What is the Difference Between Hydrocodone and Codeine?

Hydrocodone and codeine, both opioid medications that have applications for analgesia and cough suppression, display similar physiological effects. They have different compositions, however, which lead to different strengths, side effects, and varying legal regulations. Hydrocodone is a significantly stronger drug than codeine, and this leads to its increased addiction possibility, side effects, and overdose potential. All opiate analgesics work in slightly different ways inside the body, and it is usually a process of trial and error to determine which drug will be most effective for a patient. Doctors prescribe both substances for many of the same reasons, but the differences between the two determine which drug is used in treatment.

Both hydrocodone and codeine are derived from the same natural substance—the opium poppy pods of the plant species Papaver Somniferum. Codeine is found in an almost complete form within the pod, but is more often times made from the drug morphine. Hydrocodone is a semi-synthetic opioid that begins with the constituents from the plant and is then finished in a lab. It is made from two substances found within the pod: the codeine and another chemical, thebaine. The extra constituent seems to help hydrocodone work more effectively as an analgesic.

The Food and Drug Administration (FDA) in the United States and similar agencies around the world regulate opioid drugs. Hydrocodone and codeine are both illegal to buy and possess in the United States, though the laws are not as strict in other countries like Canada, where codeine is available in certain over-the-counter preparations. In the United States, hydrocodone is a schedule II or schedule III drug depending on the dose units. For example, Vicodin®, which contains hydrocodone and acetaminophen, is a less regulated, schedule III substance because the acetaminophen lowers the dose of hydrocodone contained within the pill. Codeine preparations are almost all schedule III substances within the United States.

The side effect profiles of hydrocodone and codeine are similar and include dizziness, constipation, and nausea. They differ when it comes to other side effects that are associated with opiates. Many times, people find the side effect of itching intolerable with codeine, and in this case, hydrocodone offers a less irritating alternative. Hydrocodone, however, causes more nausea, and can sometimes cause a patient to become hyperactive and have insomnia. It is up to the doctor and patient to determine which of the two substances works best with an individual’s physiology and pain-response mechanism.