How to Taper off Codeine

Codeine is one of several opiate medications used to alleviate pain in patients the world over. Most are familiar with its primary use as a cough suppressant in liquid or pill form. Codeine is classified as an opiate, which breaks down into morphine within the central nervous system. Effective and timely pain relief occurs just moments after.

This prescription painkiller is a predecessor to many opioids. Along with morphine, codeine was first created nearly 200 years ago in the early 1800s. The drug has been isolated from the opium plant for well over a century now. This has resulted in millions of kilograms of codeine being produced each and every decade. Technically, because codeine originates from the opium poppy, it is a naturally based opiate, different than man-made opioids like hydrocodone.

While it may be the precursor to several modern opioids, its longevity means nothing as far as potency is concerned. Generally speaking, codeine is ten times less potent than morphine — meaning it is also less potent than oxycodone, hydrocodone, and hundreds of times weaker than newer opioid analogs like fentanyl.

Much of its risk originates from a popular recreational variety of codeine. “Lean” is a syrupy creation of codeine and promethazine, a drug used to treat nausea. Together, these two substances act like a nervous system depressant. Codeine goes from hazardous to downright lethal when part of this concoction.

Perhaps worse than any of this, codeine dependence may make people susceptible to crossing over to its more formidable and deadlier contemporaries. The hope is for a person who uses codeine to never get to the point where codeine use creates a desire that it cannot satisfy any longer. It is paramount that those who use codeine — recreationally or clinically — seek treatment as soon as possible. What exactly might that treatment look like? Well, it will be different from person to person. But one thread connects most codeine dependences, and that is a user will likely require some form of detoxification.

There is no question about it, detox can be a scary thought. The word itself conjures up unpleasant thoughts in the minds of the general public, let alone an individual struggling with a use disorder. However, there is a method of detox that rewrites this paradigm: tapering. Deciding to taper off codeine is a monumental first step towards a lifetime of opioid-free living.

Tapering Off Codeine | How to Taper Off Codeine
Before delving into how to taper off codeine, it is best to start with some pertinent background knowledge to better inform a detox decision.

That being said, why use a taper? From the perspective of medical professionals, the answer is usually threefold:

1) Withstanding Withdrawal: First and foremost, think of tapers as the antagonist of a codeine withdrawal. Tapers, as its name alludes, requires a gradual, incremental lessening of codeine’s presence in the body. The system is never completely lacking the drug, meaning a withdrawal is not likely. Even patients with a severe dependence can avoid or lessen the extent of a withdrawal by slowly tapering off codeine.

2) Adept at Adapting: The body requires ample time to recondition itself; no matter how long a person has been using codeine. Tapers allow the body to do what it does best: heal itself, physically then mentally, and then continue to push onward.

3) Stops Outright Stopping: Tapers are designed to work on a schedule outlined by a physician. Going cold turkey is not part of such a plan. The two benefits mentioned above are reversed when a user attempts to abandon codeine completely — the body cannot adapt and withdrawal will strike at full force. As odd as it may sound, not quitting codeine can be the right move. At least, not quitting instantaneously, that is.

If a person attempts a cold-turkey detox, they are looking at potentially weeks of unrelenting pain. Some side effects they may exhibit include:

  • Flu-like symptoms: Excessive sweat, mucus or tears, are par for the course during a codeine withdrawal.
  • Nausea: Vomiting or dry heaving may amplify flu-like symptoms.
  • Insomnia: Sleep may not come easy at the onset of withdrawal. It may take days to add up to a full night’s worth of sleep.
  • Cramping: Abdominal pain and spasms are common, as too are bouts of constipation or diarrhea.
  • Muscle aching: The discomfort doesn’t stop in the stomach, muscles all over the body may exhibit abnormal or painful behavior.
  • Psychological symptoms: Usually a sign that the withdrawal is nearly over, a victim may finally suffer through intense feelings of anxiety, panic, and even depression.
Whenever possible, tapering off codeine should take place with the help of trained medical professionals. Though a withdrawal may not be deadly in and of itself, attempting to overcome codeine on one’s own drastically lowers the margin of error. At-home tapers must be meticulously planned and thoroughly supported by loved ones to have any chance of success.

Codeine tapers call for a steady reduction in dosage. A good middle-of-the-road quantity operates in the 10 percent-per-week range. Some patients will be able to reduce by 25 percent, or even 50 percent, depending on their history with codeine. Overall, the longer the individual used the opioid, the longer the taper should be. If a withdrawal appears to be unavoidable, a physician may decide to use a Suboxone prescription to ease the process along.

A highly strategic taper in a clinical setting can benefit most codeine users — whether they use the liquid, pill, or syrup variant, “lean.” With a little persistence and a lot of support, a codeine substance use disorder can be a thing of the past.

Codeine misuse can lead to a serious substance use disorder. If you or a loved one is struggling to stop using codeine, contact The Recovery Village to learn more about treatment options. Call 352.771.2700 today to sign up for a rehabilitation program and work toward a drug-free future. 

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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