Taking codeine, a prescription opiate, can lead to addiction. Learn the causes, symptoms, and treatment for codeine withdrawal.
Codeine is a prescription drug used to treat mild to moderately severe pain. It comes in a tablet. It’s also sometimes used in cough syrups to treat cough. Like other opiates, codeine has the potential for addiction.
You can become addicted to codeine even if you’re taking a combination product such as Tylenol with Codeine. Stopping codeine use can put your body through withdrawal.
Getting through it can be tough, but it’s worth the effort. Read on to learn about symptoms of codeine withdrawal and how to cope.
Over time, you may develop tolerance to the effects of codeine. This means that your body needs more and more of the drug to feel the same pain relief or other desired effects.
In other words, tolerance makes the drug seem less effective to your body.
How quickly you develop codeine tolerance depends on factors such as:
- your genetics
- how long you’ve been taking the drug
- how much of the drug you’ve been taking
- your behavior and perceived need for the drug
As your body becomes more tolerant of codeine, your cells begin relying on the drug to prevent withdrawal symptoms.
This is dependence. It’s what leads to intense withdrawal side effects if codeine use is stopped suddenly. One sign of dependence is feeling that you must take codeine to prevent withdrawal symptoms.
Dependence can occur if you take codeine for more than a few weeks or if you take more than the prescribed dosage.
It’s also possible to develop codeine dependence even if you take the drug exactly as your doctor prescribes.
Dependence is often a part of addiction, but they’re not the same.
Dependence vs. addiction
Dependence and addiction both cause withdrawal when the drug is stopped, but they’re not the same thing.
Dependence stems from long-term exposure to a drug, and people dependent on a drug will experience mild or severe withdrawal symptoms when they abruptly stop taking the drug.
Physical dependence on a prescribed opiate is a typical response to treatment and can be managed with help from your doctor.
Addiction, on the other hand, may follow dependence. It involves craving and compulsively seeking the drug. Addiction can change your brain circuitry, leading you to use a drug despite negative consequences and eventually to lose control over your usage. It often requires more support to get through.
Withdrawal symptoms may come in two phases. The early phase occurs within a few hours of your last dose. Other symptoms may occur later as your body readjusts to working without codeine.
Early symptoms of withdrawal may include:
- feeling irritable or anxious
- trouble sleeping
- teary eyes
- runny nose
- muscle aches
- faster heart rate
Later symptoms may include:
- loss of appetite
- nausea and vomiting
- stomach cramps
- enlarged pupils
- chills or goosebumps
Many withdrawal symptoms are a reversal of codeine side effects.
For instance, codeine use can cause constipation. But if you’re going through withdrawal, you may develop diarrhea. Likewise, codeine often causes sleepiness, and withdrawal may lead to trouble sleeping.
How long withdrawal lasts
Symptoms may last for a week, or they may persist for months after stopping codeine use.
Physical withdrawal symptoms are strongest in the first few days after you stop codeine use. Most symptoms are gone within
However, behavioral symptoms and cravings for the drug can last months. In rare cases, they can even last years. Everyone’s experience with codeine withdrawal is different.
With a doctor’s guidance, you can typically avoid severe withdrawal side effects. Your doctor will likely advise you to taper off your codeine use slowly rather than suddenly stopping the drug.
Gradually reducing your use allows your body to adjust to less and less codeine until your body no longer needs it to function normally.
Your doctor can help you through this process or refer you to a treatment center. They may also suggest behavioral therapy and counseling to help you avoid relapse.
Your doctor may also suggest certain medications depending on whether you have mild, moderate, or advanced withdrawal symptoms.
For mild pain and other symptoms
Your doctor may suggest non-narcotic medications to ease more mild withdrawal symptoms. These medications may include:
- pain medications such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) to help reduce mild pain
- loperamide (Imodium) to help stop diarrhea
- hydroxyzine (Vistaril, Atarax) to help ease nausea and mild anxiety
For moderate withdrawal symptoms
Your doctor may prescribe stronger medications. Clonidine (Catapres, Kapvay) is often used to
- muscle aches
- runny nose
Your doctor may also prescribe a long-acting benzodiazepine such as diazepam (Valium). This drug can help treat muscle cramps and help you sleep.
For advanced withdrawal symptoms
If you have severe withdrawal, your doctor may try different options.
For instance, they may switch you from codeine to a different medication, such as a different opiate. Or they may prescribe one of three medications that are commonly used to treat opiate addiction and severe withdrawal symptoms:
- Naltrexone: This blocks opioids from acting on the brain. This action takes away the pleasurable effects of the drug, which helps prevent relapse of misuse. However, naltrexone may not stop drug cravings due to addiction.
- Methadone: This helps prevent withdrawal symptoms and cravings. It allows your body’s function to return to its natural state and makes withdrawal easier.
- Buprenorphine: This produces weak opiate-like effects, such as euphoria (a feeling of intense happiness). Over time, this drug can reduce your risk of misuse, dependence, and side effects from codeine.
SAFETY ALERT FOR ORAL BUPRENORPHINE
In January 2022, the Food and Drug Administration (FDA) issued a
This warning follows reports of dental problems including tooth decay, cavities, oral infections, and loss of teeth. This serious adverse effect can occur whether or not you’ve had a history of dental problems.
The FDA emphasizes that buprenorphine is an important treatment for opioid use disorder and that the benefits of treatment outweigh these dental risks. Contact your healthcare professional with any additional questions.
Codeine is milder than other opiates (such as heroin or morphine), but it can still cause dependence and addiction.
Your doctor can support you through withdrawal and recovery. If you’re concerned about codeine withdrawal, talk with your doctor and ask for help. Here are a few questions you might ask:
- How can I avoid addiction to codeine?
- Are there better alternatives to codeine use for me?
- How should I stop taking codeine?
- What signs of codeine tolerance and dependence should I watch for?
- Will I go through withdrawal if I quit using codeine? What symptoms should I expect?
- How long will my withdrawal and recovery take?