Cold Turkey.

1. Cold Turkey.

Stopping cold turkey simply involves cutting out the tablets with a sudden stop rather than a by a gradual reduction. This is the fastest way to stop but harshest in the form of withdrawl effects. The effects vary from person to person and can be as easy as slight diarrhoea ranging up to a full range of withdrawl effects. Some of the effects you could experience include:-

  • Joint and muscle aches and cramps
  • Flu like symptoms
  • Insomnia
  • Restless legs
  • Headache & Migrane
  • Diarrhoea
  • Vomiting
  • Runny nose
  • Panic and anxiety
  • Lethargy
  • Profuse sweating
  • Stomach cramps

This list is not definitive and effects vary. What one person experiences, the next may not. Also, the severity varies also. A person on a high codeine dose may suffer less effects than a person on a lower dose. Codeinefree visitors report that the withdrawl effects kick in around the day 2 - 3, peaking around day 7 before rapidly easing off therafter. Using Loperamide can help to ease Diarrhoea, warm (not hot!) Lavendar baths and gentle exercise can help with muscle cramps and pains. Plain paracetamol and ibuprofen can also help with headache and joint pains.

If you can confide in a partner, relative or close friend, the support that they can offer can make a world of difference.

Taper Plan

2. Taper Plan.

A taper plan or, slow taper, is a way of coming off codeine which minimises the withdrawl side effects. Basically, all you need to do is to sit down and work out your average daily intake of tablets. Start by asking yourself "Is this the minimum I can take?". If you take 15 tablets/day, ask yourself if you could start on 10 or 12. Also give consideration on how quickly or slowly you want to taper down. You could drop one tablet a week, 1/2 tablet twice weekly, 1/2 tablet per week, just decide on what you are comfortable with.

If you're taking the more expensive "Branded" products, consider swapping to less expensive generics as your first drop.

On week 1 of your taper plan, take this amount of tablets spaced evenly throughout the day. How you space them out is up to you, it could be one at a time at more frequent intervals or 2 at a time at less frequent intervals. It is really up to you on how you start. Just plan it out on how you feel you could best cope.

If, after the first week, you feel settled then do your first planned drop and take this new lower amount of tablets per week. If at any time you feel unsettled or uncomfortable about taking a drop, just stay on your current level for another week.

Just DON'T cheat by sneaking in an extra tablet or 2. This will just make your next drop much much harder. If you feel unsettled about doing your next drop, put it off for a week. It's far better to stabilise before doing a drop than risking failure by dropping when you're not ready.

If you take 8 tablets a day and want to reduce at the rate of 1 tablet/week, an example taper plan could be:-

Week 1 - 8 tablets per day - 2 at a time, evenly spaced
Week 2 - 7 tablets per day
Week 3 - 6 tablets per day
Week 4 - 5 tablets per day
Week 5 - 4 tablets per day - Treat yourself to a reward - You deserve it!
Week 6 - 3 tablets per day
Week 7 - 2 tablets per day
Week 8 - 1 tablets per day
Week 9 - Codeine Free!!!!

Obviously, this is a generalisation and you need to give consideration to what you are taking. eg. If you are taking two products then you need to consider this when working out your plan, in particular your daily intake.

Substitute Therapy

3. Substitute Therapy.

Substitute therapy involves swapping co-codamol type products onto a safer alternative. As it's the paracetamol or Ibuprofen which causes damage to the body, swapping to alternatives immediately removes these potentially harmful products. Substitutes usually do need to have the involvement of your General Practitioner (gp) or Local Drugs team.

3.1 - Using Codeine Phosphate / Dihydrocodeine.

One of the options open to your GP is to prescribe Codeine Phosphate or Dihydrocodeine. If this option is chosen, you would then be able to work out a taper plan that both yourself and gp are comfortable with. Unfortunately, Codeine Phosphate or Dihydrocodeine are not licensed for opiate withdrawl so this option is up to how comfortable your gp is to prescribe outside the NICE guidelines. One drawback of this method of withdrawl is that, depending upon the prescription, you could have quantities available to you. Codeinefree has known of people using this form of detox to have a weekly prescription then use the entire amount within a couple of days then rely on OTC products for the rest of the week. If you feel this could be you, your gp can arrange for a daily pickup so you only have access to limited quantities.

Using Subutex or Methadone

3.2 - Using Subutex or Methadone.