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If you are on medication such as codeine, you might be wondering, ‘Can you mix codeine and alcohol?’. This may certainly be a concern as both codeine and alcohol use are very widespread in the UK. A recent study found that, in 2017/2018, 12.8% of the adult population in England were prescribed opioids – many of which would have contained codeine. 

Products containing low levels of codeine can also be obtained over the counter without a prescription, although there should be a consultation with a pharmacist. At the same time, the misuse of opioids including codeine has risen, although it is not at the same ‘epidemic’ levels as those described in the USA.

There is also a widespread ‘drinking culture’ in the UK. 24% of adults in England and Scotland regularly drink over the Chief Medical Officer’s low-risk guidelines, while 27% of drinkers in Great Britain binge drink on their heaviest drinking days. If you are a drinker who is using codeine – whether legitimately or not – it is important to understand the interactions and potential risks of mixing codeine and alcohol.

What is Codeine?

Codeine is a strong painkiller from the group of drugs known as opiates, or sometimes opioids. As with other opiates, it works by affecting the central nervous system and brain to block pain signals to the rest of the body. It can also reduce levels of stress and anxiety caused by pain and is frequently used in situations such as following an accident or surgery. It may also be prescribed when other types of painkillers such as paracetamol or ibuprofen are not effective.

Codeine has a number of known potential side effects, including:

  • Constipation
  • Nausea or vomiting
  • Sleepiness
  • Confusion
  • Dizziness and vertigo
  • Dry mouth
  • Headaches

More serious side effects could include muscle stiffness, low blood pressure and difficulty breathing. It is possible to overdose on codeine and some people can experience a serious allergic reaction known as anaphylaxis.

Codeine can also be addictive. As well as its painkilling properties, the use of the drug can cause pleasurable sensations such as relaxation and euphoria and some people will attempt to seek these out. You can also build up a tolerance to codeine and experience withdrawal symptoms when trying to stop using it – all of which can be factors leading to dependence and addiction.

The Effects of Alcohol on the Body

Alcohol, meanwhile, can also be harmful in its own right, especially when used regularly or in binge-drinking sessions. Alcohol acts as a depressant and short-term effects include depressing a neurotransmitter known as glutamate and increasing another known as GABA. This results in thoughts, movements, and speech becoming impaired during intoxication. The depression of the central nervous system slows down parts of the brain that affect inhibition, thought, perception, attention, judgement, memory, sleep and coordination.

Alcohol has a range of negative effects although the release of dopamine, especially during early to moderate stages of intoxication, can present as enjoyment. Alcohol misuse is the biggest risk factor for death, ill health and disability among 15-49 year-olds in the UK, and the fifth biggest risk factor across all ages. Alcohol is also a causal factor in more than 60 medical conditions, including high blood pressure, cirrhosis of the liver, depression and several types of cancer.

Many of these risks are associated with long-term heavy drinking but even one drinking session can be dangerous. As well as the potential for accidents and risky behaviour while intoxicated, large concentrations of alcohol in the bloodstream can cause users to become ‘woozy’ and they may pass out. A heavy concentration can also depress areas of the brain involved in breathing, causing breathing to slow and even stop entirely. The risks can be even greater when alcohol is mixed with other substances and codeine and alcohol interactions can be very dangerous.

The Danger of Mixing Codeine and Alcohol

There are a number of reasons why people may mix codeine and alcohol together. They might not realise the dangers of mixing codeine and alcohol in the first place. They may downplay or ignore the risks if they are aware that there can be codeine and alcohol side effects. And some people may intentionally mix the two to try and increase the painkilling, euphoric, relaxing or mood-altering effects of both substances.

It is the case that combining opioids with alcohol can increase the effects of the drugs, which can be dangerous. It can affect your coordination and increase the effects of intoxication, leading to more chances of having an accident.

Combining codeine and alcohol can also:

  • Lower your breathing rate
  • Increase the risk of choking on vomit or food
  • Increase the risk of overdose

The risk of a codeine and alcohol overdose can be very serious, as can the issue with breathing. Because alcohol and codeine can both slow breathing, the chances of your breath stopping can be greatly increased when you take both together.

Reasons to Avoid Mixing Codeine with Alcohol

Drinking excessive amounts of alcohol and taking codeine – especially misusing codeine by using it recreationally or taking more than the recommended or prescribed amounts – can both be dangerous even when they are used on their own. According to the charity Drinkaware, acute alcohol poisoning was the cause of 552 deaths in the UK during 2020. In 2021, meanwhile, a total of 2,219 drug poisoning deaths involved opiates – although not all of these will have involved codeine. Many thousands more people have been hospitalised and may have suffered lasting damage from overdose or other ill effects of mixing codeine and alcohol.

If you are seeking help for codeine and alcohol misuse, or any other drug-related issue, there are many sources of help available. Support groups, counselling, and treatment options available through local drug and alcohol services can all be valuable for many people. Another option may be private rehabilitation, which provides a complete recovery programme aimed at tackling every aspect of the addiction.

If you need help, get in contact today for free and confidential advice on what to do next.

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John Gillen - Director & Author at Nova Recovery

John Gillen - Author - Last updated: September 8, 2023

John has travelled extensively around the world, culminating in 19 years’ experience looking at different models. He is the European pioneer of NAD+ (Nicotinamide Adenine Dinucleotide) treatment to Europe in 2010; and recently back from the USA bringing state of the art Virtual Reality Relapse Prevention and stress reduction therapy. His passion extends to other metabolic disturbances and neurodegenerative diseases. The journey continues. In recent times, John has travelled to Russia to study and research into a new therapy photobiomudulation or systemic laser therapy working with NAD+ scientists and the very best of the medical professionals in the UK and the USA, together with Nadcell, Bionad Hospitals own select Doctors, nurses, dieticians and therapists. Johns’ passion continues to endeavour to bring to the UK and Europe new developments with NAD+ Therapy in preventive and restorative medicine and Wellness. In 2017 John Gillen was made a visiting Professor at the John Naisbitt university in Belgrade Serbia.

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