Dihydrocodeine Addiction and Abuse: Symptoms and Treatment

What Is Dihydrocodeine?

Dihydrocodeine is a medication used to treat pain, fever and swelling. It is no longer commercially available on its own but is available as a combination drug composed of dihydrocodeine, aspirin and caffeine. While dihydrocodeine interacts with the brain, the aspirin decreases fever and swelling, and caffeine increases the effectiveness of the aspirin.

Some patients may notice common side effects after taking dihydrocodeine. Common dihydrocodeine side effects include: 

• Nausea
• Vomiting
• Upset stomach
• Tremors
• Constipation
• Dry mouth
• Lightheadedness
• Dizziness
• Drowsiness 

If these side effects get worse or persist over time, be sure to let your doctor know.

Serious side effects are uncommon after taking dihydrocodeine, but they are still important to know if they need to be identified in an emergency. Serious dihydrocodeine side effects include: 

• Agitation
• Hallucinations
• Mood changes
• Irregular heartbeat
• Increased thirst or urination
• Ringing in the ears
• Easy bruising or bleeding
• Signs of infection
• Persistent sore throat
• Fever
• Heartburn
• Discomfort when swallowing
• Dark urine
• Yellowing of the skin or eyes
• Signs of kidney problems
• Difficulty urinating
• Loss of appetite
• Unusual tiredness 
• Weight loss

Tell your doctor or pharmacist if these serious side effects become noticeable as soon as possible.

Seek medical attention as soon as possible if you start to notice the following while you are taking dihydrocodeine: 

• Fainting
• Seizure
• Black stool
• Severe stomach or abdominal pain
• Vomit that resembles coffee grounds
• Slurred speech 
• Weakness on one side of the body

How Is Dihydrocodeine Used?

Dihydrocodeine should be taken by mouth only as directed by your doctor. Do not adjust your dihydrocodeine dosage or treatment schedule without explicit instruction from your doctor. Unless your doctor advises otherwise, the medication should be taken with a full glass of water.

This medication works best if you use it as the first signs of pain occur. Taking dihydrocodeine after your pain has worsened may make the medication less effective.

Dihydrocodeine Addiction

Using dihydrocodeine puts patients at risk of developing an addiction or dependence on the medication even if they use it responsibly. If you notice signs of dihydrocodeine addiction in yourself or someone you know, get help as soon as possible. Signs of dihydrocodeine addiction can include becoming obsessed with finding and taking dihydrocodeine and losing interest in the hobbies and activities you once found enjoyable.

Is Dihydrocodeine Addictive?

Dihydrocodeine is a Schedule II controlled substance. As such, it carries a high risk of abuse, dependence and addiction. Opioids like dihydrocodeine are addictive because they trigger the brain’s reward system, causing you to want to keep taking the drug even when it’s not medically necessary.

Side Effects of Dihydrocodeine Addiction

Even when taken as prescribed by a doctor, some patients may develop a dependence or addiction to dihydrocodeine. Recognizing signs of dihydrocodeine addiction, such as losing interest in once-enjoyed activities and obsessively seeking and using the drug, should prompt seeking professional help. Swift action can set you or your loved one on the path to a happy, healthy, substance-free life.

Dihydrocodeine misuse and addiction may cause serious side effects. These include: 

• Agitation
• Hallucinations
• Mood changes
• Irregular heartbeat
• Increased thirst or urination
• Ringing in the ears
• Easy bruising or bleeding
• Signs of infection
• Persistent sore throat
• Fever
• Heartburn
• Discomfort when swallowing
• Dark urine
• Yellowing of the skin or eyes
• Kidney problems
• Difficulty urinating
• Loss of appetite
• Unusual tiredness
• Weight loss

It is important to consult a medical professional or see your doctor if any of these side effects occur. 

Long-term misuse of dihydrocodeine may lead to serious consequences. Patients may experience symptoms of drowsiness, nausea, vomiting and confusion. Additionally, when discontinuing dihydrocodeine after prolonged use, people may encounter symptoms of restlessness and irritability. It is essential to be mindful of these potential consequences and discuss any concerns with your healthcare provider.

Dihydrocodeine Overdose

Dihydrocodeine overdose can have serious consequences, and its primary symptoms include pinpoint pupils, decreased level of consciousness and severe respiratory depression. This opioid drug depresses the central nervous system, particularly targeting the brain stem’s hypercapnic drive, which regulates breathing in response to carbon dioxide levels. When carbon dioxide levels rise too high, the brain stem signals the body to breathe, expelling excess carbon dioxide. However, in the case of a dihydrocodeine overdose, this system becomes suppressed, leading to dangerously reduced respiratory function.

Prompt and appropriate treatment is crucial in the event of a dihydrocodeine overdose. Since respiratory depression is the primary concern during an opioid overdose, securing the patient’s airway is most important. Additionally, administering an opioid antagonist like naloxone is essential to reverse the effects of dihydrocodeine and restore normal respiratory function. The amount of dihydrocodeine required to trigger an overdose varies among individuals due to their body size, genetics, tolerance to opioids and overall health.

If you suspect someone is overdosing on dihydrocodeine, call 911 and give naloxone if available.

Treatment for Dihydrocodeine Addiction

If you or someone you know is showing signs of dihydrocodeine addiction, such as losing interest in hobbies or becoming obsessed with finding and taking the drug, please seek professional help immediately. The sooner you get help, the sooner you can start living a happy, healthy, and substance-free life. Treatment for Dihydrocodeine will often take the form of either an inpatient or outpatient program.

Inpatient Dihydrocodeine Rehab

Inpatient dihydrocodeine rehab is a program that allows patients to live on campus at one of The Recovery Village’s designated treatment centers. This program is designed for patients experiencing severe dihydrocodeine addiction or having trouble recovering from their addiction due to distractions from the outside world.

In inpatient rehab, patients receive 24/7 care from a team of experienced professionals. They participate in individual and group therapy sessions, learn coping skills and receive medication-assisted treatment (MAT) if needed. Inpatient rehab is a highly structured program providing patients with the support and resources they need to overcome addiction.

Outpatient Dihydrocodeine Rehab

Outpatient dihydrocodeine rehab is a program that allows patients to live at home while attending treatment appointments at The Recovery Village. This program is designed for patients with milder dihydrocodeine addiction or who can maintain sobriety while living in the community.

Outpatient rehab typically involves individual and group therapy sessions and medication-assisted treatment (MAT) if needed. Patients also participate in educational workshops and support groups. Outpatient rehab is a less structured program than inpatient rehab, but it can still be an effective way to overcome addiction.

How Long Does Dihydrocodeine Stay In Your System?

The time dihydrocodeine stays in the body depends on many factors, including the patient’s metabolism, size, age, opioid tolerance, liver and kidney health, dose and frequency of use.

• Metabolism: People with faster metabolisms will typically eliminate dihydrocodeine from their bodies more quickly than those with slower metabolisms.
• Size: Larger people will typically have more body fat, which can slow the elimination of dihydrocodeine from the body.
• Age: Older people may have slower metabolisms and may take longer to eliminate dihydrocodeine from their bodies.
• Opioid tolerance: People tolerant to opioids may take longer to eliminate dihydrocodeine from their bodies than those not tolerant to opioids.
• Liver and kidney health: People with liver or kidney problems may take longer to eliminate dihydrocodeine from their bodies.
• Dose: Higher doses of dihydrocodeine will typically take longer to eliminate from the body than lower doses.
• Frequency of use: People who use dihydrocodeine more frequently will typically take longer to eliminate it from their bodies than those who use it less frequently.

On average, dihydrocodeine is eliminated from the body within 24 hours, given its four-hour half-life, as drugs typically are entirely cleared from the system after five half-lives. However, the drug may remain in urine and hair tests longer.

Mixing Alcohol and Dihydrocodeine

Taking alcohol and dihydrocodeine together can be dangerous. Both drugs slow down the central nervous system, and combining them can lead to severe side effects, such as nausea, vomiting, fainting and blackouts. In some cases, it can even be fatal.

Alcohol and dihydrocodeine both work by affecting the same receptors in the brain. When both drugs activate these receptors, the effects are amplified. Mixing alcohol and dihydrocodeine can also increase the risk of other side effects, such as headaches, difficulty breathing and constipation.

If you are taking dihydrocodeine, it is important to avoid alcohol altogether. If you do drink alcohol, be sure to do so in moderation and to drink slowly. If you experience side effects, seek medical attention immediately.

The Importance of Aftercare

Those recovering from dihydrocodeine addiction or another substance use disorder are always at risk of relapse. To minimize the risk as much as possible, it is recommended that patients find an aftercare program to support them with continued therapy. Continuing therapy will help patients maintain a solid foundation for their recovery journey.If you or a loved one is struggling with dihydrocodeine addiction, seek professional help as soon as possible. The Recovery Village has many resources and treatment programs available for patients looking to recover from their substance use disorder. Contact us today to get started on the path to living free from addiction.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more