Codeine is a drug that doctors may prescribe for pain, coughing, and sleeplessness. Short-term use of codeine under the close supervision of a doctor is generally safe. However, the drug can lead to dependence and addiction. In some cases, people may experience withdrawal symptoms when they stop taking it.

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In most cases, these symptoms pass relatively quickly, and treatments are available to alleviate them. Doctors may prescribe stronger medications if a person has developed codeine dependence.

Keep reading to learn more about the causes, symptoms, and treatment of codeine withdrawal.

Codeine belongs to a class of drugs called opioids.

People who have become dependent on codeine or have used the drug for extended periods may experience withdrawal when they stop taking it. This is a physical reaction that the body has to the absence of the substance.

Although withdrawal can be unpleasant, it is not usually dangerous. For the majority of people, the most intense withdrawal symptoms ease within a few days.

This article discusses the symptoms of codeine withdrawal and their expected duration. It also outlines the causes of codeine withdrawal and the various treatments available.

Frequent use of codeine causes the body to become chemically dependent on the drug. Over time, the body begins to depend on codeine as important for normal functioning. This is known as drug dependence. Quitting the drug disrupts the normal functioning of the body, causing a wide range of symptoms.

Factors that increase the risk of codeine withdrawal include taking a high dosage and using codeine for a long time. A person who also drinks alcohol or takes other drugs, especially benzodiazepines such as alprazolam (Xanax) and diazepam (Valium), has a higher risk of a life threatening codeine overdose.

Dependence vs. addiction

It is important to understand that dependence and addiction do not mean the same thing. Dependence is physical. Addiction describes a person being unable to stop using a substance even when they know it is causing them physical and psychological harm.

Doctors will typically diagnose addiction as a substance use disorder. Over time, dependence on codeine has the potential to become an addiction.

Treating dependence might just involve physical detoxing, which can include a period of withdrawal symptoms. Treating addiction is more complicated, which may explain why opioids represent a leading cause of overdose deaths in the United States.

Withdrawal symptoms may be both psychological and physical. The common symptoms include:

For many people, withdrawal symptoms are similar to those of a more severe bout of flu. A person experiencing withdrawal may not be able to work or go to school for several days.

The type and intensity of opioid withdrawal symptoms depend on several factors, including:

  • Overall health: People with chronic health issues may find that their symptoms get worse during withdrawal.
  • Addiction to benzodiazepines: Research suggests that codeine withdrawal may be worse in people who are also addicted to this class of anti-anxiety drugs.
  • Pregnancy: People going through codeine withdrawal during pregnancy may experience more intense symptoms. Withdrawal may also increase the risk of pregnancy loss or stillbirth. Pregnant people should speak with a doctor before coming off codeine. In many cases, a doctor may recommend medically supervised withdrawal or the use of a drug such as methadone.

Withdrawal symptoms usually begin about 8–24 hours after a person last uses the drug. For some people, symptoms may not appear until after this time window.

The severity and duration of codeine withdrawal vary from person to person. Some people may experience only mild symptoms, while others may become seriously ill.

Some people feel so overwhelmed by the withdrawal that they decide to treat their symptoms with a small dose of codeine. However, taking codeine resets the withdrawal period, causing the symptoms to last longer or become more severe.

In acute opioid withdrawal cases, symptoms may last for as long as 6 months. A person will feel unwell and experience cravings for codeine during this time.

Not everyone who experiences codeine withdrawal will require treatment. However, people should speak with a doctor if they experience severe withdrawal symptoms or require a longer-term treatment for substance use disorder.

Treatments for severe withdrawal

In some cases, a doctor may prescribe drugs to ease severe withdrawal symptoms.


One such drug is buprenorphine (Subutex), which is a partial opioid agonist (POA).

POAs stimulate the same receptors as other opioids, such as codeine, but to a lesser extent. As a result, these drugs can ease opioid withdrawal symptoms without increasing a person’s dependence on opioids.

However, while buprenorphine remains an important tool in treating opioid addiction, the Food and Drug Administration (FDA) recently warned that oral delivery might cause tooth decay, even in people with no prior history of dental problems.


In severe cases of drug dependency and withdrawal, a doctor may prescribe methadone (Methadose), which is an opioid agonist. Methadone stimulates the opioid receptors to a higher degree than POAs, so it is particularly effective in weaning a person off codeine and other opioids.

However, methadone itself can cause dependence. Therefore, a person should talk with a doctor about the risks and benefits of using methadone to ease codeine withdrawal.

Treatments for specific withdrawal symptoms

Doctors may also recommend medications to treat specific symptoms. These medications may include:

People who become severely dehydrated may need IV fluids. A doctor may also recommend undergoing supervised withdrawal in a hospital or addiction center.

Longer-term treatments

When dependence turns into an addiction, it becomes a substance use disorder. This complex illness involves not only physical but also psychological factors. Treating withdrawal is only one aspect of the treatment.

Other important aspects of addiction treatment include:

  • supporting the person to resist cravings
  • helping the person understand the reason why they developed an addiction
  • treating any underlying conditions, such as chronic pain or depression

Longer-term treatment options for drug addiction may include:

  • lifestyle changes, such as replacing addictive behaviors with pursuits that benefit well-being
  • support groups
  • psychological therapy
  • treatment for chronic pain, such as physical therapy, surgery, or exercise
  • medications to help improve mental well-being

A person should seek help for codeine dependence if they are taking the drug:

  • at higher dosages than the doctor recommended
  • for longer than the doctor recommended
  • without a prescription

Some people can wean themselves off codeine. However, it is helpful to talk with a doctor before quitting the drug. A doctor can offer treatment options that will ease withdrawal symptoms.

It is not advisable for certain people to quit taking codeine without medical assistance. These people include those who:

  • are pregnant
  • have another dependence
  • have a co-occurring mental health condition
  • have a history of severe health problems during withdrawal
  • have serious chronic health issues

Codeine addiction is a serious health issue that can cause lasting harm. The longer a person uses codeine, the harder it becomes to quit. Therefore, the best time for a person with a codeine addiction to quit the drug is right away.

The symptoms of codeine withdrawal can be intense. However, the most severe symptoms usually pass within a few days. A doctor who is knowledgeable about addiction can suggest ways to minimize the symptoms of withdrawal while quitting codeine.

Some of the psychological symptoms of codeine withdrawal can last several weeks. However, with ongoing care and support, a person can overcome these symptoms.

Below, we answer some questions that people often ask about codeine withdrawal.

How long does it take to get codeine out of the body?

Codeine can stay in a person’s saliva for up to 36 hours. It may also be detectable for 2–4 days in their urine, 7–14 days in their sweat, and 90 days in their hair.

What medications contain codeine?

Codeine is a component of different cough syrups and some pain-relieving medications. These include codeine sulfate, codeine phosphate, Tuzistra XR, Tuxarin ER, Tylenol (acetaminophen) with codeine, and promethazine with codeine.

Is codeine a good pain reliever?

People can use codeine to relieve pain. However, doctors will usually only prescribe it for short-term relief in cases of mild to moderate pain when other, nonopioid medications have not helped. Doctors more commonly use codeine to treat a cough.