BACKGROUND General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. OBJECTIVES To investigate the perspectives of addiction treatment providers regarding treatme...

Sir, Codeine phosphate is a popular drug of abuse and is commonly taken in preparations combined with either aspirin or paracetamol. Preparations containing larger amounts of codeine (30 mg) are especially popular. Opiate tolerance may result in dependent individuals needing to ingest large amounts of these drugs, thus risking potentially fatal paracetamol or aspirin toxicity. A 37-year-old wom...

T hree children died in August 2012 after receiving usual doses of codeine for postoperative pain following a tonsillectomy and/or adenoidectomy (U.S. Food and Drug Administration [FDA], 2013a). Those incidents, combined with a case report of a breast-feeding infant who died in 2005 of an apparent overdose after the mother received a standard dose of codeine for episiotomy pain (Health Sciences...

Background & Aim: Papaver bracteatum Lindl.  (Papaverace) is an important pharmaceutical plant which contains isoqinoline alkaloids. Isoqinoline alkaloids constitute one distinct group of secondary metabolites of the Papaverace family. Codeine and thebaine are important alkaloids of Papaver bracteatum which use widely due to its medicinal properties. Therefore it is...

Endogenous codeine and morphine were identified in rat brain by immunological determination following HPLC. To demonstrate occurrence of a biosynthetic pathway to morphine in mammals similar to that used by the poppy plant, (+)-salutaridine, (-)-thebaine, and (-)-codeine were administered to rats intravenously. These compounds, which are intermediates in the synthesis of morphine in Papaver som...

OBJECTIVE To assess whether codeine and caffeine enhance the analgesic effect of aspirin in post-operative pain. METHOD Systematic overview of the literature and meta-analysis of published randomized controlled trials (RCTs). RESULTS Codeine 60 mg leads to a small increase in the analgesic effect of 650 mg of aspirin when total pain relief score (TOTPAR%) is used as a efficacy end-point. Th...

Narcotic antitussives such as codeine reveal the antitussive effect primarily via the mu-opioid receptor in the central nervous system (CNS). The kappa-opioid receptor also seems to contribute partly to the production of the antitussive effect of the drugs. There is controversy as to whether delta-receptors are involved in promoting an antitussive effect. Peripheral opioid receptors seem to hav...

Codeine is metabolized by the cytochrome P450 2D6 (CYP2D6) to morphine. Codeine is a much weaker agonist at mu opioid receptors than morphine. Therefore, codeine analgesia is highly dependent on CYP2D6 activity. Large prospective studies in the clinical environment do not exist, but it appears reasonable to avoid codeine use in CYP2D6 poor metabolizers (PMs). CYP2D6 metabolizes other opioid ana...