Codeine is a prescription painkiller that is used to treat mild-to-moderate pain. It belongs to the opioid class of drugs. It is also used in cough syrups and in combination with Tylenol to address multiple symptoms at once.
Unfortunately, addiction to codeine can occur whether you are using the drug recreationally or for medical reasons. Doctors strive to ensure safe prescribing methods and to monitor patients’ development of dependence on the drug, but nonetheless, many people misuse the drug.
Codeine, like all opioids, can be habit-forming.
The American Society of Addiction Medicine recognizes that opioids play an important role in treating pain that is otherwise unresponsive to other medications, but their use is limited by the fact that they are so easily misused.
Abuse is such a high risk with opioids because they stimulate the reward system in the brain. Not only do they inhibit pain signals from being sent throughout the body, but they also create a sense of reward. The reward, or a sense of euphoria, is what leads many people to misuse opioids.
Whether you have been taking codeine for medical reasons or misusing the drug recreationally, you will most likely have to go through a withdrawal process once you stop taking it. Even if you have only been taking a combination medication that includes codeine, you may experience withdrawal symptoms when you stop taking that medication.
Withdrawal from a drug occurs once your body has become dependent on it. Drug dependence means that your body has adapted to the presence of the drug in your system and now requires that drug to function properly. This is why it can be such a painful process to detox from a substance your body has become dependent on.
In the case of codeine withdrawal, symptoms can be quite unpleasant, but they can be managed. Before you stop taking the drug, you should speak with your doctor about the smartest way to detox from your medication. Rushing the detox process can lead to withdrawal symptoms because your body is not given enough time to adapt to the substance leaving it.
Common symptoms of codeine withdrawal include:
Not everyone will experience all of the above symptoms. Likewise, the severity of the symptoms will also vary from person to person. Factors, such as the length of drug use, type of drug use, any concurrent medical or recreational drug use, age, body mass, metabolism, and general health status, will all impact how your body responds to the detox process.
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Because everyone’s withdrawal process is unique, an exact codeine detox timeline can’t be guaranteed. There is an approximate timeline, however, that you can expect for the major phases of detox.
Initial withdrawal symptoms typically start to appear within just a few hours of your last dose of codeine. They are likely to peak between 48 hours and 72 hours and then gradually reduce in severity after that. For most people, symptoms are most uncomfortable for about a week and should completely resolve within two weeks.
Physical withdrawal symptoms are what many people fear about the detox process and can be very uncomfortable. Psychological withdrawal symptoms, however, are likely to be the most challenging. Symptoms such as anxiety, depression, and drug cravings can last for months or even years after you stop using codeine. For this reason, full substance abuse treatment must include behavioral therapy.
If you are willing to work with your doctor to devise the best withdrawal plan for you, there are treatment options available to mitigate your discomfort. The first thing your doctor will probably recommend is to taper off your codeine dosage rather than quitting all at once. By gradually reducing the amount of codeine you are taking, your body will be able to adapt to the substance slowly leaving your system.
Most tapering plans reduce use gradually over a few weeks to prevent the worst withdrawal symptoms from being experienced. Tapering off a drug does not guarantee that you won’t experience any withdrawal symptoms, but it can greatly reduce the severity of those that do occur.
In combination with tapering, your doctor may also be able to prescribe medications to treat unpleasant withdrawal symptoms that do arise. For mild symptoms, such as headache and muscle aches, acetaminophen or ibuprofen may be enough to help you feel better.
Other non-opioid medications can be prescribed as well to relieve symptoms such as nausea, diarrhea, or anxiety.
Stronger prescription medications can be prescribed to address withdrawal symptoms that cause significant discomfort. Antidepressants and anti-anxiety medications can be prescribed to reduce more challenging psychological symptoms.
For people who experience severe withdrawal symptoms, even stronger prescription medications and sometimes alternative opioids can be prescribed to ease the transition off codeine.
The FDA has approved medications such as naltrexone, methadone, and buprenorphine for the treatment of opioid use disorder.
They are taken in place of codeine, or whichever opioid you have become addicted to, and help prevent withdrawal symptoms as well as cravings.
If you suspect you have become dependent on or addicted to codeine and you want to quit using it, detox centers offer a highly supportive environment to see you through the withdrawal process and beyond. The National Institute on Drug Abuse (NIDA) explains that the goal of substance abuse treatment is to help people stop using drugs and lead full and active lives within their families, communities, and workplaces. An effective detox center will help you get on the right path toward achieving this goal.
Finding the right treatment center can be difficult. With so many detox centers and treatment programs available across the country, it can be confusing to know where to start. To help you focus your search, NIDA recommends asking the following five questions:
A great place to start your search for an appropriate detox center is with the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA offers a free national helpline (1-800-662-HELP) and online Behavioral Health Treatment Services Locator.
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(December 2016). Codeine Withdrawal: What It Is and How to Cope. Healthline from https://www.healthline.com/health/codeine-withdrawal#symptoms
Definitions Related to the Use of Opioids for the Treatment of Pain. American Society of Addiction Medicine from https://www.asam.org/docs/default-source/public-policy-statements/1opioid-definitions-consensus-2-011.pdf
(June 2013). Seeking Drug Abuse Treatment: Know What to Ask. National Institute on Drug Abuse from https://www.drugabuse.gov/publications/seeking-drug-abuse-treatment-know-what-to-ask/introduction
(November 2018). What is Codeine? Alcohol and Drug Foundation from https://adf.org.au/drug-facts/codeine/
(May 2015). What is Codeine? Everyday Health. from https://www.everydayhealth.com/drugs/codeine#top