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Opioid analgesic

Codeine prescribing across the NHS.

Codeine is the opioid nobody managed to reduce: 5.6m items a year and still edging up while tramadol and fentanyl fall. Its metabolism lottery, from no effect in some patients to too much in others, is pharmacology every prescriber knows and item counts ignore.

Scorecard, last 12 months
Items
5.7m
dispensed in the last 12 months
Spend
£13.1m
at NIC, last 12 months
Year on year
+3.4% +3.4%
vs the 12 months before
Latest month
July 2026
most recent NHSBSA release
Key facts · plain English

The NHS in England dispensed 5,686,121 prescription items of Codeine in the 12 months to July 2026, across primary care and hospitals.

Spending on Codeine over those 12 months was £13.1m at net ingredient cost, the list price of what was dispensed before any discounts.

Items were up 3.4% on the previous 12 months.

86% of Codeine volume moved through primary care and 14% through hospital pharmacies.

Codeine is the largest of 16 chemical substances in Opioid analgesics (BNF 4.7.2), by items dispensed.

Among Integrated Care Boards, NHS North East and North Cumbria ICB dispensed the highest volume of Codeine.

Source: NHS Business Services Authority open data (English Prescribing Data and SCMD), OGL v3.0. Items count prescriptions dispensed, not patients treated.

National trend · since 2020
Codeine, England: monthly items and spend
Items per month (teal) and spend, £ (orange)
items £ 2020-11 2023-09 2026-07 1 Jul 2026 · Price concession granted1 Jun 2026 · Price concession granted1 May 2026 · Price concession granted1 Apr 2026 · Price concession granted1 Mar 2026 · Price concession granted1 Feb 2026 · Price concession granted1 Jan 2026 · Price concession granted1 Sep 2025 · Price concession granted1 Jun 2025 · Price concession granted1 May 2025 · Price concession granted1 Apr 2025 · Price concession granted1 Mar 2025 · Price concession granted1 Feb 2025 · Hospital framework awarded1 Feb 2025 · Price concession granted1 Jan 2025 · Price concession granted1 Jun 2024 · Hospital framework awarded20 Feb 2024 · MHRA safety alert
Source: NHSBSA English Prescribing Data (OGL v3.0).

Diamond markers show events around this period: NICE decisions, safety alerts, supply notices, Drug Tariff moves and price concessions, new suppliers in dm+d and framework awards. Hover a marker for the date and type. The evidence behind each one, with the source quote and link, sits behind Apply.

MonthItemsSpend (NIC)
July 2026 501,960 £1.6m
June 2026 487,044 £1.2m
May 2026 471,185 £1.1m
April 2026 484,449 £1.1m
March 2026 494,794 £1.0m
February 2026 444,015 £991k
January 2026 474,861 £923k
December 2025 485,739 £1.0m
November 2025 441,353 £930k
October 2025 485,103 £1.0m
September 2025 471,125 £1.1m
August 2025 444,493 £1.0m

The same series as the chart, most recent month first. The full monthly history, as CSV, sits behind Apply.

Cost per item · price erosion
Codeine, England: cost per item
Actual cost per item, primary care (£)
£3.80 £1.78 2020-11 2023-09 2026-07
Source: NHSBSA English Prescribing Data (OGL v3.0).
Market share

25.6% of its class.

Codeine is the largest of 16 chemical substances in Opioid analgesics (BNF 4.7.2), by items dispensed in July 2026. The full class league, who's gaining, and the month-by-month share movement sit behind Apply.

See the full class picture →

Seasonality
Average items by calendar month, indexed to the year (100 = average)
120 100 80 JFMAMJJASOND

Average items by calendar month across the full history, indexed to the annual mean.

Who supplies it · dm+d register

17 suppliers hold a live codeine listing, across 83 packs.

A A H Pharmaceuticals Ltd, Accord-UK Ltd, Alliance Healthcare (Distribution) Ltd, Almus Pharmaceuticals Ltd, Bristol Laboratories Ltd, Crescent Pharma Ltd, Medihealth (Northern) Ltd, Milpharm Ltd, Phoenix Healthcare Distribution Ltd, Pinewood Healthcare, Relonchem Ltd, Sigma Pharmaceuticals Plc, Special Order, Sun Pharma UK Ltd, Teva UK Ltd, Thornton & Ross Ltd, Wockhardt UK Ltd. In the last twelve months 0 packs were listed and 1 discontinued. Every pack, its GTIN and published list price, and each week's changes are in the full report.

A listing in the NHS Dictionary of Medicines and Devices means a product may be supplied. It says nothing about sales or market share, and the list price is the reimbursement price, not what any buyer pays. Contains information from dm+d 10.1.0, published by the NHS Business Services Authority under the Open Government Licence v3.0.

People, not just items · NHSBSA official statistics

1,399,629 people in England had at least one codeine item prescribed in primary care in 2025/26, 4.0 items each. Source: NHSBSA Dependency-Forming Medicines, England, official statistics, OGL v3.0. Identified patients only.

Where it's prescribed · England

Codeine across all 36 ICBs.

Every Integrated Care Board in England, shaded by how much codeine its GPs dispense per head of population. Hover an ICB to name it. The ranked figures for all 36 ICBs, and the drill-down to practice level, are in the full report.

NHS Cheshire and Merseyside ICBNHS Staffordshire and Stoke-on-Trent ICBNHS Shropshire, Telford and Wrekin ICBNHS Lincolnshire ICBNHS Leicester, Leicestershire and Rutland ICBNHS Coventry and Warwickshire ICBNHS Herefordshire and Worcestershire ICBNHS North East London ICBNHS South East London ICBNHS South West London ICBNHS Kent and Medway ICBNHS Cornwall and the Isles of Scilly ICBNHS Devon ICBNHS Somerset ICBNHS Bristol, North Somerset and South Gloucestershire ICBNHS Bath and North East Somerset, Swindon and Wiltshire ICBNHS Dorset ICBNHS Gloucestershire ICBNHS Lancashire and South Cumbria ICBNHS North East and North Cumbria ICBNHS Humber and North Yorkshire ICBNHS West Yorkshire ICBNHS Birmingham and Solihull ICBNHS Greater Manchester ICBNHS Derby and Derbyshire ICBNHS Northamptonshire ICBNHS Nottingham and Nottinghamshire ICBNHS South Yorkshire ICBNHS Black Country ICBNHS Central East ICBNHS Essex ICBNHS Hampshire and Isle of Wight ICBNHS Norfolk and Suffolk ICBNHS Surrey and Sussex ICBNHS Thames Valley ICBNHS West and North London ICB
Items per 1,000 registered patients, 12 months
FewerMore

Darker shading marks where Codeine is dispensed most per head of population. Exact figures for every ICB, and the drill-down to practice level, are in the full report.

Data: NHSBSA English Prescribing Data (OGL v3.0). Boundaries: ONS Open Geography portal, ICBs April 2026, contains OS data © Crown copyright and database right 2026.

Zoomed out to the 7 NHS regions.

The same 12 months rolled up to NHS England's seven regions, ranked by intensity.

North WestMidlandsMidlandsMidlandsMidlandsMidlandsMidlandsLondonLondonLondonSouth EastSouth WestSouth WestSouth WestSouth WestSouth WestSouth WestSouth WestNorth WestNorth East and YorkshireNorth East and YorkshireNorth East and YorkshireMidlandsNorth WestMidlandsMidlandsMidlandsNorth East and YorkshireMidlandsEast of EnglandEast of EnglandSouth EastEast of EnglandSouth EastSouth EastLondon
Items per 1,000 registered patients, 12 months
North East and Yorkshire
South West
North West
Midlands
East of England
South East
London
Data: NHSBSA English Prescribing Data (OGL v3.0). Regions: ONS Open Geography portal, NHS England regions April 2026. Contains OS data © Crown copyright and database right 2026.
Top 3 previews

The teaser view.

Three rows each. The full 36-ICB view, every prescribing organisation, every strength and the hospital picture sit below the fold, behind Apply.

Top ICBs by volume
  1. 1 NHS North East and North Cumbria ICB 996k
  2. 2 NHS Greater Manchester ICB 341k
  3. 3 NHS West Yorkshire ICB 304k
  4. – + 33 more. See the full 36-ICB table. See all →
Fastest-growing ICBs (YoY)
  1. 1 NHS Lancashire and South Cumbria ICB +8.9%
  2. 2 NHS Norfolk and Suffolk ICB +8.6%
  3. 3 NHS Shropshire, Telford and Wrekin ICB +8.4%
  4. – + 33 more. See every ICB, ranked. See all →
Top formulations
  1. 1 Codeine 30mg tablets 61%
  2. 2 Codeine 15mg tablets 38%
  3. 3 Codeine 60mg tablets 1%
  4. – + 3 more. See every strength and pack. See all →
Primary vs secondary care
Primary 86% Hospital 14%

Split of items across NHSBSA primary care and SCMD hospital dispensing.

Deprivation · IMD 2019

Prescribing by deprivation.

Items per 1,000 registered patients by IMD decile: 1 = most deprived, 10 = least
58.1 0 12345678910

Items per 1,000 registered patients by deprivation decile (1 = most deprived), practice deprivation weighted by where each practice's patients live. Read the shape rather than the absolute level: the most and least deprived deciles cover far fewer practices, and age structure drives much of the gradient.

Beyond England

The devolved nations.

NationItems · 12 monthsData to
England 5.7m July 2026
Scotland 382k June 2026
Northern Ireland 95k May 2026
Wales 243k April 2026

Each nation publishes its own community prescribing data, with different coding and list rules, so read these per-nation rather than as an exact UK total. Sources: NHSBSA (England), Public Health Scotland, NHS Wales Shared Services Partnership, OpenDataNI. Used under the Open Government Licence v3.0.

Honesty strip

What open data won't tell you about codeine.

Over-the-counter codeine combinations sit outside this data, so total population exposure runs well above what this line shows.

Read exactly what the data covers →

Common questions

Asked and answered.

Is codeine prescribing rising or falling in the NHS?

Rising. England dispensed 5,686,121 items of Codeine in the 12 months to July 2026, up 3.4% on the previous 12 months. Items count prescriptions dispensed, not patients treated, so the change can reflect dose and duration shifts as well as patient numbers.

How much does the NHS spend on codeine?

£13.1m at net ingredient cost in the 12 months to July 2026. Net ingredient cost is the list price of the medicine before discounts and rebates; the NHS's final bill, especially for hospital medicines, is usually lower.

Where in England is codeine prescribed most?

By raw volume, NHS North East and North Cumbria ICB dispensed the most codeine in the last 12 months. Raw volume favours the biggest populations; the map on this page shades every ICB by items per head to correct for that.

How up to date is this data?

This page runs to July 2026, the most recent NHSBSA release. Prescribing data publishes roughly six to eight weeks in arrears, and DoseTrend refreshes within 48 hours of each monthly release.

Locked · Applicants only

The full breakdown.

Every ICB, every prescribing organisation, every strength, the hospital view with what trusts paid and who holds each framework line, Signals with their sources, and the monthly briefing PDF. The rows below are placeholders; the real tables sit behind the application.

Locked · Applicants only

See the full picture for Codeine.

All 36 ICBs, prescribing organisations, formulation splits, Signals, and the hospital view with what trusts paid. Plus who won the NHS contract: 5 codeine framework lines, 4 suppliers. £1,500 a month per molecule, price published, applications reviewed by a human within one working day.

No card details to apply. About one applicant in ten gets told the open data can't answer their question, before paying anything.

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