medicine/s to ease out withdrawl symptoms of codeine addiction

[medicos]

I have been taking the cough syrups containing codiene(10mg/5ml) as one of te ingredients for the past 15 years or so. The dose ranges between 200 ml per week initially to 2500 ml per wk for the last few years. Now i want to give up this dirty habit but whenever i try to do this i fail to concentrate on my work,feel fatigue,get loose motions and feel restlessness. I live at at a place where we dont have rehabilitation centres for detoxification. Are there any medicines to ease out my withdrawl symptoms? Is it dangerous to give up my addiction at once? Please help.

[medicos]

I am writting this question,sir, with hope that i will get response. I am now 43 days clean but after i stopped drugs i faced lot of problems which went after consulting docs except one. The puffiness of face and eyes particularly left side and the hands. Although, i consulted physicians but i couldn't tell them about my addiction. Is this problem because of withdrawls and do i need to take any medicine for this ? I shall feel highly obliged for your help, doctor ? This problm is continously taking my mind towards relapse which i never wish.

[medicos]

Thankyou very much sir. In my case it is simply codeine and chloropheneramine maleate and nothing else. However,i am smoker also. Just tobbaco,brands like 555 or Dunhill available in market. It is because of this i feel chest congestion and all that. One thing is certain,sir! i am not in a group and have never tried before.

[J T Junig, MD PhD]

Assuming that your medication does not contain barbiturates or benzodiazepines, there is no significant risk of death from stopping-- although as the saying goes, you 'only wish you were dead.'  Opioids like codeine (which is converted to morphine in the liver) cause a miserable withdrawal when discontinued, but the withdrawal is not fatal.  The other components of most cough medicines, like acetaminophen, hydroxyzine, or phenylephrine are also OK to simply stop taking.

Clonidine is a medication that is generally used to ease the symptoms of opioid withdrawal.  To be honest, though, clonidine is only slightly helpful, and comes with its own side effects like sedation, dry mouth, fatigue, and dizziness.  Opioid withdrawal can be very severe in people taking high-potency opioids like heroin, fentanyl, or oxycodone-- so severe that people generally cannot even walk during the first week, and the legs are kicking uncontrollably. In those cases, clonidine may make more sense than in the case of withdrawal from less-potent opioids like codeine.

Imodium can help as well, by reducing diarrhea and cramping.  Tylenol or ibuprofen helps with body aches.  A hot bath does wonders for cramped muscles.  Some people swear by exercise.  Then there are drugs like ibogaine that have 'cult followings' for treating withdrawal;  I've even seen ads for ibogaine 'treatment centers' in Mexico.  I cannot recommend Ibogaine, and would recommend avoiding anything that doesn't have a clear line of quality control. You never know what might get dried and crushed, put in a baggie, and sold as 'medicine'!

The issue usually isn't so much getting through withdrawal, but staying away from the opioid afterward.  Many people relapse not when the withdrawal is severe, but as soon as the withdrawal is over (my own theory is that being sick reminds them of why they are stopping, but once they feel better, they 'forget').

Be honest with yourself, if you are in the group of people who cannot stop.  If you repeatedly violate your promises to yourself, be sure to take the action necessary to keep those promises-- whether through a maintenance program or through a sobriety-based treatment program.