Codeine is a very common opioid drug that’s used in prescription medications and hospital settings. It’s one of the most commonly used opioids in the world, along with morphine. Like morphine, codeine is derived from the opioid poppy plant and used as a mild to moderate painkiller. Codeine is a weaker opioid than morphine and other prescription painkillers, but it can have some potent effects. Like other opioids, codeine can cause chemical dependence and addiction. Quitting codeine after developing a substance use disorder may mean going through uncomfortable withdrawal symptoms. But how bad is codeine withdrawal, and how long does it last? Learn more about codeine withdrawal and how it can be treated.
What is Codeine?
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, codeine addiction 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 many people misuse the drug.
Codeine, like all opioids, can be habit-forming.
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.
How Does Medical Detox Work?
Medical detox is the highest level of care on the continuum of care model produced by the American Society of Addiction Medicine. Medical detox is a common term for medically managed intensive inpatient treatment. It involves 24-hour care that usually lasts between a week to ten days. Through detox, you’ll be treated by medical professionals that are experienced in treating substance use disorders.
Medical detox is often reserved for people that are likely to experience significant withdrawal symptoms. Some drugs can cause severe and life-threatening withdrawal. As an opioid, codeine isn’t known to cause deadly withdrawal symptoms, but withdrawal can be unpleasant. Detox can help get you through withdrawal effectively, lowering your chance of relapse. Medical detox can also address other common medical and psychological needs alongside codeine withdrawal symptoms.
Detox usually takes between five to ten days, but it ultimately depends on your needs. While it’s an important part of recovery, detox may not be all you need to treat addiction. After you complete detox, you may move on to other levels of care in addiction treatment.
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 the drug 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:
Symptoms of Codeine Withdrawal
- Trouble sleeping or insomnia
- Teary eyes
- Runny nose
- Muscle aches and pains
- Increased heartbeat
- Appetite loss
- Abdominal cramps
- Dilated pupils
- Cravings for codeine or other opioids
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.
Codeine Detox Timeline
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.
Do I Need Codeine Withdrawal?
Codeine withdrawal is a consequence of chemical dependency. Chemist dependence, also called physical dependence, occurs as a result of your body’s ability to adapt to the presence of a drug in your brain like codeine. Codeine works by mimicking your body’s natural pain management chemical called endorphin. It blocks pain receptors and lowers your body’s ability to send pain signals. However, long-term codeine use can cause your body to adapt by adding more pain receptors to send pain signals. When getting off codeine, your brain’s adjustment will cause a chemical imbalance until it can readjust to life without codeine. This adjustment period can cause withdrawal symptoms.
There are a few signs and symptoms that your brain has adjusted to codeine, causing you to become chemically dependent. One of the most obvious signs is withdrawal symptoms. If you feel drug cravings, nausea, and other flu-like symptoms when you cut back or skip a dose, you may be chemically dependent. Another sign is tolerance.
Tolerance will make it feel like the drug is less effective than it used to be or like it’s wearing off sooner than it once did. As your brain adjusts to the drug, you’ll need higher or more frequent doses to achieve the same effects.
If you believe that you’ve become chemically dependent on codeine, you can speak to a doctor about tapering off the drug. If you have a mild to moderate substance use disorder, tapering may be all you need to stop using codeine. However, if you’ve become addicted to codeine, it may be difficult to detox on your own, even with a tapering schedule.
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.
What To Look for in a Detox Center
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:
Ask These 5 Questions
- Does the treatment program use methods backed by scientific evidence?
- Does the treatment program strive to meet the individual needs of each client?
- Does the treatment program update the client’s treatment plan as their needs change?
- Is the length of the treatment program sufficient?
- How do recovery programs, like 12-step programs, fit into the addiction treatment plan of the program?
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 an online Behavioral Health Treatment Services Locator.