Over the past two decades, Americans of ages, genders, social backgrounds, and demographics have been exposed to what has primarily become known as a nationwide epidemic. Opioid abuse, addiction, and overdose have mostly taken the country by storm, and nearly 130 American citizens currently lose their lives to opioid overdose every day. Heroin largely fuels the epidemic, but prescription opioid narcotics – like codeine – are also responsible for a significant number of overdose-related deaths.
Table of Contents
- 1 What is Cold Water Extraction of Codeine?
- 2 Why Do People Use Cold Water Extraction?
- 3 Addiction to Codeine Requires Professional Help
- 4 Codeine Cold Water Extractions Mean You’re Addicted to Codeine
- 5 Cold Water Extractions Are Not a Safe Way to Use Codeine
- 6 Allure Detox and Codeine Addiction Recovery
What is Cold Water Extraction of Codeine?
Codeine Cold Water Extraction (CWE) is a method used to separate codeine from combination analgesic medications that contain paracetamol (acetaminophen), ibuprofen, or aspirin. The process takes advantage of the different solubility of these substances in water, allowing for the removal of potentially toxic ingredients while isolating the opioid for recreational use.
This practice is considered high-risk and poses significant public health concerns due to the dangers of opioid toxicity, overdose, and dependence.
Why Do People Use Cold Water Extraction?
Many over-the-counter (OTC) and prescription combination analgesic products contain codeine phosphate along with acetaminophen (paracetamol) or ibuprofen. Since consuming high doses of these non-opioid ingredients can cause severe liver toxicity (acetaminophen) or stomach ulcers and kidney damage (ibuprofen), CWE is used to reduce these risks while isolating codeine.
Common Medications Used for CWE
- Co-Codamol (Codeine + Acetaminophen)
- Co-Codaprin (Codeine + Aspirin)
- Nurofen Plus (Codeine + Ibuprofen)
- Panadeine Forte (Codeine + Acetaminophen)
Warning: CWE is not foolproof and does not guarantee complete removal of toxic substances.
How Does Cold Water Extraction Work?
The principle behind CWE is solubility:
- Codeine phosphate is highly soluble in cold water (~800 mg/100 mL at 5°C).
- Acetaminophen, ibuprofen, and aspirin are less soluble in cold water.
Basic CWE Process (Filtration Method)
- Crush Tablets – Pills are ground into a fine powder.
- Dissolve in Cold Water – The powder is mixed in a small amount of very cold water (~4°C).
- Filtration – A coffee filter or similar method is used to separate the solid acetaminophen, ibuprofen, or aspirin from the liquid.
- Consumption – The filtered liquid contains codeine and is consumed.
Risk: Poor filtration can still allow dangerous amounts of acetaminophen into the final product, leading to liver damage or failure.
Dangers & Risks of Codeine CWE
Although CWE is intended to reduce toxic effects from other analgesic products, it still carries serious risks:
1. Overdose & Respiratory Depression
- CWE isolates codeine, which the liver metabolizes into morphine.
- Large doses or combining with alcohol, benzodiazepines, or other CNS depressants increases the risk of fatal respiratory depression.
2. Liver Toxicity Risk Still Exists
- Incomplete filtration can still leave toxic amounts of acetaminophen in the solution.
- Over 4g of acetaminophen per day can cause acute liver failure, which may be fatal.
3. Increased Tolerance, Dependence & Addiction
- Repeated use of CWE-extracted codeine increases tolerance, leading to higher doses over time.
- This can result in opioid dependence and withdrawal symptoms.
4. Public Health Concerns
- OTC access to codeine combination analgesics has led to concerns in clinical toxicology and addiction medicine.
- Many countries (e.g., UK, Australia, Canada) have restricted access to codeine-containing OTC products due to the rise in misuse.
Side Effects of CWE-Extracted Codeine
Even when using CWE, codeine still carries risks:
- Drowsiness & confusion
- Nausea & vomiting
- Constipation
- Dizziness & low blood pressure
- Itchy skin & allergic reactions
- Severe withdrawal symptoms if used frequently
Regulations & Restrictions on Codeine
Due to the high-risk potential of opioid extraction from combination analgesic products, many governments have tightened regulations:
- United Kingdom – Codeine is no longer available OTC; prescription required.
- Australia – As of 2018, all codeine-containing products require a prescription.
- Canada – Codeine-containing OTC medications are limited in availability.
- United States – Codeine is a Schedule II-V controlled substance, depending on formulation.
Cold Water Extraction is a method used to separate codeine from combination painkillers, but it is not a safe practice. Even with filtration, toxic ingredients may still remain, and the extracted codeine still carries overdose and addiction risks.
If you or someone you know is struggling with opioid use, seek professional help. Treatment options, including medication-assisted therapy (MAT) with methadone or buprenorphine, can help manage opioid dependence safely.
Addiction to Codeine Requires Professional Help
If you or someone you know has been abusing codeine, seeking professional help is critical. Allure Detox is available to help you or your loved one take the first step on the lifelong road to recovery – medical detox. However, you might have a sneaking suspicion that someone you love has been grappling with codeine addiction, but you still might not be sure. If you are unsure, several signs will unquestionably indicate that your loved one needs treatment.
Codeine Cold Water Extractions Mean You’re Addicted to Codeine
How do you know that treatment has become a necessity? There are several ways to tell that treatment has become necessary and that codeine use has developed in substance abuse. One of the best ways to tell is to observe whether or not your loved one has been using the medication other than as prescribed – for example, crushing and snorting codeine in its tablet form or engaging in codeine cold water extraction (cwe). What is codeine cold water extraction? Essentially, this is one of many tampering with codeine to make it more easily abused and feel its effects more quickly. This is a popular method of tampering because it can usually be completed with several relatively basic household supplies.
Cold Water Extractions Are Not a Safe Way to Use Codeine
People who abuse codeine in this way extract the drug from over-the-counter cough syrup that contains codeine, either codeine/paracetamol 8/500mg or codeine/ibuprofen 12/200mg. Codeine cold water extractions increase the drug’s potency by removing all acetaminophen in the tablets, leaving pure codeine to abuse and get high on. This is absolutely an indication of a drug abuse problem – one that requires professional treatment. How do you tell if someone you love is using the cold water extraction method? The best way to tell is by looking through your loved one’s browser search history. Most people who use this method will need to research it extensively online because it is certainly not a straightforward – or safe – process.
Allure Detox and Codeine Addiction Recovery
If you or someone you love has been abusing codeine in any capacity, seeking professional help is necessary – and medically monitored detox is always an essential initial step. Allure Detox offers a comprehensive and unique program of medical codeine detox, seeing as we tackle the root cause of addiction along with the physical and psychological symptoms of codeine withdrawal. Call us today to learn more about our detox program or get you or your loved one started on a long-term journey of codeine addiction recovery.
FAQ
What is Codeine?
Published on: 2021-02-21
Updated on: 2025-02-19
