Zapain Use, Abuse and Addiction - Detox Plus UK

image of packet from zapain 30mg tablets

Zapain is commonly prescribed for moderate to severe pain and is an opioid drug.

If you have just been prescribed Zapain as a painkiller, you may be wondering what its potential side effects are and how quickly it will take to work.

This article will provide an overview of what is known about Zapain, including how it works and its potential uses. Additionally, common questions regarding the duration of onset and the length of its effects will also be answered.

Zapain contains two key ingredients, paracetamol and codeine phosphate- which make co-codamol. We will explore the effects of codeine on the body and how it makes the user feel.

As Zapain contains prescription-strength codeine, it carries the same addictive properties as other opioid analgesics and also has a potential for abuse. Because of this, certain people should be wary of taking this painkiller. We will advise who should and shouldn’t take Zapain further on.

Continuous use of Zapain over a period can lead to physical dependence, making it difficult to cease use due to developing opioid withdrawals. If you or someone close to you is having difficulty managing their consumption of this widely prescribed analgesic, we are available to provide guidance, treatment and support in order for them to stop.

What is Zapain?

Zapain is a common brand name for prescription-strength co-codamol, a drug that combines codeine and paracetamol.

Zapain is available in tablet or capsule form and comes in various strengths and dosages, each containing 500mg of paracetamol and either 8mg, 15mg or 30mg of codeine 1

Codeine is commonly prescribed for severe pain, such as post-operative pain, or moderate pain that does not respond to other non-opioid analgesics.

The strength and dosage of Zapain will be detailed on the packet that contains your medication. In order to avoid unwanted side effects and reduce your chances of developing a dependence on Zapain, you should always follow the precise instructions given by your prescriber 1

In some instances, a dependence on Zapain can occur within just a few days or weeks of use. Your doctor will be aware of this and should prescribe you a tapering-off regime should dependence occur. This will reduce the severity of co-codamol withdrawal symptoms and help you to stop the drug safely and comfortably.

How long Zapain takes to work

Co-codamol can take up to an hour before its full effects are felt. The painkilling effects of Zapain last approximately 4 to 6 hours.

Regardless of the dosage you are prescribed, it is important not to take any more than 8 Zapain tablets over a period of 24 hours. If you do take more, not only do you risk overdosing, but it also damages the health of your liver. Paracetamol overdose is life-threatening and can occur if you take more than the prescribed safe amount.

Co-codamol works on the central nervous system and the brain to block pain signals to the rest of the body. It also helps to reduce the levels of anxiety and stress caused by pain. As Zapain has depressant effects, it also slows down bodily functions, commonly causing digestive problems, drowsiness and constipation.

The side effects of Zapain

Zapain is associated with many potential side effects, including constipation, drowsiness and, more rarely, allergic reactions. Additionally, vision problems may occur in some people. Strategies to reduce the severity of these side effects are available and should be discussed with your healthcare professional.

Female hand holding zapain tablet

It should be noted that side effects are extremely common in those who take opioid treatment. Clinical trials suggest that between 50% and 80% of all patients experience at least one problematic side effect when taking Zapain or a similar opioid. The incidence of side effects is likely to be even higher in someone who takes opioids daily or for a long period of time. 1

Common side effects of Zapain include:

  • Constipation
  • Sleepiness
  • Headaches
  • Feeling or being sick (nausea or vomiting)
  • Dizziness
  • Dry mouth
  • Itchy skin

Serious side effects of prescription-strength co-codamol include:

  • Difficulty breathing
  • Respiratory depression and breathing problems
  • Difficulty urinating
  • Skin rash
  • Changes in vision 1,2

Some people may find that they are allergic to the codeine phosphate in Zapain. An allergic reaction will include symptoms of anaphylaxis, including shortness of breath, tightness in the chest and throat, swelling of the face, tongue, lips, and throat and a skin rash that can result in blistering of the skin.

If you experience any side effects that are troublesome or worrying after taking Zapain, stop the medication and speak to your doctor as soon as possible. If you worry you may be having an allergic reaction to co-codamol, it is important to seek emergency medical help at once.

Taking Zapain if you have a history of drug and alcohol abuse

Prolonged use of codeine can lead to drug dependence, even at therapeutic doses.  Drug dependence can happen to anyone who takes addictive substances or medications regularly. This is easily remedied with a tapering-off regime planned and monitored by your doctor.

Addiction occurs when a person develops a psychological dependence on a substance. More often than not, this is accompanied by physical dependence. Addiction is a recognised chronic medical condition that is far more complex to treat than dependence alone and is considered life-threatening.

When a drug addiction develops, lasting changes take place in the brain’s reward circuits. These changes make it virtually impossible for a person to stop substance use without professional treatment and help. 4

The risks of developing an addiction to Zapain are increased in those with a current or past history of a substance use disorder, including alcohol. Those with a family history of addiction or who suffer from a mental health disorder such as depression, PTSD or generalised anxiety disorder are also at a greater risk of developing an addiction. 3,4

If you have previously had an addiction to opioids, prescribed or otherwise, it is wise to let your doctor know. Where no other suitable alternatives are available, your doctor will prescribe for as short a time as possible and should offer additional support and monitoring.

Tolerance and dependence on opioid painkillers

warning of excessive opioid use in UK

When a person takes an opioid such as Zapain for more than 3 to 5 consecutive days, they risk developing physical dependence. The longer they take the drug and the higher the dosage, the more severe the dependence and withdrawal symptoms become.

Over time and with repeated use, a dosage of an opioid drug will lose its effects and pain-killing properties. When this happens, your pain is likely to return and feel unmanaged as you have developed tolerance to the Zapain dosage. Once a tolerance to a dosage has occurred, you may well be tempted to return to your doctor to advise that your pain has worsened.

The reality is that your pain levels may not have changed and have only returned due to tolerance to Zapain developing. Whilst your doctor may well suggest an increased dosage to manage your pain, it is worth discussing other pain management options, especially if your condition is chronic. Long-term pain can be managed in a variety of ways other than with addictive pain relief.

Be cautious when taking an increased dosage of Zapain for an extended period of time, as this will only result in tolerance once more. This can develop into a vicious circle of ever-increasing opioid pain relief until you reach a point where your pain can no longer be managed by medication. Increasing the frequency and/or dosage often leads to drug dependence and puts you at higher risk of Zapain addiction.

Co-codamol overdose

If taking Zapain causes you to become excessively drowsy or confused to the point that you cannot remember when you took your last dose, it is essential to let your doctor know. Experiencing these side effects could cause you to accidentally take more than you are prescribed.

Deliberate abuse of Zapain and Zapain addiction can lead to co-codamol overdose, which can result in respiratory arrest, organ failure, coma and death. Combining Zapain with other depressant drugs such as sleeping pills, benzodiazepines, opioids or alcohol also vastly increases your risk of overdose.

Symptoms of Cocodamol overdose:

  • Bluish lips and fingernails
  • Breathlessness
  • Cold, clammy skin
  • Shallow breathing
  • Losing consciousness
  • Unresponsive or difficult to wake
  • Pinpoint pupils
  • Extreme muscle weakness
  • Coma
  • Weak pulse
  • Low blood pressure
  • Slow heart rate
  • Respiratory arrest 5

If you or someone you love has taken too many Zapain pills and are showing the symptoms of overdose, please seek emergency medical help.

Additionally, anyone taking more than 7.5g of paracetamol within a 4-hour timeframe risks acute liver damage and should attend a hospital for treatment immediately. The sooner a paracetamol overdose is treated, the better the outcome for the patient 1

Zapain and alcohol

zapain tablets and glass of alcohol

Zapain and alcohol should never be taken together. This medication comes with a warning on the packaging to avoid alcohol.

The codeine within Zapain is a central nervous system depressant, and drinking alcohol with it will increase the depressant effects of both substances.

Those who abuse drugs may not give a second thought to combining Zapain and alcohol; however, this can easily lead to overdose. Frequently combining Zapain and alcohol also increases your risk of dual dependence and addiction.

Consuming alcohol whilst taking a course of Zapain is likely to make you feel initially euphoric and then extremely drowsy. Some people who abuse alcohol and Zapain may take them both together to initiate sleep.

Drinking alcohol to the point of losing consciousness whilst taking Zapain could mean that you never wake up. The risk of stopping breathing whilst asleep is very real for those who abuse this drug.

Codeine dependence and addiction

female lying on sofa suffering from zapain withdrawal

Codeine dependence can occur even when you follow a prescription. This is due to the addictive properties of opioid drugs. Even over-the-counter strength codeine will cause drug dependence when taken for more than 3 to 5 days consecutively. It is, therefore, important that you only take Zapain when you really need to and for as short a time as possible.

Unfortunately, due to the uncareful prescribing of Zapain, many people find themselves taking this drug for extended periods of time, even years after suffering an initial injury or the onset of chronic pain. There is nothing to suggest clinically that it is helpful to take opioid painkillers for longer than 3 months in cases of non-cancer-related chronic pain.

Data collected from prospective cohort studies suggest that opioids delay returning to work after injury and may prolong functional recovery or worsen physical functioning.

A Danish cross-sectional study also indicates that opioid users are associated with poorer quality of life, employment status, increased healthcare use, and worse pain than non-opioid users 4

Long-term use of drugs such as Zapain can also cause chronic constipation and depression. Additionally, due to tolerance developing, a person may also find themselves turning to illicit Class A opioids.

Zapain addiction and treatment

Whilst Zapain can be taken safely by the majority of people under medical care, a minority will be predisposed to developing an addiction.

Zapain addiction is likely to occur when a person takes a drug other than exactly as prescribed (including not spacing out the dosages properly) or when a person purposely abuses it.

Forms of Zapain abuse include:

  • Buying prescription-strength co-codamol from the internet without a prescription
  • Doctor shopping (Seeking out different doctors for more prescriptions)
  • Taking co-codamol with alcohol or other drugs to increase its effects
  • Binging on Zapain, having saved up tablets
  • Taking the drug to get high
  • Taking Zapain, that is prescribed for someone else

Addiction is an illness and not a moral failing. No one chooses to become addicted. If you or someone you love have become addicted to Zapain, there is professional help and treatment available.

Signs of Zapain addiction include

  • Preoccupation with getting and taking Zapain
  • Frequent intoxication
  • Regular abuse of the drug
  • Suffering opioid withdrawal symptoms
  • Suffering negative consequences to mental and physical health, occupation or education and social and personal relationships as a result of Zapain use
  • Breaking to law, lying, cheating or manipulating in order to obtain Zapain
  • Frequently losing control over the amount consumed
  • Experiencing strong cravings for Zapain
  • Unable to follow a reduction regime due to loss of control and cravings

Someone who suffers from Zapain addiction is very unwell with a substance use disorder and requires a combination of professional medical and therapeutic treatment in order to recover.

Our inpatient rehab programmes for Zapain addiction treatment offer:

  • A safe, recovery-focused space, free from temptation
  • A full medical Zapain detox
  • A comprehensive doctors assessment
  • Comprehensive treatment for dual diagnosis and any additional addictions or dependencies
  • Evidence-based addiction treatment therapies delivered by a multi-disciplinary team of professionals
  • A comprehensive discharge plan
  • Free aftercare and ongoing support on completion of treatment

Detox Plus UK specialise in bespoke addiction treatment. This means that we will tailor our treatment plan to your specific treatment preferences and needs.  We can also provide an opioid detox with therapeutic support, although a comprehensive rehabilitation programme is strongly recommended.

We have numerous locations throughout the UK, and all of our detox clinics and rehabs are CQC registered and heavily regulated.

We understand how important it is to treat the root causes of a person’s addiction. We achieve this by utilising a combination of proven, evidence-based therapies. Furthermore, we will equip you with essential relapse prevention tools to help keep you firmly on the path of recovery.

Whether you have developed a dependence on Zapain or suffer from addiction, we can help. Call or contact our team of friendly, trained experts for a free, confidential assessment and advice without obligation today.




  1. Zapain 30mg/500mg Tablets:
  2. Co-codamol for adults:
  3. Understanding Drug Use and Addiction Drug Facts:
  4. The effectiveness of opioids for long-term pain:

Codeine Overdose: Signs, Symptoms, and How To Get Help:


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