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Codeine Withdrawal Symptoms & Treatment

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Sep 20, 2023 • 6 cited sources

Codeine withdrawal symptoms occur when someone who is physiologically dependent on this opioid drug suddenly stops taking it. [1] These symptoms tend to be flu-like in nature, incluidng nausea, vomiting, muscle and joint pain, sleep disturbances, excessive sweating, and anxiety.[2],[3]

Although these symptoms can be unpleasant and distressing, they don’t tend to be life-threatening, although some complications can be dangerous if left untreated. Fortunately, professional codeine detox treatment can provide you with 24-hour care, supervision and monitoring to ensure your comfort and safety.

Codeine is often combined with Tylenol in a combination mediation known as Tylenol 3. It is usually prescribed as a painkiller or as a cough suppressant in severe cases. 

What Causes Codeine Withdrawal? 

Codeine withdrawal syndrome is a manifestation of physical dependence, and physical dependence develops along with chronic codeine use and addiction. [1]

When you take codeine regularly, you experience neuroadaptations, or changes in the brain chemistry and functioning. Once your brain adapts to the presence of codeine, it needs this drug or another opioid in order to function without you feeling seriously uncomfortable.[1]

When you suddenly stop taking codeine, your neurons release excessive amounts of noraderenaline, resulting in codeine withdrawal symptoms like diarrhea, jitters, anxiety and muscle cramps.[1]

Codeine Withdrawal Symptoms

Codeine withdrawal symptoms are similar to withdrawal from other opioids and typically include: [1],[2],[3]

  • Anxiety
  • Hyperthermia
  • Increased blood pressure
  • Sweating
  • Rapid heart rate
  • Rapid breathing
  • Overactive reflexes
  • Insomnia
  • Nausea and vomiting
  • Diarrhea
  • Increased tearing and runny nose
  • Muscle and joint pain
  • Goosebumps
  • Dilated pupils
  • Sensitivity to light
  • Excessive yawning

Codeine withdrawal syndrome can range from mildly unpleasant to severe and painful, depending on many different factors.

Opioid withdrawal is rarely life-threatening, although some fatalities have occurred, particularly in the context of incarceration. This is often due to complications caused by opioid withdrawal symptoms like severe diarrhea and vomiting, which can cause dehydration and elevated sodium levels.[5]

The best way to stay safe and ensure your comfort during codeine withdrawal is to seek out medical detox treatment where you can receive withdrawal medications that reduce symptoms and cravings.

Factors that Affect Codeine Withdrawal

The severity of your codeine withdrawal symptoms may depend on many factors, such as:

  • Codeine dose
  • How long you’ve been using codeine
  • The method of administration (snorting, injecting, or swallowing)
  • Whether you mix codeine with other substances
  • Individual physiology
  • Co-occurring medical or psychological conditions
  • Previous withdrawal experiences

How Long Does Codeine Withdrawal Last?

Codeine is a short-acting opioid drug, which means the withdrawal symptoms come on fast and typically resolve within about one week.[6]

Codeine Withdrawal Timeline

Generally, those who are dependent on or addicted to codeine will experience withdrawal symptoms within about 6-12 hours after their last dose. These symptoms tend to peak in intensity within 1-3 days, at which point they may experience severe gastrointestinal issues and muscle pain. Then symptoms are expected to dissipate and resolve within 5-7 days.[6]

Time Since Last UseExperience
6-12 hoursCodeine withdrawal symptoms appear
1-3 daysSymptoms peak in severity, very distressing
5-7 daysSymptoms gradually disappear

Post-Acute Withdrawal Symptoms

Once your acute codeine withdrawal symptoms resolve, you may experience post-acute withdrawal, which are typically less intense symptoms that can last for weeks, months, or even years after you quit using codeine. Protracted withdrawal symptoms may include:[6]

  • Sleep issues
  • Depression
  • Anxiety
  • Fatigue and low energy
  • Difficulty feeling pleasure
  • Cravings for codeine and other opioids

Codeine Detox Services: Managing Withdrawal

Codeine withdrawal can be very distressing, but thankfully, detox treatment can help. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends around-the-clock care for opioid withdrawal because of how uncomfortable it can be.

Medical detox services for codeine withdrawal can occur in several settings, such as:

  • Psychiatric hospital
  • Acute care hospital
  • Detox in an inpatient addiction treatment program
  • Freestanding inpatient detox program

When you attend a codeine detox program, you’ll receive many benefits and treatment modalities, such as:

  • Medications for Addiction Treatment (MAT), such as methadone or buprenorphine
  • Adjunctive medications for specific symptoms, such as gastrointestinal issues
  • Supportive care, such as IV fluids
  • Detox counseling

Methadone and buprenorphine are medications that can alleviate codeine cravings and minimize withdrawal symptoms during acute detox from codeine. They can also be prescribed on an ongoing basis to promote long-term recovery. You can access methadone at a specialized clinic but buprenorphine or Suboxone is available through doctors, both in-office and online.Some treatment providers, like Bicycle Health, offer telehealth services, so you can receive MAT in virtually any location. This makes medications for opioid use disorder much more accessible, helping people to get the vital help they need more easily and conveniently.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science & Clinical Practice. July 2022. Accessed March 2023.
  2. Opioid Withdrawal. StatPearls. May 2022. Accessed March 2023.
  3. Opiate and Opioid Withdrawal. U.S. National Library of Medicine. May 2020. Accessed March 2023.
  4. Opioid Treatment Program Directory. Substance Abuse and Mental Health Services Administration. Accessed March 2023.
  5. Yes, People Can Die From Opiate Withdrawal. Addiction. August 2016. Accessed March 2023.
  6. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

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