I. The Basics of Codeine Rehabilitation

In 2016, 11.8 million Americans aged 12 and older reported that they had misused an opioid like codeine at least once within the past 12 months. According to the World Drug Report, which is published by the United Nations Office on Drugs and Crime, the United States had more than 30,000 daily doses of opioids available per one million inhabitants between 2015 and 2017.

If codeine is not taken according to the prescription instructions, the user can develop a physical and psychological dependence on the drug. Even if the user wants to stop taking codeine, it can be difficult to do so due to the threat of undesirable or even dangerous withdrawal symptoms. It is also difficult to stop using codeine if an individual does not have a strong support system in place.

The codeine rehabilitation process begins with a comprehensive assessment by a trained professional. During the assessment, a customized treatment plan is developed to address the user’s unique medical, psychological, and psychosocial needs. Once a treatment plan is in place, the individual participates in a medically-managed detoxification period, which helps clear codeine from the body in a safe manner.

Following this detoxification period, the individual participates in individual or group therapy sessions designed to address some of the underlying issues that contribute to codeine addiction. During these sessions, the individual learns how to avoid triggers and manage emotions appropriately. Once the individual is discharged, ongoing support is available on an outpatient basis.

II. What Makes Codeine Rehabilitation Difficult?

Codeine-based products may be classified as either Schedule II or Schedule III substances. Schedule II substances contain more than 90 milligrams of codeine per dose, while Schedule III substances contain no more than 90 milligrams of codeine per dose. According to the 2015 World Drug Report released by the United Nations Office on Drugs and Crime, more than 20% of the people in treatment for addiction use opioids like codeine.

It can be difficult to stop using codeine because of the way it works in the brain. Codeine and other opioids slow down the central nervous system, which has a relaxing effect on the user. Some users even experience a sense of euphoria when they take codeine. People who misuse codeine may need to take higher doses of the substance or take more daily doses than prescribed, increasing the risk for overdose and severe side effects. Codeine can also cause serious withdrawal effects, which discourages some users from stopping.

The Unique Struggle of Codeine Addicts
Codeine…
  • slows down the activity of the central nervous system, making the user feel relaxed or even euphoric
  • does not produce the same desirable feelings once a tolerance develops, forcing the user to take more and more of the drug to experience the same effects
  • produces serious withdrawal effects, making it difficult to stop using
  • addiction is especially difficult to overcome if the user has a high level of stress at home or work/school

III. Codeine Rehabilitation Statistics

Opiate Treatment Admissions by Gender

52.7% Male
47.3% Female

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated in 2015:

  • 12,462,000 individuals 12 years of age and older — 4.7% of the population — misused prescription pain relievers like codeine.
  • 124,943 individuals 12 years of age and older in need of treatment enrolled in a rehabilitation program for misuse of opiates other than heroin.

According to a 2017 SAMHSA report that charts admissions to and discharges from publicly funded substance use treatment facilities, men are more likely to seek treatment for abuse of opiates other than heroin, which includes codeine. The gender breakdown of treatment admissions for opiates other than heroin was 52.7% male and 47.3% female. While opiate addiction occurs in all age groups, the most common age group admitted to a treatment facility for opiate use was individuals aged 25 to 34, with 35 being the average age of all individuals from all age groups who are seeking rehabilitation.

Opiate Treatment Admissions Percentages by Age Group, 2017

Age at the Time of Treatment AdmissionPercentage of Opiate Treatment Admissions
12-170.4%
18-2410.4%
25 – 3444.9%
35 – 4425.4%
45-5412.1%
55-645.9%
65+0.9%

IV. Codeine Detoxification and Withdrawal Process

The recovery process for codeine addiction starts with a detoxification process that eliminates the substance from the body in a safe, comfortable manner. Codeine has a half-life of 9 to 11 hours, which means that about half of it should be removed from the body within this time frame. It may take up to four days to complete the initial detoxification process, but the full withdrawal process lasts longer. In long-term users, complete withdrawal may take several weeks.

If withdrawal symptoms persist for more than two weeks, they are labeled “post-acute” symptoms. For long-term codeine users, it may take several months to a year to complete the recovery process.

V. Withdrawal Symptoms

BodyMind
Short-Term SymptomsIncreased tear production
Difficulty sleeping
Sweating
Runny nose
Frequent yawning
Fast heartbeat
Muscle aches
Irritability
Anxiety
Long-Term SymptomsLoss of appetite
Stomach cramps
Pupil enlargement
Nausea
Vomiting
Goosebumps
Chills
Nervousness

Source: Healthline

Codeine withdrawal increases the risk for dehydration, which can be fatal if not treated

While withdrawing from codeine, some users experience nausea and vomiting, which can result in a loss of fluid and electrolytes. Some individuals develop a condition known as dehydration, which is when the body loses more fluid than it takes in. Left untreated, dehydration can cause seizures, kidney problems, or a type of shock caused by low blood volume.

Withdrawing from codeine can produce serious psychological symptoms

During the first stage of detoxification, many codeine users report increased levels of irritability and anxiety. Nervousness may persist even after the user completes the detoxification process. These psychological symptoms may interfere with an individual’s ability to work or maintain fulfilling personal relationships.

Codeine withdrawal can lead to depression, increasing the risk for suicide

Codeine affects the central nervous system, which is comprised of the brain and spinal cord. Once the initial detoxification process is complete, it may take time for the central nervous system to return to its normal state. In some users, this can lead to depression, which is one of the leading causes of suicide in the United States.

The codeine withdrawal process can be dangerous for users with chronic health conditions

While withdrawing from codeine, some users may experience a fast or pounding heartbeat. In an individual with pre-existing heart conditions, this can increase the risk for stroke, heart attack, and other heart-related complications.

VI. Codeine Detoxification Medications

In the United States, several types of medication are used to prevent withdrawal symptoms and make the detoxification process easier. Agonists, which activate the opioid receptors in the brain, are taken daily to reduce cravings. Partial agonists activate opioid receptors but do not produce the same calming effect or euphoric feeling as codeine. Like agonists, partial agonists are used to control cravings and reduce withdrawal symptoms. Antagonists block opioid receptors, which prevent the user from experiencing the desirable effects of opioids.

For more information about withdrawal, read our guide on Codeine Addiction.

VII. Treatment for Codeine Addiction

The U.S. Food and Drug Administration has approved several medications for the treatment of opioid addiction. Methadone is an agonist that reduces cravings and helps prevent some codeine withdrawal symptoms. The main advantage of methadone is that it is effective as long as it is taken as prescribed. One of the main drawbacks is that methadone is usually only available via outpatient treatment programs, making it difficult for some users to receive treatment. Buprenorphine is a partial agonist that can be prescribed by a licensed physician, nurse practitioner, or physician assistant. Therefore, participation in a daily treatment program is not required, making this medication more accessible to codeine users. Naltrexone is an antagonist used to prevent the user from experiencing the desirable effects of opioids. One of its main advantages is that it is not physically addictive. The main disadvantage of Naltrexone is that the individual must stop using codeine and other opioids for at least seven days before starting it, which makes compliance difficult.

Counseling and other forms of behavioral therapy are also used to treat codeine addiction. Working with a counselor or therapist can help the user improve his or her coping skills, reducing the risk of relapse. Therapy programs also provide social support, which can help the user through the recovery process.

Rehabilitation Settings

Within either an inpatient or outpatient setting, treatments such as detoxification services, behavioral therapies, and medication-assisted treatments are offered for varying lengths of time.

Inpatient treatment involves living full-time (including overnight) at a treatment facility for a set period. Outpatient treatment involves scheduled appointments at a facility in which you are free to come and go. Within each category, there are several distinctions.

Codeine Treatment Programs
SettingType of TreatmentDescriptionDurationTime Commitment
InpatientShort-Term ResidentialIntensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify.14-30 daysHours Per Day:

24

Day Per Week:

7

Long-Term ResidentialIntensive treatment in a non-hospital setting, most often a therapeutic community with other patients. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify3-12 monthsHours Per Day:

24

 

Days Per Week:

7

Partial HospitalizationIntensive treatment in a hospital setting. Patients do not stay overnight. Considered inpatient due to the hospital setting. Extensive services are provided and require a near full-time commitment every week. Medication-assisted treatment is available to those who qualify.14-30 daysHours Per Day:

6-8

 

Days Per Week:

5

OutpatientIntensive Day TreatmentExtensive services of an inpatient program but patients return home each day following treatment. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify.3-4 monthsHours Per Day:

2-4

Days Per Week:

3

CounselingBoth individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medication-assisted treatment is not available.As long as desiredHours Per Day:

1-2

 

Days Per Week:

1-3

Support GroupsSupport groups center on maintaining abstinence after another form of treatment. Typically meet one day a week for 1-2 hours.As long as desiredHours Per Day:

1-2

Days Per Week:

1

VIII. Behavioral and Medication-Assisted Therapies

Behavioral therapy for substance addiction seeks to identify and manage addictive behaviors that lead to use and prevent relapse. Behavioral therapy is based on the concept that all behavior is learned, and thus, unhealthy behavior can be changed through learning coping skills and increasing awareness of negative thoughts and beliefs that contribute to substance abuse.

Medication-assisted therapy is an approach that acknowledges both the physical and psychological aspects of addiction and recovery. Users who participate in medication-assisted therapy may receive medications to reduce their cravings and control withdrawal symptoms, participate in behavioral therapies, and receive counseling from licensed professionals.

Behavioral Therapies for Codeine Addiction
Type of TherapyDefinition
Cognitive-Behavioral Therapy

 

Further reading:

Cognitive-behavioral therapy, often referred to as CBT, is a structured form of psychotherapy that helps users develop appropriate coping strategies. With the right tools and strategies, users can stop using codeine and avoid relapse in the future.

 

While participating in CBT, the user sets goals related to ways of acting, feeling, and thinking. For example, the user might set a goal of learning how to avoid negative thinking.

The Matrix Model

 

Further reading:

The Matrix Model was developed to help stimulant users control their addictions, but it is now being used in the treatment of other substance use disorders. Within the Matrix Model, the therapist is viewed as a coach. The user learns about addiction and relapse, develops positive behaviors, and gains tools that can help them stay on the road to recovery.

 

Treatment plans incorporating the Matrix Model focus on healthy lifestyle changes, family involvement, and participation in 12-step programs.

IX. How to Find Help

When searching for a rehabilitation program for codeine addiction, it is essential to find a program that offers medically-managed detoxification, as medical supervision makes the withdrawal process safer for codeine users and may help prevent some of the most severe side effects associated with withdrawal. A facility with experienced treatment professionals can provide both medical supervision and social support, reducing the risk of relapse once the user has completed the program.

Rehabilitation centers that offer a wide range of services, including support groups and behavioral therapy sessions with licensed professionals, can help the individual recover from codeine addiction and learn how to avoid addiction triggers in the future. Facilities that offer cognitive-behavioral therapy, programs based on the Matrix Model, and medication-assisted treatment may be the most helpful for codeine users.

Our Directory

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.