Codeine is a mild opioid that is used in a host of medications to treat everything from mild to moderate pain symptoms to coughs. Codeine is the most commonly prescribed opioid in the world, and its prescribing rate started to increase dramatically in the 1990s. Though codeine is mild compared to other opioid medications like morphine or oxycodone, it can still be addictive when it’s abused. Dependence and addiction can mean experiencing extremely uncomfortable withdrawal symptoms when you attempt to quit.

Learn more about codeine withdrawal symptoms, the withdrawal timeline, and how it can be treated.

What are the Codeine Withdrawal Symptoms?

Codeine withdrawal can cause uncomfortable symptoms that people often described as similar to a bad case of the flu. Some say that it’s like the worst flu they’ve ever experienced. Along with these typical flu-like symptoms, you will also most likely experience powerful drug cravings. If you had a moderate to severe opioid use disorder, you might feel compulsions to use codeine or other opioids that are difficult to control. This craving mixed into the uncomfortable symptoms, often cause people to relapse, especially if you’re going through withdrawal alone without medical help.

Opioid symptoms aren’t typically life-threatening, but they can be unpleasant and lead to some medical complications. Symptoms include:

  • Irritability
  • Anxiety
  • Runny nose
  • Insomnia
  • Yawning
  • Teary eyes
  • Muscle and joint pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Sweating
  • Fever
  • Chills
  • Dilated pupils

Even though codeine withdrawal is unlikely to lead to serious consequences, it can be dangerous if it leads to dehydration. According to opioid addiction researcher Shane Darke, opioid withdrawal can be deadly if symptoms cause dehydration, hypernatremia, and heart failure. Because opioid withdrawal causes vomiting, sweating, and diarrhea, it can cause you to lose water quickly. If you don’t hydrate properly, it can lead to addiction symptoms and complications.  However, most recorded deaths that are caused by opioid withdrawal occurred in jail or prison settings, where neglect lead to deadly dehydration.

However, opioid symptoms can be intense, and anyone with other medical concerns that could be affected by the flu can be affected by opioid withdrawal. People with heart conditions, older people, and people with other health issues may need extra care.

What Are the Stages of the Codeine Withdrawal Timeline?

The timeline on which you might experience codeine withdrawal can depend on a number of factors including the amount of time you were dependent on codeine, the size of the dose you were dependent on, your relative size and weight, and if you were also using other drugs with codeine. Generally, if you took a large dose for a long time, you will feel more intense withdrawals quickly than someone who took a small dose for a short time. Still, opioid withdrawal may follow a fairly typical timeline.

Withdrawal symptoms will last about a week, and they may start within 24 hours of your last dose. The first symptoms you experience will be similar to when you are coming down with a cold. You may experience fatigue, runny nose, irregular heartbeat, teary eyes, sweating, yawning, irritability, and anxiety. Sometime after the first 24 hours, your symptoms will peak, and they will be at their most intense. At this point, you might feel stomach pain, nausea, vomiting, diarrhea, chills, body aches, and fever. Other symptoms may include irregular heartbeat, insomnia, goosebumps, and dilated pupils.

After your symptoms peak, they will start to subside. Your physical symptoms will be the first to disappear, but your psychological symptoms may linger. Symptoms like anxiety, depression, and irritability can last longer than a week and may even be indefinite without treatment. Cravings will also continue past your week of detox, and it may take more comprehensive addiction treatment to learn to deal with those compulsions to use again.

Why Should I Detox?

Codeine withdrawal isn’t typically deadly and probably won’t lead to life-threatening complications in otherwise healthy adults, but it can be extremely uncomfortable. Plus, if you have other medical conditions like heart disease, a particularly bad case of withdrawal can pose a threat. Medical detoxification in a hospital or a detox center is the safest way to go through opioid withdrawal symptoms. Quitting cold turkey can produce intense flu-like symptoms that can be extremely uncomfortable and dangerous in rare cases. In situations where opioid withdrawal becomes life-threatening, it’s often due to dehydration caused by diarrhea, vomiting, and sweating. Medical detox can monitor your condition, treat your symptoms, and keep you as comfortable as possible.

Besides the threat of withdrawal symptoms, detoxing on your own may likely lead to relapse. In addition to uncomfortable withdrawal, you may experience powerful drug cravings. Going through withdrawals on your own will make it difficult to resist compulsions to use codeine again. In a detox program, you will have people with you to keep you accountable to your commitment to recovery.

What Is the Next Treatment Step?

In most cases of addiction, medical detox isn’t enough to facilitate a lasting change. According to The National Institute on Drug Abuse (NIDA), “…detoxification alone is rarely sufficient to help addicts achieve long-term abstinence…” For that reason, you may need to go through the full continuum of care in addiction treatment. After you complete detox, you may move on to the next level of care that’s appropriate for your needs.

If you still have high-level medical or psychological needs that require 24-hour care, you may move on to an inpatient treatment program. Inpatient or residential services are designed to treat people with significant needs. If you don’t need 24 hours of care every day, you may move on to intensive outpatient treatment (IOP) or partial hospitalization (PHP). IOP is the highest level of care in addiction treatment, where you can also live at home. IOP involves more than nine hours of therapy each week, and PHP involves more than 20 hours of treatment per week.

As you progress in treatment, you may move to outpatient therapy, which involves fewer than nine hours of treatment services each week. In outpatient, you will have more time to pursue goals and responsibilities in your normal everyday life, while you still have the support of individual and group therapy.

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