Codeine Withdrawal Symptoms?

Helenbothknees

Greetings all. My new knees are going from good to great, so much so that I'm now cutting back on the pain medication (paracetamol and codeine). I was taking two 30mg codeine tabs four times a day; I cut back (weekly) one at a time to one a day; now I've cut out one of those. But....

I think I may be getting withdrawal symptoms from giving up the codeine. I've only been on it since coming home from hospital 10 weeks ago, but before that I was on morphine in hospital, tramadol before that, codeine for a while earlier, etc etc - all opiate derivatives I think. This is the least medication I've taken for ages. But when I cut back now, I'm OK for a couple of days, then I start waking up anxious and depressed, and getting upset and flying off the handle about little things, which really isn't me.

Is this codeine withdrawal? If so, is my cutting back slowly going to work, now that every tablet I miss out is a larger percentage of what I'm taking, if you follow that? Or should I do it some other way. Any thoughts appreciated....

tillytop

Hi Helen

What you are describing could well be codeine withdrawal - I know there are forum members (myself included) who have struggled with this. Obviously I am no medic and it would be wise to check with your GP about this but what I did (with codeine and with sleeping pills previously) was to cut the pills into quarters and cut back by only a quarter of a pill at a time. I would stick with the reduced dose for up to a week, then reduce by another quarter pill and so on. You may already know this but you can buy "pill splitters" from many chemists which make it quite easy to cut the pills fairly accurately in half. When it came to quarters it was down to my husband and a sharp knife though. :roll:

I do think you need to take some advice from your docs though cos codeine withdrawal can be quite challenging for some people if you have been taking it regularly for some time.

Tilly xxx

barbara12

Hi Helen
This does sound like withdrawal symptoms , If I miss my night time one, I wake in the early hours feeling very anxious. so god knows what would happen if I stopped them all.
I suppose you have tried taking less, and bring them down really slowly, I do hope the symptoms ease up for you very soon.x

Helenbothknees

Thanks Tilly and Barbara. Actually what I wrote was wrong. The first bit should read " I was taking two 30mg codeine tabs four times a day; I cut back (weekly) one at a time to one FOUR TIMES a day; now I've cut out one of those."

So I am doing it slowly (now on three a day), and up to now it's worked. But as I said, now each tablet I leave out is a larger percentage of what I'm taking. I have a pill splitter (for the cats!) so I could try that...I'll think about it and see what others here say. Reluctant to try to get an appointment at the doc unless I absolutely have to!

hileena111

It does sound like withdrawal symptoms but you should def see your GP.
They wont want you to be on any more meds than necessary so I would think they will help you come off them the safest possible way.
We dont have medical knowledge....just personal knowledge.
I was put on morphine a while back when I fractured my pelvis and SI joint.....they monitored it closely and got me off them {when the time was right} at the proper speed

Love
Hileena

elnafinn

Codeine is obviously very addictive. I cannot remember who it was, on the forum, who got into a pickle with that particular med, and we coaxed her to go to the gp (because they know best regarding meds) who was extremely supportive and she was told exactly what to do to gradually wean herself off them. She did find it very difficult at times, but she regularly posted on here and we helped her along with it.

If you do not wish to make an appointment with the gp, do you have a system at your surgery where you an ask the gp to give you a call to discuss?

Elna x

Helenbothknees

Yes, Elna, we do, and that's an excellent idea!

dreamdaisy

'Neat' codeine is very strong stuff and should always be treated with respect. It is so easy to slip into the habit of taking possibly too many for too long, not for the pain dulling effects but to 'feed' an addiction you may not realise is there until you try to cut back. Once you're sorted on this try to keep the duller intake to the barest minimum. - and steer clear of codeine. Hopefully you won't be needing too many but there is still a fair bit of internal healing to be done and the older one is the longer that can take. DD

mig

I had problems with codeine and not just for pain killers,they are highly addictive,when I realized what was happening with the advice of the folk on here and my doctor I finally started to reduce,I now have them just for pain (one in the morning and one at night)so far this is working for me as l can't take tramadol or diclo,if i need anything else ican take paracetomol i try not to as i am on naproxen.It has taken me 6 months to get where i am now it has been very hard,please stick with it and see your doctor.Mig

marrianne

I was on the codeine phosphate,the same dose as Helen,but the prescription had to be continualy renewd ,I got fed up so simply stopped takeing it ,I have to mannage with gaberpentine ,the naproxen and thats it ,my knees hurt a little I still dont get much sleep but I think I was lucky to have no symtoms of withdrawel ...I was on then since April5 mths ,my bp is up again and e s r is elevated but thats the R/A side of things ,Marrianne

Helenbothknees

Friends, thankyou. I've talked to my partner and others who've discussed this kind of stuff with GPs. They've all said there's no point in seeing the GP, and to carry on cutting down slowly, which as I said is what I've been doing. To be honest, looking at it more objectively it's not that bad. I'm having about one day a week when I wake early feeling anxious, and get upset and on edge until about mid-morning; then I'm OK. If that's all that happens I can cope, now that I understand it. If it gets worse as I go on, I'll cut back even more slowly. Besides, I think I've developed enough tolerance now that they're not even doing anything painwise; effectively I'm just on paracetamol!

But please keep coming with the personal experiences; that actually helps more than anything....

RitaW

Hi,I too am having problems with withdrawal from Codeine.I have tried cutting down but get terrible restless legs,irritability,anxiety and insomnia.I have been on 30/500 codeine/paracetamol for about 6 years.If I miss a dose I know all about it.My husband and myself are trying to come up with a plan for a gradual reduction to try and cope with the withdrawal symptoms. :?

Helenbothknees

Rita, wow, six years is a long time. My cutting out one tablet at a time is OK so far for me (bearable anyway), but it sounds like you've tried that and it doesn't work. Have you tried cutting tablets in half? Or, more simply perhaps, getting the codeine/paracetamol you can buy over the counter. This has 8mg of paracetamol in each tablet, so you have scope to vary the dose by much smaller amounts (combining it with what you have, if you follow me). I have some, and I'm thinking of trying that if necessary - be careful not to overdose on the paracetamol if you do it that way though.

Keep in touch and let me know how you get on and what works.

Helen

RitaW

Hi Helen,I have a tablet cutter and am thinking of maybe cutting down by half a tablet a day for a week,then the following week (or 2 weeks) by a whole tablet.I cannot wean myself off them completely though,as they are the only thing that takes the edge of the pain.I will let you know how it goes and keep you updated. x

Helenbothknees

Hi Rita,

If you need them for the pain then you need to take them of course!

My pain is lessening a lot now since my TKRs, and I think I could manage on paracetamol alone. I cut down by one tablet a week when I was on two, 4 times a day, until I was on one, 4 times a day. The problem seemed to start last week when I missed out one tablet altogether.
However, the symptoms only lasted for about a day, which in hindsight doesn't seem so bad - isn't it fascinating how quickly you forget?

Anyway, today is my first full day with another one gone, ie only two a day altogether - I missed last night's and my mid-morning one. So far I'm fine, and I even finished writing a fairly complex magazine article at top speed this morning (I'm a writer). But last week it hit me on the second night/day, so I have very little planned for tomorrow. If it doesn't get any worse I think I can cope, but if it does (and each time I'm cutting down by a greater percentage of course) I'll have to start cutting tablets in half or taking the over-the-counter less powerful tabs.

I too will post how I'm getting on. I'm actually still hoping that last week was one of those quirks of being human and not withdrawal symptoms at all, and that this week I'll be fine, but...we'll see...

AlexanderNixon

Hello,

I am pleased to have found this site and this is my first posting. Arthritis is my family curse, my mother, grandmother and great aunts, have all suffered from this painful illness. However, I don’t want to moan. There are people here whom I am sure are suffering a great deal more.

I was prescribed co-codamol, 30/20 and Indomethacin many years ago. I am only 46 but I think I’ve been taking these drugs for well over 20 years. I can limit my intake to four tablets of co – codamol a day, but sometimes it is 6. When I try to stop, I experience an increased heart rate, anxiety, sweating, tummy cramps and bowel problems as well as a general feeling of being unwell. Codeine appears to have a cumulative effect; so, I guess I am an addict. I say this because, I find myself thinking, “I must have a co-codamol,” it the first thing I reach for when I wake up, in fact taking them has become perfunctory.

For the past four days, I have had no co codamol. As I write, I am feeling ghastly, and have resorted to taking two tablets this evening. I have heavy workload this week, a professional assessment, and an examination. I cannot function as well as I ought if I am in withdrawal. As you all know here, the pain of arthritis can be ghastly, but when I have tried to discuss the possibility of coming off codeine my GP has dismissed my concerns and told me I would not get the same pain relief. Therefore, I have to do this myself.

I am going away for a week very soon, and I intend to start during that time. My aim is to reduce the co-codamol by taking 3 ¾ tablets for the first two weeks, and then reduce in increments of ¼ of a tablet until I am clean. I think I ought to continue the Indomethacin, for the inflammation. Does anyone have any Ideas as to extra analgesia if I need it? I suppose paracetamol is my only option?

Thanks for letting me have a whinge. Any encouragement or ideas will be gratefully received.
Alex

stickywicket

Hello Alex. It’s good to meet you and I hope we can be of some help and support. Please don’t worry about people ‘suffering a great deal more’. There are always people suffering a great deal more than any of us but that doesn’t lessen our own pain.

You don’t say what type of arthritis you have. As you appear to have been prescribed only anti-inflammatories and co-codamol I presume it’s osteo though the family connection could indicate an auto-immune form.

There are other forms of pain relief besides co-codamol which your GP could prescribe. You don’t say how you feel you will cope with the pain without the co-codamol. None of us here can say if you’re addicted to them as we’re not medically qualified. If you think you are, and wish to come off them though, I think you should do it with medical help. If your own GP is unhelpful you should see someone else in the practice. If necessary change to another practice. At the very least, you should seek advice from a pharmacist who knows all the meds you are taking.

AlexanderNixon

Thank you Stickywicket, your reply it was good to hear from you. I do indeed have osteoarthritis, in my knees, ankles, wrists, and shoulders and more recently in the spine at the top of my neck. All the GP’s in the practice have been unhelpful. I live in a remote part of Northumberland, and commute to work in London once every two weeks. Changing GPs is going to be difficult, although not impossible but I would prefer to receive treatment at home, rather than in London.

The only people who have been helpful are the practice nurse who does believe, that I am, indeed addicted to codeine; and my local pharmacist, Stephen, who is wonderful chap and a good friend. He is going to speak to one of the GPs for me this week, as he very supportive of my intention to come off this drug. In fact, he told me over a drink this weekend that he has been worried about my reliance on co codamol for some years. (I have occasionally used Syndol when I couldn't get a prescription.

You know, I am angry with myself, as being a relatively intelligent man; I didn’t see what was happening. That, of course, is the nature of addiction. In the early days medication helped me to enjoy sport. I played squash at county level, ran most days, and hunted most weekends. (I know that is an issue for many people, but it is in my very bones, if you excuse the phrase). The other thing I am rather angry about, is that my late mother, of all things a research pharmacist, had talked to Stephen, about my drug usage not long before she died five years ago! Why she didn’t tell me this herself I don’t know. I understand Stephen’s reticence, but not mummy’s!

However, there was a time about fifteen years ago, when I think she weaned herself off codeine. She was, I believe at that point taking codeine phosphate, and I suspect she had been self medicating. She took a sabbatical year, and I remember her being unable to complete a paper she was writing. She was quite poorly, but she refused to see a doctor. At the end of that year, she was revitalised, and was taking another pain killer. I wish I’d paid more attention.

Your advice is sound. I will talk this over with a GP yet again, and insist that he either helps, or refers me on. I thank God that I have some allies. And once again, thank you for reading this diatribe.

stickywicket

Your GP situation is difficult if you feel all those in your current practice are unhelpful yet you are some way from any other practice. I’m not sure how helpful it would be to find one in London if you’re not actually living there.

There are many on this forum who would consider 4-6 cocos daily very routine and nothing to worry about even when they have to be taken before we can get out of bed but I guess it all hinges on whether or not you are taking them to relieve the pain of the OA. Only you will know this. Taking pain relief to enable one to continue with ones sporting activities is something that many people do. However, it sounds, from what you are saying, that pain relief is not your main purpose.

At the dose you are on I wouldn’t have thought it would be too difficult to get off them as long as it’s medically supervised. If codeine is the problem I believe there is at least one non-codeine based pain med but it would need a doctor’s prescription.

I’m also a tad concerned if you’re taking indomethacin regularly without a stomach-protecting med.

This wasn’t ‘a diatribe’, Alex, just an enquiry with some very helpful information. I hope you can solve things to your satisfaction. Please let us know how you get on.

AlexanderNixon

Hello,
I have at last found someone to help me withdraw from codeine. I am Bi – Polar and saw my psychiatrist on Monday. We talked at length about the amount of co-codamol I was taking and he agreed with my desire to withdraw. He is overseeing my withdrawal, which will start next week. This is a huge relief as I was getting nowhere with my GP’s Thanks for your support. I’ll post my progress over the coming week.

barry2013

Helenbothknees wrote:

Greetings all. My new knees are going from good to great, so much so that I'm now cutting back on the pain medication (paracetamol and codeine). I was taking two 30mg codeine tabs four times a day; I cut back (weekly) one at a time to one a day; now I've cut out one of those. But....

I think I may be getting withdrawal symptoms from giving up the codeine. I've only been on it since coming home from hospital 10 weeks ago, but before that I was on morphine in hospital, tramadol before that, codeine for a while earlier, etc etc - all opiate derivatives I think. This is the least medication I've taken for ages. But when I cut back now, I'm OK for a couple of days, then I start waking up anxious and depressed, and getting upset and flying off the handle about little things, which really isn't me.

Is this codeine withdrawal? If so, is my cutting back slowly going to work, now that every tablet I miss out is a larger percentage of what I'm taking, if you follow that? Or should I do it some other way. Any thoughts appreciated....

Hi.
I am three weeks post TKR and was on one codeine every 8 hours, my GP advised me after 1 week to cut down as they were causing bowel problems, I am now off condeine and Paracetamol down to 1 every eight hours, not having any withdrawal problems. hope things work out for you.
Barry.

stickywicket

AlexanderNixon wrote:

Hello,
I have at last found someone to help me withdraw from codeine. I am Bi – Polar and saw my psychiatrist on Monday. We talked at length about the amount of co-codamol I was taking and he agreed with my desire to withdraw. He is overseeing my withdrawal, which will start next week. This is a huge relief as I was getting nowhere with my GP’s Thanks for your support. I’ll post my progress over the coming week.

Well done, Alex! That sounds like a very sensible plan. I hope you find it succeeds.

One thing, when you post your progress, if you start a new thread I think it will be easier for us to follow. I'll look forward to reading it.

frogmorton

Alex

I have only just read your post and am so very very pleased for you that there is help for your withdrawal.

I can tell in your 'voice' that you feel really positive about it now

Love

Toni xx

barbara12

Helen I have just popped in to see how you are doing....
And welcome to Alex..its good to have you on board....and I do wish you well getting off the codiene x