What Is A Lethal Dose Of Codeine?

Codeine is an opiate drug that can be lethal when taken in very high doses, or when mixed with other drugs, including other opioids, benzodiazepines, or alcohol. Codeine is commonly prescribed to treat pain. According to the U.S. Food and Drug Administration (FDA), the lethal dose of codeine is 0.5 to 1 gram, or 500 to 1000 milligrams (mg).

Learn more about the lethal doses of commonly abused drugs.

Determining The Lethal Dose Of Codeine

Codeine is a prescription pain medication that belongs to a class of drugs called opioids, which are derived from the opium poppy plant. While codeine is considered one of the weaker opioids and is often used for mild to moderate pain or cough suppression, it can still be dangerous when taken in large amounts or by people who are sensitive to its effects. Codeine can begin to have toxic effects after 240 mg in the average person. Toxicity, also known as overdose or drug poisoning, can be lethal or non-lethal and may have lasting effects on health.

Codeine is prescribed in the following doses in tablet form:

• 15 mg
• 30 mg
• 60 mg

Codeine is listed as an ingredient in several medications, including Tylenol with codeine, and prescription cough syrups. To put the toxic level in perspective, a person would need to take the equivalent of eight 30 mg tablets or sixteen 15 mg tablets to reach the potentially dangerous 240 mg level. However, individual tolerance varies, and people with certain genetic factors, liver problems, or those taking other medications may experience toxic effects at much lower doses.

How Common Are Overdose Deaths Involving Codeine?

Opioid drugs remain a major factor in fatal overdoses across the United States, though the recent trend shows encouraging decreases in overall opioid-related deaths. Recent data from the Centers for Disease Control and Prevention (CDC) shows drug overdose deaths involving prescription opioids declined from 17,029 in 2017 to 13,026 in 2023, indicating that commonly prescribed opioids are no longer driving the overdose epidemic.

Codeine falls into the category of natural and semi-synthetic opioids, which includes drugs like morphine, oxycodone, and hydrocodone, and this category saw its death rate decrease from 4.0 per 100,000 people in 2021 to 3.5 per 100,000 in 2022. While approximately 105,000 people died from drug overdose in 2023 and nearly 80,000 of those deaths involved opioids, the majority of these deaths now involve illicitly manufactured fentanyl.

Risk Factors For Fatal Codeine Overdose

Certain biological and personal factors can increase the risk of experiencing life-threatening codeine overdose. Below are some of the factors that may increase risk for fatal overdose.

You may be at increased risk for fatal overdose if you:

• are a child
• are an older adult
• take codeine in ways other than prescribed
• take very high doses of codeine
• drink alcohol while taking codeine
• take codeine with other drugs
• have impaired liver or kidney function
• have recently completed opioid detox

The best way to prevent codeine overdose is to take codeine exactly as directed by a doctor. Use of codeine without a prescription may be a sign of drug abuse or addiction.

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Recognizing A Codeine Overdose

Codeine overdose can be fatal if an excessive amount of codeine has been ingested and symptoms are left untreated. Knowing the signs of an overdose can be life-saving. These warning signs can develop quickly and require immediate medical attention.

Signs and symptoms of codeine overdose include:

• very slow, shallow, or stopped breathing
• being awake but not able to talk
• unresponsiveness
• vomiting
• bluish or ashen skin
• bluish-purple fingernails and lips
• choking or gurgling sounds
• weak pulse
• limp body
• unconsciousness

Codeine overdose can be reversed with the quick administration of naloxone (Narcan), a drug FDA-approved to treat opioid overdose. Getting emergency medical help immediately is critical for the person’s survival. Even if naloxone is given, professional medical care is still necessary because codeine’s effects can last longer than the medication.

Treatment For Codeine Addiction

Codeine is an opioid, and like other drugs in its class, it can cause physical dependence and addiction with regular misuse. Because stopping codeine abruptly after prolonged use can trigger uncomfortable withdrawal symptoms, a medically supervised detox program is often the recommended first step for those looking to stop using the drug. Within a detox program, healthcare professionals can monitor withdrawal symptoms, provide supportive care, and in some cases use medications to ease the process and reduce the risk of complications.

Following detox, continued treatment through an inpatient or outpatient rehab program is recommended to address the underlying causes of addiction. Treatment options may include medication-assisted treatment (MAT), cognitive behavioral therapy (CBT), group counseling, and dual diagnosis care for those dealing with a co-occurring mental health condition. Aftercare planning can also play an important role in maintaining sobriety.

Written by the Addiction Resource Editorial Staff