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Codeine with promethazine is an opiate containing cough syrup. It is widely abused as "syrup" or "purple drank" and the codeine in this cough syrup is very addictive.

Although less potent than heroin, codeine belongs to the same class of drugs (the opiates) as heroin, and produces a strong addiction and a syndrome of withdrawal that is quite similar to a heroin or oxycontin withdrawal.

Once addicted to codeine and promethazine, users will need to drink the syrup daily or more, to avoid feeling the pains of withdrawal.

What Does Codeine with Promethazine Do to the Brain?

Codeine enters the brain and stimulates certain receptors that make us feel very good. If you abuse codeine with regularity, the brain gets used to this easy stimulation, and will reduce the number of these "feel good" receptors. When this happens, you will need to take more codeine to feel the same effects that a smaller dose once induced, and when you don’t take any codeine, you will feel worse than normal. Once your brain has adjusted to your regular use of codeine, you are physically addicted to the drug, and will feel withdrawal pains when you don’t have it in your body.

The "feel good" receptors that codeine stimulates are also responsible for pain regulation, and this is why the withdrawal can be so unpleasant. You are not getting as much natural pain regulation as you would normally have.

What Are the Symptoms of Codeine with Promethazine Withdrawal?

Codeine with promethazine withdrawal will last in intensity for about a week. Some of the symptoms commonly experienced include:

  • Restless legs
  • Insomnia
  • Pain
  • Nausea
  • Depression
  • Vomiting
  • Headaches
  • Muscle aches
  • Others

The physical symptoms will peak in intensity after about 4 days, but the depression can last for months after a cold turkey detox.

Getting Off

There are three basic options for codeine with promethazine detox. You can try a cold turkey detox, either alone or with medical support. You can taper down the dosage over time or you can use a substitute opiate, like methadone or Suboxone.

Cold Turkey

The fastest way free from a codeine and promethazine addiction is by simply stopping completely, and enduring a very tough week of opioid detox pains. Depending on the length and intensity of your addiction, the cravings and pains can be very severe, and an unassisted detox is a very tough week.

If possible, a better option is to detox under medical supervision. By detoxing in a medical clinic, you ensure the safety of the detox, you receive non addictive medications for symptoms management and you get therapeutic support and education, to help you better understand the addiction, and to learn how you might stay drug free in the future.

Cold turkey detox is tough, and for the best odds of success, some professional help is often warranted.

Tapering Off

A longer, but less intense and less painful way to break an addiction, is by slowly reducing the amount you consume in a day. The obvious advantage to tapering off is that you avoid extreme discomfort. The disadvantage is that it can take a long time. It also requires great self discipline.

As a general guideline, if you have a serious and lengthy addiction to codeine, you will not want to reduce your dosage by more than 10% per week.

Substitution

Codeine and promethazine get you high – there are substitute drugs that you can take that fool the brain into thinking you are taking codeine, but that do not get you high. By using one of these substitute medications, you can function normally once again, and avoid the pains of a cold turkey detox.

Two of the most well known opiate substitution medications are methadone and Suboxone. Methadone has been widely used for decades, but is a very addictive drug in its own right, and some people say that the ultimate battle to quit methadone is worse than the fight to quit codeine.

Suboxone is a new and improved version of methadone. It works in much the same way, but is not as addictive, and is not as easily abused. An additional advantage of Suboxone over methadone is that you can receive a monthly prescription of Suboxone from a doctor, while methadone must be taken daily in a clinic under supervision.

No Relapse

Most people that go through detox, but skip drug treatment aftercare - will relapse. Once you are free from a physical addiction to codeine, you should get some drug treatment counseling to learn how to stay drug free over the long run. Drug treatment options can include drug rehab, outpatient counseling or NA meetings.

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Page last updated Jun 10, 2014

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