Codeine vs. Hydrocodone: What’s the Difference?

woman pouring prescription pills out of a bottle

Codeine and hydrocodone are both prescription opioid painkillers which are commonly abused in the United States [1]. Many people mistakenly believe that the only dangerous opioids are ones of the highly potent variety, such as morphine, heroin, or fentanyl. However, even the prescription opioids used to treat minor to moderate pain have the potential to be addictive and dangerous. This article will discuss the differences and similarities between codeine and hydrocodone, along with the risks associated with both drugs.

What is Codeine?

Codeine is naturally occurring opioid derived from morphine which is prescribed to treat mild to moderate pain and is also used as a cough suppressant. When used to alleviate pain, codeine binds to opioid receptors in the body to reduce pain signals, and when prescribed to treat coughing it works by decreasing activity in the part of the brain responsible for the cough response. Codeine is considered a relatively mild opioid as compared to others, but it still carries a risk of abuse, addiction, and overdose [2]. Common side effects associated with codeine use can include dizziness, lightheadedness, nausea, vomiting, and sedation.

What is Hydrocodone?

Hydrocodone is also classified as an opioid pain reliever that works by binding to certain central nervous system receptors. Hydrocodone is considered a semi-synthetic opioid that is more potent than codeine, and the drug is intended for pain ranging from moderate to severe. Hydrocodone is often used in combination drugs such as Lortab and Vicodin, which include both hydrocodone and acetaminophen. It is also available in controlled-release versions for longer lasting pain relief. Like codeine, hydrocodone also carries a risk of abuse, addiction, and overdose; however, hydrocodone has been classified by the DEA as a Schedule II controlled substance, indicating that it has a higher potential for abuse than drugs like codeine [3][4].

Signs of Hydrocodone and/or Codeine Addiction

Both hydrocodone and codeine can cause physical dependence and addiction with ongoing abuse. Some of the common signs and symptoms of hydrocodone and/or codeine addiction include:

  • Using more hydrocodone or codeine than prescribed or taking it longer than intended
  • Being unable to cut back on the amount of hydrocodone or codeine used
  • Continuing to use hydrocodone or codeine despite the mental, physical, and social problems it causes
  • Having strong urges or cravings to use hydrocodone or codeine
  • Spending large amounts of time planning to get hydrocodone or codeine, using it, or recovering from its use
  • Needing more hydrocodone or codeine to achieve the same effects (tolerance)
  • Displaying withdrawal symptoms when hydrocodone or codeine use stops suddenly

Hydrocodone Withdrawal Symptoms

Withdrawal symptoms from stopping hydrocodone use are varied, and may include some or all of the following [5]:

  • Anxiety
  • Insomnia
  • Irritability
  • Sweating
  • Muscle aches
  • Agitation
  • Yawning
  • Runny nose
  • Tearing
  • Sweating
  • Goose bumps
  • Dilated pupils
  • Nausea
  • Vomiting
  • Abdominal cramping
  • Diarrhea

Related post: How Long Does Hydrocodone Withdrawal Last?

Codeine Withdrawal Symptoms

There are a variety of unpleasant codeine withdrawal symptoms that can stem from stopping the use of codeine cold-turkey as well.[6]

  • Body aches and pains
  • Anxiety
  • Diarrhea 
  • Fever and chills
  • Depression
  • High blood pressure
  • Insomnia 
  • Irritability
  • Agitation
  • Muscle twitching
  • Nausea and vomiting
  • Rapid heart rate
  • Runny nose
  • Sweating
  • Stomach pain

Related post: Codeine Withdrawal Symptoms, Timeline, and Detox

Treatment for Prescription Opioid Abuse is Possible

Opioid abuse and addiction is a dangerous widespread epidemic, and if you or a loved one are experiencing signs of addiction or dependence to either codeine or hydrocodone, the expert medical staff at Briarwood Detox Center will work with you to develop a drug tapering plan and withdrawal treatment program that is best suited to you or your loved one’s needs in order for you to recover safely. Please call us today at (512) 262-4426 or contact us online.


  1. 11 Commonly Abused OTC and Prescription Drugs (webmd.com)
  2. Codeine Addiction And Abuse – Addiction Center
  3. Hydrocodone Addiction And Abuse – Addiction Center
  4. Hydrocodone – StatPearls – NCBI Bookshelf (nih.gov)
  5. Hydrocodone Withdrawal| Symptoms & Side Effects (recovery.org)
  6. Codeine Withdrawal Symptoms (& The Top 20 Things That Can Help) – Opiate Addiction Support 
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