Living with pain can be debilitating. It affects daily activities, making even the simplest of tasks difficult and unbearable.
That’s where codeine comes in. Prescribed by physicians as a form of short-term pain reliever, codeine is safe to use as long as you take it only for as long as your doctor tells you to.
Yet, our bodies can build tolerance for its analgesic effect, forcing us to increase the dosage, which can lead to an onslaught of unwanted repercussions.
If you or someone you care about is taking codeine regularly, you might be concerned about what might happen if you continue to take it or suddenly stop taking it. It’s true that its withdrawal symptoms can seem overwhelming, but with medical assistance, codeine detox can be easy and with minimal negative side effects.
In this post, we’ll explore how codeine works and what possible withdrawal symptoms you can expect during detox. We’ll also talk about additional treatment methods to consider alongside detox to make a full recovery and start a life free of codeine and other addictive opioids.
Table of Contents
- 1 What Is Codeine?
- 2 What Is Codeine Used for and How Does It Work?
- 3 Getting Help for Codeine Addiction
- 4 Is Detox from Codeine Necessary?
- 5 Can Codeine Detox Be Enough to Make a Full Recovery?
- 6 Final Thoughts
Codeine is an opiate painkiller used to bring short-term relief of moderate to mild feelings of pain. It’s not recommended for the treatment of long-term or chronic pain and is only available with a prescription from your physician.
Because of its moderately addictive nature, as an individual uses it more frequently, their tolerance for it increases. So, they feel they need to consume higher and higher doses to feel the drug’s effects, leading to prolonged misuse.
This results in severe changes in the brain’s chemistry and the body’s central nervous system. Over time, the brain becomes so dependent on the drug—both physically and psychologically—that the individual can’t function without it.
Codeine is often prescribed when other forms of non-opioid pain relievers haven’t been able to manage pain.
When consumed, codeine changes into opioid morphine, which makes it metabolize better and more efficiently, thus helping the body make use of the drug’s analgesic effect. This process is carried out in the liver with the help of an enzyme called CYP2D6, which plays a huge role in the metabolism, or break down, of codeine as well as many other drugs.
It’s through CYP2D6 that the drugs become active in our systems.
With codeine, the active agent, or metabolite, morphine, works by directly affecting the central nervous system. In other words, they interrupt the way nerves signal pain between the brain and the body, thus effectively reducing the sensation of pain.
They also affect the region of the brain that controls coughing. As such, codeine has been widely hailed as one of the most effective cough suppressants on the market that works to relieve the symptoms of cough, such as wheezing, clearing the throat, and gasping for air.
Even though codeine isn’t as habit-forming as other painkillers like hydrocodone or oxycodone, users can still become hooked to it through prolonged misuse and increased dosages. That’s why codeine is often considered to be a gateway drug to other opiates, such as morphine and heroin.
The withdrawal symptoms and duration of codeine are similar to those of other opiate painkillers. However, if done without proper medical supervision, the symptoms can be uncomfortable and difficult to handle.
Plus, there’s always the chance that even the more mild symptoms can develop into something worse. For instance, if codeine withdrawal symptoms aren’t treated in time, they can lead to dehydration, which can then result in risky and even fatal health problems.
The symptoms of Codeine detox tend to range from mild to severe, depending on the individual receiving treatment.
The majority of those in recovery will feel the effects of withdrawal within a couple of days after taking their last dose of Codeine. During those first days, symptoms will be at their strongest.
The first symptoms of withdrawal can include sweating and muscle pain. They can also include various flu-like symptoms, such as a runny nose, chills, and a slight fever. Then, they’ll begin to subside and even disappear completely, after a week or so.
The second stage of withdrawal is usually accompanied by spells of nausea and loss of appetite. In severe cases, individuals may also experience vomiting and diarrhea.
There are also emotional and psychological side effects associated with substance use disorder. These tend to last longer than the physical symptoms.
Fortunately, there are plenty of treatment facililties where individuals can get the help and support they need to recover from their addiction.
In addition to those mentioned above, other common symptoms include:
- Low blood pressure
- Cold, clammy skin
- Stomach pain
- Extreme fatigue
- Abdominal pain
Those recovering from codeine withdrawal likely feel irritable and highly anxious as their bodies transition and adjust to life without codeine. Doctors will likely prescribe an anti-hypertensive and vasodilator medication, such as clonidine.
This class of medicines works to ease the effects of psychological symptoms, which can include the following:
- Intense cravings for codeine
Most individuals can take from one to three months in detox. Yet, this mainly depends on the individual’s level of opioid addiction and the type of treatment they’re receiving.
On average, the most difficult physical withdrawal symptoms, such as nausea and muscle aches, within around 12 hours after the last use of codeine, and can last for about a week. After that, they begin to slowly subside until disappearing completely after about 2–3 weeks.
It’s worth noting that psychological symptoms of withdrawal, like anxiety and depression, tend to last much longer. Though, with the proper medical supervision and tailored therapy techniques, they, too, will begin to subside after about a month.
Additionally, the user’s method of detox plays a major role in the duration of withdrawal.
For example, suddenly stopping codeine, which we sometimes refer to as ‘quitting cold turkey’ is the quickest way to rid the body of codeine. However, it’s often accompanied by extremely intense symptoms, which can be incredibly stressful both physically and psychologically.
Alternatively, using the taper method to overcome the effects of codeine dependence can take much longer, typically weeks or months. Nevertheless, it’s usually recommended as the more successful of the two as it’s carried out under the supervision of a professional team of physicians, therapists, and health care providers.
Here are some factors that affect the severity and timeline of an individual’s withdrawal process:
- The duration of codeine use
- The frequency of codeine use
- Average dosage levels
- How the drug was consumed
- Whether codeine was combined with other drugs or alcohol
- Their mental health
- Their gender
- Their body weight
- Their medical history
Now, let’s take a look at a general timeline of codeine withdrawal:
- First 12 hours: the drug leaves the body during the first 12 hours after the last time it was used, which triggers the onset of opioid withdrawal symptoms
- Days 1–2: symptoms start slowly, but intensify during this time. Medication-assisted treatments are usually used to control symptoms if required.
- Days 3–5: symptoms will begin to resolve because the body has adjusted to the absence of codeine
- Days 6–30 and onward: while physical symptoms will likely have disappeared, some psychological symptoms may persist for weeks or even months in some cases
Prolonged codeine dependence has a detrimental effect on mental and physical health. It can cause a slew of issues, such as low blood pressure, breathing difficulties, reduced cognition, and drowsiness.
In more severe cases, codeine addiction can result in kidney and liver damage, respiratory failure, and even death.
Then, there’s the psychological and mental aspect of the addiction. For example, misuse of codeine has been linked to high levels of anxiety and severe bouts of depression.
All these side effects can certainly impact day-to-day activities as well as have a negative effect on an individual’s personal and professional life.
In most cases, detox on its own isn’t enough. That’s why experts and health care professionals recommend combining it with proper medical guidance and long-term support, such as interaction within the 12-Step Program, to minimize the risk of a relapse.
Cognitive Behavioral Therapy (CBT), personalized counseling, and group therapy are also integral parts of a successful recovery process. They aim to help individuals address the triggers of their addiction. When an individual understands what their triggers are, they can find coping mechanisms to avoid them, thus preventing them from relapsing.
To help get started with codeine detox, individuals can choose from any of the handful of treatment options below, depending on their personal needs and health requirements.
- Inpatient detox: involves staying in a rehab center for 1–6 months, depending on the severity of the case
- Outpatient detox: involves the on-site administration of medications carried out during regularly scheduled visits to a treatment facility or hospital for mental and physical check-ups
- Medically assisted detox (MAT): is often administered during the first week of detox to help ease the intense symptoms of codeine withdrawal
- Detoxing at home: involves the monitoring of a specialized medical professional who can advise on medical support and perform individual health assessments
The first step in overcoming codeine addiction is through detox. Codeine users are recommended to go through the withdrawal process in a safe environment surrounded by medical professionals.
By getting the help and support they need, patients can go through the codeine detox process safely and comfortably. Plus, by getting proper therapy and treatment, they can reduce their chances of a relapse and enjoy living a codeine-free life.