This Page was last reviewed and changed on June 15th, 2020
Trying to quit or cut down on your use of codeine can lead to withdrawals, which can end up being extremely unpleasant if not managed correctly. With a supervised codeine detox, medication can be administered if appropriate. This could help to lessen the impact of withdrawal and make it easier for you to quit the drug.
Once addiction to codeine has developed, detox is usually necessary to safely withdraw from this medication. Codeine is an opioid drug that although is considered less potent than other opioids is still highly addictive and more than capable of destroying the lives of the affected person if not treated.
And know that without treatment, codeine addiction will only ever get worse. It is therefore extremely important to seek out help if you have become addicted to this drug. When you do, your recovery journey will more than likely begin with a detox programme whose aim is to break the cycle of abuse.
Codeine is an opiate drug that has an exceedingly high potential for abuse. Users develop a tolerance to the drug with either prolonged use or when it is abused. Either way, after a while, the brain will become less responsive to the codeine and will start to produce fewer feel-good chemicals when it is taken. The result of this for you if you are an affected individual is that you will not achieve the desired level of satisfaction when taking it, therefore potentially prompting you to take a higher dose to compensate.
What most people do not realise though is that taking codeine in high doses is classed as prescription drug abuse and it is a very dangerous thing to do. It could not only lead to an accidental overdose, but it can also result in a physical or psychological dependence developing – probably both.
As the brain and body get used to your regular use of codeine, they will learn to rely on it for ‘normal’ functioning. This means that when you try to quit or cut back on your use of the medication, you will likely struggle. You are probably going to experience a range of withdrawal symptoms as your body and brain respond to the removal of the drug that they have learned to depend on.
Codeine Withdrawal Symptoms
The effects of codeine withdrawal can appear just a few hours after the last dose has been taken. These could include:
Causes of Codeine Withdrawal
With continued regular use of codeine, you are likely to build up a tolerance to it. This means that you are going to need increasingly more of the drug to achieve the feelings of pleasure or pain relief that you want or need. Over time, your body will begin to crave the drug as you develop a physical dependence to it. Furthermore, when your brain learns to rely on it for normal physiological function, you will feel quite unwell whenever the effects wear off.
Taking codeine in higher than recommended doses can cause a dependence, but even taking it exactly as prescribed but for a longer period than recommended by your doctor could also induce dependence.
When you try to quit codeine, your body will need time to get back to normal. As it does so though, a range of unpleasant symptoms is likely to occur. The type and severity of the symptoms you might potentially suffer will depend on how long you have been taking codeine, how much of it you were taking before you quit, your age, and your overall mental and physical health.
Treatment for Codeine Withdrawal
Many affected people realise rather quickly that taking codeine again can help the withdrawal symptoms to subside and so these individuals end up in a cycle of abuse that is then extremely hard to break.
For most people who want to overcome a codeine addiction, detox will be necessary. This is the process whereby they quit the drug and allow their body to expel any remaining toxins or chemicals that have accumulated. It is actually this process that results in the unpleasant symptoms.
However, if the process takes place in a dedicated detox facility, codeine withdrawal can be effectively treated and managed, usually with appropriate medications and nutritional supplements. Other methods such as meditation and mindfulness may also provide relief and are utilised as and when appropriate.
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Does Codeine Withdrawal Work?
The presence of withdrawal symptoms when trying to quit codeine might be enough to send you straight back to the drug, possibly making you feel as though you are never going to be able to break free. Nevertheless, codeine withdrawal can and does work, provided it is managed correctly.
Within a detox facility, you would have the care and support to help you get through the process. Staff with experience of opioid withdrawal will be aware of the best methods to make the process easier and more comfortable. They can prescribe medication to help lessen the severity of any symptoms being experienced, while they may also be able to prevent other symptoms from occurring in the first place.
Withdrawing from codeine on your own at home is not recommended because the symptoms may become so uncomfortable that you start taking the drug again just to make them subside. This can be extremely dangerous though because your tolerance levels will have dropped significantly, even with just a few days of abstinence. Taking the same amount of codeine as you were taking before the process began could result in an overdose.
It is best to go for professional help if you want to successfully withdraw from codeine. In a detox facility, you will have a greater chance of getting through the process to the end and making a full break from your medication.
Medications for Codeine Withdrawal
Managing codeine withdrawal using different medications and nutritional supplements can help to make the process run smoother and ensure your comfort and safety. Within a dedicated detox facility, staff will have a range of options available to them to help you get through your detox safely.
You are likely to have experienced nutritional deficiencies during your addiction, which can continue during the detox process. These deficiencies might be the cause of muscle spasms or pain and in some cases can result in a condition known as restless leg syndrome. Your carers are therefore likely to recommend a healthy diet but may also prescribe vitamins and minerals to help restore the balance.
You are also likely to experience dehydration as the codeine leaves your system; this is generally caused by excess sweating, vomiting and diarrhoea.
It will, therefore, be necessary for you to be rehydrated. You will be advised to drink plenty of fluids, but doctors may also recommend rehydration salts or sports drinks to restore the lost electrolytes.
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As diarrhoea and vomiting often occur during codeine withdrawal, it might become necessary to take medications to relieve the symptoms of said conditions. Anti-diarrhoea and anti-nausea medication can help to make you feel better in such circumstances, enabling you to give all your energies once again to withdrawing safely.
Your doctor might also prescribe anti-inflammatory drugs such as aspirin or ibuprofen as well as a natural sleep remedy to help you get some rest.
In some instances, it may be considered appropriate to prescribe a substitute opioid medication, which can help to keep withdrawal symptoms to a minimum while you withdraw from codeine. Nevertheless, as most other opioids are more potent than codeine, this method is usually only used for those with the most severe of addictions.
Codeine Withdrawal Psychosis
According to the NHS, psychosis is defined as a ‘mental health problem that causes people to perceive or interpret things differently from those around them’. The condition causes four main symptoms:
Confused and disturbed thoughts
Lack of insight and self-awareness.
Mental health problems such as bipolar disorder or Schizophrenia can cause psychosis.
During codeine detoxification, the stress to the system is huge. It may cause psychosis. This is why medical supervision is preferred.
In the case of codeine withdrawal, psychosis can occur as a result of severe anxiety and it may subsequently cause a loss of logical thinking and judgement.
Those who experience codeine withdrawal psychosis might feel an intense sense of hopelessness, and their desperation might cause them to act irrationally, putting themselves and others in danger. They may become paranoid and experience intense fear. Panic is another common symptom, often making it impossible to reason with the individual.
Medical Detox from Codeine as Part of a Whole Treatment Plan
Treatment for codeine withdrawal typically involves a detox, as described above, followed by rehabilitation. For most people, a medical detox is recommended as it is the safest and most effective way to break free from the drug.
A medical detox will make withdrawal more comfortable and safer and has a greater record of success than trying to quit on your own. In a medical environment, you are less likely to experience severe symptoms as staff can respond appropriately to prevent the worst symptoms from occurring and can prescribe medication if necessary to relieve symptoms that do occur.
Opioid replacement therapy is possible during a medical detox, but this is usually reserved for those with the worst symptoms. An alternative opioid drug such as methadone or buprenorphine may be prescribed to help you withdraw safely from codeine if you are experiencing severe symptoms.
Naltrexone is also an option; this medication blocks the effects of the codeine and can prevent a relapse by taking away the pleasurable effects of the drug.
Once detox has been completed, you can move on to the next part of the recovery process – rehabilitation. This is the process that will teach you how to live without codeine going forward.
Codeine Addiction Detox
When you start to detox from codeine, you are likely to experience the first symptoms within a few hours of taking the last dose. The first four days tend to be the time when most of the symptoms you are going to experience will appear. These could include muscle cramps, restless legs, nausea, diarrhoea, sweating, and headaches. Your symptoms might be quite intense during this time but will usually reach their peak around the fourth day.
Over the next couple of days, you will notice that most of the physical symptoms will begin to subside. You might, however, see the development of psychological symptoms such as depression or anxiety. These psychological symptoms could potentially last for many months.
Although a sudden cessation of codeine is the quickest way to break free from the drug, it is the most unpleasant way to withdraw. Due to this being so, your doctor might recommend opioid replacement therapy.
If your addiction is not severe and you are planning to withdraw from codeine at home (something we do not typically recommend, by the way), you will likely be given a medication tapering schedule where you slowly withdraw from the drug over the course of a few weeks or months.
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Codeine Detox Protocol
When detoxing in a medical facility, it is likely that a codeine detox protocol will be put in place. This is an important part of the process as it gives everyone involved clear instructions as to how the detox should proceed.
Your codeine detox protocol will include details about your medical history and the types of medications that may be used to make you more comfortable during the process. It is also likely to include information about nutritional supplements and the diet that you should be following to maintain good health during the process.
Putting a codeine detox protocol in place helps to ensure your safety and comfort and means that everyone involved in your care will be fully aware of your requirements before, during, and immediately after, the process. They will also have detailed information on the best way to react in case of an emergency.
Physical Dependence vs. Addiction
There is a common misconception that physical dependence and addiction are the same thing. A physical dependence can occur separately from addiction, but most people with an addiction to a drug such as codeine will also have a physical dependence. This is because a physical dependence is usually a precursor for addiction. There are distinct differences between the two.
We touched upon this in the above passages, but just to summarise again, when you use a mood-altering drug for a prolonged period, you will have an increased risk of developing a tolerance to it. This means that the drug becomes less effective, increasing the need to take more of it to achieve the same level of satisfaction or relief.
Continued regular use of the drug can then causes the body to get used to it and to depend on it for normal functioning. When you develop a physical dependence, you are likely to experience withdrawal symptoms when you try to quit or significantly cut down on your use.
Having a physical dependence does not mean you are addicted though. An addiction is a compulsive desire to use the drug despite knowing that doing so could result in harmful consequences.
If you have an addiction to codeine, you will be unable to stop using it even though it may be interfering with your ability to meet family, work, and/or social obligations.
Overdose is a very real concern for those abusing drugs such as codeine. Taking too much medication can lead to a serious depression of your central nervous system, which could, in turn, lead to respiratory failure or cardiac arrest.
A tolerance to codeine can develop very quickly and when it does, the temptation to take more of the drug exists. What often happens though is that you will become tolerant to the higher dose of codeine too.
Some individuals then find that combining codeine with another sedative substance such as another opioid or alcohol can enhance its effects, without realising that doing so could have dangerous and even fatal consequences.
If you have taken too much codeine or have mixed it with other substances, it is important that you seek medical help, particularly if you notice the following signs of overdose:
Low blood pressure
Extreme fatigue or drowsiness
Cold clammy skin
Blueish nails and lips
Opiate overdose is usually accidental, and many people do not realise they have taken too much or have otherwise underestimated the dangers of mixing such drugs with other substances. Getting help as soon as possible can prevent serious complications from developing.
Codeine Addiction Treatment and Rehab
As we said above, treatment for codeine addiction involves a detox and rehabilitation but this is generally followed up with aftercare support. It is important to know that a successful recovery will incorporate all three elements.
Addiction treatment is complex, and each step is necessary; detox will help to treat the physical element of the illness while rehabilitation is required to address the psychological. Aftercare support is necessary for ongoing sobriety maintenance.
Treatment programmes are usually inpatient or outpatient based and will depend on a range of factors including your age, health, personal preferences, budget, and the severity of your illness.
Codeine Addiction Withdrawal and Detox Statistics
The number of individuals being treated in hospital in England for opioid poisoning more than doubled between 2005/2006 and 2015/2016.
The number of people being treated for poisoning from opioids such as fentanyl and codeine in 2005/2006 was 4,891. In 2015/2016, the figure was 11,660.
The number of opioids prescribed in 2006 was 12 million, compared to 24 million in 2016.
There are an estimated 192,000 people in the UK with a physical dependence on opioid drugs such as codeine.
In terms of opioid prescriptions, nine out of ten of the highest prescribing regions in the UK are in the north.
Researchers have discovered that one in twenty individuals in England has been prescribed opioid painkillers such as codeine.
A study by the Public Health Research Consortium of 50,000 NHS patients ascertained that five per cent were receiving regular prescriptions of opioid medications. This was double the number for 2000.
Frequently Asked Questions
How does codeine withdrawal affect my health?
Withdrawing from codeine can result in a range of symptoms, which can end up being mild to severe in intensity. They are likely to make you feel unwell, but they will pass. You may feel as though you have the flu, as opiate withdrawal causes symptoms that are similar.
Sweating, headaches, vomiting, fever, and muscle aches are all common during codeine withdrawal and you might also notice psychological symptoms such as depression. However, with time, all these symptoms should disappear.
Will my information be kept confidential?
Your personal and medical information will be kept completely private by any organisation taking care of you as you try to withdraw from codeine. It is natural to worry about others finding out that you are in treatment for addiction, but you can rest assured that your details and information will not be shared with a third party without your permission.
Am I addicted?
It is hard to tell when substance use has crossed a line to addiction, but by examining your behaviour and your use of codeine, you can get a clearer picture as to what your situation is. If you feel the need to use more codeine to achieve a certain level of satisfaction or relief, it is probably because you have become tolerant to the medication.
Nevertheless, addiction is more than just having a tolerance to a particular substance or even a physical dependence. It is more to do with how much control you have over your use. If you are unable to resist the urge to use, even when it is having obvious negative consequences for yourself or your loved ones, you almost certainly have an addiction and need professional intervention.
How serious is codeine detox?
Although detox from opioid drugs is rarely fatal, it is important to seek professional help as there is the risk that complications could occur without treatment. Your detox needs to be effectively managed to prevent issues such as dehydration from persistent vomiting or diarrhoea.
The development of codeine withdrawal psychosis is also something that needs to be managed properly as this can lead to paranoid delusions and the subsequent risk that you could harm yourself or another person.
Can medications help me detox from codeine?
As a range of symptoms can occur during codeine withdrawal, a variety of medications can help. For mild pain, medications such as ibuprofen or aspirin might be prescribed. If you are experiencing nausea or vomiting, your care team might prescribe anti-nausea tablets, and for diarrhoea, medications such as loperamide can be useful.
Anti-anxiety medication helps to prevent or ease symptoms such as sweating, agitation, cramps, and muscle aches, and for severe symptoms, an opioid replacement such as buprenorphine or methadone can help.
Can I die from codeine withdrawal?
Deaths from codeine withdrawal are extremely rare, but it is important to be aware of the risk of a return to your medication after a period of abstinence. Because you are likely to have developed a tolerance to codeine while you were using it, you may have needed higher doses to get the relief you desired at the time.
What most people do not realise is that after a period of abstinence, tolerance reduces significantly. Taking the same amount of codeine as you were taking before could put you at risk of an overdose, which could be fatal if not treated immediately.
How to detox from codeine?
It is recommended that detox from codeine take place in a supervised facility to ensure your comfort and safety. However, if you have a physical dependence without addiction and want to stop using your medication, it is recommended that you detox slowly. Your doctor is likely to give you a tapering schedule to follow, which will involve a gradual reduction of your dose over the course of a few weeks or months.
For those with an addiction, a detox in a dedicated facility might also involve a gradual reduction of codeine, but over a shorter period. Nevertheless, it is more likely that you will stop taking your medication suddenly and will be treated with other medication as appropriate to ease any symptoms you are experiencing.
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