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Death may result when opiates are combined with other depressants such as benzodiazepines, barbiturates, gabapentinoids, thienodiazepines, alcohol or other GABAergic substances.[1]

It is strongly discouraged to combine these substances, particularly in common to heavy doses.

Summary sheet: Ethylmorphine
Chemical Nomenclature
Common names Ethylmorphine, codethyline, dionine
Substitutive name 3-ethylmorphine
Systematic name 7,8-didehydro-4,5-α-epoxy- 3-ethoxy-17-methylmorphinan-6-α-ol
Class Membership
Psychoactive class Opioid
Chemical class Morphinan
Routes of Administration

WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section.

Threshold 20 - 40 mg
Light 40 - 50 mg
Common 50 - 100 mg
Strong 100 - 200 mg
Total 4 - 5 hours
Onset 15 - 30 minutes
Peak 2 - 3 hours

DISCLAIMER: PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy.


Ethylmorphine, also known as codethyline and dionine, is a semi-synthetic morphinan opioid first created by Merck in 1884 and used as a weaker alternative to morphine. Today, it is most commonly used as an antitussive which is available in cough syrup preparations like Cocillana, Cosylan, Solvipect comp. (in combination with guaifenesin) and Lepheton (in combination with ephedrine), or in tablet form sold as Tussipax (in combination with codeine). Cough syrup preparations commonly include a mild laxative to counter the constipation which is a common side effect of opioids.

Ethylmorphine is also used in ophthalmic preparations as dionine to treat inflammations of the eye. In 1904, an ethylmorphine preparation was described as "a new ocular analgesic."[2]


Ethylmorphine, or 3-ethylmorphine, is an opioid of the morphinan class. Ethylmorphine and other molecules of this class contain a polycyclic core of three benzene rings fused in a zig-zag pattern called phenanthrene. A fourth nitrogen containing ring is fused to the phenanthrene at R9 and R13 with the nitrogen member looking at R17 of the combined structure. This structure is called morphinan.

Ethylmorphine, along with other morphinans, contains an ether bridge between two of its rings, connecting R4 and R5 through an oxygen group. It contains a hydroxy group (OH-) bound at R6 and a methyl group located on the nitrogen atom at R17. On the same ring containing the hydroxy group, ethylmorphine contains a double bond which is shared with codeine and morphine.

Ethylmorphine is closely related to morphine; both contain an oxygen group at R3, but this oxygen group in ethylphenidate is substituted by an ethyl group (making an ethoxy group). Ethylmorphine differs from the naturally occurring codeine (3-methylmorphine) only in having an ethoxy group in place of the methoxy group (they are homologous). It is also analogous to the other morphinans such as dihydrocodeine, heroin, hydrocodone, and oxycodone.


The active metabolites of ethylmorphine, notably morphine, exert their effects by binding to and activating the μ-opioid receptor. This occurs because opioids structurally mimic endogenous endorphins which are naturally found within the body and also work upon the μ-opioid receptor set. The way in which opioids structurally mimic these natural endorphins results in their euphoria, pain relief and anxiolytic effects. This is because endorphins are responsible for reducing pain, causing sleepiness, and feelings of pleasure. They can be released in response to pain, strenuous exercise, orgasm, or general excitement.

Ethylmorphine has been described as less potent than morphine but slightly more potent than codeine.[3]

Subjective effects

The effects listed below are based upon the subjective effects index and personal experiences of PsychonautWiki contributors. These effects should be taken with a grain of salt and will rarely (if ever) occur all at once, but heavier doses will increase the chances of inducing a full range of effects. Likewise, adverse effects become much more likely on higher doses and may include serious injury or death.

Physical effects

Cognitive effects

Experience reports

There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:

Toxicity and harm potential

Ethylmorphine has a low toxicity relative to dose. However, despite its relatively low toxicity for an opioid, at least one death has been attributed to oral consumption of ethylmorphine alone, without the presence of other depressants.[4] As with all opioids, long-term effects can vary but can include diminished libido, apathy and memory loss. It is also potentially lethal when mixed with depressants like alcohol or benzodiazepines.

It is strongly recommended that one use harm reduction practices when using this drug.

Tolerance and addiction potential

As with other opioids, the chronic use of ethylmorphine can be ethylmorphine very addictive with a high potential for abuse and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and withdrawal symptoms may occur if a person suddenly stops their usage.

Tolerance to many of the effects of ethylmorphine develops with prolonged and repeated use. The rate at which this occurs develops at different rates for different effects, with tolerance to the constipation-inducing effects developing particularly slowly for instance. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption). Ethylmorphine presents cross-tolerance with all other opioids, meaning that after the consumption of ethylmorphine all opioids will have a reduced effect.

Dangerous interactions

Although many psychoactive substances are reasonably safe to use on their own, they can quickly become dangerous or even life-threatening when taken with other substances. The following lists some known dangerous combinations, but cannot be guaranteed to include all of them. Independent research should always be conducted to ensure that a combination of two or more substances is safe to consume. Some interactions listed have been sourced from TripSit.

  • Alcohol - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely
  • Amphetamines - Stimulants increase respiration rate which allows for a higher dose of opiates than would otherwise be used. If the stimulant wears off first then the opiate may overcome the user and cause respiratory arrest.
  • Benzodiazepines - Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position blackouts/memory loss likely.
  • Cocaine - Stimulants increase respiration rate which allows for a higher dose of opiates than would otherwise be used. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.
  • DXM - CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.
  • GHB/GBL - The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position
  • Ketamine - Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
  • MAOIs - Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.
  • MXE - This combination can potentiate the effects of the opioid
  • Nitrous - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.
  • PCP - PCP can reduce opioid tolerance, increasing the risk of overdose.
  • Tramadol - Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

Legal issues

  • Internationally: Ethylmorphine is listed in the Single Convention on Narcotic Drugs in Schedule III.[5]
  • France: Tussipax tablets containing 10 mg of ethylmorphine and 10 mg of codeine are sold over the counter.[citation needed]
  • Germany: Ethylmorphine is controlled under BtMG Anlage II, making it illegal to manufacture, import, possess, sell, or transfer it without a license. There is an exception for preparations containing up to 2.5% or up to 100mg ethylmorphine per unit, which can be prescribed on a narcotic prescription form.[6]
  • Norway: Cosylan and Solvipect comp. cough syrups containing ethylmorphine hydrochloride 1.7mg/mL and 2.5mg/mL, respectively, are regulated in prescription Class B.[7][8] They are commonly prescribed for dry cough.
  • Sweden: Cocillana-Etyfin cough syrup containing ethylmorphine 2.5mg/mL is sold as a prescription drug.[9] The same goes for Lepheton, a combination containing 0.82 mg/mL ethylmorphine hydrochloride and 2.05 mg/mL ephedrine.[10]
  • United Kingdom: Ethylmorphine is a Class B controlled substance under the Misuse of Drugs Act.[11] This is the same class as codeine, but unlike codeine, there exist no legal preparations of ethylmorphine.
  • United States: No preparations containing ethylmorphine are on the market in the US. Pure ethylmorphine is listed in Schedule II and combination products containing no more than ethylmorphine 3mg/mL (or 15 mg per dosage unit together with a non-narcotic active ingredient) are listed in Schedule III. Preparations containing no more than ethylmorphine 1mg/mL or 1mg/g are listed in schedule V.[12] This is similar to codeine, but unlike codeine, ethylmorphine is not available for medical purposes in the United States.

In general, ethylmorphine and codeine, owing to their structural and pharmacological similarity, are treated similarly by law in most countries.

See also

External links