Codeine - Are There Any Medical Reasons for Taking This Substance?

Are There Any Medical Reasons for Taking This Substance?

Codeine-containing medications are usually prescribed to relieve pain or control coughs. Pills containing codeine and other analgesics are typically used for mild to moderate pain that is expected to go away within days or weeks. Cough syrups containing codeine are usually prescribed for dry coughs that keep a patient up at night.

"Tylenol by the Numbers"

People experiencing levels of pain that will not respond to over-the-counter drugs can sometimes receive prescription pain relievers containing various dosages of codeine. Tylenol-brand acetaminophen is one product that contains codeine in its prescription form. These drugs are assigned the numbers one through four to indicate their various strengths. Here's a quick rundown of "Tylenol by the Numbers":

  • Tylenol with Codeine No. 1 (more commonly referred to as Tylenol 1) contains 8 milligrams of codeine and 300 milligrams of acetaminophen.
  • Tylenol with Codeine No. 2 (more commonly referred to as Tylenol 2) contains 15 milligrams of codeine and 300 milligrams of acetaminophen.
  • Tylenol with Codeine No. 3 (more commonly referred to as Tylenol 3) contains 30 milligrams of codeine and 300 milligrams of acetaminophen.
  • Tylenol with Codeine No. 4 (more commonly referred to as Tylenol 4) contains 60 milligrams of codeine and 300 milligrams of acetaminophen.
Tylenol 3 contains codeine and is available by prescription only. Copyright 2002 Thomson MICROMEDEX. All rights reserved.
Tylenol 3 contains codeine and is available by prescription only. Copyright 2002 Thomson MICROMEDEX. All rights reserved.

The brand-name product Fiorinal with Codeine contains aspirin, butalbital (a barbiturate), caffeine (a stimulant), and codeine. This prescription drug is used primarily for relief of migraine headache pain.

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To Cough, or Not to Cough

It is important to note that cough syrups containing codeine can actually be dangerous for patients with certain kinds of respiratory illnesses. Coughing is the body's natural way of clearing fluids out of the lungs and bronchial tubes. Because codeine works on the brain to quiet a cough, users may experience a buildup of unwanted fluids that block their airways. As noted in the journal Pediatrics, "Cough suppression may adversely affect patients … by pooling of secretions, airway obstruction, [and] secondary infection." In other words, patients run the risk of choking on their own secretions, and these secretions may serve as a source of infection that can spread throughout the body. Therefore, cough syrups with codeine are not prescribed for patients with asthma, allergies, cystic fibrosis, or pneumonia.

In the early part of the twentieth century, codeine was commonly prescribed for diarrhea. However, it is rarely used for that purpose anymore. Likewise, the use of codeine-enhanced products for migraine headaches is being phased out with the introduction of more effective non-narcotic medications for migraine pain.

How Effective Is Codeine?

Reports in Chemist & Druggist and the Western Journal of Medicine both cited recent studies comparing codeine-containing and noncodeine-containing pain relievers. The evidence suggests that pain relievers with codeine prove no more effective than plain, over-the-counter analgesics. In addition, "patients receiving codeine were more likely to stop therapy because of side effects," wrote Sanjay Arora and Mel E. Herbert in the Western Journal of Medicine. The researchers went on to state that codeine's pain-relieving powers are largely a "myth."