person. It is available as an over the counter medication or via a script from a prescriber. It is recommended that anyone using opioids should have immediate access to naloxone either to be administered to them in the event of an opioid overdose or to administer to another person who has overdosed.

For more information about naloxone speak to your doctor, local needle and syringe program or contact Adis on 1800 177 833.

Adis - Understanding Codeine Fact Sheet

Adis fact sheet about codeine, also known as cody, sizzurp, syrup.

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