In England, more than 74 million controlled drugs were prescribed in 2024, with over 25 million of these falling under Schedule 5 drugs, which include codeine, as per data from the Care Quality Commission. Codeine, an opioid drug, acts on the brain and other body parts’ opioid receptors to provide pain relief similar to morphine. The NHS commonly administers codeine for post-surgery or injury-related pain, especially when other painkillers like paracetamol and ibuprofen are ineffective.
Codeine is typically provided through prescriptions in tablet, liquid, or injection forms. Additionally, lower-strength codeine combinations, such as co-codamol with paracetamol or with ibuprofen like in Nurofen Plus, can be purchased over the counter at pharmacies.
While effective in alleviating pain, codeine may cause several side effects, especially with prolonged use. The NHS cautions that more than one in 100 individuals might experience issues like constipation, nausea, confusion, fatigue, dizziness, and headaches.
According to NHS information, the likelihood of side effects increases with higher codeine doses. Some individuals may face more severe reactions, with fewer than one in 100 people possibly developing symptoms like muscle rigidity and signs of low blood pressure, such as dizziness or fatigue.
The duration of codeine use varies depending on the pain relief required. Short-term codeine usage for a few days may reduce the risk of adverse effects. However, for chronic pain, alternative medications might be recommended, especially if adverse effects like constipation arise.
Although constipation can be inconvenient, it is usually temporary, particularly when associated with codeine use. Increasing fiber intake, recommended at 18-21g daily for adults, can aid in bowel movements. Fiber-rich foods can help with this, and additional guidance on codeine usage and boosting fiber intake can be found on the NHS website.