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What are the Pros and Cons of Codeine Cough Syrup?

By Rhonda Rivera
Updated Mar 03, 2024
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Like most medications, codeine cough syrup has a number of pros and cons, but the biggest advantages tend to center on the drug’s potency and effectiveness while the downsides include the potential for abuse and the possibility of serious side effects, particularly in children. Codeine is a powerful ingredient that is derived from the poppy plant, and it’s generally classed as an opiate. Different countries have different drug sale regulations, but codeine-containing medications are widely available in most places. It is popular not only in cough medications but also in a range of painkillers and other drugs. The body is often able to absorb it really quickly when it’s suspended in syrup, which can be an asset when it comes to treating things like sore throat pain or the headaches that commonly accompany a cough. It can also be easy to take too much this way, though, which can cause breathing problems and other health issues; it also opens up the potential for syrups to be used in the manufacture of homemade recreational drugs.


The biggest “pro” is, in most cases, the syrup’s general effectiveness and strong potency. It works in two distinct ways: on the one hand, it eases the pain of hard coughs, while on the other it actually suppresses the part of the brain that controls coughing and respiratory distress. Taken together these two attributes can make colds shorter and less uncomfortable. In most cases these sorts of products begin working within minutes, too, since the codeine is able to enter the bloodstream very quickly once the liquid is swallowed.

These sorts of cough syrups are usually believed to be much more potent and effective than more “standard” syrups, most of which contain only temporary numbing agents or light pain killers. As a consequence, people often find themselves taking less to achieve similar results.

Wide Availability

It’s usually fairly easy for people to get this sort of product, as well. Codeine is popular all over the world. There are differences when it comes to whether or not people need a prescription to buy these sorts of syrups, but even then prescriptions aren’t usually that hard to procure. Medical professionals frequently view codeine syrups one of the most effective ways to cure a cough quickly, and will often order the prescription almost as a matter of course once it’s clear a person is suffering.

Potential for Abuse

Availability can also work as a “con,” at least where drug abuse is concerned. Codeine is a popular addition to a number of recreational drugs, and cough syrup suspensions are often prized in these circles because of their quick absorption and generally high concentrations. This sort of syrup is actually the main ingredient in a drug called “purple drank” that originates from the southern part of the United States. Other medications and ingredients are added to the cocktail according to preference. Purple drank is also commonly know as “Texas tea,” “sizzurp,” and “purple jelly,” with the “purple” attributions owing to the cough syrup’s usual color.

In some countries, measures have been taken to prevent abuse. Sometimes manufacturers will add medications to the cough syrup to produce undesirable effects if taken in the amount needed to make drugs. It’s also common in many places for people to have to show identification to purchase codeine-containing products, and some pharmacies and chemists keep track of clients and monitor anyone who seems to be making more codeine purchases than normal.

Side Effects

The side effects of codeine cough syrup are normally mild, but can be severe and life-threatening in some instances. Allergic reactions are some of the most common, and some people may also experience hallucinations and yellowing of the skin and eyes, though these experiences are most common with prolonged use. Commonly observed mild side effects include headache, nausea and vomiting, and drowsiness. It is possible to overdose with this medication, too, which can be fatal if treatment is not sought right away.

There are usually a number of special precautions for children and pregnant women, and in general neither should use this sort of cough syrup. Children under six are more at risk for experiencing a range of breathing and respiratory problems, and the drug may also stunt the growth or damage the growing organs of developing fetuses.

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Discussion Comments
By DugDug — On Nov 25, 2013

If used properly, codeine syrup can be a miracle drug for someone with a serious and persistent cough. Syrup addiction, however. is something altogether different.

The issue of codeine syrup addiction and the crime associated with it will soon become a national issue. It is already being talked about in the mainstream media. (By the way, it is also called Drank, Purple Stuff, Syrup or Lean).

Syrup gained notoriety in Houston in the 1990's among rappers like Pimp C and Big Moe and inspired DJ Screw's "chopped and screwed" music, which Houston is now famous for in the hip-hop culture. All three died in syrup-related overdoses.

Other notable incidents related to purple drank addiction include the arrests of San Diego Chargers NFL player Terrence Kiel, Green Bay Packers player Johnny Jolly and former Oakland Raiders quarterback JaMarcus Russell. All have faced criminal charges as the result of illegally possessing Codeine-Promethazine syrup.

John Stogner, Ph.D., Assistant Professor within the Department of Criminal Justice and Criminology at the University of North Carolina, composed an article in the Addictive Behaviors Journal which reports that Syrup addiction is spreading like wildfire.

Beware: like many pharmaceutical drugs prescribed by a doctor, this stuff can be lethal and it is highly addictive.

By anon334598 — On May 14, 2013

I got addicted to codeine cough syrup, and got stuck with it for a very, very long time. The problem is the physical dependency; it is really hard to liberate yourself from it.

Codeine-based cough syrup used to be sold as an over-the-counter medicine in Belgium and I have the impression that a lot of people used it for recreational purposes. It costs loads of money and the human body gets very quickly used to it, and then you are in for a tough physical and psychological opiate addiction where you have to increase the doses constantly to receive the same effect and you're fighting withdrawal.

I got off it last summer, but it took me some eight weeks to get my body totally clean of it and to recover and get used to not feeding it with that substance. Codeine is extremely effective against pain, cough, cold, but beware of its addictive powers.

By myharley — On Jun 10, 2012

@honeybees-- I have also had great benefits using this cough syrup. I haven't found any cough syrup that works better than those I can only get with a prescription.

Another advantage to the codeine in the cough syrup is that it helps soothe the pain of a sore throat or any other mild pain symptoms you might be having.

When I have a bad cough and cold, I like to stay home and nurse my cold. I make sure I am comfortable, drink plenty of liquids, and get lots of sleep. I can take the cough syrup throughout the day because I don't need to worry about getting sleepy or driving anywhere.

By honeybees — On Jun 10, 2012

When I have a really bad cough that won't go away, I will ask for this cough syrup when I go to the doctor. Usually by this time, I have tried several other remedies, and I am tired of still fighting the cough.

Since I can't buy codeine cough syrup without a prescription, the chances of misusing this are pretty slim. One of the things I like best about it is the codeine really knocks me out.

I can finally get a good night of sleep without tossing and turning all night long, and that is well worth it.

By candyquilt — On Jun 09, 2012

@feruze-- It's true that codeine is addictive. They've added larger doses of antihistamines in codeine cough syrups to prevent people from abusing it. Unfortunately, there are still people who abuse them to get high.

But codeine cough syrup doesn't work for everyone. Either it doesn't suppress coughing as it should or the side effects prevent people from taking it. For my daughter, it doesn't work at all. Actually no cough medicine helps with her coughs.

It helps me when I have a cough but I don't use it because it gives me constipation. My mother also can't take it because the codeine increases her blood pressure. So if you do develop codeine side effects like us or are allergic to it, you won't be able to use it anyway.

By ysmina — On Jun 08, 2012

@feruze-- Don't be silly! You won't get addicted to it with one prescription. Just follow the directions listed on the bottle, don't take more than necessary and you'll be fine.

People who abuse cough syrup with codeine take exaggerated doses on a regular basis. This is not something that's going to happen overnight. You have a legitimate medical condition and that is precisely what this cough syrup was made for.

Over the counter cough suppressants don't work. The most important ingredient found in over the counter cough syrup is dextromethorphan which has been proven to do nothing. Codeine is one of the few medicines that actually suppresses coughing. If it works for you, then you are lucky to have that option. Please get that prescription filled and get a good night's sleep tonight.

By bear78 — On Jun 08, 2012

I've heard about people abusing cough syrups with codeine for recreational purposes and I've been avoiding it for that reason.

I've had a really bad cough for the past week. I haven't even gotten any proper sleep for the past two days because of the coughing. First I tried over the counter cough medicines. None of them worked. Then I went to my doctor who prescribed a codeine cough syrup but I haven't had the prescription filled.

That was two days ago and my cough hasn't gotten better but worse. I wonder if I should try the codeine cough syrup. But I'm afraid of its addictive qualities.

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