Ethylmorphine (3-O-ethylmorphine) is a semi-synthetic opioid analgesic belonging to the substituted morphinan chemical class. It is the 3-ethyl ether of morphine — structurally analogous to codeine (morphine's 3-methyl ether) but with an ethyl group in place of the methyl group at the 3-position. Like codeine, ethylmorphine is a prodrug that is partially converted to morphine through hepatic demethylation, accounting for a significant portion of its analgesic activity.
Ethylmorphine has historically been used as a cough suppressant (antitussive) and mild analgesic, sold under the trade name Dionine in Europe and under various other names. It was incorporated into compound cough preparations in the early-to-mid 20th century and was available in some European countries as late as the 1990s. Its antitussive potency is considered intermediate — more effective than codeine but less potent than morphine — and it was favored in some formulations for its claimed rapid onset of cough suppression.
The clinical use of ethylmorphine declined substantially as regulatory scrutiny of opioid-containing cough preparations intensified and as non-opioid antitussive alternatives became available. It is now largely a historical pharmaceutical curiosity in most Western countries, though it retains limited use in certain European and Asian markets. Ethylmorphine is subject to international narcotic controls as a Schedule I substance under the UN Single Convention on Narcotic Drugs.
Safety at a Glance
High Risk- Recognize the Opioid Risk Context
- Avoid Combinations
- Toxicity: Opioid Class Risks Ethylmorphine carries the full risk profile of opioid compounds, with particular emphasis on its p...
- Dangerous with: 3-Cl-PCP, 3-HO-PCE, 3-HO-PCP, 3-MeO-PCE (+43 more)
- Overdose risk: Opioid overdose from Ethylmorphine is a critical medical emergency that kills rapidly through res...
If someone is in crisis, call 911 or Poison Control: 1-800-222-1222
Dosage
oral
Duration
oral
Total: 4 hrs – 5 hrsHow It Feels
Ethylmorphine introduces itself with the unhurried grace of a compound that knows its place in the opioid hierarchy. The onset takes thirty to fifty minutes, beginning as a faint warmth in the center of the chest that expands outward with the patience of ripples in still water. It is not dramatic, not urgent, but steady and assured -- a warmth that builds in layers, each one adding a fraction more depth to the gathering comfort.
As the compound reaches its working level, the body softens. Muscles that held their habitual tension begin to loosen, releasing knots of discomfort that had become so familiar they were almost invisible. The sensation is akin to stepping into a warm room after a long walk in cold air -- a relief so fundamental it feels almost primal. There is a heaviness to the limbs, gentle and welcome, and a gravitational pull toward horizontal surfaces that is easy to obey and difficult to resist.
The emotional tone at the peak is one of quiet well-being. It is not euphoria in any grand sense -- there are no fireworks, no surges of chemical joy. Instead, there is a pervasive sense that things are acceptable, that the world is manageable, that whatever was bothering you an hour ago has lost its urgency. This is morphine's cousin speaking, and the family resemblance is clear: the same dreamy warmth, the same cotton-wrapped consciousness, the same gentle suppression of the body's alarm systems. But the volume is turned down a notch, the colors slightly less saturated.
Physically, ethylmorphine produces the expected opioid signature in muted form. Pupils constrict. Breathing slows modestly. A faint itch may surface on the nose or forearms. Nausea is possible but not prominent, and constipation develops with the inevitability common to all compounds in this class. The visual field takes on a soft quality, as though viewed through a gauze curtain, and sounds seem to arrive from slightly farther away than usual, their edges rounded and gentle.
The duration is moderate, with primary effects lasting three to five hours before beginning their slow recession. The comedown is remarkably smooth -- the warmth simply thins, like watercolors growing more transparent with each stroke of the brush. What remains after the primary effects depart is a lingering drowsiness, a heaviness in the eyelids that invites sleep, and a faint residual comfort that takes another hour or two to fully dissipate. The overall character of the experience is one of gentle, reliable warmth -- nothing spectacular, nothing alarming, simply a quiet recess from discomfort.
Subjective Effects
The effects listed below are based on the Subjective Effect Index (SEI), an open research literature based on anecdotal reports and personal analyses. They should be viewed with a healthy degree of skepticism. These effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects.
Physical Effects
Physical(17)
- Appetite suppression— A distinct decrease in hunger and desire to eat, ranging from reduced interest in food to complete d...
- Constipation— A slowing or cessation of bowel movements resulting in difficulty passing stool, commonly caused by ...
- Cough suppression— A decreased desire and need to cough, medically known as antitussive action, which can also allow in...
- Decreased libido— Decreased libido is a diminished interest in and desire for sexual activity, commonly caused by subs...
- Diarrhea— Diarrhea is the occurrence of frequent, loose, or watery bowel movements as a side effect of certain...
- Difficulty urinating— Difficulty urinating, also known as urinary retention, is the experience of being unable to easily p...
- Insomnia— A persistent inability to fall asleep or maintain sleep despite physical tiredness, often characteri...
- Itchiness— A persistent, diffuse urge to scratch the skin that arises without any external irritant, most commo...
- Nausea— An uncomfortable sensation of queasiness and stomach discomfort that may or may not lead to vomiting...
- Orgasm suppression— Orgasm suppression (anorgasmia) is the difficulty or complete inability to achieve orgasm despite ad...
- Pain relief— A suppression of negative physical sensations such as aches and pains, ranging from dulled awareness...
- Physical euphoria— An intensely pleasurable bodily sensation that can manifest as waves of warmth, tingling electricity...
- Pupil constriction— A visible narrowing of the pupil diameter (miosis) that reduces the size of the dark center of the e...
- Respiratory depression— A dangerous slowing and shallowing of breathing that can progress from barely noticeable reductions ...
- Sedation— A state of deep physical and mental calming that manifests as a progressive desire to remain still, ...
- Serotonin syndrome— Serotonin syndrome is a potentially fatal medical emergency caused by excessive serotonergic activit...
- Stomach cramp— Stomach cramps are sharp, intermittent pains in the abdominal region that can occur when psychoactiv...
Cognitive & Perceptual Effects
Cognitive(6)
- Anxiety— Intense feelings of apprehension, worry, and dread that can range from a subtle background unease to...
- Anxiety suppression— A partial to complete suppression of anxiety and general unease, producing a calm, relaxed mental st...
- Cognitive euphoria— A cognitive and emotional state of intense well-being, elation, happiness, and joy that manifests as...
- Compulsive redosing— An overwhelming, difficult-to-resist urge to continuously take more of a substance in order to maint...
- Depression— A persistent state of low mood, emotional numbness, hopelessness, and diminished interest or pleasur...
- Dream potentiation— Enhanced dream vividness, complexity, and recall, often occurring as REM rebound after discontinuing...
Pharmacology
Mechanism of Action
Ethylmorphine is a prodrug opioid whose pharmacological activity derives from two mechanisms: direct opioid receptor activity of the parent compound, and conversion to morphine (and to a lesser extent normorphine and other metabolites) in the liver.
Direct Activity: Ethylmorphine itself binds to μ-opioid receptors (MOR) — the primary target mediating analgesia, cough suppression, euphoria, and respiratory depression in opioid compounds. Its intrinsic activity and receptor binding affinity are lower than morphine, making it a less potent direct agonist.
Prodrug Conversion: Hepatic CYP2D6 and other enzymes catalyze O-demethylation (analogous to codeine's conversion to morphine), producing morphine as an active metabolite. This conversion rate varies substantially between individuals based on CYP2D6 genotype:
- Ultra-rapid metabolizers — Convert a greater proportion to morphine; experience more potent effects and greater risk
- Poor metabolizers — Convert little to morphine; the antitussive and analgesic effects may be substantially reduced
Receptor Profile
- μ-opioid receptor (MOR): Primary target — analgesia, antitussive effect, respiratory depression, euphoria, constipation
- κ-opioid receptor (KOR): Lower affinity; contributes to sedation and dysphoria
- δ-opioid receptor (DOR): Minimal contribution at therapeutic doses
Pharmacokinetics
Oral bioavailability is moderate, improved over morphine due to reduced first-pass extraction. Duration of action is approximately 4–6 hours. Like codeine, ethylmorphine crosses the placental barrier and is excreted in breast milk, representing significant risks in pregnancy and lactation, particularly in CYP2D6 ultra-rapid metabolizers.
Detection Methods
Standard Drug Panel Inclusion
Ethylmorphine is a natural or semi-synthetic opiate that is detected on standard 5-panel drug screens under the opiates channel. The standard opiate immunoassay targets morphine and codeine as primary analytes, and Ethylmorphine or its metabolites will trigger a positive result due to structural similarity to the morphine backbone. Most workplace, clinical, and probation drug tests include opiate detection at a 2000 ng/mL or 300 ng/mL cutoff.
Urine Detection
Ethylmorphine can be detected in urine for approximately 2 to 3 days after the last dose. The primary metabolic pathways involve glucuronidation, O-demethylation, and N-demethylation. Key urinary metabolites include glucuronide conjugates and, depending on the specific compound, morphine or hydromorphone as downstream metabolites. Hydration status, urinary pH, body mass, and metabolic rate all influence the exact detection window.
Blood and Saliva Detection
Ethylmorphine is detectable in blood for approximately 6 to 24 hours after administration. Oral fluid (saliva) testing can detect Ethylmorphine for approximately 24 to 48 hours post-dose. Blood and oral fluid testing are most commonly used in emergency medicine, pain management compliance monitoring, and roadside testing programs.
Hair Follicle Detection
Hair follicle testing can detect Ethylmorphine for up to 90 days (approximately 1.5 inches of hair growth). Opiate incorporation into hair is well-characterized, and most commercial hair testing panels include the opiates category. A standard hair test screens for codeine, morphine, and 6-monoacetylmorphine; Ethylmorphine or its metabolites will typically be captured under this panel.
Confirmatory Testing
Immunoassay screening results for opiates are confirmed using gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-tandem mass spectrometry (LC-MS/MS). These methods can distinguish between specific opiates, identifying Ethylmorphine and its metabolites with high specificity. Confirmation testing eliminates false positives from poppy seed consumption or structural analogues.
Reagent Testing
Marquis reagent produces a purple to violet color with Ethylmorphine, consistent with the morphine-class opiate reaction. Mecke reagent yields a deep blue-green to blue color. Mandelin reagent produces a grey-brown reaction. These reagent responses are characteristic of the opiate class and can help differentiate opiates from synthetic opioids, which may show different or no reactions.
Interactions
| Substance | Status | Note |
|---|---|---|
| 3-Cl-PCP | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| 3-HO-PCE | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| 3-HO-PCP | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| 3-MeO-PCE | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| 3-MeO-PCMo | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| 3-MeO-PCP | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| 4-MeO-PCP | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Alcohol | Dangerous | — |
| Atropa belladonna | Dangerous | Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure |
| Benzodiazepines | Dangerous | — |
| Cake | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Datura | Dangerous | Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure |
| Deschloroetizolam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Deschloroketamine | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Desomorphine | Dangerous | Compounding respiratory depression and overdose risk |
| Diclazepam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Diphenhydramine | Dangerous | Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure |
| Diphenidine | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Ephenidine | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Eszopiclone | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Etizolam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Flubromazepam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Flubromazolam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Flunitrazepam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Flunitrazolam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Gaboxadol | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| GBL | Dangerous | — |
| GHB | Dangerous | — |
| Harmala alkaloid | Dangerous | Risk of serotonin syndrome and severe respiratory depression; potentially fatal |
| HXE | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Inhalants | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Ketamine | Dangerous | — |
| Lorazepam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Memantine | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Mephenaqualone | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Metizolam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| Midazolam | Dangerous | Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths |
| MXiPr | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Naloxone | Dangerous | Compounding respiratory depression and overdose risk |
| Nicotine | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Nifoxipam | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| O-PCE | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| PCE | Dangerous | Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration |
| Peganum harmala | Dangerous | Risk of serotonin syndrome and severe respiratory depression; potentially fatal |
| Pentobarbital | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| Phenobarbital | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| SAMe | Dangerous | Severe respiratory depression risk; leading cause of polydrug overdose |
| 3-FMA | Caution | Stimulants mask opioid sedation, increasing overdose risk when the stimulant wears off |
| 4-MMC | Caution | Stimulants mask opioid sedation, increasing overdose risk when the stimulant wears off |
| 8-Chlorotheophylline | Caution | Stimulants mask opioid sedation, increasing overdose risk when the stimulant wears off |
| Adrafinil | Caution | Stimulants mask opioid sedation, increasing overdose risk when the stimulant wears off |
| Benzydamine | Caution | Stimulants mask opioid sedation, increasing overdose risk when the stimulant wears off |
| Nitrous | Uncertain | — |
| PCP | Uncertain | — |
| 1,3-Butanediol | Low Risk & No Synergy | No significant pharmacological interaction; opioids may slightly dull the psychedelic experience |
| 25E-NBOH | Low Risk & No Synergy | No significant pharmacological interaction; opioids may slightly dull the psychedelic experience |
| 2C-T | Low Risk & No Synergy | No significant pharmacological interaction; opioids may slightly dull the psychedelic experience |
History
Early Pharmaceutical Development
Ethylmorphine was synthesized in the late 19th century, during a period of intensive chemical modification of the morphine molecule by pharmaceutical chemists seeking to separate morphine's analgesic utility from its dependence and abuse potential. The compound was one of many morphine derivatives introduced in this era — which also produced heroin (diacetylmorphine), hydromorphone, and codeine derivatives — under the optimistic (and generally mistaken) assumption that chemical modification could preserve therapeutic benefits while eliminating the liability for dependence.
Dionine and Commercial Use
Ethylmorphine was marketed as Dionine by Merck and other manufacturers in the early 20th century. It found a niche as a cough suppressant and mild analgesic, particularly in ophthalmological applications where it was used as a local anaesthetic for eye procedures — an unusual application that distinguished it from most opioid compounds. Dionine enjoyed a period of commercial success in Europe as an ingredient in cough preparations and combination analgesics.
Regulatory Decline
The 20th century brought increasing recognition of opioid dependence as a significant public health problem and gradually tightening regulatory controls on narcotic preparations. Ethylmorphine was included in international narcotic control frameworks and progressively restricted or removed from non-prescription markets. As more effective and less abuse-prone cough suppressants (dextromethorphan, benzonatate) became available, the clinical rationale for ethylmorphine-containing cough preparations weakened.
Contemporary Status
Ethylmorphine has largely disappeared from clinical use in the United States, the United Kingdom, and most Western European countries. It retains a degree of use in some Eastern European, Scandinavian, and Asian markets, primarily in compound cough preparations available in regulated pharmacy settings. It is classified as a controlled substance under the UN Single Convention on Narcotic Drugs (Schedule I), requiring strict import/export controls. In current harm reduction and recreational drug contexts, ethylmorphine is rarely discussed or encountered.
Harm Reduction
Recognize the Opioid Risk Context
Ethylmorphine is rarely encountered in pure form in contemporary drug markets. Someone using ethylmorphine is most likely either using a pharmaceutical preparation in a country where it remains available, or has obtained a research chemical supply. In either context, the full spectrum of opioid harm reduction applies.
Naloxone Access
Anyone using opioids, including ethylmorphine, should have naloxone available and ensure that people nearby know how to use it. Naloxone reverses opioid-induced respiratory depression and can be life-saving in an overdose. It is available without prescription in many jurisdictions.
Never Use Alone
Opioid overdose is typically a gradual loss of consciousness followed by respiratory failure. A person who is alone cannot call for help. Use with a trusted companion who is aware of the risks and has naloxone.
Avoid Combinations
The combination of opioids with benzodiazepines or alcohol dramatically increases overdose risk. This is not merely additive — the combination is responsible for the majority of opioid fatalities.
Test Your Substance
Ethylmorphine in illicit supply chains may be adulterated or mislabeled. Fentanyl contamination of the opioid supply has caused mass casualties. Fentanyl test strips can detect fentanyl and many analogs in dissolved samples.
Understand Your Metabolism
If you know your CYP2D6 metabolizer status (available through pharmacogenetic testing), this directly affects your sensitivity to prodrug opioids. Ultra-rapid metabolizers face substantially higher risk from standard doses.
Dose Calibration
Start low, go slow. Ethylmorphine's effective dose varies widely between individuals based on metabolism. Never assume a dose is safe because it felt safe previously — tolerance changes, and supply can vary in potency.
Toxicity & Safety
Opioid Class Risks
Ethylmorphine carries the full risk profile of opioid compounds, with particular emphasis on its prodrug nature and the variability in morphine production between individuals.
Respiratory Depression
The primary acute danger of opioid overdose is respiratory depression — reduced drive to breathe leading to hypoxia, brain injury, and death. Ethylmorphine's risk of respiratory depression scales with dose and is substantially modified by CYP2D6 metabolizer status. Ultra-rapid metabolizers face disproportionate risk as they produce morphine at higher rates.
Dependence and Withdrawal
Regular use of ethylmorphine, like all μ-opioid agonists, produces physical dependence. Tolerance develops to analgesic and euphoric effects more rapidly than to constipation and miosis. Opioid withdrawal syndrome — characterized by anxiety, diaphoresis, muscle aches, insomnia, diarrhea, and dysphoria — is highly unpleasant but rarely life-threatening in otherwise healthy adults.
Drug Interactions
- CNS depressants (benzodiazepines, alcohol, barbiturates, antihistamines): Synergistic respiratory depression — this combination accounts for a large proportion of opioid-related fatalities
- MAOIs: Potentially fatal serotonin syndrome and opioid toxicity; absolute contraindication
- CYP2D6 inhibitors (fluoxetine, paroxetine, bupropion): Reduce conversion to morphine, altering efficacy
- Naloxone/naltrexone: Opioid antagonists reverse ethylmorphine's effects; naloxone is the emergency treatment for ethylmorphine overdose
Special Populations
Neonates of mothers who are CYP2D6 ultra-rapid metabolizers are at particular risk from breast milk exposure, as documented in case reports involving codeine (a structural analog). The same risks apply to ethylmorphine.
Addiction Potential
very addictive with a high potential for abuse
Overdose Information
Opioid overdose from Ethylmorphine is a critical medical emergency that kills rapidly through respiratory depression. Every second counts.
Signs of opioid overdose (recognize any of these):
- Extremely slow, shallow, or absent breathing
- Blue or gray lips, fingernails, or skin
- Pinpoint (very small) pupils
- Gurgling or snoring sounds
- Unresponsive to voice or painful stimulation
- Limp body, pale face
EMERGENCY RESPONSE — ACT IMMEDIATELY:
- Call emergency services (911 in US)
- Administer naloxone (Narcan) if available — intranasal spray or intramuscular injection. Naloxone temporarily reverses opioid overdose. A second dose may be needed after 2-3 minutes if no response.
- Begin rescue breathing if the person is not breathing — tilt head back, lift chin, give one breath every 5 seconds
- Place in recovery position if breathing but unconscious
- Stay with them — naloxone wears off in 30-90 minutes and overdose can recur
Naloxone access: In many jurisdictions, naloxone is available without prescription at pharmacies. Carrying naloxone saves lives. Learn how to use it.
Dangerous Interactions
The combinations listed below may be life-threatening. Independent research should always be conducted to ensure safety when combining substances.
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure
Severe respiratory depression risk; leading cause of polydrug overdose
Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Compounding respiratory depression and overdose risk
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Compounding CNS depression with anticholinergic effects; risk of cardiac events and respiratory failure
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Severe respiratory depression risk; leading cause of polydrug overdose
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Severe respiratory depression risk; leading cause of polydrug overdose
Risk of serotonin syndrome and severe respiratory depression; potentially fatal
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Severe respiratory depression risk; leading cause of polydrug overdose
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Severe respiratory depression; this combination is the leading cause of prescription drug overdose deaths
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Compounding respiratory depression and overdose risk
Severe respiratory depression risk; leading cause of polydrug overdose
Severe respiratory depression risk; leading cause of polydrug overdose
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Both cause respiratory depression and unconsciousness; vomiting while dissociated risks aspiration
Risk of serotonin syndrome and severe respiratory depression; potentially fatal
Severe respiratory depression risk; leading cause of polydrug overdose
Severe respiratory depression risk; leading cause of polydrug overdose
Severe respiratory depression risk; leading cause of polydrug overdose
Tolerance
| Full | develops with prolonged and repeated use |
| Half | 3 - 7 days |
| Zero | 1 - 2 weeks |
Cross-tolerances
Legal Status
Internationally, Ethylmorphine is listed in the Single Convention on Narcotic Drugs in Schedule III.
- France:** Tussipax tablets containing 10 mg of ethylmorphine and 10 mg of codeine are sold over the counter.
- 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.
- Norway:** Cosylan and Solvipect comp. cough syrups containing ethylmorphine hydrochloride 1.7mg/mL and 2.5mg/mL, respectively, are regulated in prescription Class B. They are commonly prescribed for dry cough.
- Russia:** Ethylmorphine is a Schedule II controlled substance.
- Sweden:** Cocillana-Etyfin cough syrup containing ethylmorphine 2.5mg/mL is sold as a prescription drug. The same goes for Lepheton, a combination containing 0.82 mg/mL ethylmorphine hydrochloride and 2.05 mg/mL ephedrine.
- Switzerland: Ethylmorphine is a controlled substance specifically named under Verzeichnis A. Medicinal use is permitted. Some preparations containing ethylmorphine are included in Verzechnis C, while certain ones are excluded.
- United Kingdom:** Ethylmorphine is a Class B controlled substance under the Misuse of Drugs Act. 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. 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.
Responsible use
Codeine
Ethylmorphine (Wikipedia)
Ethylmorphine (Isomer Design)
Ethylmorphine (Drugs.com)
Experience Reports (1)
Tips (6)
In most US states, Good Samaritan laws protect you from drug charges if you call 911 for an overdose. Never hesitate to call emergency services. A legal charge is infinitely preferable to a death.
Even with a weaker opioid like ethylmorphine, always have naloxone on hand and never use alone. The risk multiplies dramatically when combined with any other CNS depressant. One reported death involved ethylmorphine taken alone orally.
Ethylmorphine is metabolized to morphine in the liver via CYP2D6. If you are a CYP2D6 ultra-rapid metabolizer, even therapeutic doses can produce unexpectedly strong opioid effects. Be aware of your metabolizer status, especially if codeine or similar prodrugs have hit you unusually hard.
Cocillana-etylmorfin syrups contain multiple active ingredients including ethylmorphine and cocillana bark extract. Do not attempt to extract or concentrate the opioid content from cough syrup formulations as the other ingredients can cause serious gastrointestinal distress in concentrated amounts.
Never use Ethylmorphine alone. Use the Never Use Alone hotline (1-800-484-3731 in the US) where an operator stays on the line and dispatches EMS if you become unresponsive. This service has saved thousands of lives.
The highest risk of fatal overdose from Ethylmorphine comes after a tolerance break, whether from rehab, jail, hospital, or even a few days of abstinence. Your old dose can kill you. Always start at a fraction of your previous dose.
See Also
References (4)
- Opioid receptors — Pasternak & Pan Annual Review of Pharmacology (2013)paper
- PubChem: Ethylmorphine
PubChem compound page for Ethylmorphine (CID: 5359271)
pubchem - Ethylmorphine - TripSit Factsheet
TripSit factsheet for Ethylmorphine
tripsit - Ethylmorphine - Wikipedia
Wikipedia article on Ethylmorphine
wikipedia