Your brain becomes accustomed to codeine after long-term exposure. Trying to quit can make you feel sick and desperate for drugs. If you try to quit multiple times, you may believe you’ll never get sober.
You have choices, including a codeine taper. By limiting your dose just a little bit every day, you could finally quit using drugs for good.
And if a taper doesn’t work, you can try a Medication for Addiction Treatment (MAT) program.
With the right approach, you can quit taking codeine and start your life new. Here’s what you need to know.
Why Taper Off Codeine?
For many people, codeine is an introduction to opioids. It’s a drug doctors often prescribe when their patients have pulled muscles, broken bones or sore tendons. And researchers say more than 40% of people using opioids over the long term develop an opioid use disorder (OUD).[1] It’s very hard to quit using opioids after long-term use.
Opioids change brain chemistry, and those alterations persist even when the drugs wear off. Between your doses, you may feel sick with flu-like symptoms and drug cravings. Those problems could be so strong that you’re unable to even consider quitting.
A codeine taper allows your brain to adjust to sobriety very slowly. Instead of shocking your body with a sudden change, you give your brain cells time to recalibrate and function properly without drugs.
While you taper, you can also work on creating healthy habits that help you to stay sober. If you move slowly enough, the habits you create could help you stay away from codeine for good.
What Are the Dangers of Quitting Cold Turkey?
When tapers are done properly, it can take weeks or even months. When tapers fail, it’s often because they moved too quickly.[2] A cold-turkey detox is the quickest way to quit codeine, but it rarely works.
In a cold-turkey detox process, you take your normal dose of codeine one day, and you take none the next. Your brain cells are no longer accustomed to functioning without the drug, and they react badly to sudden sobriety.
Opioid withdrawal can cause life-threatening dehydration due to vomiting and diarrhea. You might also be tempted to relapse to drugs to make the withdrawal symptoms stop.
Your brain cells adjust very quickly, and sobriety that lasts even one day could change them. A dose you took before your cold-turkey quitting process could be strong enough to cause an overdose when you relapse.
A failed cold-turkey detox can also make you less likely to attempt the approach again. The more uncomfortable you are, the more you’ll think about sobriety with fear.
How to Taper Off Codeine
The most successful tapering plans are individualized. Your body is unique and deserves care and consideration.
Start your taper with planning. Take the following steps:
- Consider your dose. How much do you take right now? Be honest about how much you take and when. The more precise you can be with the information you give your doctor, the better the tapering process will be for you.
- Tell your doctor. Explain that you’d like a taper, and ask about prescriptions you can use to ease symptoms like diarrhea and muscle aches.
- Tell your family and friends. Explain what you’re doing, and ask the people you love to help make this a success. When you’re tempted to relapse back to opioid misuse, reach out to them for support.
- Find a reduction schedule. Your doctor can help you create a plan that’s right for you. Follow their schedule to gradually reduce your daily dose.
Successful tapers involve reductions of 5% to 20% per month.[2] The goal is to help you take a little less each day without feeling incredibly sick or desperate for drugs. If your withdrawal symptoms are intense, your doctor will likely raise your dose temporarily and slow down the tapering schedule.
Your goal isn’t to create a predetermined timeline or a target dose. Instead, you’re focused on making incremental changes that help you function better and stop misusing drugs.[4]
Can You Taper Off Codeine Without Withdrawal Symptoms?
Severe discomfort raises your relapse risks, and your taper should never move so fast that you face life-threatening problems. But many people feel slightly uncomfortable as they taper.
You might experience mild discomfort, especially the day after you reduce your dose. When you’re feeling fine and healthy, you can make yet another reduction.
Think of your mild withdrawal symptoms as markers. When they fade away, you’re ready to make even more changes. Your body is guiding the process for you. It’s important that you remain in communication with your doctor about what you experience.
Identifying & Managing Withdrawal Symptoms
Experts say withdrawal symptoms mean the taper is moving too quickly.[2] Staying in touch with your doctor is critical.
Doctors use the Clinical Opiate Withdrawal Scale (COWS) to assess withdrawal signs in their patients. Items included on that list include the following:[7]
- Fast heartbeat
- Sweating
- Restlessness
- Dilated pupils
- Aching joints or muscles
- Runny nose or tearing
- GI upset
- Tremors
- Yawning
- Anxiety or irritability
- Goosebumps
If you have several of these signs, or the symptoms you have are severe, contact your doctor and discuss your taper schedule. Slowing down to allow your body to adjust to a smaller dose might be smart.[7]
Make sure that you take additional steps to support your body during the taper process. Eat nutritious meals, get plenty of rest, and wear layers you can take on and off.
However, know that significant withdrawal symptoms can’t be treated at home. Significant withdrawal often means your taper is moving too fast.[2] Tell your doctor about all of the symptoms you experience.
What Is Medical Detox?
A codeine taper moves very gradually, but some medical detox programs are different. In a medical detox program, your treatment team replaces your codeine with other medications.
Your doctor can use methadone or buprenorphine-based products like Suboxone to ease withdrawal symptoms. These medications connect to receptors used by opioids like codeine. While these medications don’t make you feel high, they can help to reduce your discomfort as your brain adjusts to a lack of codeine.
In medical detox programs, your doctors can also use medications to assist with withdrawal symptoms like these:
- Nausea
- Vomiting
- Diarrhea
- Headaches
- Insomnia
Medical detox programs move quickly. They’re often complete within a few weeks. While they can help you get sober, medications are not a comprehensive treatment program for OUD. Without follow-up care like therapy, you’re likely to relapse to drugs.
Taper vs. Detox
Both a codeine taper and a medical detox program can help you get sober safely. However, they are very different processes. This chart can help you understand the differences and similarities:
| Medical Detox | Codeine Taper | |
| Time frame | A few weeks | A few months |
| Doctor directed? | Yes | Yes |
| Which primary medications are used? | Methadone or buprenorphine | Codeine |
| Are severe withdrawal signs expected? | No | No |
| Where does it typically take place? | Hospital or clinic | At home |
The Role of MAT
Medication for Addiction Treatment (MAT) programs can pick up where medical detox ends. And they can be useful after opioid tapers too.
Researchers say people who taper have a higher risk of visiting an emergency department and getting hospitalized.[5] While you may think the taper worked, you could be at risk for relapse without MAT.
MAT programs use take-home medications like Suboxone.[6] Your dose doesn’t make you feel high, but it can ease drug opioid cravings. You can achieve stability in an MAT program, while you find your footing in recovery.
Studies suggest MAT works. In a large study completed in 2018, researchers found that people using MAT had a lower risk of early death from any cause, along with a lower risk of overdose death. Staying in MAT for more than a year was most effective, researchers said.[8]
Studies also say MAT programs save money. When compared to no treatment, enrolling people in MAT means fewer costs associated with overdose deaths and drug-related sickness.[9]
While MAT is effective, few people with OUD get it.[9] Sometimes, a lack of local providers is to blame.
Contact us to see if our telemedicine approach at Bicycle Health is right for you. We can help you get started today, as telemedicine makes appointments accessible for everyone.
Frequently Asked Questions
These are some of the most frequently asked questions we’ve heard about codeine tapers:
It’s not smart to adjust your dose without a doctor’s help. Quitting too quickly can lead to significant discomfort and increase your risk of relapse. Ask your doctor to create a schedule for you.
You shouldn’t. Your doctor will create a slow schedule that helps your body gradually adjust to sobriety. If you feel really sick, the taper might be moving too fast.
No. MAT involves the long-term use of medications like Suboxone to help you manage withdrawal symptoms and cravings to treat OUD. A taper is a short-term process that involves taking smaller codeine doses.
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
- Opioid Taper Decision Tool. U.S. Department of Veterans Affairs. https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/Pain_Opioid_Taper_Tool_IB_10_939_P96820.pdf. October 2016. Accessed March 2023.
- Oregon Opioid Tapering Guidelines. Oregon Health Authority. https://www.oregon.gov/obnm/Documents/Oregon%20Opioid%20Tappering%20Guidelines.pdf. January 2020. Accessed March 2023.
- HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. U.S. Department of Health and Human Services. https://www.cms.gov/About-CMS/Story-Page/CDCs-Tapering-Guidance.pdf. October 2019. Accessed March 2023.
- Tapering and Discontinuing Opioid Use. Minnesota. https://mn.gov/dhs/opip/opioid-guidelines/tapering-opioids/. June 2021. Accessed March 2023.
- Association Between Opioid Tapering and Subsequent Health Care Use, Medication Adherence, and Chronic Condition Control. JAMA. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801014. February 2023. Accessed March 2023.
- Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. Spring 2018. Accessed March 2023.
- Clinical Opiate Withdrawal Scale. Journal of Psychoactive Drugs. https://nida.nih.gov/sites/default/files/ClinicalOpiateWithdrawalScale.pdf. June 2003. Accessed January 2024.
- Effects of Medication-Assisted Treatment on Mortality Among Opioids Users: A Systematic Review and Meta-Analysis. Molecular Psychiatry. https://www.nature.com/articles/s41380-018-0094-5. June 2018. Accessed January 2024.
- Cost-Effectiveness of Treatments for Opioid Use Disorder. JAMA. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2778020. March 2021. Accessed January 2024.
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