Codeine withdrawal is healthy. Your body is learning how to function without drugs, and your damaged brain cells begin to heal.
While withdrawal might be natural, it can also be very unpleasant. If you’re hoping it ends quickly, you’re certainly not alone.
Thankfully, the most uncomfortable part of codeine withdrawal is over in about a week. But it might take months or even longer for all your symptoms to fade.
There are therapies your doctor can use to help you go through this process with as little discomfort as possible.
How Does Codeine Cause Dependence?
Codeine is a prescription medication, and it’s designed to help people overcome pain symptoms. When taken properly, it’s effective. But its intersection with brain cells can lead to serious changes that spark addiction.
Codeine, like all opioids, works by increasing dopamine levels inside the brain. That chemical is responsible for the warm, fuzzy feeling that takes over after an opioid hit. You may still feel pain, but you also feel safe and secure. Your discomfort is easier to ignore.
Codeine brings these feelings about by hijacking normal brain systems. Cells pump out twice the chemicals they once did, and they can’t recycle unused portions. It’s like turning on a fire hose and plugging all the drains. The brain is flooded.
Brain cells respond by learning to ignore dopamine. When that happens, people must take more codeine to get the same response. In time, people can take staggering amounts of drugs.
For example, in a study from Australia, researchers found that people addicted to codeine were taking 435 to 602 mg of codeine per day. A recommended dose, per Medline, should not exceed 360 mg per day.
You won’t wake up one morning and choose to take a massive dose of drugs. Instead, you’ll build tolerance over time by:
- Adjusting the timing. You might take your doses three times per day rather than two.
- Splitting doses. You might take 1.5 pills.
- Citing forgetfulness. You might claim you simply can’t remember when you took your last pill, so you can have one more.
- Getting creative. You might snort pills instead of swallowing them. Or you might boil down syrups to ingest just the crystals.
Over time, as your body becomes accustomed to codeine, you’ll feel like you need it to survive. When you try to stop, withdrawal sets in.
What Does Withdrawal Feel Like?
Withdrawal begins soon after your last dose, and you’ll probably feel terrible for several days. Some symptoms will persist for even longer.
Acute withdrawal from codeine starts a few hours after your last dose, says the Alcohol and Drug Foundation, and it worsens until about 72 hours pass. During that time, you’ll feel:
- Nauseated. Your stomach may cramp, you’ll vomit, and you may have diarrhea too. You probably won’t have an appetite.
- Restless. You may feel like pacing, and you’ll find it hard to fall asleep.
- Sore. Your muscles and joints will ache, even if you haven’t done anything physical.
- Cold. You’ll get goosebumps, and you’ll feel chilled. You may have a fever, and you may sweat, but you’re likely to feel cold at the same time.
If you’ve ever had the flu, you’re familiar with these symptoms. It’s hard to think or get anything done when you feel so ill and worried.
You’ll also have deep cravings for codeine, and it’s this symptom that might persist.
Altered brain cells are powerful, and they know just what’s missing. They will send impulses to the central nervous system to prompt you to take more codeine. You’ll experience that as a craving for drugs, and you might find that it’s hard to ignore.
Your cravings may spike when you:
- See people, like drug dealers, who remind you of codeine.
- Revisit spaces where you got high.
- See people who seem intoxicated.
- Touch things that remind you of using, like spoons.
- See advertisements for codeine products.
A craving like this can completely derail your recovery, and if you don’t resist it, you might relapse to codeine use. That’s why some people insist on isolation during early withdrawal. It’s one way to control the discomfort of cravings.
For some people, those cravings last for months. A woman interviewed by Yale Medicine, for example, says she had cravings for three months during one point of her opioid recovery journey. She managed to ignore them, but they stuck with her throughout that time.
How Is Withdrawal Treated?
You’re an individual, and the way your body reacts to codeine will be unique. Your withdrawal experience will be similar. Your doctor can assess your symptoms and develop a therapy program that’s right for you.
Tests, including the Clinical Opiate Withdrawal Scale, help your doctor measure how many symptoms you have and how severe they are. You’ll take part of the test and describe what you’re feeling, and your doctor will complete another portion. At the end of the assessment, you’ll have a grade. That helps your doctor understand how much help you need.
People going through a difficult withdrawal are at risk for relapse, and that’s something your doctor wants to prevent. Medications can help. Drugs like buprenorphine and methadone work on the same portions of the brain damaged by codeine. They can block drug cravings and ease discomfort.
Researchers point out that this therapy can’t cure your addiction; there is no cure for addiction. With the help of medications, you’ll feel better. But all the triggers that led to your drug use will remain. Even with medications, you’ll need the help of a rehab program to kick the habit for good.
Medications aren’t the only option to soothe discomfort. In a study from Scandinavia, researchers found that tapering codeine doses over eight weeks helped people to stop using the drug, with no increase in distress. Your doctor might achieve this by:
- Giving you a full dose for one week.
- Cutting your dose back by 0.25 each week for four weeks.
- Asking you to take only one dose per day instead of two.
This approach lets you back out of addiction the same way you went in. Each day, you take a little less. In time, you take nothing at all. You may not experience withdrawal, as you’re giving your body the chance to adjust.
What Happens Next?
When codeine withdrawal is complete, you’re ready to move to the next stage of recovery. You’ll enter a rehab program and work with a therapist on a roadmap to sobriety. Plan on staying in this program for several months, so you can learn all you can about how to stay sober.
Codeine withdrawal may feel like the worst part of your life, but the best is coming your direction. Just be persistent.