What is it?
Some over-the-counter products — including codeine-containing painkillers and certain sedating antihistamines — can be misused or cause dependence. Combination painkillers can also contain paracetamol, which is dangerous in excess.
Common forms
- Tablets and capsules
- Liquids
- Cough and cold products
How it affects the body
Effects depend on the ingredients; combination products often contain more than one active drug.
Short-term effects
- Intended symptom relief
- Drowsiness with sedating products
- Nausea and constipation with codeine-containing products
Long-term effects
- Dependence with prolonged codeine use
- Medication-overuse headache
- Organ damage from repeated excess paracetamol
Dependence and addiction
Dependence can develop when the body and brain adapt to regular use. It is not a moral failing or a lack of willpower. Signs people describe include needing more to get the same effect, difficulty cutting down, spending more time thinking about use, and continuing despite harm. Support is available at any stage — you do not need to have reached a crisis point.
Withdrawal
Stopping or reducing after regular use can cause withdrawal. Withdrawal varies between people and depends on how much and how long someone has used, their physical health and other substances involved. Some withdrawal can be medically serious, so it is safer to plan a reduction with a clinician or a drug and alcohol service rather than stopping abruptly alone. A pharmacist or GP can support a planned reduction.
Overdose risks
Paracetamol overdose is a medical emergency even if the person feels fine — call 999 or 111 straight away. Do not wait for symptoms.
Mixing substances
Check whether products contain the same ingredient — accidental double-dosing is common. Ask a pharmacist.
Harm-reduction information
- Read labels and check for paracetamol in combination products
- Ask a pharmacist if you are using painkillers most days
- Buy from a pharmacy where you can get advice
- Speak to a pharmacist about alternatives if you feel unable to stop
When to seek urgent medical help
Call 999 if someone is unconscious or cannot be woken, is having difficulty breathing, has a seizure, has chest pain, becomes very confused or agitated, or you are worried they may have overdosed. For urgent advice that is not life-threatening, call NHS 111. You will not get someone into trouble by calling for medical help.
Treatment and recovery options
- Talking therapies and structured psychosocial support
- Community drug and alcohol services, including self-referral where available
- Medication-assisted treatment where clinically appropriate
- Medically supported withdrawal, arranged and monitored by clinicians
- Peer support and recovery communities
- Residential rehabilitation for some people, usually via assessment
- Support for related needs — mental health, housing, family and welfare
UK support resources
- NHS — health information and service finders (nhs.uk)
- Talk to FRANK — UK drug information service (talktofrank.com)
- Your local community drug and alcohol service — many accept self-referrals
- Local pharmacy teams, who can offer advice and signposting
Sources / references
This page is a plain-language summary written for education. For clinical or legal detail, use authoritative UK sources: NHS (nhs.uk), Talk to FRANK (talktofrank.com), NICE (nice.org.uk), UK Government and devolved government publications, and guidance from UK professional bodies. Each page on this site carries a review date, and we welcome corrections.