When to jump off a codeine taper?

[DevilishOne]

Long story short, I had a bad shoulder injury (destroyed my brachial plexus) which resulted in the major cluster of nerves in my shoulder that provide strength of movement to my arm to suffer severe damage and re-generate. They did re-generate and I got full strength and movement back but it took 18 months, a lot of physical therapy and was very painful for the first 6 months. Dr's prescribed oxycodone for longer than I knew was wise, so I tapered down to Codeine and now at the end of the 18 months am down to about 10mgs of codeine 3 x daily (no apap). Million dollar question: just "rip the band-aid off " and jump or keep tapering? In other words, feel a little uncomfortable for 20 minutes 3 times a day or just go for feeling crappy for a few days?

[Loubitan]

I think you should taper a little more each day. Why feel crappy. Taper to the point of where you are finally off the med.

[peacefulfeeling]

I agree with Loubitan if you have to maintain a moderate to high function level for work/life. I spent an extended period, almost 8 mos, prescribed some pretty heavy meds for a major illness. I went completely cold turkey and boy did I have some hard times for a couple weeks. There is some great reading, advice and methods here at PR that some have used to help that battle. Best of luck to you DelishOne.

[VictoriaIvy]

I have been on hydros 7.5 not as heavy as you, for years, I can stop for 2/3 weeks and no withdrawl, I would get some xanax, I know thats what they give you in the hospital. According to my sister who is a head E.R. nurse. They keep you from seizing, and if your not sure, maybe they should be around, just in case.

[sophie30]

I don't think seizures are very likely based on the very small dose of codeine they're taking. Also, xanax is not an anticonvulsant to begin with, its one of the few benzos that isn't, they just keep you more comfortable mentally. Personally I'd also just taper down to nothing but if you really want to jump off fast, 30 mg codeine really isn't a large amount and if anything, I'd take some valium for a few days to sleep.

[brandon7467]

At that low off a dose you'll be fine...

[alumni]

@DevilishOne
If you are only using 10mg of codeine 3 times/day, I would strongly advise you to just stop cold turkey. 30mg of codeine is approximately equipotent to just one-half of a 10mg Vicodin tablet. Any acute withdrawal symptoms should be quite brief and transitory.
There is really no need to complicate the process with Xanax or any other psychoactive substance. In my experience with self-tapering low doses such as yours, that can frequently only cause more problems.
And there's no risk of "seizure" from opioid withdrawal that I have ever heard of. Possibly the prior poster misunderstood the feedback from her sister.

[DevilishOne]

Thanks folks. I've been at 3 x 10 mg for a week, I think I'll take it down some more for another week and then jump. I'm covered as far as sleep assistance, fortunately I respond to Melatonin very favorably and I have access to zopiclone and xanax if necessary. Those I would use very minimally for a day or two, but I usually try and keep things simple and not involve other medications. kind of a takle one thing at a time and try not to substitute approach.

[Swizzlestick]

@DevilishOne

If your dose has really on been 3 x 10 mg for a week, you could jump off now and have maybe one or two days of very mild symptoms.

Don't let the anxiety of potential WD's make them worse. Hot baths, stay busy and focus on other things and try to avoid substituting another medication. Your dosage is not that high.

If Melatonin works for you, then that is a great option.

Good luck!

I should have read all threads. Just do what @alumni recommends.

[piecinitup]

Like Swizzlestick said, most WD symptoms or the severity are mental. Take a three day weekend, have some Imodium on hand, eat some bananas and go sit in the sauna and you should be golden. If you wanna get off, no need to prolong it any more than you have to.

[GreenThumb]

30mg of codeine is close to nothing, you should just stop cold...if you do get some nasty side-effects, you might consider jumping back to say 20mg or so and then continuing the taper....just to put things in perspective, I've gone from 600mg of codeine daily to 0, and had withdrawal, but it was not debilitating, so you will be fine.

[peacefulfeeling]

Good advice on the imodium! I had quite a few restroom visits! I was also on pic line rocephin at the time too so that could have ramped up potty time!

Like Swizzlestick said, most WD symptoms or the severity are mental. Take a three day weekend, have some Imodium on hand, eat some bananas and go sit in the sauna and you should be golden. If you wanna get off, no need to prolong it any more than you have to.

[DevilishOne]

Well, I'm down to around 7 or 8 mg 3X a day and I can tell that it's pretty much a done deal. I just get a little "tingly nervous energy" around 6 hours after dosing. None of the yawning or subtle dysphoria. I'll stop by the weekend. Thanks for the advice folks. It is mostly mental at this point, but after a year of 20 - 30 mg of oxycodone a day (2 or 3 10/325 percocets), it was quite physical. I had to taper that down to 10 and then jump to the weaker codeine at around 200 mg a day and then 4 - 5 weeks to get here. It's encouraging to know it can be done without impairment of work performance or family life.

[mmille42]

I wish you the best of luck, I know it isn't easy....I use to "take a break" for a couple of months and then go back on my meds cause I was ready to pull my hair out. Can't do that anymore unfortunately. I really hope you are able to stay on track and quit! I am happy for you!

[DevilishOne]

Thanks for everything folks. I'm 72 hours past my last 7 mg dose of codeine and none the worse for wear. My stomach's a little rumbly, grumbly and I have a bit of nervous energy, but I'm sure in a day or two that will pass completely. I figured I'd "pay it forward" a little and share what I learned. At the point of tapering from 3 x 10 mg doses a day to 3 x 7 (20 mg in all) I actually felt worse at the end of my 6 hour dosing interval than I felt when I just stopped. Also, exercise definitely helped. Swimming laps at the YMCA is my favorite exercise and I went yesteerday morning (40 hrs past last dose) and for a few hours after a rigorous swim, I felt the best I'd felt in quite a while. So there is some truth to the exercise to stimulate endorphins theory. I also did use DLPA (500 mg a day) for the last two weeks and I think that helped also. The best part of this is that day after tomorrow I have an 8 day vacation scheduled, and I find that witout work related stress, abstinence and moderation are much easier.

[alumni]

You've done a great job for yourself and those around you who care about you.
Congratulations and don't let the "drug fairy" start whispering in your ear on vacation.

[NotMyRealName]

I want to commend you @DevilishOne on the taper! Please keep at it and let us know how you do.

I find this thread very interesting. I am prescribed from my internist Hydro 10/325's and too many of them. The problem is I need them for pain and I also like them. If I stop taking them now I find it difficult to sleep and I get restless legs and turn back and forth all night. This might not happen after one day without but for sure it does on day two which is not fun for me or my wife. If I then take one or anything similar it stops as soon as it hits me. Does anyone else get the restlessness and restless legs?

[alumni]

Insomnia, agitation, "restless legs" are all very common symptoms of acute withdrawal syndrome.
You're obviously experiencing withdrawals after abruptly discontinuing hydrocodone for any length of time. For some people, it occurs within a few hours. For others, a couple of days.
Start up again and they disappear.

[royce]

Do you (or immediate) family have a histoy of any seizures?

I see lots of benzos used for this (short term)

I have had withdrawal seizure (s) when stopping suddenly, either accidently or on purpose. Literature discusses it but I found no good definitive answer. Need to be careful here.

I was not looking for any detinitive answer. I had absence seizures since I was a kid. I had withdrawal seizure several times, maybe five, upon the sudden cessation of a med, (accidental or on purpose) both opiate and not. I never needed to follow up because I am (was) under the care of doc. Having a seizure is actually common. My intention was not to discuss epilepsy, but to suggest caution. Sorry if I confused.

IV diazepam is routinely the drug of choice sspecifically because of it's efficacy. It stops seiaures when given IV and PO. IV would be the route of choice for emergencies. I am unaware of loss of anticonsulsant activity or properties. Valium (diazepam) is a benzodiazepam. It is not narcotic. Long half life.

[sophie30]

Do you (or immediate) family have a histoy of any seizures?

I see lots of benzos used for this (short term)

I have had withdrawal seizure (s) when stopping suddenly, either accidently or on purpose. Literature discusses it but I found no good definitive answer. Need to be careful here.

I have epilepsy and you're right, benzos are used for that, I think of the popular benzos, the only one that isn't an anti-convulsant is xanax. Diazepam generally loses its anti-convulsant properties after about six months, a good non-narcotic alternative to benzos (especially during tapering/withdrawal) is keppra. Fairly expensive but easier to obtain if you have insurance and a doctor.