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20
1 strong · 15 moderate · 4 weak

Studies and references cited across this article, graded by evidence strength.

Values approved
95/95 (100%)

Data points an editor reviewed and accepted for publication.

01

Value Provenance

Dosing

oraltrace

FieldPublishedAI ProposedConfidence
Threshold20 mg20 mglow
Low40–50 mg40–50 mglow
Common50–100 mg50–100 mglow
Strong100–200 mg100–200 mglow
Heavy200+ mg200+ mglow
Editorial

Values carried forward from existing seed/DB data. Published therapeutic range is 5–50 mg (Wikidoc), placing the seed 'common' range (50–100 mg) at and above therapeutic ceiling. No controlled dose-finding studies exist. Seed values appear to reflect recreational/supratherapeutic context rather than clinical dosing. CYP2D6 phenotype creates up to 9-fold inter-individual variation in effective opioid dose (Hedenmalm 1997). Safety-critical flag: these dose values lack primary literature verification.

Reasoning

Values carried forward from existing seed/DB data. Published therapeutic range is 5–50 mg (Wikidoc), placing the seed 'common' range (50–100 mg) at and above therapeutic ceiling. No controlled dose-finding studies exist. Seed values appear to reflect recreational/supratherapeutic context rather than clinical dosing. CYP2D6 phenotype creates up to 9-fold inter-individual variation in effective opioid dose (Hedenmalm 1997). Safety-critical flag: these dose values lack primary literature verification.

Evidence basis: community_consensus_large

Duration

oral

FieldPublishedAI ProposedConfidence
Onsettrace20–45 minutes20–45 minuteslow
Editorial

Inferred from PK data: Tmax 45 min for syrup (Aasmundstad 1995), 2.2h for tablet (ElMeshad 2020). Opioid effects depend on CYP2D6 morphine formation rate, not just parent compound absorption. Range represents syrup formulation onset; tablet onset would be longer.

Reasoning

Inferred from PK data: Tmax 45 min for syrup (Aasmundstad 1995), 2.2h for tablet (ElMeshad 2020). Opioid effects depend on CYP2D6 morphine formation rate, not just parent compound absorption. Range represents syrup formulation onset; tablet onset would be longer.

Evidence basis: structural_analogy

Come uptrace30–60 minutes30–60 minuteslow
Editorial

Inferred from PK parameters and mu-opioid class subjective timecourse. Morphine levels build progressively as CYP2D6 conversion proceeds. No controlled subjective-effects study exists.

Reasoning

Inferred from PK parameters and mu-opioid class subjective timecourse. Morphine levels build progressively as CYP2D6 conversion proceeds. No controlled subjective-effects study exists.

Evidence basis: structural_analogy

Peaktrace1–2 hours1–2 hourslow
Editorial

Inferred from t½ = 2h (Aasmundstad 1995) and typical mu-opioid agonist peak duration. Peak opioid effects expected around Tmax and persisting for approximately one half-life of the parent compound.

Reasoning

Inferred from t½ = 2h (Aasmundstad 1995) and typical mu-opioid agonist peak duration. Peak opioid effects expected around Tmax and persisting for approximately one half-life of the parent compound.

Evidence basis: structural_analogy

Offsettrace1–2 hours1–2 hourslow
Editorial

Inferred from t½ = 2h and active metabolite morphine persistence. Sedation typically outlasts euphoria during the offset phase. Class-level inference from morphine/codeine.

Reasoning

Inferred from t½ = 2h and active metabolite morphine persistence. Sedation typically outlasts euphoria during the offset phase. Class-level inference from morphine/codeine.

Evidence basis: structural_analogy

Totaltrace4–5 hours4–5 hoursmedium
Editorial

Seed data value (4–5 hours oral). Consistent with parent compound t½ = 2h (Aasmundstad 1995) plus continued morphine metabolite activity. This represents subjective experience duration, not pharmacological half-life or drug test positivity window.

Reasoning

Seed data value (4–5 hours oral). Consistent with parent compound t½ = 2h (Aasmundstad 1995) plus continued morphine metabolite activity. This represents subjective experience duration, not pharmacological half-life or drug test positivity window.

Evidence basis: community_consensus_large

After effectstrace2–6 hours2–6 hourslow
Editorial

Residual sedation and constipation expected after subjective opioid effects resolve. Opiate immunoassay remains positive 24+ hours (Popa 1998). Impairment may persist beyond subjective awareness. Class inference from morphine/codeine.

Reasoning

Residual sedation and constipation expected after subjective opioid effects resolve. Opiate immunoassay remains positive 24+ hours (Popa 1998). Impairment may persist beyond subjective awareness. Class inference from morphine/codeine.

Evidence basis: structural_analogy

Safety

Toxicity Profiletrace

FieldPublishedAI ProposedConfidence
Acutemoderatemoderatemedium
Chronicmoderatemoderatemedium
Organs Affectedpulmonary, hepatic, CNSpulmonary, hepatic, CNSmedium
Editorial

Work-notes recommend moderate for both acute and chronic, correcting the contradictory seed data. Evidence base: one fatal case report (Kintz 1994), hepatic GSH depletion in mice (Skoulis 1989), and mu-opioid class extrapolation for respiratory depression mechanism. Fatal concentration required ~9x therapeutic levels, supporting moderate rather than high acute toxicity. Chronic toxicity reflects hepatic GSH vulnerability and opioid-induced hyperalgesia risk from class inference.

Reasoning

Work-notes recommend moderate for both acute and chronic, correcting the contradictory seed data. Evidence base: one fatal case report (Kintz 1994), hepatic GSH depletion in mice (Skoulis 1989), and mu-opioid class extrapolation for respiratory depression mechanism. Fatal concentration required ~9x therapeutic levels, supporting moderate rather than high acute toxicity. Chronic toxicity reflects hepatic GSH vulnerability and opioid-induced hyperalgesia risk from class inference.

Evidence basis: single_case_report

Dependence Profiletrace

FieldPublishedAI ProposedConfidence
Physicalhighhighmedium
Psychologicalhighhighmedium
Compulsive Redosingmoderatemoderatemedium
Dose Escalationhighhighmedium
Editorial

Work-notes specify high physical and psychological dependence, moderate compulsive redosing, high dose escalation. No ethylmorphine-specific dependence studies exist; all inferred from morphine/codeine class pharmacology plus forensic abuse evidence (Kintz 1994 heroin-switching case, Jones 2008 impaired driving data).

Reasoning

Work-notes specify high physical and psychological dependence, moderate compulsive redosing, high dose escalation. No ethylmorphine-specific dependence studies exist; all inferred from morphine/codeine class pharmacology plus forensic abuse evidence (Kintz 1994 heroin-switching case, Jones 2008 impaired driving data).

Evidence basis: structural_analogy

Withdrawal Profiletrace

FieldPublishedAI ProposedConfidence
Severitymoderatemoderatelow
SymptomsLacrimation, Rhinorrhea, Myalgia, Insomnia, Anxiety, Diarrhea, Piloerection, Autonomic instability, Restlessness, YawningLacrimation, Rhinorrhea, Myalgia, Insomnia, Anxiety, Diarrhea, Piloerection, Autonomic instability, Restlessness, Yawninglow
FatalNoNolow
Medical SupervisionRequiredRequiredlow
Editorial

Withdrawal characterization entirely from morphine/codeine class inference. Onset 8–24 hours (using 12h midpoint) reflects ethylmorphine t½ = 2h but active metabolite morphine persists longer. Acute phase 5–10 days from morphine class. No ethylmorphine-specific withdrawal study published.

Reasoning

Withdrawal characterization entirely from morphine/codeine class inference. Onset 8–24 hours (using 12h midpoint) reflects ethylmorphine t½ = 2h but active metabolite morphine persists longer. Acute phase 5–10 days from morphine class. No ethylmorphine-specific withdrawal study published.

Evidence basis: structural_analogy

Tolerance Profiletrace

FieldPublishedAI ProposedConfidence
Buildupmoderatemoderatelow
Half-life5 days5 dayslow
Full Reset1.5 weeks1.5 weekslow
Cross-tolerancesmorphine, codeine, oxycodone, hydrocodone, heroin, all mu-opioid agonistsmorphine, codeine, oxycodone, hydrocodone, heroin, all mu-opioid agonistslow
Editorial

Work-notes flag tolerance timeline as unverified class estimate. Mechanism is well-established for morphine class (receptor desensitization, GRK/β-arrestin pathway). Cross-tolerances confirmed at class level. Confidence is low because no ethylmorphine-specific tolerance study exists.

Reasoning

Work-notes flag tolerance timeline as unverified class estimate. Mechanism is well-established for morphine class (receptor desensitization, GRK/β-arrestin pathway). Cross-tolerances confirmed at class level. Confidence is low because no ethylmorphine-specific tolerance study exists.

Evidence basis: structural_analogy

Effects & Profile

Contraindications

FieldPublishedAI ProposedConfidence
respiratory Respiratory insufficiencytraceabsoluteabsolutehigh
Editorial

Documented in HandWiki and Wikidoc product information. Standard mu-opioid agonist class contraindication with direct clinical relevance to ethylmorphine via its morphine metabolite.

Reasoning

Documented in HandWiki and Wikidoc product information. Standard mu-opioid agonist class contraindication with direct clinical relevance to ethylmorphine via its morphine metabolite.

other Concurrent CNS depressant usetraceabsoluteabsolutehigh
Editorial

Ethanol metabolic inhibition data from Xu et al. 1997 in isolated rat hepatocytes. Pharmacodynamic synergism is class-level for all opioid–depressant combinations. Seed interaction data rates alcohol, GHB, GBL, tramadol, and ketamine as lethal.

Reasoning

Ethanol metabolic inhibition data from Xu et al. 1997 in isolated rat hepatocytes. Pharmacodynamic synergism is class-level for all opioid–depressant combinations. Seed interaction data rates alcohol, GHB, GBL, tramadol, and ketamine as lethal.

age Pediatric patients under 8 yearstraceabsoluteabsolutemedium
Editorial

Wikidoc lists age contraindication. Codeine pediatric fatality analogy cited in article prose. Ethylmorphine produces more morphine per dose than codeine (7.0% vs 3.8%), potentially amplifying the UM risk.

Reasoning

Wikidoc lists age contraindication. Codeine pediatric fatality analogy cited in article prose. Ethylmorphine produces more morphine per dose than codeine (7.0% vs 3.8%), potentially amplifying the UM risk.

other Intravenous administrationtraceabsoluteabsolutemedium
Editorial

Documented in Wikidoc product information. Histamine release is a known property of morphinan opioids administered intravenously, and ethylmorphine is specifically flagged for this risk.

Reasoning

Documented in Wikidoc product information. Histamine release is a known property of morphinan opioids administered intravenously, and ethylmorphine is specifically flagged for this risk.

metabolic CYP2D6 ultrarapid metabolizer statustracerelativerelativemedium
Editorial

Inferred from codeine CYP2D6 UM pharmacogenomic data (structural analogy). Ethylmorphine's higher morphine yield vs codeine (7.0% vs 3.8%, Hedenmalm 1997) may amplify this risk. No ethylmorphine-specific UM case reports exist.

Reasoning

Inferred from codeine CYP2D6 UM pharmacogenomic data (structural analogy). Ethylmorphine's higher morphine yield vs codeine (7.0% vs 3.8%, Hedenmalm 1997) may amplify this risk. No ethylmorphine-specific UM case reports exist.

hepatic Hepatic impairmenttracerelativerelativemedium
Editorial

GSH depletion from Skoulis 1989 (animal data). Hepatic metabolism dependence from Aasmundstad 1995 and Hedenmalm 1997 PK studies. Class-level contraindication for hepatically-metabolized opioid prodrugs.

Reasoning

GSH depletion from Skoulis 1989 (animal data). Hepatic metabolism dependence from Aasmundstad 1995 and Hedenmalm 1997 PK studies. Class-level contraindication for hepatically-metabolized opioid prodrugs.

neurological Head injury or raised intracranial pressuretraceabsoluteabsolutelow
Editorial

Class-level mu-opioid agonist contraindication listed in work-notes under class-level contraindications inherited from morphine. No ethylmorphine-specific data; standard opioid prescribing guidance.

Reasoning

Class-level mu-opioid agonist contraindication listed in work-notes under class-level contraindications inherited from morphine. No ethylmorphine-specific data; standard opioid prescribing guidance.

other Paralytic ileustraceabsoluteabsolutelow
Editorial

Class-level mu-opioid agonist contraindication inherited from morphine, listed in work-notes. No ethylmorphine-specific data.

Reasoning

Class-level mu-opioid agonist contraindication inherited from morphine, listed in work-notes. No ethylmorphine-specific data.

Timeline Phases

oral

FieldPublishedAI ProposedConfidence
Onsettrace1200–2700 sec(i=0.15)1200–2700 sec(i=0.15)low
Editorial

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Reasoning

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Evidence basis: structural_analogy

Come uptrace1800–3600 sec(i=0.50)1800–3600 sec(i=0.50)low
Editorial

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Reasoning

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Evidence basis: structural_analogy

Peaktrace3600–7200 sec(i=1.00)3600–7200 sec(i=1.00)low
Editorial

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Reasoning

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Evidence basis: structural_analogy

Resolutiontrace3600–7200 sec(i=0.35)3600–7200 sec(i=0.35)low
Editorial

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Reasoning

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Evidence basis: structural_analogy

Afterglowtrace7200–21600 sec(i=0.10)7200–21600 sec(i=0.10)low
Editorial

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Reasoning

Phase breakdown inferred from PK parameters (Aasmundstad 1995: Tmax 45 min syrup, t½ 2h; ElMeshad 2020: Tmax 2.2h tablet) and mu-opioid class subjective effect timecourse. Total duration of 4–5 hours from seed data is consistent with t½ = 2h plus active metabolite morphine persistence. No controlled subjective-effects timeline study exists for ethylmorphine. All phase durations are class-inferred from morphine/codeine pharmacology.

Evidence basis: structural_analogy

Dose Tier Summaries

thresholdtrace
low

Minimal perceptible opioid effects at this range. A faint sense of warmth and mild anxiolysis may emerge as CYP2D6 begins converting ethylmorphine to morphine, though the subjective shift is subtle and may be imperceptible in CYP2D6 poor metabolizers. Physically, slight muscle relaxation and a gentle easing of bodily tension are the most noticeable signs. No significant sedation, analgesia, or respiratory effects are expected. This range falls below the established therapeutic antitussive dose. CYP2D6 phenotype is the dominant variable at this level — an ultrarapid metabolizer may perceive mild opioid effects where a poor metabolizer notices nothing.

Editorial

Work-notes specify threshold at ~20 mg. No controlled subjective-effects studies exist for ethylmorphine at any dose. Description inferred from mu-opioid agonist class pharmacology (morphine/codeine) and the prodrug conversion kinetics described in Aasmundstad 1995 and Hedenmalm 1997.

Reasoning

Work-notes specify threshold at ~20 mg. No controlled subjective-effects studies exist for ethylmorphine at any dose. Description inferred from mu-opioid agonist class pharmacology (morphine/codeine) and the prodrug conversion kinetics described in Aasmundstad 1995 and Hedenmalm 1997.

Evidence basis: structural_analogy

lighttrace
low

Mild analgesia and anxiolysis become clearly perceptible. A gentle sedation settles in alongside bodily warmth and slight heaviness. Antitussive effects are present at this range, which overlaps with the lower end of therapeutic dosing. Physical effects include mild muscle relaxation, possible pupil constriction, and a subtle reduction in pain sensitivity. Nausea is uncommon but possible in opioid-naive individuals. Cognitive function remains largely intact, though slight thought deceleration may be noticed. Comparable in character to a low therapeutic dose of codeine, though ethylmorphine produces proportionally more morphine per milligram (7.0% vs 3.8%).

Editorial

Work-notes specify light at 40–50 mg. Therapeutic range per Wikidoc is 5–50 mg, placing the light tier at the upper end of therapeutic dosing. Effects inferred from morphine/codeine class and the comparative PK data (Hedenmalm 1997).

Reasoning

Work-notes specify light at 40–50 mg. Therapeutic range per Wikidoc is 5–50 mg, placing the light tier at the upper end of therapeutic dosing. Effects inferred from morphine/codeine class and the comparative PK data (Hedenmalm 1997).

Evidence basis: structural_analogy

commontrace
low

Clear mu-opioid agonist effects emerge — moderate analgesia, noticeable sedation, and a warm euphoric contentment. Anxiety suppression is pronounced. Pupil constriction is visible and consistent. The antitussive ceiling is reached within this range. Bodily heaviness and muscle relaxation are prominent. Nausea is possible, particularly in opioid-naive users. Constipation onset begins. Mild respiratory slowing occurs but is typically not subjectively distressing at this level. A body high characterized by diffuse warmth and spontaneous pleasant sensations is common. Cognitive effects include thought deceleration, focus suppression, and mild motor control impairment. This range straddles the upper therapeutic boundary — doses above 50 mg exceed published therapeutic recommendations.

Editorial

Work-notes specify common at 50–100 mg. Published therapeutic range tops out at 50 mg (Wikidoc), so the upper half of this tier is supratherapeutic. Effect descriptions inferred from mu-opioid class pharmacology. The discrepancy between therapeutic and seed 'common' dose is noted per work-notes instruction.

Reasoning

Work-notes specify common at 50–100 mg. Published therapeutic range tops out at 50 mg (Wikidoc), so the upper half of this tier is supratherapeutic. Effect descriptions inferred from mu-opioid class pharmacology. The discrepancy between therapeutic and seed 'common' dose is noted per work-notes instruction.

Evidence basis: structural_analogy

strongtrace
low

Pronounced sedation and euphoria dominate the experience. Analgesia is substantial. Cognitive impairment becomes significant — decision-making, psychomotor coordination, and attention are markedly reduced. Emotional suppression and a sense of detached contentment are characteristic. Respiratory depression risk becomes clinically significant at this range. Nausea and vomiting are likely in non-tolerant individuals. Constipation is expected. Pupil constriction is marked. Sexual arousal suppression is typical. The body high is intense, with heavy sedation that may approach somnolence at the upper end. This range exceeds all published therapeutic dosing. Driving and machinery operation are absolutely unsafe. The risk of adverse outcomes increases substantially, particularly in CYP2D6 ultrarapid metabolizers who may experience morphine levels equivalent to a heavy dose.

Editorial

Work-notes specify strong at 100–200 mg, well above the 5–50 mg therapeutic range. All effect descriptions are class-inferred from morphine/codeine pharmacology. Respiratory depression risk escalation at supratherapeutic doses is a well-established mu-opioid class property.

Reasoning

Work-notes specify strong at 100–200 mg, well above the 5–50 mg therapeutic range. All effect descriptions are class-inferred from morphine/codeine pharmacology. Respiratory depression risk escalation at supratherapeutic doses is a well-established mu-opioid class property.

Evidence basis: structural_analogy

heavytrace
low

This range carries severe risk of life-threatening respiratory depression. Sedation is profound and may approach or reach unconsciousness. The one published fatal ethylmorphine overdose (Kintz et al. 1994) occurred at blood concentrations consistent with doses in this range. Nausea, vomiting, and aspiration risk are high. Cardiovascular depression may occur. Complete psychomotor incapacitation is expected. The combination of respiratory depression and loss of consciousness creates extreme overdose danger, compounded by the unpredictable CYP2D6-dependent morphine formation rate. Co-ingestion of any CNS depressant at this dose level is potentially fatal. Naloxone should be immediately accessible. This range is never therapeutically indicated and represents a medical emergency threshold.

Editorial

Work-notes specify heavy at 200+ mg. Fatal case (Kintz 1994) at 488 ng/mL blood (~9x therapeutic level) provides the only direct human toxicity anchor. All other characterization is class-inferred from morphine overdose pharmacology. Approximate lethal dose of ~500 mg from Wikidoc is unverified (flagged as safety-citation-needed).

Reasoning

Work-notes specify heavy at 200+ mg. Fatal case (Kintz 1994) at 488 ng/mL blood (~9x therapeutic level) provides the only direct human toxicity anchor. All other characterization is class-inferred from morphine overdose pharmacology. Approximate lethal dose of ~500 mg from Wikidoc is unverified (flagged as safety-citation-needed).

Evidence basis: structural_analogy

02

History

current version
published Oct 2, 2026system—
versions
2 total · since previous: +0 / −0 citations
publication ledger

publish Oct 2, 2026 · by agent-psx

backfill Jun 4, 2026

Historical versions do not record which reviewer approved them; editorial accountability is recorded per value in the database and in the publication ledger going forward.

03

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1 strong · 15 moderate · 4 weak
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04

Claim Verification

No claim verification has run for this version.

05

Coverage & Gaps

effect links
66 links · 66 approved · 0 audited0/66 with evidence basis
interactions
7 approved pairs0/7 graded