Codeine Withdrawal & Detox | Symptoms & Timelines

Codeine is a prescription opioid painkiller prescribed to treat pain or relieve a persistent cough. However, many people misuse codeine for its euphoric and relaxing effects. Chronic codeine abuse can lead to physiological dependence, which means the body has adapted to the presence of this opioid and requires it to function optimally. When someone is dependent on codeine and abruptly stops taking it, they’ll experience distressing codeine withdrawal symptoms. [1]

Uncomfortable psychological and physical symptoms often begin within a manner of hours of last use. Their severity and the overall length of withdrawal and detox depend on the extent of codeine use and other personal factors.

What Is Codeine Withdrawal?

Codeine withdrawal occurs when someone who is physically dependent on this opioid abruptly stops taking it, resulting in a myriad of symptoms. While dependence is common in cases of sustained codeine abuse, it can also occur when the drug is used as prescribed. This is why many physicians won’t recommend codeine or any prescription opioid for long-term use. [2]

With dependence, the brain has grown accustomed to functioning in the presence of codeine. Once someone stops using codeine, or the average dose is lowered, the body attempts to rebalance without codeine present, and unpleasant withdrawal symptoms appear. [2]

Codeine withdrawal symptoms can range from uncomfortable to severely distressing, depending on many factors.

Codeine Withdrawal Symptoms

Codeine withdrawal symptoms are similar to those of most opioids. Codeine withdrawal can cause both physical and emotional discomfort, and it usually lasts several days to a couple of weeks. Symptoms typically begin within a day of last use. 

Common symptoms of codeine withdrawal include the following: [1],[2].[3]

• Anxiety
• Agitation 
• Muscle aches and pains
• Increased tearing and runny nose
• Sweating 
• Yawning
• Insomnia 
• Nausea and vomiting 
• Stomach cramps
• Diarrhea 
• Dilated pupils
• Goosebumps 

The symptoms of codeine withdrawal are uncomfortable but not typically life-threatening. The greater danger lies in individuals who have recently detoxed and returned to codeine use. Unaware of their lower drug tolerance, they may take a dose that would be considered normal for their prior levels of use. With their reduced tolerance, this can lead to unintentional overdose, which can be life-threatening.

Factors That Influence the Intensity of Withdrawal Symptoms

The severity of codeine withdrawal symptoms varies depending on the history of use and an individual’s physiological response to detox. Individuals with a high level of codeine intake for six months or longer are likely to have more severe withdrawal symptoms. Withdrawal symptoms may also be worse for individuals who also abuse other substances, such as other opioids and benzodiazepines. [3]

Other factors that may influence the withdrawal process include the following:[4]

• Length of codeine use
• Average codeine dose used
• Method of administration (e.g. snorting or injecting)
• Age
• Kidney and liver functioning
• Individual metabolism
• Medical conditions
• Mental health conditions

How Long Does Codeine Withdrawal Last? 

People withdrawing from short-acting opioids, such as codeine, are likely to experience a quicker onset of symptoms but also a shorter length of withdrawal. 

As a short-acting opioid, codeine withdrawal begins within 6-12 hours after the last use, and these acute symptoms tend to last between 5 and 7 days.[4] However, protracted withdrawal symptoms can linger for weeks, months, or even years after acute withdrawal resolves. 

If you opt for medication-assisted treatment (MAT) with buprenorphine or methadone, you may largely avoid the withdrawal process. These medications manage withdrawal symptoms and cravings, enabling you to focus on the therapy involved in addiction treatment.[5]

The key to remember is that no matter how long withdrawal takes for your situation, long-term recovery is possible.

Codeine Withdrawal Timeline 

Withdrawal from codeine begins relatively quickly. Typical codeine withdrawal develops as follows:[4],[6]

• Day 1: Symptoms begin 6 to 12 hours after last use. They will usually build after the initial onset.
• Day 3: Codeine withdrawal symptoms will peak in intensity.
• Days 5–7: Symptoms start to dissipate and resolve

Depending on the stage of withdrawal, the symptoms may vary:[7]

Early Codeine Withdrawal	Late Withdrawal
Agitation	Stomach cramping
Body aches and pains	Nausea
Anxiety	Vomiting
Insomnia	Diarrhea
Sweating
Teary eyes and runny nose

Protracted Withdrawal

Protracted or post-acute withdrawal symptoms refer to symptoms that linger after acute codeine withdrawal has resolved. These symptoms can last for months or years and may include:[4]

• Anxiety
• Depressive mood
• Insomnia
• Anhedonia (inability to feel pleasure)

These symptoms may waver in intensity and be brought on by stress or triggering situations, which can increase the risk of relapse. This is one of the many reasons it’s important to receive ongoing care and support throughout your recovery.

Codeine Detox Services

The safest way to detox from codeine is under the care of a medical professional. While not usually life-threatening, opioid withdrawal symptoms can be highly uncomfortable. When people attempt to detox from codeine or other opioids on their own, they often relapse back to codeine misuse simply due to the discomfort of withdrawal.

With medical detox, the risk of relapse is much lower. Treatment providers provide a combination of medication, therapy, and support to ease the process and increase the likelihood of a successful detox. 

A variety of medications can be used to safely detox from codeine. Here are some of the medications that may be used:[5],[8]

• Methadone: Can reduce or eliminate withdrawal symptoms and codeine cravings in both the short and long term. It is the longest-used form of MAT for opioid use disorder. 
• Buprenorphine: Often used in the form of combination medications like Suboxone, where naloxone is also present to deter abuse of the medication. 
• Clonidine can address flu-like symptoms, such as aches, sweating, and cramping, as well as anxiety and agitation. 
• Naltrexone can help to prevent relapse once all opioids are out of the individual’s system. 

The above medications, as well as others, can be combined to alleviate codeine withdrawal symptoms and aid sleep. Only take medications as prescribed by a treatment provider. 

Individuals who are detoxing from opioids, such as codeine, should be screened for co-occurring mental health problems, such as depression. Accurately treating such mental health conditions greatly reduces the risk of relapse and future opioid abuse. 

Post-Detox Addiction Treatment

Codeine addiction isn’t solved by just going through detox. Further treatment is needed to address the addiction. 

Whether in the form of inpatient or outpatient treatment, addiction treatment will involve therapy. This is where the bulk of recovery work will take place, as you identify the root causes that led you to abuse codeine. You’ll also begin to build skills that help you to better cope with temptations to abuse substances. 

At Boca Recovery Center, we offer a comprehensive codeine addiction treatment program that includes medical detox services as well. We offer individualized treatment planning that addresses your unique needs. We accept a variety of insurance providers and plans, and if you are uninsured, we will work with you to create a financing plan.

While opioid detox isn’t easy, it is the first step on the path to a better life in recovery.