Ethylmorphine

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. ⇣ Oral Dosage Threshold 20 mg Light 40 - 50 mg Common 50 - 100 mg Strong 100 - 200 mg Heavy 200 mg + Duration 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.
Interactions
Stimulants
MAOIs
Nitrous
PCP
Alcohol
Benzodiazepines
DXM
GHB
GBL
Ketamine
MXE
Tramadol
Grapefruit

Ethylmorphine, also known as codethyline and dionine, is a semi-synthetic opioid first created by Merck in 1884 and used as a weaker alternative to morphine. Today, it is most commonly used as an antitussive, 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, used to treat inflammations of the eye. In 1904 an ethylmorphine preparation was described as "a new ocular analgesic".

Chemistry

Codeine is a benzylisoquinoline alkaloid with two additional closed rings. Ethylmorphine differs from the naturally occurring codeine (3-methylmorphine) only in having an ethoxy group in place of the methoxy group.

Pharmacology

Like codeine, ethylmorphine is a prodrug for morphine, which exerts its effects primarily by binding to and activating the μ-opioid receptor. The metabolism of ethylmorphine is similar to that of codeine, so please refer to that article for more details. Ethylmorphine is metabolized into morphine by the cytochrome P450 enzyme CYP2D6. In addition to O-deethylation to morphine, ethylmorphine can also be N-demethylated to norethylmorphine and glucuronidated to ethylmorphine-6-glucuronid in humans.

Although mixing opioids with other depressants is always dangerous due to the potentiation of effects, including respiratory depression, combinations with alcohol are doubly dangerous. Ethanol not only mixes synergistically with the depressant effect of morphine, the active metabolite of codeine and ethylmorphine, but it also reduces the elimination rate; in vitro experiments with rat hepatocytes (liver tissue) showed that peak concentrations of morphine with 100 mM ethanol were 1.4 and 1.3 times higher than in controls for ethylmorphine and codeine, respectively.

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

Subjective effects

The subjective effects of opioids are extremely similar across individual substances with very little variation. These usually only differ in terms of their potency, intensity and duration.

Physical effects

• Pain relief - This component is subjectively different from other anaesthetics as it does not necessarily remove the pain entirely whilst still remaining equal in terms of its effectiveness. Instead of directly suppressing pain, these substances simply dull the perceived sensation and cover it up with feelings of physical and emotional pleasure.
• Euphoria - This particular substance can be considered as less intense in its physical euphoria when compared with that of morphine or diacetylmorphine (heroin) due to the upper limit of how much can be converted into its active form through metabolism.
• Itchiness - It presents greater amounts of itchiness due to higher amounts of histamine release and is considerably more sedating than that of oxycodone and hydrocodone.
• Constipation
• Respiratory depression - At low to moderate doses, this effect results in the sensation that the breath is slowed down mildly to moderately, but does not cause noticeable impairment. At high doses and overdoses, opioid-induced respiratory depression can result in a shortness of breath, abnormal breathing patterns, semi-consciousness, or unconsciousness. Severe overdoses can result in a coma or death without immediate medical attention.
• Cough suppression
• Difficulty urinating
• Nausea
• Stomach cramps
• Sedation
• Pupil constriction
• Salivation

Cognitive effects

• Euphoria - Like codeine, this particular substance can be considered as less intense in its cognitive euphoria when compared with that of morphine or diacetylmorphine (heroin) due to the upper limit of how much can be converted into its active form through metabolism. It is still however capable of extreme intensity and overwhelming bliss at heavier dosages with a low tolerance.
• Anxiety suppression
• Compulsive redosing

Toxicity and harm potential

Like its cousin codeine and other opioids, ethylmorphine appears to be physically benign in reasonable doses.

Lethal dosage

One source estimates the minimum lethal dose at 500 mg. Codeine and ethylmorphine are widely believed to be safer than other opioids due to the ceiling effect. This occurs when the enzymes that convert the inactive drug into the active metabolite morphine become saturated. However, lethal overdoses of ethylmorphine are attested.

Mouse and rat oral LD50 are 520mg/kg and 810mg/kg, respectively.

Tolerance and addiction potential

Tolerance to many of the effects of ethylmorphine develops with prolonged use, including therapeutic effects. The rate at which this occurs develops at different rates for different effects.

As with other opioid drugs, chronic use of codeine can be considered highly addictive and is capable of causing both physical and psychological dependence. When physical dependence has developed, withdrawal symptoms may occur if a person suddenly stops their usage.

Legal issues

• 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.
• 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.
• Sweden: Cocillana-Etyfin cough syrup containing ethylmorphine 2.5mg/mL is sold as a prescription drug. The same goes for Lepheton, a combination containing ethylmorphine hydrochloride 0.82 mg/mL and 2.05 mg/mL ephedrine.
• 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.
• 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.

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

See also

• Ethylmorphine (Wikipedia)
• Codeine