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Because of its potential for abuse, dependence, and negative effects, codeine should only be used with caution when treating pain and suppressing coughs. As with other opioids, codeine can cause respiratory depression, particularly at large dosages or in combination with other substances that depress the central nervous system, such as alcohol or benzodiazepines. Codeine use should be cautious in patients with respiratory disorders including asthma or chronic obstructive pulmonary disease (COPD), as they are more vulnerable to respiratory depression.

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