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  • BDD Moderators: Keif’ Richards | negrogesic

Codeine addiction

Sidban said:
I'm back on the codeine. And about to CT AGAIN! Yippee
Click to expand...

I would say it is nothing to beat yourself up about -- it is the beginning of the next step in getting clean and does not cancel the work you did before, and it is a physiological condition which can relapse -- the psychology of it is simple -- any organism, and for all we know, the robots and computers they are coming out with now, in distress will want to alleviate the problem and doing so is a basic human right. . . If you were truly failing in your efforts, you would be heading into hard-core nihilism and ceasing for that reason, which it does not sound like is what is happening.


I also am not sure the codeine habit is an apples to apples comparison to booze: unlike alcohol, codeine by itself does not create organic damage. . . What did the codeine do to your body again, and if you live in the UK, what is the main supply problem? Does it actually put you out of it enough that you cannot do what you need to during the day?

The one thing I could recommend trying to get off codeine is to not let the gastrointestinal symptoms get out of hand as they are not just a comical thing and they are potentially lethal ad extremis. Codeine is especially efficient at creating constipation, which is why it is a second-line diarrhoea and irritable bowel syndrome treatment and almost always does the job so there is no need to escalate to whole opium, morphine, or dihydrocodeine to treat the latter . . . something that may help you is loperamide in a low-moderate dose at most. It is partially cross-tolerant with codeine as it is a 4-phenylpiperidine opioid also related to normethadone and piritramide which can also lessen CNS effects of cessation and needs the dose needs to be indexed accordingly . . . a loading dose and doses of half that dose 24 and 48 hours later can keep things safe and at least halfway bearable for 72 to 108 hours depending on your metabolism.

But I would stop there and allow at least a week before attempting it again, because it is cardiotoxic at high doses and has the same neurological toxicities as pethdine and alphaprodine. It does not take a lot to close up the bowels and leak into the CNS; depending on the situation the loading dose can be as low as 10 mg and anything above 50 mg could be dangerous . . . The partial cross-tolerance also means that your codeine requirement will continue to decrease, albeit a little bit more slowly, whilst you are on it. If there is any evidence of it creating a productive cough and/or crackling noises in the lungs and/or unusual muscle movements, the loperamide should be discontinued forthwith and permanently and if needed replaced with a dose of codeine, dihydrocodeine, or a whole opium product, and those take maybe half the dose required for euphoria to work. Drowsiness from the loperamide by itself means one can go to a more conservative dose, starting at 40 per cent of the old one.

If insomnia is the major problem, any chance that you can combine tramadol with the strong antihistamine and/or diazepam at night? Any way to get nitrazepam? That helped me get off 135 mg/day of dextromoramide so I could start again with codeine or propoxyphene before I moved to the States to go to university.

good luck.
 
Last edited:
What is the dose now and how provided? If they are, for example, 30 mg tablets, one can cut them into quarters and use that as the step down -- a solution of one type or another is easier to do of course, which is why one can also dissolve tablets in liquid and get as small fraction of a dose as needed.
 
IMHO, I would give a slow taper a shot. Yes it’s work but if done nice and easy, it should be pretty smooth. There are more then a few staff here that could give you rough examples, but the point is slow. The slower you go (within reason) the more time your mind and body can adjust.

There is absolutely no shame in going to a doctor and opening up. Idk what they can offer to help you, but your choice is
a slow taper (it’s otc, 60 mg / month ) for example or see the doctor.
 
Tapering the codeine, even if it is only two or three steps, will be more likely to work. Since codeine in the forms mentioned is not a long-acting narcotic like methadone or levorphanol, the intermediate steps will not prolong the process by that much and certainly not make it worse.

For other people who may be on longer acting codeine -- I have heard of people tapering off extended-release codeine (Perduretas, Codeine Contin, and so forth) by doing the regular dose and first lengthening the dose interval to 24 hours, and then reducing those doses by cutting the tablets, or switching to immediate release like the tiny 30 mg codeine hydrochloride tablets, co-codamol, paracetamol with codeine or whatever and then tapering that. The extended-release codeine with which I am familiar can be chewed to make it immediate release, of course.

Potentiators have the other use of reducing the absolute amount of codeine used in a particular stage in a taper, with promethazine being the best, unless somehow one can obtain glutethimide.

Knowing what to expect -- here are the stages of narcotic withdrawal listed in the book Inside Narcotics in the somewhat chopped form in which they survive in Wikipedia, which really needs new people and a better attitude amongst contributors and editors especially in the drugs and other medical sections. It seems like the articles get shorter and shorter all the time and the omissions are often they most useful information, and it is not for lack of cites or whatever the excuse du jour is. In any case, here they are, and note that Stage 0 is starting to think about the drug a little more because it is getting time for a dose:


Cessation of dosing with morphine creates the prototypical opioid withdrawal syndrome, which, unlike that of barbiturates, benzodiazepines, alcohol, or sedative-hypnotics, is not fatal by itself in neurologically healthy patients without heart or lung problems.
Acute morphine withdrawal, along with that of any other opioid, proceeds through a number of stages. Other opioids differ in the intensity and length of each, and weak opioids and mixed agonist-antagonists may have acute withdrawal syndromes that do not reach the highest level. As commonly cited[by whom?], they are:
  • Stage I, 6 h to 14 h after last dose: Drug craving, anxiety, irritability, perspiration, and mild to moderate dysphoria[citation needed]
  • Stage II, 14 h to 18 h after last dose: Yawning, heavy perspiration, mild depression, lacrimation, crying, headaches, runny nose, dysphoria, also intensification of the above symptoms, "yen sleep" (a waking trance-like state)[clarification needed]
  • Stage III, 16 h to 24 h after last dose: Rhinorrhea (runny nose) and increase in other of the above, dilated pupils, piloerection (goose bumps – a purported origin of the phrase, 'cold turkey,' but in fact the phrase originated outside of drug treatment),[43] muscle twitches, hot flashes, cold flashes, aching bones and muscles, loss of appetite, and the beginning of intestinal cramping[citation needed]
  • Stage IV, 24 h to 36 h after last dose: Increase in all of the above including severe cramping and involuntary leg movements ("kicking the habit" also called restless leg syndrome), loose stool, insomnia, elevation of blood pressure, moderate elevation in body temperature, increase in frequency of breathing and tidal volume, tachycardia (elevated pulse), restlessness, nausea[citation needed]
  • Stage V, 36 h to 72 h after last dose: Increase in the above, fetal position, vomiting, free and frequent liquid diarrhea, which sometimes can accelerate the time of passage of food from mouth to out of system, weight loss of 2 kg to 5 kg per 24 h, increased white cell count, and other blood changes[citation needed]
  • Stage VI, after completion of above: Recovery of appetite and normal bowel function, beginning of transition to postacute and chronic symptoms that are mainly psychological, but may also include increased sensitivity to pain, hypertension, colitis or other gastrointestinal afflictions related to motility, and problems with weight control in either direction[citation needed]
In advanced stages of withdrawal, ultrasonographic evidence of pancreatitis has been demonstrated in some patients and is presumably attributed to spasm of the pancreatic sphincter of Oddi.[44]

from https://en.wikipedia.org/wiki/Morphine



Symptoms:

Also make a point of treating the symptoms as they appear -- there is no medical reason not to, and I don't think the symptoms build character, either.
  • Fever -- Paracetamol, then more paracetamol plus aspirin if needed; with cold beverages and food
  • Insomnia -- Sleeping preparations from benzodiazepines to carisoprodol/phenprobamate/meprobamate to barbiturates to valerian to hydroxyzine to diphenhydramine, phenyltoloxamine, dimenhydrinate, doxylamine plus paracetamol . . . diphenhydramine plus nitrazepam plus carisoprodol is a personal favourite for this.
  • Aches -- Naproxen or ibuprofen plus paracetamol
  • Nausea -- Cyclizine, hydroxyzine, meclizine, scopolamine, and the other prescription anti-emetics work, so wash them down with soda. In milder cases, soda itself is good, and here is why: Sprite, 7-Up, and especially cola drinks like Coca-Cola, Cherry Coke, Pepsi, RC, and the like are in fact medicines which were first introduced for upset stomach and paediatricians and gastroenterologists as well as other doctors and nurses and apothecaries recommend it for this reason still today. The worst cases, of course, respond to cannabis, and with vomiting is great to be able to inhale it from a bong, joint, vapouriser and so forth.
  • Vomiting -- Keep close track of nausea so that you are less likely to be vomiting up any oral medications you are taking. Make a point of sleeping in a sitting position or at least on the side and not the back and preferably not sleeping on the stomach either during a taper and other times when vomiting can happen.
  • Cramps in Legs -- Quinine plus naproxen
  • Diarrhoea and Intestinal Cramps -- Dicycloverine (Bentyl) plus loperamide, diphenoxylate, difenoxin . . . or, in severe cases, paregoric or other whole opium products or dihydrocodeine or codeine 10 mg as a last resort . . . in place of the Bentyl, trihexyphenidyl and high doses of orphenadrine also work, as do the belladonna alkaloids.
  • Run of the Mill Dysphoria -- Carisoprodol does a good job on this, as do any dopaminergic stimulants and both as the same time.
  • Overall Shitty Feeling -- Orphenadrine can help, as can tripelennamine and especially the two combined, baclofen, pregabalin, gabapentin
  • Serious Dysphoria & Temptation -- Late in the taper, or when cold-turkey withdrawal is starting to lessen, Stage V and later, something that can be done as a one-off in the case of temptation which is so extreme that it could derail the entire project when you have almost succeeded is to . . .
    • by itself or starting with a partial dose of a gabapentinoid, the above mild euphoriant mixture (orphenadrine or trihexyphenidyl plus tripelennamine), taken with a smaller than usual dose of codeine, dihydrocodeine, nicocodeine, dionine, or tramadol mixed with dextromethorphan plus doxylamine or phenyltoloxamine.
    • Another possibility, which requires prior research and should be done conservatively and as infrequently as possible is to take a moderate dose of loperamide, or preferably difenoxin (Motofen) or diphenoxylate (Lomotil) along with either hydroxyzine, cyclizine, meclozine, buclizine or another piperazine class first generation antihistamine.
    • This combination, or the other above-mentioned weak narcotics in fractional doses, can also be combined with promethazine, with codeine and dihydrocodeine working the best for this. The hydroxyzine type antihistamines and the promethazine potentiate in different ways which are at least additive to one another so do both.
    • Close to the normal dose of paregoric, Laudanum, or poppy seed tea or poppy pod tea, or codeine or DHC (or conservative dose of something stronger) combined with tripelennamine, and the preferred sleeping agent so that one can take a long, conservatively narcotised nap which does not actually end the taper but is one more dose in it.
  • Big Time Temptation -- Enough clonazepam or another benzodiazepine or meprobamate/carisioprodol/phenprobamate combined with diphenhydramine, phenyltoloxamine, or doxylamine with paracetamol and DXM to take a nap for several hours
  • Runny Nose, Sneezing -- Antihistamines either first or second generation, and decongestants like pseudoephedrine will do their usual job to some extent, but adding an actual drying agent will be more effective -- conservative doses of hyoscyamine (scopolamine) as a drying agent, or atropine, hyoscyamine, or belladonna. Other anticholinergics in higher dose should also have drying action, with diphenhydramine being the best for this purpose.
 
Last edited:
T
Nicomorphinist said:
I would say it is nothing to beat yourself up about -- it is the beginning of the next step in getting clean and does not cancel the work you did before, and it is a physiological condition which can relapse -- the psychology of it is simple -- any organism, and for all we know, the robots and computers they are coming out with now, in distress will want to alleviate the problem and doing so is a basic human right. . . If you were truly failing in your efforts, you would be heading into hard-core nihilism and ceasing for that reason, which it does not sound like is what is happening.


I also am not sure the codeine habit is an apples to apples comparison to booze: unlike alcohol, codeine by itself does not create organic damage. . . What did the codeine do to your body again, and if you live in the UK, what is the main supply problem? Does it actually put you out of it enough that you cannot do what you need to during the day?

The one thing I could recommend trying to get off codeine is to not let the gastrointestinal symptoms get out of hand as they are not just a comical thing and they are potentially lethal ad extremis. Codeine is especially efficient at creating constipation, which is why it is a second-line diarrhoea and irritable bowel syndrome treatment and almost always does the job so there is no need to escalate to whole opium, morphine, or dihydrocodeine to treat the latter . . . something that may help you is loperamide in a low-moderate dose at most. It is partially cross-tolerant with codeine as it is a 4-phenylpiperidine opioid also related to normethadone and piritramide which can also lessen CNS effects of cessation and needs the dose needs to be indexed accordingly . . . a loading dose and doses of half that dose 24 and 48 hours later can keep things safe and at least halfway bearable for 72 to 108 hours depending on your metabolism.

But I would stop there and allow at least a week before attempting it again, because it is cardiotoxic at high doses and has the same neurological toxicities as pethdine and alphaprodine. It does not take a lot to close up the bowels and leak into the CNS; depending on the situation the loading dose can be as low as 10 mg and anything above 50 mg could be dangerous . . . The partial cross-tolerance also means that your codeine requirement will continue to decrease, albeit a little bit more slowly, whilst you are on it. If there is any evidence of it creating a productive cough and/or crackling noises in the lungs and/or unusual muscle movements, the loperamide should be discontinued forthwith and permanently and if needed replaced with a dose of codeine, dihydrocodeine, or a whole opium product, and those take maybe half the dose required for euphoria to work. Drowsiness from the loperamide by itself means one can go to a more conservative dose, starting at 40 per cent of the old one.

If insomnia is the major problem, any chance that you can combine tramadol with the strong antihistamine and/or diazepam at night? Any way to get nitrazepam? That helped me get off 135 mg/day of dextromoramide so I could start again with codeine or propoxyphene before I moved to the States to go to university.

good luck.
Click to expand...
Thanks man
 
Nicomorphinist said:
Tapering the codeine, even if it is only two or three steps, will be more likely to work. Since codeine in the forms mentioned is not a long-acting narcotic like methadone or levorphanol, the intermediate steps will not prolong the process by that much and certainly not make it worse.

For other people who may be on longer acting codeine -- I have heard of people tapering off extended-release codeine (Perduretas, Codeine Contin, and so forth) by doing the regular dose and first lengthening the dose interval to 24 hours, and then reducing those doses by cutting the tablets, or switching to immediate release like the tiny 30 mg codeine hydrochloride tablets, co-codamol, paracetamol with codeine or whatever and then tapering that. The extended-release codeine with which I am familiar can be chewed to make it immediate release, of course.

Potentiators have the other use of reducing the absolute amount of codeine used in a particular stage in a taper, with promethazine being the best, unless somehow one can obtain glutethimide.

Knowing what to expect -- here are the stages of narcotic withdrawal listed in the book Inside Narcotics in the somewhat chopped form in which they survive in Wikipedia, which really needs new people and a better attitude amongst contributors and editors especially in the drugs and other medical sections. It seems like the articles get shorter and shorter all the time and the omissions are often they most useful information, and it is not for lack of cites or whatever the excuse du jour is. In any case, here they are, and note that Stage 0 is starting to think about the drug a little more because it is getting time for a dose:


Cessation of dosing with morphine creates the prototypical opioid withdrawal syndrome, which, unlike that of barbiturates, benzodiazepines, alcohol, or sedative-hypnotics, is not fatal by itself in neurologically healthy patients without heart or lung problems.
Acute morphine withdrawal, along with that of any other opioid, proceeds through a number of stages. Other opioids differ in the intensity and length of each, and weak opioids and mixed agonist-antagonists may have acute withdrawal syndromes that do not reach the highest level. As commonly cited[by whom?], they are:
  • Stage I, 6 h to 14 h after last dose: Drug craving, anxiety, irritability, perspiration, and mild to moderate dysphoria[citation needed]
  • Stage II, 14 h to 18 h after last dose: Yawning, heavy perspiration, mild depression, lacrimation, crying, headaches, runny nose, dysphoria, also intensification of the above symptoms, "yen sleep" (a waking trance-like state)[clarification needed]
  • Stage III, 16 h to 24 h after last dose: Rhinorrhea (runny nose) and increase in other of the above, dilated pupils, piloerection (goose bumps – a purported origin of the phrase, 'cold turkey,' but in fact the phrase originated outside of drug treatment),[43] muscle twitches, hot flashes, cold flashes, aching bones and muscles, loss of appetite, and the beginning of intestinal cramping[citation needed]
  • Stage IV, 24 h to 36 h after last dose: Increase in all of the above including severe cramping and involuntary leg movements ("kicking the habit" also called restless leg syndrome), loose stool, insomnia, elevation of blood pressure, moderate elevation in body temperature, increase in frequency of breathing and tidal volume, tachycardia (elevated pulse), restlessness, nausea[citation needed]
  • Stage V, 36 h to 72 h after last dose: Increase in the above, fetal position, vomiting, free and frequent liquid diarrhea, which sometimes can accelerate the time of passage of food from mouth to out of system, weight loss of 2 kg to 5 kg per 24 h, increased white cell count, and other blood changes[citation needed]
  • Stage VI, after completion of above: Recovery of appetite and normal bowel function, beginning of transition to postacute and chronic symptoms that are mainly psychological, but may also include increased sensitivity to pain, hypertension, colitis or other gastrointestinal afflictions related to motility, and problems with weight control in either direction[citation needed]
In advanced stages of withdrawal, ultrasonographic evidence of pancreatitis has been demonstrated in some patients and is presumably attributed to spasm of the pancreatic sphincter of Oddi.[44]

from https://en.wikipedia.org/wiki/Morphine



Symptoms:

Also make a point of treating the symptoms as they appear -- there is no medical reason not to, and I don't think the symptoms build character, either.
  • Fever -- Paracetamol, then more paracetamol plus aspirin if needed; with cold beverages and food
  • Insomnia -- Sleeping preparations from benzodiazepines to carisoprodol/phenprobamate/meprobamate to barbiturates to valerian to hydroxyzine to diphenhydramine, phenyltoloxamine, dimenhydrinate, doxylamine plus paracetamol . . . diphenhydramine plus nitrazepam plus carisoprodol is a personal favourite for this.
  • Aches -- Naproxen or ibuprofen plus paracetamol
  • Nausea -- Cyclizine, hydroxyzine, meclizine, scopolamine, and the other prescription anti-emetics work, so wash them down with soda. In milder cases, soda itself is good, and here is why: Sprite, 7-Up, and especially cola drinks like Coca-Cola, Cherry Coke, Pepsi, RC, and the like are in fact medicines which were first introduced for upset stomach and paediatricians and gastroenterologists as well as other doctors and nurses and apothecaries recommend it for this reason still today. The worst cases, of course, respond to cannabis, and with vomiting is great to be able to inhale it from a bong, joint, vapouriser and so forth.
  • Vomiting -- Keep close track of nausea so that you are less likely to be vomiting up any oral medications you are taking. Make a point of sleeping in a sitting position or at least on the side and not the back and preferably not sleeping on the stomach either during a taper and other times when vomiting can happen.
  • Cramps in Legs -- Quinine plus naproxen
  • Diarrhoea and Intestinal Cramps -- Dicycloverine (Bentyl) plus loperamide, diphenoxylate, difenoxin . . . or, in severe cases, paregoric or other whole opium products or dihydrocodeine or codeine 10 mg as a last resort . . . in place of the Bentyl, trihexyphenidyl and high doses of orphenadrine also work, as do the belladonna alkaloids.
  • Run of the Mill Dysphoria -- Carisoprodol does a good job on this, as do any dopaminergic stimulants and both as the same time.
  • Overall Shitty Feeling -- Orphenadrine can help, as can tripelennamine and especially the two combined, baclofen, pregabalin, gabapentin
  • Serious Dysphoria & Temptation -- Late in the taper, or when cold-turkey withdrawal is starting to lessen, Stage V and later, something that can be done as a one-off in the case of temptation which is so extreme that it could derail the entire project when you have almost succeeded is to . . .
    • by itself or starting with a partial dose of a gabapentinoid, the above mild euphoriant mixture (orphenadrine or trihexyphenidyl plus tripelennamine), taken with a smaller than usual dose of codeine, dihydrocodeine, nicocodeine, dionine, or tramadol mixed with dextromethorphan plus doxylamine or phenyltoloxamine.
    • Another possibility, which requires prior research and should be done conservatively and as infrequently as possible is to take a moderate dose of loperamide, or preferably difenoxin (Motofen) or diphenoxylate (Lomotil) along with either hydroxyzine, cyclizine, meclozine, buclizine or another piperazine class first generation antihistamine.
    • This combination, or the other above-mentioned weak narcotics in fractional doses, can also be combined with promethazine, with codeine and dihydrocodeine working the best for this. The hydroxyzine type antihistamines and the promethazine potentiate in different ways which are at least additive to one another so do both.
    • Close to the normal dose of paregoric, Laudanum, or poppy seed tea or poppy pod tea, or codeine or DHC (or conservative dose of something stronger) combined with tripelennamine, and the preferred sleeping agent so that one can take a long, conservatively narcotised nap which does not actually end the taper but is one more dose in it.
  • Big Time Temptation -- Enough clonazepam or another benzodiazepine or meprobamate/carisioprodol/phenprobamate combined with diphenhydramine, phenyltoloxamine, or doxylamine with paracetamol and DXM to take a nap for several hours
  • Runny Nose, Sneezing -- Antihistamines either first or second generation, and decongestants like pseudoephedrine will do their usual job to some extent, but adding an actual drying agent will be more effective -- conservative doses of hyoscyamine (scopolamine) as a drying agent, or atropine, hyoscyamine, or belladonna. Other anticholinergics in higher dose should also have drying action, with diphenhydramine being the best for this purpose.
Click to expand...
Thanks
 
Thanks for all the help. Most WD symptoms resided. Now to remove valium from the equation.

Not been using it as heavily but I know the WD are much worse. Long process.

Got some ketamine. Wonderful stuff. Micro doses
 
Thanks for all the help. Most WD symptoms resided. Now to remove valium from the equation.

Not been using it as heavily but I know the WD are much worse. Long process.

Got some ketamine. Wonderful stuff. Micro doses
 
Ket will help. Valium isnt quite as easy to get re-addicted to physically than any opiate in my experience. 2 weeks using a benzo and I'll get rebound anxiety and insomnia, but 4 days of any opiate and I might as well be using heroin for 6 months. Weird.
 
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