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Medically Reviewed By: Diana Vo, LMFT

November 17, 2023

Table of Contents

Codeine is a medication prescribed for pain relief, sleeplessness, and coughing. Although the short-term use of codeine under medical supervision is typically safe and effective, the drug can trigger dependence and addiction. When this occurs, you will experience codeine withdrawal symptoms in the absence of the substance.

What is Codeine Withdrawal?

Codeine is an opioid analgesic. A prescription opioid usually administered for moderate or severe pain, codeine is highly effective for pain relief but also has the potential for abuse and addiction.

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If you use codeine long-term and become physically dependent on the opioid, intensely uncomfortable withdrawal symptoms will manifest when the effects of the medication wear off. Codeine withdrawal is a physical and emotional reaction to the absence of the drug in the system.

While this form of withdrawal can be uncomfortable and unpleasant, it is not normally dangerous or life-threatening. Most people find that symptoms resemble a bad cold or flu in presentation and subside within a few days.

The sustained use of codeine will cause tolerance to build. This means the effects of the medication become diminished, requiring you to take more codeine or more frequent doses of codeine to get the pain relief you need.

Variables that influence the risk and severity of codeine withdrawal include:

  • Degree of physical dependence.
  • Dosage of codeine taken.
  • Duration of codeine abuse.

If you use codeine in combination with other CNS depressants like alcohol or benzos, this will increase the likelihood of a fatal codeine overdose. Breathing can slow so much that it stops completely, triggering respiratory depression, a condition where you will need medical intervention or you may suffocate.

It is worth underscoring the fact that codeine dependence and addiction are not the same. Dependence is a physical issue causing you to require codeine simply to function normally. Addiction to codeine is characterized by a compulsive desire to use opioids in the face of obviously negative outcomes. Codeine addiction is diagnosed as opioid use disorder, a chronic and relapsing brain condition. Withdrawal is a diagnostic criterion for addiction.

When tolerance and dependence to codeine develop, addiction often but not always follows.

Codeine Withdrawal Symptoms

The symptoms of codeine withdrawal often occur in two distinct phases.

The first phase typically begins just a few hours after the last dose of codeine. Early codeine withdrawal symptoms include:

  • Runny nose
  • Teary eyes
  • Irritability
  • Anxiety
  • Yawning
  • Insomnia
  • Sweating
  • Increased heart rate
  • Muscle aches

The following symptoms of codeine withdrawal often present after a few days of detoxification:

  • Vomiting
  • Nausea
  • Appetite loss
  • Diarrhea
  • Stomach cramps
  • Chills
  • Enlarged pupils

Many of these withdrawal symptoms are the reverse of codeine’s regular side effects – this drug can cause constipation, for instance, while withdrawal is often associated with explosive diarrhea. Similarly, taking codeine induces sleepiness, while many people undergoing codeine withdrawal find their sleep patterns are disrupted.

How long does codeine withdrawal last, then?

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Codeine Withdrawal Timeline

The most intense physical withdrawal symptoms present during the first few days after the last dose of codeine. Most symptoms will subside within ten days to fourteen days.

Cravings for codeine and behavioral symptoms may linger for months after discontinuing use of the medication. All experiences of withdrawal are unique.

Although codeine withdrawal is seldom life-threatening, it is generally advisable to detox with medical guidance and supervision. Your prescribing doctor may use a tapered reduction to incrementally reduce the amount of codeine you take instead of abruptly stopping the medication. A tapered withdrawal can mitigate many of the more unpleasant side effects of detox and withdrawal.

During codeine withdrawal, the following medications may be administered:

  • For generalized pain and mild withdrawal symptoms: Non-narcotic pain medications like ibuprofen (Advil) or acetaminophen (Tylenol).
  • To stop diarrhea: Loperamide (Imodium).
  • For nausea or mild anxiety: Hydroxyzine (Atarax).
  • For moderate withdrawal symptoms:  Clonidine (Catapres) is often used to treat high blood pressure and anxiety during moderate withdrawal. Long-acting benzos like diazepam (Valium) can help you to sleep and may also be administered to alleviate muscle cramps.
  • For severe withdrawal symptoms: For more severe withdrawal from codeine, your treatment team may use a substitute medication like a different opioid instead of codeine. Alternatively, they may prescribe naltrexone, methadone, or buprenorphine. These three medications are FDA-approved for the treatment of opioid use disorder.
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Codeine Withdrawal Treatment at Renaissance Recovery

The most effective codeine withdrawal treatment begins with a supervised clinical detox. At Renaissance Recovery, we can connect you with a licensed medical detox center near you, enabling you to address the physical aspect of withdrawal with a tapered reduction in dosage.

Once you have detoxed from codeine, you’ll be ready to engage with ongoing treatment for opioid use disorder. At Renaissance, we specialize in treating addictions and mental health conditions in an outpatient setting. This provides you with an affordable and flexible route to recovery from codeine addiction.

If you require more support than a traditional outpatient delivers, choose from an IOP (intensive outpatient program) or a PHP (partial hospitalization program). IOPs offer up to 15 hours of therapy sessions per week, while PHPs are full-time outpatient programs with up to 35 hours of therapy sessions scheduled on weekdays.

All of our addiction treatment programs draw from the following holistic interventions and evidence-based therapies:

Whether you transition directly into sober living or step down to a less intense form of treatment, your treatment team will ensure you leave Renaissance with appropriate aftercare and relapse management strategies in place. We’re here to help you from detox to discharge and into ongoing recovery.

Start living codeine-free by reaching out to admissions right now at 866.330.9449.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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