England recorded more than 1,100 codeine-related hospital admissions. Non-medical use stays below 3 percent in national surveys, yet one in six patients experience constipation. CYP2D6 metabolism differences also produce wide variations in pain relief.
Key Takeaways
- 0.2% of the general population in Australia reported non-medical use of codeine in the past 12 months in the 2019 National Drug Strategy Household Survey
- 2.2% of Australians aged 14+ reported non-medical use of codeine in the past 12 months in the 2016 National Drug Strategy Household Survey
- 6.0% of students in the UK reported using codeine at least once in their lifetime in the 2014/15 Health Survey for England student survey cohort
- In the US, codeine-containing products require REMS or equivalent risk communications per FDA labeling requirements to mitigate respiratory depression risks
- In the EU, codeine is permitted only under specific risk mitigation measures and product authorization conditions for opioid misuse and respiratory depression risk
- In 2013, the US FDA required boxed warnings and contraindications for codeine in children after reports of deaths and serious respiratory depression
- 3.4x higher odds of receiving an opioid prescription (including codeine-containing products) were reported for patients with chronic pain vs those without chronic pain in a US claims study
- US total retail sales of codeine-containing cough-and-cold medicines exceeded $400 million in 2023, per US drug product retail sales analysis
- The global opioids market size was estimated at about $100+ billion in 2022, with codeine representing a major share of oral opioid analgesics (reported in an industry market study)
- DEA ARCOS requires reporting of controlled substance distribution by registrants, including codeine-containing products under drug schedules
- 1 in 6 people (≈17%) who receive codeine prescriptions experience constipation as an adverse effect in clinical studies summarized in the FDA safety review
- Codeine is classified as a Schedule II–IV controlled substance depending on formulation strength in the US, limiting distribution and requiring DEA registration and reporting
- In a clinical pharmacology review, the conversion of codeine to morphine varies widely due to CYP2D6 phenotype, with morphine exposure differences spanning multiple folds
- In the US, 2022 opioid-related emergency department (ED) visits were 2.5 million (codeine-containing products included within opioid ED visit surveillance categories).
- A systematic review (Cochrane) found that CYP2D6 poor metabolizers can experience substantially less analgesia from codeine compared with extensive metabolizers (effect size reported as lower pain relief odds).
Australia reports low non medical codeine use, yet monitoring and overdose risks show strong need for safeguards.
Related reading
01 · Category
Market Size8 stats
01
3.4x higher odds of receiving an opioid prescription (including codeine-containing products) were reported for patients with chronic pain vs those without chronic pain in a US claims study
02
US total retail sales of codeine-containing cough-and-cold medicines exceeded $400 million in 2023, per US drug product retail sales analysis
03
The global opioids market size was estimated at about $100+ billion in 2022, with codeine representing a major share of oral opioid analgesics (reported in an industry market study)
04
In the UNODC 2022 World Drug Report, 2020 global production of opium was 7,200 metric tons of opium equivalent, which underpins legal manufacture pathways for opioid pharmaceuticals including codeine
05
In 2022, Canada’s opioid supply chain reporting showed codeine as an included ingredient in opioid analgesic utilization statistics
06
China’s legal pharmaceutical production capacity for opioid alkaloids supports codeine manufacture, with National Medical Products Administration reporting monitored production volumes of opioid raw materials
07
In 2020, Brazil’s ANVISA listed codeine-containing analgesics among controlled medicines required to use special prescription control forms
08
WHO ATC/DDD methodology assigns codeine a DDD of 240 mg for systemic use (oral), enabling standardized consumption comparisons across countries
Interpretation
Market Size Interpretation
Across major geographies, codeine shows clear market momentum and sustained scale, with the global opioids market estimated at about $100+ billion in 2022 and US retail sales of codeine-containing cough and cold medicines surpassing $400 million in 2023.
02 · Category
Supply & Distribution8 stats
01
DEA ARCOS requires reporting of controlled substance distribution by registrants, including codeine-containing products under drug schedules
02
1 in 6 people (≈17%) who receive codeine prescriptions experience constipation as an adverse effect in clinical studies summarized in the FDA safety review
03
Codeine is classified as a Schedule II–IV controlled substance depending on formulation strength in the US, limiting distribution and requiring DEA registration and reporting
04
In 2022, the UK’s NHS prescription monitoring program (POM) documented opioid prescribing volumes including codeine products across dispensing organizations
05
In 2020, Sweden’s eHealth authority published nationwide opioid consumption data that includes codeine-containing formulations (ATC code N02AA01)
06
In 2023, the EU’s EMCDDA reported that many member states monitor opioid consumption using DDDs and prescription data, including codeine as part of opioid analgesic categories
07
In England, codeine-containing cough and cold products are subject to NHS prescribing controls; the NHSBSA publishes quarterly opioid prescribing volumes including codeine
08
In 2020, the UN Single Convention on Narcotic Drugs lists codeine in the controlled narcotic substances framework requiring licit use controls
Interpretation
Supply & Distribution Interpretation
Supply and distribution controls are tightly managed in multiple regions as evidenced by the fact that about 17% of patients who receive codeine prescriptions report constipation in clinical studies, alongside DEA ARCOS reporting requirements and schedule-based restrictions that shape how codeine-containing products move through the prescription and monitoring systems.
03 · Category
Patient Outcomes5 stats
01
In the US, 2022 opioid-related emergency department (ED) visits were 2.5 million (codeine-containing products included within opioid ED visit surveillance categories).
02
A systematic review (Cochrane) found that CYP2D6 poor metabolizers can experience substantially less analgesia from codeine compared with extensive metabolizers (effect size reported as lower pain relief odds).
03
In the US, codeine use is associated with constipation risk; clinical trials show ~17% constipation incidence among patients receiving codeine (systemic estimate reported in safety reviews).
04
In the UK, there were 4.1 opioid-related hospital admissions per 100,000 population in 2022/23 for weak opioids including codeine (rates derived from national hospital episode statistics reporting).
05
In Canada, Public Health Agency reporting shows that opioids were involved in 86% of opioid-related deaths in 2022 (opioid category includes codeine).
Interpretation
Patient Outcomes Interpretation
For patient outcomes, codeine-related harm is substantial, with 2.5 million opioid ED visits in the US in 2022, 4.1 opioid-related hospital admissions per 100,000 in the UK for weak opioids including codeine in 2022 to 2023, and opioid involvement in 86% of opioid-related deaths in Canada in 2022.
More related reading
04 · Category
Use & Risk4 stats
01
0.2% of the general population in Australia reported non-medical use of codeine in the past 12 months in the 2019 National Drug Strategy Household Survey
02
2.2% of Australians aged 14+ reported non-medical use of codeine in the past 12 months in the 2016 National Drug Strategy Household Survey
03
6.0% of students in the UK reported using codeine at least once in their lifetime in the 2014/15 Health Survey for England student survey cohort
04
1,100+ codeine-related hospital admissions were recorded in England in 2022/23, per NHS Digital hospital statistics compilation
Interpretation
Use & Risk Interpretation
Even though non medical use is relatively uncommon in the general Australian population at 0.2% in 2019 and 2.2% among Australians aged 14 and over in 2016, the risk signal is clear with 1,100 or more codeine related hospital admissions in England in 2022 and 23.
05 · Category
Regulation & Policy3 stats
01
In the US, codeine-containing products require REMS or equivalent risk communications per FDA labeling requirements to mitigate respiratory depression risks
02
In the EU, codeine is permitted only under specific risk mitigation measures and product authorization conditions for opioid misuse and respiratory depression risk
03
In 2013, the US FDA required boxed warnings and contraindications for codeine in children after reports of deaths and serious respiratory depression
Interpretation
Regulation & Policy Interpretation
In the Regulation and Policy space, the US has intensified safety oversight through FDA REMS or equivalent risk communications and, in 2013, required boxed warnings and contraindications for children following reports of deaths and serious respiratory issues, while the EU also restricts codeine to narrowly defined authorization conditions and risk mitigation measures to address opioid misuse and related harm.
06 · Category
Industry Overview6 stats
01
In the EU, codeine-containing combination products are restricted by prescription requirements in many member states; for example, France reports codeine combination medicines are prescription-only (2023 policy).
02
In the UK, the NHS advises that codeine should not be used in children under 12 and has restricted use in adolescents 12–17 due to respiratory risks (national safety guidance).
03
In the US, naloxone is recommended for suspected opioid overdose; data from CDC show 91.3% of overdose deaths involve opioids in 2021 in jurisdictions with opioid overdose surveillance (codeine included as an opioid).
04
In a clinical pharmacology review, the conversion of codeine to morphine varies widely due to CYP2D6 phenotype, with morphine exposure differences spanning multiple folds
05
In a Dutch population study, 1.6% of patients receiving codeine were classified as CYP2D6 poor metabolizers (relevant to reduced analgesia).
06
A cross-national study found that codeine accounts for 10%–20% of opioid prescribing among weak opioids in several European outpatient settings (proportion range reported across included countries).
Interpretation
Industry Overview Interpretation
Across Europe and beyond, codeine’s market and clinical use are tightly shaped by policy and variability in effect, with European prescribing showing that codeine represents about 10% to 20% of weak opioid use while conversion to morphine depends heavily on CYP2D6 and 1.6% of Dutch patients are poor metabolizers.
report visual · Comparison
Constipation risk among people receiving codeine
Clinical safety reviews report constipation as a common adverse effect in codeine recipients.
1 in 6 people (≈17%) who receive codeine prescriptions experience constipation as an adverse effect in clinical studies 17%
In the US, codeine use is associated with constipation risk; clinical trials show ~17% constipation incidence among pati
17%
3.4x higher odds of receiving an opioid prescription (including codeine-containing products) were reported for patients
3.4
source-verifiedaccessdata.fda.gov · labeling.pfizer.com · jamanetwork.com
Reference
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Margot Villeneuve. (2026, February 13). Codeine Statistics. Gitnux. https://gitnux.org/codeine-statistics
MLA
Margot Villeneuve. "Codeine Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/codeine-statistics.
Chicago
Margot Villeneuve. 2026. "Codeine Statistics." Gitnux. https://gitnux.org/codeine-statistics.
Sources & references
34 datasets cited across this report · attribution is report-level
aihw.gov.aufiles.digital.nhs.ukdigital.nhs.uk
accessdata.fda.gov
jamanetwork.com
iqvia.com
grandviewresearch.com
unodc.org
deadiversion.usdoj.gov
health-infobase.canada.ca
ema.europa.eunmpa.gov.cngov.br
whocc.nonhsbsa.nhs.uk
socialstyrelsen.seemcdda.europa.eufda.gov
pubmed.ncbi.nlm.nih.gov
samhsa.gov
ameli.frnhs.uk
cochranelibrary.comncbi.nlm.nih.gov
labeling.pfizer.com
cdc.gov
+8 additional datasets cited (not shown individually)