Codeine Withdrawal & Detox: Symptoms & Timeline
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If you or a loved one take codeine regularly, you may be concerned about what happens when you stop taking the drug. The prospect of withdrawal symptoms can be overwhelming. However, with medical assistance, it is possible to wean off the drug and start a codeine-free life.
What Is Codeine?
Codeine is an opioid medication often used to treat pain or suppress coughs. Unfortunately, it is also a controlled substance that can be addictive. For this reason, people who misuse it often become physically and mentally dependent on it.
When someone dependent on codeine decides to quit taking the drug, they will go through withdrawal. The detox period can be difficult and uncomfortable as your body is weaned from codeine, but it is a necessary first step towards recovering from a substance use disorder.
Medical professionals can help make the codeine detox process safer and ease withdrawal symptoms. When someone abusing codeine seeks help, they can become free from drug dependency.
What Is Codeine Withdrawal?
Codeine, like other opioids, binds to special receptors on the surface of nerve cells in your brain and throughout your body. This binding decreases the ability of the cell to pass on signals and helps dampen a person’s perception of pain.
If a person misuses codeine, takes too much of it or uses it for too long, the drug will build up in their system until their body becomes physically dependent on its presence. Once that person stops using codeine, they will experience codeine withdrawal symptoms as their body adjusts to not having the drug anymore.
Physical dependence is related to addiction, but they refer to different things. Someone who has become dependent on codeine may also experience changes in their brain chemistry and lose control over their ability to choose whether or not to continue to take the drug. At this stage, they may display drug-seeking behavior, lie about codeine use, have cravings and be unable to stop using despite having financial, legal or health problems. This stage represents codeine addiction or psychological dependence.
Codeine Withdrawal Symptoms
If someone has taken a lot of codeine or has been using it for a long time, they will probably experience codeine withdrawal symptoms when they stop. These symptoms can make it even more difficult to quit using. A person experiencing side effects of codeine withdrawal can get medical assistance to help ease some of the symptoms. Doctors and other medical professionals can prescribe other drugs to help with pain or make the patient more comfortable.
It’s important to know that people using other codeine-containing medications may experience slightly different symptoms. Common drugs in this category include Tylenol 3 and Tylenol 4. These contain codeine and paracetamol, also known as acetaminophen. High doses of acetaminophen can cause liver damage, so these drugs should only be taken at doses recommended by a doctor. Codeine and paracetamol withdrawal symptoms include mental changes, blurred vision, abdominal pain, jaundice and passing out.
Physical Symptoms of Withdrawal
Physical signs that a person is going through codeine withdrawal include:
- Muscle aches
- Nausea and vomiting
- Abdominal pain
- Flu-like symptoms
If someone is experiencing symptoms like diarrhea from codeine withdrawal, it is a sign that their body has become physically dependent on the drug. Medical intervention can help ease these issues.
Psychological Symptoms of Withdrawal
Psychological symptoms that some people encounter during the withdrawal process are:
Medications such as clonidine can help with codeine withdrawal signs like insomnia. A doctor can prescribe these at a rehab facility. If a patient is dealing with mental health issues such as depression during codeine withdrawal, a comprehensive treatment center can help treat these issues along with codeine dependence.
Related Topic: Clonidine Dosage for Withdrawal
Codeine Withdrawal Timeline
How long withdrawal from codeine lasts may be slightly different for different people. It often begins within 12 hours after the last use and persists for up to five days. Additionally, not all physical or psychological signs may appear at the same time, with some manifesting earlier and some later after a person takes their last dose.
Codeine withdrawal symptoms follow a general timeline:
First 12 Hours
The drug slowly leaves your body during the first 12 hours after the last use. In the absence of codeine, withdrawal symptoms can begin. These symptoms may start slowly but generally intensify over the next few days.
Withdrawal symptoms peak over the first one to two days after the last dose. Although this period can be unpleasant, it is short. Further, if you detox under medical supervision, medication-assisted treatment (MAT) may be used to control your symptoms if medically appropriate.
Withdrawal symptoms generally resolve within five days after the last use. This is because your body quickly acclimates to the drug’s absence, leading to you feeding better within a few days after the last codeine dose.
Following Weeks and Months
Although most withdrawal symptoms will improve within a few days, symptoms can sometimes linger. These include symptoms like insomnia, anxiety and depression, which can persist for weeks to months in some people. However, with continued abstinence, these symptoms will also resolve.
If someone is struggling to get through codeine withdrawal, contact The Recovery Village at Baptist Health to learn more about treatment and medical detox options. Getting medical help makes the process safer and more comfortable.
Factors Impacting Codeine Withdrawal
Research tells us that addiction affects different people differently. For example, genetics can affect which symptoms people experience and how severe they are.
Other factors that might affect the severity of a person’s withdrawal experience include:
- How much codeine they typically used
- How long and how often they used it
- Whether they used codeine along with other drugs
- How much they weigh
- Whether they have a history of mental or physical disorders
These factors can affect a person’s experience with physical withdrawal and psychological cravings once they have detoxed.
Environmental cues can play a big role in fighting substance use disorder. If a person struggling with addiction finds themselves in a certain place where they would typically use codeine or surrounded by people they used to use codeine with, they may experience cravings. People may also experience behavioral withdrawal, where they want to take codeine in stressful or unpleasant situations where they would previously have used the drug. Behavioral therapy and counseling can help people find different ways to cope with problems.
Is It Safe To Go Off Codeine “Cold-Turkey”
Suddenly stopping codeine, also known as quitting the drug cold turkey, is unsafe. Not only is sudden discontinuation linked to relapse, but it can also lead to uncontrolled withdrawal symptoms. These symptoms can include complications like excessive nausea, vomiting and diarrhea, which can be dangerous. Instead of quitting cold turkey, it is safer to seek medical advice and arrange for a codeine taper, in which your codeine dose is slowly reduced over time. This allows your body to slowly adjust to progressively lower codeine doses, reducing the risk of withdrawal and relapse.
Undergoing a codeine detox can be incredibly uncomfortable. Medical professionals don’t usually recommend going through a codeine detox at home because the discomfort often leads people to relapse. Several options patients can choose when they are ready to begin a codeine detox include:
This is the safest and most comfortable option for people going through withdrawal. Inpatient detox involves living at a treatment center 24 hours a day, where medical professionals can monitor symptoms and immediately address any health issues.
Finding a Detox Center
It is important for people with substance use disorders to find a facility they can trust to help them through the detox phase. Physical and psychological symptoms may be so strong that a patient can’t stop themselves from using again to make the symptoms disappear. Enlisting medical professionals helps make the withdrawal process smoother, safer and more likely to be successful.
People looking for medical detox centers should ensure that the facility can offer medical treatment to help ease symptoms and cravings. They should also look for a treatment center that offers behavioral therapy and counseling to increase their long-term success and help make relapses less likely. Finally, medical detox centers should be able to evaluate patients for co-occurring mental health disorders and be prepared to offer treatment for those issues while a patient is undergoing medical detox.
Codeine Addiction Recovery
Detox is the first stage of recovery but is not the only step needed. People who go through detox but don’t pursue any other treatment are more likely to keep abusing a drug. A long-term treatment plan is needed to recover from addiction.
If a codeine user stops or tries to stop using the drug and their body’s tolerance to codeine begins to decrease, and then they take a high dose of codeine, they may experience an overdose. This risk is why it’s so important to seek professional help when you’re ready to detox from codeine and begin your recovery.
Fighting a codeine addiction is difficult, but recovery is possible, especially with the necessary tools and support from a professional medical staff.
Frequently Asked Questions
Am I addicted to codeine?
This self-assessment can help you evaluate your codeine use to see if you are at risk for addiction or may already be addicted.
What are the stages of opiate withdrawal?
Opiate and opioid withdrawal go through multiple stages. Symptoms often begin within the first 12 hours after the last dose, peak within one to two days and resolve within five days. However, lingering symptoms may persist for the next few weeks to months.
Can you overdose on codeine?
It is possible to overdose on codeine. A codeine overdose can be deadly, especially if the codeine is mixed with other central nervous system depressants like benzodiazepines or alcohol. People who have the genetic ultrarapid metabolizer form of the liver enzyme CYP2D6 are also at risk for a codeine overdose, as this causes the drug to turn into morphine too quickly in your system.
How long does codeine stay in your system?
Although the drug’s pain and cough-relieving effects may wear off within a few hours, it can linger longer in your body. Codeine can be found in your blood for almost four hours after the last dose and in urine up to three days after the last dose. A 1.5” hair sample can show if codeine was used in the past 90 days.
How do you taper off codeine?
A doctor can help you taper off codeine by slowly reducing your dose over time. The speed of the taper will depend on factors, including how long you have been taking codeine, your current codeine dose and if you start to experience any withdrawal effects during the taper.
Will codeine help with hydrocodone withdrawal?
Medication-assisted treatment (MAT) with methadone and buprenorphine products is recommended for withdrawal symptoms of other opioids like hydrocodone. This is because those agents are longer-acting than other drugs like codeine, meaning they can ward off cravings better than codeine and better prevent relapse and overdose.
If you want to know more about codeine addiction recovery, contact The Recovery Village at Baptist Health. Our team can help you learn more about the medical detox process, and our facilities are a safe, comfortable place to treat withdrawal symptoms and become free from addiction. The Recovery Village at Baptist Health offers medical assistance, inpatient and outpatient programs, family counseling and therapy to help you or your loved one get on the road to long-term recovery.
Peechakara, Basil V.; Tharp, Jack G.; Gupta, Mohit. “Codeine.” StatPearls, February 13, 2023. Accessed September 30, 2023.
Drug Enforcement Administration. “Controlled Substances.” September 18, 2023. Accessed September 30, 2023.
Corder, Gregory; Castro, Daniel C.; Bruchas, Michael R.; Scherrer, Grégory. “Endogenous and Exogenous Opioids in Pain.” Annual Review of Neuroscience, May 31, 2018. Accessed September 30, 2023.
National Institute on Drug Abuse. “Treatment.” January 2023. Accessed September 30, 2023.
Gryczynski, Jan; Schwartz, Robert P; Mitchell, Shannon D; et al. “Hair Drug Testing Results and Self-reported Drug Use among Primary Care Patients with Moderate-risk Illicit Drug Use.” Drug and Alcohol Dependence, May 17, 2014. Accessed September 30, 2023.
American Society of Addiction Medicine. “National Practice Guideline for the Treatment of Opioid Use Disorder.” December 18, 2019. Accessed September 30, 2023.
Substance Abuse and Mental Health Services Administration. “Protracted Withdrawal.” July 2010. Accessed September 30, 2023.
World Health Organization. “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.” 2009. Accessed September 30, 2023.
ARUP Laboratories. “Drug Plasma Half-Life and Urine Detection Window.” September 2022. Accessed September 30, 2023.
Piper, Megan E. “Editor’s choice: Withdrawal: Expanding a Key Addiction Construct.” Nicotine and Tobacco Research, December 2015. Accessed September 30, 2023.