Can You Use Marijuana if You’re on Codeine?
Article written by
Tina MagrabiSenior Content Writer
Content reviewed by
Dr. Lewis Jassey
Using marijuana while on codeine or other prescription opioids is not recommended due to the risk of suppressing the central nervous system (CNS) and slowing brain activity. Combining codeine and weed may also have other health consequences, particularly for people with depression and anxiety.
Learn more about the potential risks of mixing codeine and cannabis and how you can use each independently to help manage pain.
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What Is Codeine?
Codeine is an opioid pain reliever indicated for the use of chronic pain. It is generally only prescribed to treat moderate to severe pain that has not responded to other milder drugs. The analgesic (pain-relieving) properties of codeine are sometimes combined with acetaminophen, as the two drugs enhance each other’s effectiveness.
Opioid drugs like codeine are controlled substances that are generally not available without a prescription; the exception is that certain over-the-counter medications like Tylenol may contain minor amounts of codeine, which is a weak version of co-codamol.
All opioids may interact negatively with cannabis. As CNS depressants, opioids can slow the heart rate to dangerous levels and reduce oxygen intake. Combined with cannabis, these potential effects may be magnified, even at low doses.
Uses and How It Works
Codeine is usually administered orally in tablet form. Doctors begin by prescribing the lowest possible dose of this potent opioid and may incrementally increase the dose over time. But most doctors will only prescribe opioids for short-term use due to the high potential for addiction.
Codeine reduces pain intensity by interrupting nerve signals that send pain messages to the brain. Opioids like codeine directly connect to opioid receptors in the central nervous system, making them effective at targeting pain.
Besides pain relief, one other use for codeine is to reduce coughing. Codeine may be used in certain cold and flu medications to control coughing. Minimal amounts of codeine may be present in over-the-counter pain and cough medications.
Potential Benefits and Risks of Mixing Cannabis and Codeine
Combining cannabis use with opioids like codeine is not advisable for most individuals. There are numerous risks to mixing the substances and few, if any, benefits.
Potential Risks
The following serious side effects may occur when combining cannabis and codeine:
- Central nervous system (CNS) suppression
- Slow heart rate
- Dangerously low blood pressure
- Low breathing rate
In addition to these adverse effects, which may be fatal in some cases, marijuana and codeine may trigger other problems. For example, people with mental health conditions like depression and anxiety may find these conditions exacerbated when combining weed and codeine, especially those with higher sensitivity to tetrahydrocannabinol (THC). Greater anxiety may develop in people taking high doses of THC with codeine.
What to Do If You Need to Use Both Codeine and Marijuana
If you’re managing severe pain, you need an effective treatment option that may work long-term. Opioids are not intended for long-term use, as many people become addicted to them and abuse them.
Cannabis, on the other hand, could be a viable long-term treatment option for relieving pain. The plant has been shown to have analgesic effects and ease many types of severe pain, including cancer-related neuropathy, pain due to multiple sclerosis (MS), and chronic muscular pain.
Your healthcare provider can help determine if cannabis could be an adequate alternative to opioids and other addictive prescription drugs. Do not begin or cease prescription drug use without guidance from your physician.
The Bottom Line
Mixing marijuana use with codeine or other opioid prescription medications can wreak havoc on the central nervous system, leading to an increased risk of dangerously low blood pressure and heart rate. An overdose of opioids alone can lead to these same life-threatening issues, but the likelihood of these occurring increases central nervous depressant drugs, including alcohol. Speak with your doctor about safely managing your chronic pain and see if cannabis medicine may be a promising treatment option.
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