Codeine and Percocet are among the most popular opioid pain medications in the United States. Although both produce similar effects, they have different potencies, with Percocet being the more potent. Because of this, codeine is prescribed for mild-to-moderate pain, whereas Percocet is used to treat moderate-to-severe pain.
If you’re looking for a detailed codeine vs. Percocet comparison, keep reading—this article will explore the key similarities and differences between these opioids.
What Is Codeine, and How Does It Work?
Codeine is an opioid analgesic prescribed for mild-to-moderate pain that cannot be relieved with weaker painkillers such as acetaminophen. Due to its antitussive properties, it can also be found in cough syrups. Codeine is an opiate or a natural opioid, meaning it occurs naturally in the opium poppy.
Codeine comes as a tablet, oral solution, or injection. It is also a common ingredient in combination medications, such as Tylenol® #3 and #4 (codeine/acetaminophen), Aspalgin® (codeine/aspirin), and Solpadeine® (codeine/ibuprofen). Moreover, codeine can be used to produce other, more potent opioids like hydrocodone.
Codeine works by binding to the opioid receptors located throughout the central nervous system (CNS), which disrupts the transmission of pain signals. While it can also cause rewarding effects like euphoria, its effects tend to be relatively mild compared to other opioids.
Nonetheless, codeine can be abused. Most commonly, it is misused by mixing codeine cough syrup with soda, alcohol, or hard candy, which creates a polysubstance drink known as “purple drank,” “sizzurp,” or “lean.”
Since prolonged codeine use and abuse can lead to dependence and codeine addiction, it is imperative to take it strictly as prescribed.
What Is Percocet, and How Does It Work?
Percocet is an opioid-based combination drug prescribed for moderate-to-severe pain resistant to non-opioid pain relievers. Like codeine, Percocet relieves pain by attaching to opioid receptors and blocking pain signals. It has two active ingredients:
- Oxycodone, a potent semi-synthetic opioid
- Acetaminophen, an over-the-counter medication used to reduce pain and fever
Generic Percocet (acetaminophen/oxycodone) comes as a tablet or oral liquid, whereas the brand-name version—also marketed under Roxicet®, Endocet®, and other brands—is only available as a tablet comprising 325 mg of acetaminophen and 2.5 mg, 5 mg, 7.5 mg, or 10 mg of oxycodone.
Percocet is also a popular street drug, most commonly known as Percs. In 2023, oxycodone products, including Percocet, were misused by 31.3% of all Americans who misused any type of prescription painkiller. In other words, Percocet and other oxycodone products were the second most frequently misused prescription pain relievers in the United States that year.
Now, let’s compare codeine vs. Percocet and learn more about their differences.
Key Differences Between Codeine vs. Percocet
The key difference between codeine vs. Percocet is potency. Compared to Percocet, codeine is much less potent. While codeine is about 10 times less potent than morphine, oxycodone—the opioid ingredient in Percocet—is about twice as potent as morphine.
Here’s an overview of some other differences between codeine vs. Percocet:
Codeine vs. Percocet Effectiveness
Although codeine and Percocet differ significantly in terms of potency, numerous studies show that codeine is no less effective in relieving pain than Percocet.
A study by Pooja Saigal from the University of Chicago found that codeine/acetaminophen provides comparable pain relief to oxycodone/acetaminophen for patients suffering from acute musculoskeletal pain.
Similarly, researchers from the Albert Einstein College of Medicine suggest that oxycodone/acetaminophen does not provide superior pain relief to codeine/acetaminophen. The study concludes that codeine/acetaminophen can be a reasonable alternative to oxycodone/acetaminophen for patients with acute pain following ED discharge.
Codeine vs. Percocet Chemical Composition
When it comes to chemical composition, the main difference between codeine and Percocet lies in the fact that codeine is a natural alkaloid extracted from opium. Meanwhile, the opioid ingredient in Percocet—oxycodone—is partially synthetic, i.e., it is produced by synthesizing thebaine, another opium alkaloid.
However, opium contains very low concentrations of codeine compared to other alkaloids, such as thebaine or morphine. Because of this, around 85–90% of codeine is currently methylated from morphine.
Moreover, Percocet is a combination drug that also contains acetaminophen, whereas codeine is available as a single-entity and combination drug. It can also be combined with acetaminophen to enhance its potency and effectiveness.
Codeine vs. Percocet Addictiveness
Like all drugs in the opioid class, codeine and Percocet are both addictive, as they produce rewarding effects, such as euphoria, and gradually alter brain chemistry.
Percocet is treated as a Schedule II controlled substance; meanwhile, the scheduling of codeine largely depends on its strength. For instance, codeine products containing less than 90 mg of codeine per unit are classified as Schedule III substances, whereas those containing less than 200 mg fall under Schedule V controlled substances.
Codeine vs. Percocet Cost
The cost of codeine vs. Percocet primarily depends on the type of medication prescribed, prescription strength, and similar factors. As a general rule, generic drugs cost less than brand-name ones. They may also be covered by insurance.
To give you a broad idea, the price of a 30 mg generic codeine pill ranges between $0.89 and $1.68. Meanwhile, a 325 mg/5 mg acetaminophen/oxycodone tablet costs around $0.17–$0.34. However, a single tablet of Percocet® of the same strength may cost you as much as $28.08.
Codeine vs. Percocet Overdose
Both codeine and Percocet can cause an opioid overdose.
Opioid overdose is an emergency that should never be taken lightly. If not treated promptly, it may result in death.
Call 911 immediately if you or someone you know is displaying the following signs of an opioid overdose after taking codeine or Percocet:
- Vomiting
- Confusion
- Pin-point pupils
- Unresponsiveness
- Cold, pale, clammy skin
- Slowed, shallow breathing
- Pale, discolored lips and nails
- Trouble speaking, moving, or staying awake
Codeine vs. Percocet Side Effects
Codeine and Percocet may cause similar side effects, such as:
- Itching
- Nausea
- Vomiting
- Sedation
- Headache
- Dry mouth
- Constipation
- Stiff muscles
- Stomach pain
- Difficulty breathing
Moreover, there have been cases of manic episodes associated with codeine/paracetamol. Therefore, codeine may not be the best choice for those with a predisposition to mania.
If you experience any adverse effects after taking codeine or Percocet—including those not listed above—inform your doctor. Some side effects, such as allergic reactions, may require immediate medical attention.
Prolonged codeine or Percocet use significantly increases the risk of tolerance and opioid dependence. It also puts you at a heightened risk of:
- Liver and other organ damage
- Opioid use disorder (OUD)
- Respiratory depression
- Chronic constipation
- Decreased fertility
- Opioid overdose
- Death
Mixing codeine and Percocet with other drugs further increases the risk of serious adverse effects, including overdose.
Let’s take a closer look at codeine vs. Percocet drug interactions.
Codeine and Percocet Drug Interactions
As opioids, codeine, and Percocet interact with many of the same drugs, including but not limited to:
- Other opioids
- Antihistamines
- Muscle relaxers
- Antidepressants
- Sleep medication
- Anxiety medication
- Blood pressure medications
Since Percocet contains acetaminophen, you should avoid other acetaminophen-containing drugs while taking it to reduce the risk of acetaminophen toxicity.
Drinking alcohol with Percocet is particularly dangerous, as it can not only cause an opioid overdose but also damage your liver. Never mix opioids, including codeine and Percocet, with alcohol or other CNS depressants, as this combination can have fatal consequences.
Inform your doctor about any medications and supplements you’re taking before initiating codeine or Percocet therapy to avoid dangerous—and potentially life-threatening—drug interactions.
Other Risk Factors of Codeine and Percocet
Some health conditions, such as cardiovascular, lung, or liver disease, may make you more vulnerable to the risks associated with codeine and Percocet use. For this reason, you should discuss your medical history with your doctor before taking opioids.
Other common risk factors of codeine and Percocet include:
- Opioid allergy
- Kidney disease
- Thyroid conditions
- Low blood pressure
- Gallbladder problems
- Acetaminophen allergy
- Alcohol use disorder (AUD) and other substance use disorders (SUDs)
If you are trying to conceive or expecting a baby, it’s in your and your baby’s interest to avoid opioid pain medications. Opioid use during pregnancy can have detrimental effects on both the mother and the baby, increasing the risk of neonatal abstinence syndrome (NAS), miscarriage, stillbirth, developmental delays, maternal death, and more.
Physical Dependence and Addiction to Opioids
Anyone taking codeine or Percocet for a prolonged time, including those taking them precisely as prescribed, risks developing physical dependence and addiction to opioids.
While these terms are often used interchangeably and may co-occur, opioid dependence and opioid addiction are different conditions.
Opioid dependence is primarily physical; people dependent on opioids rely on them to maintain normal functioning. If not untreated, however, it can develop into an addiction, which is primarily psychological.
People addicted to opioids experience a compulsive urge to take opioids that causes them to continue using opioids, even when it harms them. Recognizing and treating opioid dependence, therefore, is of vital importance.
Signs and Symptoms of Opioid Dependence
Seek professional help if you recognize the following signs of opioid dependence in yourself or a loved one:
- Tolerance. Over time, opioids like codeine and Percocet cause the brain to stop producing endorphins while also stimulating the production of opioid receptors. This results in tolerance; once you become dependent on opioids, you’ll need increasingly larger doses to achieve the initial effect.
- Opioid withdrawal symptoms. Cravings, insomnia, body aches, and other opioid withdrawal symptoms occur when people stop taking opioids or reduce their dosage after becoming dependent. Since these symptoms can be extremely hard to bear, many people continue taking prescription opioids just to avert them, even when they no longer need them.
ANR Opioid Dependence Treatment
Accelerated Neuro-Regulation (ANR) is a cutting-edge opioid dependence treatment developed by Dr. Andre Waismann. By re-balancing the endorphin-receptor system, ANR has empowered nearly 25,000 people worldwide to leave codeine, Percocet, and other opioids behind.
What sets ANR apart from traditional treatments is that it targets the root of opioid dependence rather than its symptoms. Since it reverts the brain to its pre-addiction state by repairing the opioid-induced changes, ANR treatment negates the risk of ongoing withdrawal symptoms and relapse. As such, its success rate is unparalleled.
Furthermore, ANR is scientifically proven to be safe. It is suitable even for those with complex medical conditions, such as cardiovascular disease, as we tailor the treatment to each patient. Moreover, ANR is only performed by highly experienced board-certified medical professionals in accredited hospitals with state-of-the-art medical equipment in an ICU setting.
Better yet, ANR Clinic can help you overcome codeine or Percocet dependence in a matter of days—the hospital stay for ANR patients lasts an average of 36 hours.
Take the first step toward an opioid-free life today by contacting us for a free, 100% confidential consultation!
Key Takeaways
If you’re facing the codeine vs. Percocet dilemma, your best option is to consult your doctor. Remember that all opioids—even weaker ones like codeine—have addictive properties. Therefore, you should only resort to them if all else fails.
Now, let’s reiterate the key points we covered today:
- Codeine is a relatively weak opioid used to relieve pain and suppress cough.
- Percocet is a potent combination drug consisting of opioid (oxycodone) and non-opioid (acetaminophen) ingredients.
- Codeine has a lower potential for addiction and overdose than Percocet due to being less potent; still, codeine and Percocet provide similar pain relief.
- ANR is an innovative treatment that eliminates the risk of relapse by addressing the root cause of opioid dependence.
Codeine vs. Percocet FAQ
Codeine is not considered a strong opioid, which is why it is prescribed for mild-to-moderate pain. Although it is the least potent opioid, codeine is stronger than non-opioid pain relievers and can lead to opioid abuse, dependence, and addiction.
You should never mix codeine and Percocet. Given that both of these drugs are opioids, taking them together can significantly increase the risk of side effects and other negative outcomes, including a potentially deadly overdose.
Yes, ANR is suitable for people with codeine or Percocet addiction. By repairing your endorphin-receptor system, this treatment can help you make a lasting recovery from codeine or Percocet dependence, regardless of its extent. To learn more about ANR, feel free to contact our office at +1 (813) 519-6720 or [email protected].
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