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It is a powerful drug, and people can quickly develop tolerance or dependence. Although there is no cure for chronic obstructive pulmonary disorder (COPD), treatments can help relieve the symptoms and slow the progression of the disease. Opioids — such as codeine — may be valuable in alleviating some symptoms, but doctors do not prescribe them frequently because of the risks. There are also numerous side effects associated with codeine, including drowsiness, constipation, and breathing difficulties. Keep reading to learn about why doctors prescribe codeine for COPD, the risks and benefits, and the other treatment options for people with this condition. Why is codeine a treatment option for COPD Share on PinterestFRED TANNEAU/AFP via Getty ImagesCodeine is an opioid medication that doctors use to treat mild to moderate pain. They may use it off-label in combination with other medications to relieve coughing, a primary symptom of COPD. It helps reduce this by decreasing activity in the part of the brain that causes coughing. Generally, codeine does not appear on lists of treatments for COPD. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, for example, do not mention codeine as a treatment for COPD. However, some doctors may prescribe codeine for people who have particularly severe bouts of coughing and breathlessness. Various clinical studies have investigated the efficacy of opioids for breathlessness in COPD. Overall, the research suggests that low dose opioids slightly improve chronic breathlessness. However, most of the studies to date are small and of low quality. There is little compelling evidence to support using codeine in COPD treatment regimens. Risks and side effects As with all medications, codeine can cause side effects. These may include:headachesstomach paindifficulty urinating In some cases, codeine can cause severe, life threatening breathing problems, particularly during the first 24–72 hours of starting treatment. It can also cause other serious side effects that require immediate medical attention, including:agitationhallucinationsfever and sweatingconfusionracing heartbeatshiveringsevere muscle stiffness or twitchingnausea, vomiting, diarrhea, or constipationweakness or dizzinessrashes and itchingchanges in visionseizures Another major concern with codeine is that it can lead to dependence and, in some cases, addiction. People who take codeine for a long time may develop a tolerance to it, meaning that they need increasingly larger doses to get the same effect. They may also experience dangerous withdrawal symptoms if they suddenly stop taking the medication. Due to these risks, doctors rarely prescribe opioids for breathlessness in people with advanced COPD. Benefits Despite the risks, codeine may offer some benefits for people with COPD. In particular, it may relieve breathlessness and help alleviate the pain associated with the chronic lung disease. If a doctor prescribes codeine, the individual must take it exactly as the prescription dictates. They should not take more or less than the prescribed amount, and they should not take it for longer than the doctor advises. Other medications for COPD Treatment for COPD aims to control the symptoms, improve quality of life, and reduce the likelihood of exacerbations, or flare-ups. Commonly prescribed medications include:Bronchodilators: These are often the first-line treatment for COPD. They open the airways to make breathing easier.Inhaled corticosteroids: These drugs can reduce airway inflammation.Antibiotics: If a person has a bacterial infection, they can take antibiotics. Pain in COPD is a significant concern, affecting up to 60% of individuals with the disease. Doctors may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and aspirin. If these do not work, they may prescribe opioids, such as morphine and codeine. Some research claims that the medical community should consider opioids — such as sustained-release morphine — a first-line treatment for breathlessness in COPD. The authors suggest that doctors prescribe a low dosage and gradually increase it over time, depending on how the person responds. Despite concerns over opioid side effects, studies show that low dose opioids may not have harmful effects. Evidence does not associate them with increased hospitalization or death rates among people with severe COPD. However, tolerance and dependence are primary concerns. Contacting a doctor People should work with a doctor to find the best COPD treatment plan for them. The doctor may suggest medications to ease the person’s symptoms and lifestyle adjustments to help them maintain their overall health and well-being. COPD is a progressive and incurable condition, so treatment focuses on managing pain, addressing other symptoms, and slowing disease progression. It is also very important to have regular checkups with a doctor to ensure the prompt detection and treatment of any changes in a person’s health. Summary Codeine is an opioid medication that can help relieve pain and breathlessness in people with COPD. Some research also suggests that other opioids, such as morphine, may effectively treat these symptoms. However, opioids have associated risks, including dependence, addiction, and significant side effects. Therefore, if a doctor recommends these potent medications, a person must follow the dosage instructions carefully. If a person has any concerns about the medication they are taking, they should contact a doctor. Last medically reviewed on July 21, 2022COPDPulmonary SystemRespiratoryDrugs 5 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Agarwal, A. K., et al. (2021). Chronic obstructive pulmonary disease. https://www.ncbi.nlm.nih.gov/books/NBK559281/Ahmadi, Z., et al. (2016). Prescription of opioids for breathlessness in end-stage COPD: A national population-based study. https://www.dovepress.com/prescription-of-opioids-for-breathlessness-in-end-stage-copd-a-nationa-peer-reviewed-fulltext-article-COPDCodeine. (2020). https://medlineplus.gov/druginfo/meds/a682065.htmlvan Dam van Isselt, E. F., et al. (2014). Pain in patients with COPD: A systematic review and meta-analysis. https://bmjopen.bmj.com/content/4/9/e005898Widera, E. W. (2020). The role of opioids in patients with chronic obstructive pulmonary disease and chronic breathlessness [Abstract].https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2769368FEEDBACK:Medically reviewed by Jennie Olopaade, PharmD, RPH — By Zia Sherrell, MPH on July 21, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat to know about COPD medicationsMedically reviewed by Alan Carter, PharmD What type of medications can help manage COPD? 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