Skip to main content
Psychedex
Facts label

Dihydrocodeine Facts

Opioid; Depressant; Substituted morphinan; Mu-opioid receptor agonist

Dose and durationby route · individual sensitivity varies

Oral(mg)
Threshold< 20 mgLight50 – 100 mgCommon100 – 150 mgStrong150 – 200 mgHeavy200+ mg

Starts in 30 – 60 minLasts 4 – 6 hoursAfter-effects 2 – 6 hours

Body and dependence

Acute toxicity
High
Chronic toxicity
Moderate
Physical dependence
Moderate
Psychological dependence
Moderate
Withdrawal
Moderate
Compulsive redosing
Moderate

Tolerance

Builds
Moderate
Fully resets after
10.5 days
Carries over to
opioids

Effectslikely at a common dose

Perception
none likely · 4 possible, including Vestibular distortion, Visual acuity suppression
Body
Sedation; Constipation; Pupil constriction; Pain suppression; +19 possible, including Respiratory depression, Dizziness, Motor control impairment
Thinking
none likely · 15 possible, including Cognitive impairment, Information processing suppression, Decision impairment
Feeling
none likely · 4 possible
Self
none likely · 6 possible, including Craving, Communication suppression, Social disconnection
Time
none likely · 2 possible, including Temporal disorientation

Who shouldn't take it

Absolute
Respiratory insufficiency; Severe hepatic impairment; Severe renal impairment; Neonates and infants; Concurrent MAO inhibitor use
Relative
Raised intracranial pressure; History of opioid use disorder; CYP2D6 ultrarapid metabolizer status; Concurrent CNS depressant use; Paralytic ileus or obstructive bowel disease

Combinations62 recorded

Lethal (6)
Benzodiazepines, Barbiturates; GHB, Baclofen; GHB, GBL; Ketamine; Local anesthetics; Tramadol
Dangerous (39)
Antihistamines; Benzodiazepines; Buprenorphine, Kratom; Cannabis, THC; Gabapentin, Pregabalin; MDMA, Amphetamines; Naltrexone; NRIs; Stimulants; THC; 5-HTP, Tryptophan; Alpha-2 adrenergic receptor antagonist; Amphetamines; Anticholinergics; Antipsychotics; Atypical antipsychotics; Buspirone; Caffeine; Cannabis; CBD; Dopamine agonists; DXM; Ephedrine, Pseudoephedrine; Glutamate modulator; and 15 more, see full page
Caution (12)
See full page: psychedex.org/substances/dihydrocodeine
Not graded (5)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

psychedex.org/substances/dihydrocodeine · Version r1 · Not medical adviceValues as of
On the printout