{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:39:09Z","timestamp":1768318749348,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"Medical University of Silesia in Katowice","doi-asserted-by":"publisher","award":["BNW-1-010\/K\/4\/F"],"award-info":[{"award-number":["BNW-1-010\/K\/4\/F"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>Codeine, an opioid analgesic present in many over-the-counter (OTC) formulations, is frequently misused through non-medical extraction techniques such as cold water extraction (CWE). These practices carry substantial risks, including incomplete removal of hepatotoxic co-formulants, contamination, and highly unpredictable dosing. We report a fatal case of a 29-year-old man who ingested codeine extracted from Antidol\u00ae tablets in combination with energy drinks and psychotropic medications. Post-mortem LC\u2013MS\/MS analysis revealed the presence of codeine (0.66 \u00b5g\/mL), morphine (0.02 \u00b5g\/mL), hydroxyzine (2.52 \u00b5g\/mL), alprazolam (0.15 \u00b5g\/mL), paracetamol (30.64 \u00b5g\/mL), and additional substances in blood samples. Concentrations of codeine and hydroxyzine exceeded therapeutic ranges and were consistent with values reported in fatal intoxications, confirming a poly-drug poisoning. This case highlights the danger associated with non-medical codeine use, particularly when combined with central nervous system (CNS) depressants, and underscores the need for stricter regulation of OTC codeine-containing products as well as improved public awareness of the risks associated with domestic extraction methods.<\/jats:p>","DOI":"10.3390\/toxics14010071","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T09:27:12Z","timestamp":1768296432000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Domestic Abuse of Codeine: A Case Study of Non-Medical Use Leading to Fatal Outcome"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5499-1450","authenticated-orcid":false,"given":"Karolina","family":"Mrochem","sequence":"first","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1469-1933","authenticated-orcid":false,"given":"Ewelina","family":"Pieprzyca","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Skalniak","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5672-7704","authenticated-orcid":false,"given":"Jakub","family":"Obrzut","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2907-7322","authenticated-orcid":false,"given":"Julia","family":"Cie\u015bla","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0111-438X","authenticated-orcid":false,"given":"El\u017cbieta","family":"Che\u0142mecka","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4668-4685","authenticated-orcid":false,"given":"Marcin","family":"Tomsia","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1445-3807","authenticated-orcid":false,"given":"Rafa\u0142","family":"Skowronek","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 18 Medyk\u00f3w Street, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref_1","first-page":"413","article-title":"Analiza zjawiska nadu\u017cywania przez polsk\u0105 m\u0142odzie\u017c lek\u00f3w dost\u0119pnych bez recepty i zi\u00f3\u0142 niepodlegaj\u0105cych kontrolowanemu obrotowi: Cz\u0119\u015b\u0107 I","volume":"68","author":"Suchecka","year":"2017","journal-title":"Med. 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