Opioids PAWS from codeine?

[Crepsirezzell]

Hi, I have been using codeine on and off for about two years recently I have been using doses of 210-240 mg for a period of three months dosing 5/7 days a week.

during this period I have been drinking pod tea when I couldn't get any codeine but note that the pods were very weak and each cup I drank felt like 60 mg codeine but lasted all day, drank PT about 8 times during the three months.

I was still not using 2/7 days though, but never not using two days in a row.

so about 210 mg codeine 5/7 days a week for three months with a little pod tea that was very weak.

My questions are:

1 Is there a chance I could get post acute withdrawal syndrome?

2 If I were to develop this, how severe do you think it would be?

(Sorry if I dragged this out ... shit I'm still rambling on... )

 

[stray cat]

i would say your chances of getting something like paws are probably higher than getting severe physical wd. it sounds like you have been doing codeine for a while and that you have escalated to pretty consistent usage in the past few months. i imagine that using opiates (codeine/pt) has started to dominate your thoughts more than before. when you stop, you may experience some depression for a while, and it will probably feel like there is a hole in your life where the codeine used to be. if your activities have been mainly centered around using those drugs for a bit, then it may feel weird trying to find new things to do/focus on. then again, codeine is fairly weak on the opiate scale, and 3 months almost daily is not that long. that's why i would think you'd probably experience more of a mental than physical thing if you do have negative effects from stopping, but you may not have any severe aftereffects at all. or it could be awful, lol. it can vary from person to person, so i guess the only way to know for sure is to go through it. good luck!

EDIT: also, i'm not sure if what i'm talking about would necessarily/technically be classified as post acute withdrawal syndrome in your case, but i'm just referring to lingering negative mental aftereffects like depression, anxiety, etc.

 

[monstanoodle]

PAWS and the chances of experiencing them have a few factors.
Obviously there's dose, length of use and your predisposition to Depression in the first place.

It's likely that you'll feel slightly crappy but I wouldn't imagine it being anything major at all. It'll just be like yer experiencing a few days down in the dumps. So I wouldn't worry too much
Then again I suffer from Depression myself and I've found myself being able to cope with it better than I did when I first noticed it becoming really intense (this isn't shlong-sizing, just fact).

So I suppose another factor is how well you're able to deal with Depression.

 

[Mr Blonde]

I have some PAWS from codeine use, but I was using in doses up to 2 grams and that was daily use for about three years.

PAWS effects for me include depression, the worst part is the anxiety as I was using codeine as an anxiolytic and the rebound anxiety is very overwhelming sometimes but I'm dealing with it.

 

[Deluded]

Since codeine isnt active, you are basically dependant on about 15-30mgs of morphine. You didnt say how many times a day you dosed? If only once then you will be fine, but if you are using the amount you said multiple times a day, then that quickly accumulates to a fair amount of morphine, which is codeine's parent and metabolic drug.

You spoke of getting pod tea when codeine wasnt available, so the fact that you needed another opiate when out of your DOC, leads me to believe you are physically dependant on opiates, do correct me if Im wrong. The question is, how psychologically dependant are you on opiates? If your answer is yes, then so is my answer to your question.

I hate to burst your bubble, but withdrawal from codeine dependance can actually be quite severe. Even at ceiling doses of say 350-400mg, taken every 4-6 hours, is the same as taking 150-250mgs of morphine per day depending on individual metabolism. I always said there is no such thing as codeine withdrawal, only morphine withdrawal.

Post back and answer these questions and I can give you an idea e><actly what to e><pect. I have been dependant and addicted to tylenol #4, O><ycontin, MS Contin, Hydromorph Contin/dilaudid, Fentanyl, and e><perienced all of their withdrawals.

1. What was your dose two months ago?

2. What was your dose one month ago?

3. How many times a day do you dose?

4. Assuming you do only use once a day, 5 days a week, how do you feel on the days you dont use?

5. Do you suffer from depression?

6. Do you suffer from any personality disorders?

7. Are you prescribed codeine?

8. Do you have constant access to codeine?

9 How does your family, spouse, or loved ones feel about your drug use?

I realize some of them dont make sense, but try your best to answer all of them.

 

[Mr Blonde]

^ Taking codeine multiple times a day is not easy to calculate into an equivalent morphine dose because codeine inhibits the very enzyme that metabolizes it into morphine, making redoses less effective. A multiple times a day habit can be severe but you can't easily calculate what the equivalent morphine dose is easily.

 

[Deluded]

I know........and?????????

I was basically giving a rough idea of the amounts for a near perfect metabolizer. It would be impossible to come up with an e><act number.

 

[Mr Blonde]

^ So it wouldn't be the same thing as withdrawal from the 'equivalent' dose of morphine you provided. It would be less.

Codeine WD can be severe but OP is on a fairly low dose, he will be fine if he does it cold turkey and apart from cravings I doubt he will have many problems past the acute WD stage.

 

[monstanoodle]

It's more commonly thought that yes, Morphine does play a role in Codeine's painkilling and high-baring properties, but that C6G (Codeine-6-Glucuronide) plays a larger role than first thought (possibly even the largest role with Codeine).
Around 70% of Codeine is metabolised into C6G so someone who's good at Maths can work out what they're taking

 

[Crepsirezzell]

1. What was your dose two months ago?

About 190 - 210 mg

2. What was your dose one month ago?

About 210-240

3. How many times a day do you dose?

Usually only once in the evening but if I do dose in the morning and then the evening i try to half each dose but I have found this to be a waste as dosing twise in a day can be ineffective.

4. Assuming you do only use once a day, 5 days a week, how do you feel on the days you dont use?

I feel low when I wake up knowing I cant dose and often get very depressed.

5. Do you suffer from depression?

Yes, this is why i started using in the first place.

6. Do you suffer from any personality disorders?

Yes, bipolar

7. Are you prescribed codeine?

No.

8. Do you have constant access to codeine?

Yes

9 How does your family, spouse, or loved ones feel about your drug use?

My family are unaware of the extent of my drug use but they are upset regarding the effects it has had on my life but don't realise this is the cause.

My one and only real friend wants me to stop so we are going camping at the start of the summer holidays and hopefully i would have tapered down by then.

Thanks for the response, truly appreciate it.

 

[monstanoodle]

After reading your responses to those Q's. I'd say that yes, you will suffer from PAWS for quite a while. It does sucks yes, but there are ways to try and combat it:

The main one is the keep yourself occupied - if you've a creative outlet (making music, painting / drawing, writing etc.) then this can be a good way to occupy your mind and also to get out any negative feelings you're experiencing. Sort of a kind of emotional purge
Other than that then yea you should really taper as much as you can before you decide to fully "jump off".

Codeine withdrawal was a great deal worse than I imagined it to be. I don't know why either...
With H I get RLS, cold sweats and temperature fluctuation, Depression, a bit of stomach cramping and obviously Insomnia.
With Codeine I had all that but a lot of aches and pains too, which I've not experienced much of.

It's strange that a greatly less potent Opiate could create such withdrawals... Perhaps certain metabolites (I'm thinking C6G) are more likely to cause certain withdrawal symptoms???
I dunno though, I'm fairly uninformed compared to others

Good luck with it all

 

[cornflakes]

Hi there, in reply to the OP, I'm currently in day three of cold turkey from 200mg codeine over 7 years. I even recently considered a bupe maintenance program but did my research and realized that was very much NOT FOR ME.

Having knowledge of what I was in for was very helpful. I have managed to avoid the worst of WD, minor aches and pains and a headache I just resigned myself to. I have taken time off work to do this and I am extremely pleased with myself so far.

So in your case, you're not on much more than I was. Give the turkey a go! If you arm yourself with knowledge on the topic then you're set, what's the worst that could go wrong?

72 hours for me so far. I know I'm small fry but it's a big achievement for me. Yay me!