Dihydrocodeine addiction: The causes, symptoms and side effects
Dihydrocodeine is a strong painkiller, usually given when someone’s dealing with intense or long-lasting pain, like after major surgery or during cancer treatment. In these cases, dihydrocodeine can make a significant difference, helping people navigate situations that would otherwise feel unbearable. Because of how powerfully it works, however, when misused or taken for too long, dihydrocodeine can lead to dependence and even full-blown opiate addiction.
What is dihydrocodeine?
Dihydrocodeine is a stronger version of codeine and belongs to the opioid family of medicines. It works by binding to your body’s pain receptors, helping to dull or block pain so you can cope with things like surgical recovery, cancer discomfort or even severe coughs and respiratory illness.
Even though it’s helpful in the right situation, dihydrocodeine can easily be taken in ways it wasn’t meant to be. Some people start using a higher dihydrocodeine dosage than prescribed or take it without a prescription at all, hoping it will help them relax or escape for a bit. But that kind of use can come with some nasty dihydrocodeine side effects, like feeling dizzy, constipated or nauseous. It also puts you at risk of developing a dihydrocodeine addiction, which can be very harmful and even put your life at risk.
What is dihydrocodeine addiction?
Dihydrocodeine addiction is when you find yourself needing the drug even though deep down you know it’s starting to cause harm. It can happen when dihydrocodeine is taken in ways it wasn’t meant to be, or even if you take a prescription for too long.
Like other forms of prescription drug addiction, dihydrocodeine addiction often begins with a growing tolerance. At first, dihydrocodeine helps, but then your body gets used to it, and the same dose stops working the way it used to. As you take more, bit by bit, your brain starts to treat dihydrocodeine like something it can’t function without. When you try to reduce your dihydrocodeine dosage or stop altogether, your brain reacts hard, triggering withdrawal symptoms that feel impossible to push through on your own.
But addiction isn’t just about the physical cravings, and for some people, dihydrocodeine becomes a way to get through tough days or painful feelings. That emotional reliance, alongside the physical one, is what makes dihydrocodeine addiction so hard to break. However, with professional dihydrocodeine addiction treatment, recovery is very much possible.
Dihydrocodeine factsheet
- Dihydrocodeine is classified as a Class B controlled drug in the UK with unlawful possession risking up to 5 years in prison or an unlimited fine.
- Low-dihydrocodeine dosage combination products are available over the counter but single-ingredient forms require a prescription.
- Between 2001–2020, there were 2,071 UK deaths directly attributed to dihydrocodeine abuse.
- Approximately 6.8% of all opioid-related deaths in one study involved dihydrocodeine.
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How to spot dihydrocodeine addiction symptoms?
Recognising a dihydrocodeine addiction early can make all the difference. However, it’s not always easy to spot, especially if you started with a genuine prescription for pain. That’s why it helps to know some of the dihydrocodeine addiction symptoms to prevent a slide into dangerous territory:
- You have had to up your dihydrocodeine dosage because the old one doesn’t seem to work anymore
- You’re taking dihydrocodeine without a prescription or not as your doctor advised.
- You feel rough if you go too long without taking dihydrocodeine.
- You’re not being honest with the people around you about how much dihydrocodeine you’re taking.
- You’ve done things you normally wouldn’t to get more dihydrocodeine, like lying or borrowing pills.
- Your behaviour feels out of control and out of character.
- Deep down, you know it’s becoming a problem, but you’re not sure how to stop.
If any of these dihydrocodeine addiction symptoms sound worrisome, please don’t wait for it to get worse. Dihydrocodeine rehab and detox can help you turn things around and start again.
What factors increase dihydrocodeine addiction liability?
Not everyone who takes dihydrocodeine ends up addicted. Some people can use it exactly as prescribed and never feel the urge to take more. But for others, things unfold very differently, with a few personal and environmental factors increasing dihydrocodeine addiction liability:
How your brain responds
Dihydrocodeine acts a lot like your body’s own feel-good chemicals, which is what makes it so effective at easing pain. However, some people’s brains are wired in a way that quickly grasps those effects and resists letting go.
Your background and environment
If addiction has affected your family before, there may be a genetic link that makes you more vulnerable. Similarly, if you grew up in a place where drug use was common or normalised, that can make dihydrocodeine feel more like an option when life gets hard.
Your mental and emotional state
When you’re going through something tough like grief, anxiety or trauma, it’s not unusual to use painkillers like dihydrocodeine for emotional relief. But what starts as a way to cope can quietly develop into an addiction.
How long you have been taking dihydrocodeine
Even if you started dihydrocodeine under a doctor’s care, long-term use carries risks. The longer you’re on dihydrocodeine, the more your body can come to rely on it, making it harder to stop.
What are the dangers of dihydrocodeine abuse and addiction?
Long-term dihydrocodeine misuse and abuse can cause enormous physical, mental and emotional harm. Here are the main dangers you need to understand:
Dihydrocodeine overdose
Even though some people think of dihydrocodeine as a “weaker” painkiller, taking too much, especially with other drugs or alcohol, can be deadly. A dihydrocodeine overdose can lead to shallow breathing, confusion or unconsciousness. If any of that happens, it’s a medical emergency, and you need to get help immediately.
Liver and kidney problems
Your body isn’t built to handle large amounts of dihydrocodeine over long periods. The liver and kidneys are put under constant pressure to process the drug, and that can lead to lasting damage if it goes unchecked.
Mental health effects
If you’re already struggling with anxiety, depression or other mental health issues, dihydrocodeine addiction can make things worse. You may also start feeling disconnected or overwhelmed, developing new mental health problems as addiction adds more pressure to your life.
Finding help if you have a dihydrocodeine addiction
If you’re feeling stuck in a cycle with dihydrocodeine and can’t see the way out, please know you don’t have to face it by yourself. At Providence Projects, we offer rehab treatment for prescription drug dependencies, and we can provide what you need to begin your sober journey.
If today’s the day you want to talk, contact us to get started.
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Start the Dihydrocodeine Rehabilitation Process Today
Finding the best addiction treatment is vital for long-term recovery success. Our friendly and compassionate team will hold your hand through the process until you learn to love yourself again.
Frequently Asked Questions
How is dihydrocodeine addiction screened?
Dihydrocodeine addiction is usually screened through a series of questions and conversations with a healthcare professional. They will ask about how often you take dihydrocodeine, how much you use, whether you have tried to stop and how it’s affecting your life. There are also clinical tools like the DSM-5 criteria and specific questionnaires that help doctors understand whether your use has crossed into addiction. If you’re not sure where to start, contacting the Providence Projects can be a great first step.
How to prevent a dihydrocodeine addiction?
The best way to prevent a dihydrocodeine addiction is to take the medication exactly as prescribed and only for as long as your doctor recommends. If you start noticing you’re taking it just to feel “normal” or you’re tempted to increase the dose without guidance, that’s a sign to reach out. Being aware of your mental health, especially if you’ve got a history of anxiety, depression or past substance issues, can also make a big difference. It is very important to discuss all of this with your doctor so they can decide whether dihydrocodeine is right for you.
Can the combination of dihydrocodeine and alcohol be dangerous?
Yes, combining dihydrocodeine and alcohol can be extremely dangerous and even put your life at risk. Both substances slow down your body’s central nervous system, which controls things like breathing and heart rate. When taken together, this can lead to trouble breathing, unconsciousness or overdose. You might not feel the effects creeping up, which makes the combination especially risky. If you are prescribed dihydrocodeine, it is safest to avoid alcohol completely while you’re taking it.
(Click here to see works cited)
- UK Addiction Treatment Centres. “Understanding Dihydrocodeine.” UK Addiction Treatment Centres, 2 January 2024, https://www.ukat.co.uk/blog/substance-abuse/understanding-dihydrocodeine/ – Accessed 17 July 2025.
- UK Rehab. “Dihydrocodeine Addiction | Causes, Symptoms and Diagnosis.” UK Rehab, https://www.uk-rehab.com/prescription-drug-addiction/opioid/dihydrocodeine/ – Accessed 17 July 2025.
- GOV.UK. “Over-the-counter painkillers containing codeine or dihydrocodeine.” GOV.UK, 11 December 2014, https://www.gov.uk/drug-safety-update/over-the-counter-painkillers-containing-codeine-or-dihydrocodeine – Accessed 17 July 2025.
- Rock, Kirsten L et al. “Highlighting the hidden dangers of a ‘weak’ opioid: Deaths following use of dihydrocodeine in England (2001-2020).” Drug and alcohol dependence vol. 233 (2022): 109376. doi:10.1016/j.drugalcdep.2022.109376
- NHS. “Dihydrocodeine: medicine for treating moderate to severe pain.” NHS, https://www.nhs.uk/medicines/dihydrocodeine/ – Accessed 17 July 2025.
- Rock, Kirsten L et al. “Highlighting the hidden dangers of a ‘weak’ opioid: Deaths following use of dihydrocodeine in England (2001-2020).” Drug and alcohol dependence vol. 233 (2022): 109376. doi:10.1016/j.drugalcdep.2022.109376
- Jani, Meghna et al. “Time trends and prescribing patterns of opioid drugs in UK primary care patients with non-cancer pain: A retrospective cohort study.” PLoS medicine vol. 17,10 e1003270. 15 Oct. 2020, doi:10.1371/journal.pmed.100327
- Zamparutti, Giuliano et al. “Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997-2007.” British journal of clinical pharmacology vol. 72,2 (2011): 330-7. doi:10.1111/j.1365-2125.2011.03908.x