Have you ever taken a medication – whether recreationally or prescribed – for a period of time and find yourself painfully uncomfortable when you stop? Maybe you noticed an increase in body sweat, a new level of anxiety you hadn’t had before, or pain in your joints and muscles. These are signs of withdrawal, and many medications and substances cause it, including codeine. But why does this happen? Is withdrawal avoidable?

In 2019, over 190,000 Tennessee residents reported misusing prescription pain medications. However, the good news is that same year, almost 29,000 residents were enrolled in a substance use disorder treatment program. Here at ReVIDA® Recovery, we are proud to be serving our Appalachian communities as residents begin their recovery journey. We offer same-day appointments so there is no gap in starting treatment today. Our blog serves as a free resource for families and loved ones wanting to know more about substance use disorders. Today, we are exploring codeine withdrawals, what causes them, and what to do when they arise.

Codeine Withdrawal Defined

Codeine withdrawal occurs when the body has become used to having codeine and it is suddenly taken away. This does not refer to taking a low dose of codeine for a short period, such as a few days or a week. Codeine use would have to extend for a long period, and the dosage typically would increase along the way. This is because the longer codeine is used at a singular dose, the body becomes accustomed to it and doesn’t produce the same effects. Higher doses will cause codeine effects to be felt again. However, this increases the likelihood and severity of withdrawal. Not everyone will build tolerance the same, and some may take codeine for a long period and only experience mild withdrawal. Each person will vary in their experience.

What Causes Codeine Withdrawal?

Codeine withdrawal is caused by a response from the brain. When the brain becomes used to codeine, it sends signals to the body that indicate a need for the substance. This triggers withdrawal symptoms to begin, and at this point, the person has become dependent on codeine. As withdrawal symptoms become more intense, the person will do whatever it takes to get their next dose of codeine. Once codeine enters the brain and body, withdrawal will subside.

Dependence vs Regular Use

As we mentioned above, dependence is when both the brain and body have a need for codeine. Withdrawal symptoms vary in severity, but are often uncomfortable enough that the person keeps using codeine. At this point, the person has most likely experienced relationship difficulties, work or school performance drops, and financial strain from their codeine use. However, the body’s need is more important, continuing the cycle of dependence.

Regular use does not necessarily mean dependence when it comes to codeine use. Remember, codeine is a prescription medication and serves many purposes for pain management. In these instances, doctors are working with their patients to manage pain but to also prevent dependence from happening. This is through the form of dosage adjustments, treating the patient’s needs while keeping them safe, and tapering off codeine if the patient no longer needs the medication. Tapering means slowly lowering the dose until codeine is out of the system, and by doing this method, withdrawal will be very mild and manageable.


Symptoms of Codeine Withdrawal

There are various symptoms of codeine withdrawal, and many can interfere with everyday life. Codeine is an opiate which is a natural form of opioid. In general, withdrawal causes flu-like symptoms and general feelings of being unwell. Let’s take a look further into the specifics.

Digestive Problems

A common symptom of opioid use is constipation. This is because opioids such as codeine inhibit peristalsis within the gastrointestinal (GI) tract. Peristalsis is the process in which the intestines contract and relax to move waste products through the colon. When the process cannot be carried out, waste builds up within the intestinal tract, which can lead to blockages. Opioids also increase fluid absorption in the intestines, creating hard stools that cause constipation.

When opioid use stops, the GI system begins trying to function normally again. This causes cramping, specifically in the stomach and upper intestines as well as nausea. Constipation can continue if measures have not been taken to address it. Once constipation clears, the person may experience diarrhea while going through withdrawal.

Chills and Goosebumps

Chills can occur during withdrawal for different reasons. Another symptom of withdrawal is increased sweating, which can lead to chills and goosebumps as it cools the skin. This is especially common when temperatures around the person would not normally trigger sweating. Another cause of chills and goosebumps is the central nervous system trying to regulate temperature. Opioids directly affect the central nervous system and can cause disruptions in processes including breathing and body temperature regulation. As this system restores, chills and goosebumps may be noticed.

Sweating and Dehydration

As we just mentioned, sweating is a common codeine withdrawal symptom. The central nervous system will take time to adjust to no longer compensating for codeine, causing the body to respond differently than normal. Also, codeine causes dilation of the blood vessels, resulting in low blood pressure and changing skin reactions. Once codeine is taken away, blood vessels constrict, which can cause excess sweating. If fluid is not replenished, sweating can lead to dehydration, which can become serious. It is important to keep drinking fluids if you are experiencing sweating during codeine withdrawal.

Muscle Aches

Muscle aches are often combined with joint and bone pain during codeine withdrawal. Dehydration and poor eating habits contribute to these symptoms. Codeine works in the brain by attaching to opioid receptors, blocking feelings of pain. As codeine leaves the system, pain is able to be felt again, often more intensely at first. Muscle aches and joint pain can seem agonizing during the withdrawal phase.

Psychological Withdrawal Symptoms

When our bodies do not feel 100%, it is easy for mental health to take a toll. Codeine use disorder can cause depression to develop, and during withdrawal, these symptoms can worsen. Feelings of guilt or shame for experiencing codeine withdrawal also increase depression and the possibility of developing suicidal ideation. Agitation and lashing out at loved ones can occur as the mind copes without codeine.

Psychological codeine withdrawal symptoms are often more dangerous than physical. In these moments, the person will feel vulnerable and helpless. If thoughts of suicide, self-harm, or harming others occur, seek medical attention immediately.

Withdrawal Symptoms Timeline – How Long After Codeine Use Do Symptoms Begin?

Codeine withdrawal symptoms can begin in as little as 6-12 hours after the last dose. Symptoms typically begin with a runny nose, yawning, sweating, and anxiety. The peak symptom timeline tends to be 24-48 hours after the last dose and is the most severe. Abdominal pain, muscle cramps, depression, vomiting, and diarrhea are at their height during this time. Codeine withdrawal typically subsides after 5 days, but for some, symptoms can last up to two weeks.

Codeine Detox and Aftercare

The safest way to stop using codeine is to attend a medical, codeine detox. This ensures you are surrounded by medical professionals who will monitor your physical and mental health while providing medications to make symptoms more comfortable. A detox stay is usually around 7 days, but what happens once codeine is out of your system? Having a plan to enroll in a treatment program is crucial to prevent a return to use. Inpatient, intensive outpatient, and outpatient programming all offer quality codeine treatment. You will choose with the help of a care coordinator and your specific needs on what program will work best for you. In some cases, medication-assisted treatment (MAT) will be utilized throughout your recovery process.


Treatment for Codeine Use Disorder and Withdrawals in Tennessee

Codeine use disorder can quickly take over your life, and withdrawals can make it feel impossible to stop. The good news is there is hope, and the cycle does not have to keep going. Finding quality codeine addiction treatment is the first step to a brighter tomorrow. Therapy, coping skill development, and medication-assisted treatment will provide the building blocks for a life in recovery and free from the grips of codeine.

Managing a codeine use disorder doesn’t have to be your way of life forever. ReVIDA® Recovery has helped many rediscover their value and lead the way to an opioid-free life. Our program is flexible and can accommodate many work and school schedules. Call us today at 423-631-0432 to learn more about our program offerings.

Reclaim your life.