Promethazine is an antihistamine remedy used to treat various conditions, such as allergies, motion sickness, and pain from surgery. This synthetic drug is also a powerful sedative, so it is often added to sleep aids and prescription medications that can cause drowsiness.
On its own, promethazine is not exceptionally addictive. However, this drug is not always used independently. Promethazine is often combined with other potentially addictive substances, namely codeine, and consumed as a drug called lean. Codeine is an opioid in an addictive substance from the same drug class as heroin, and it induces a feeling of euphoria when ingested. Combine the euphoric feeling with the powerful sedative effects of promethazine, and the result is a highly addictive drug that is relatively easy to obtain.
Withdrawing from promethazine and codeine may be somewhat challenging, but by no means should it be fatal. This is because codeine, like all opioids, binds to and activates brain opioid receptors. The drug also impacts the brain’s limbic system that controls mood and feelings of pleasure and relaxation.
As a result, as the drug leaves the body, individuals are met with physical pain and mental anguish. This withdrawal period can linger up to about a week, and some symptoms can persist even longer. Moreover, promethazine use by itself can lead to psychological dependence, which in turn causes psychological withdrawal symptoms.
Among the most common withdrawal symptoms from promethazine and codeine include the following:
- Restless leg syndrome
- Nausea and vomiting
- Drug cravings
- Muscle aches and pains
Persons undergoing detox from promethazine may experience more severe pain than they are accustomed to. This is particularly true of individuals experiencing chronic pain. Research from 2015 found that “having a prescription for methadone…or being in methadone maintenance for the treatment of opioid dependence were both…associated with promethazine use.”
When someone goes through withdrawal, be it from methadone, codeine, or another analgesic, the body eliminates the promethazine in their system. This can lead to heightened senses (hyperalgesia) and can make withdrawal quite unpleasant.
A typical detox period lasts around seven days, although, as noted, some symptoms (particularly those that are emotional in nature) can persist for longer. The first phase lasts 1-4 days, during which physical withdrawal is at its peak. A person may experience nausea, soreness, headaches, and other unwanted symptoms as codeine is purged from their system. The U.S. National Library of Medicine states that promethazine has a half-life of 12 hours, which means that its sedating effects will usually subside within 24 hours of an individual’s last dose.
The next stage of withdrawal tends to occur within 5-7 days. At this time, physical symptoms will begin to subside, and new effects will take their place. For example, instead of feeling shaky, sweaty, or nauseous, the individual may feel tired and dehydrated. This directly affects the previous four days, and these symptoms often dissipate with proper care.
Psychoemotional symptoms tend to set in during this stage too. For example, people who have had withdrawal from promethazine and codeine have reported feeling depressed around the 5th day. They have also reported having drug cravings for their drug of choice. This withdrawal period is pivotal, as these feelings can lead a person to relapse if they don’t have a solid support network.
The final stage of withdrawal typically onsets on day eight and lasts for some time after, sometimes for up to one month. At this time, almost all physical symptoms should have subsided, and the person will be fully detoxed from promethazine and codeine.
However, cravings, depression, and other psychoemotional effects remain. During this time, individuals in recovery should continue looking to their family, friends, and treatment providers for support because their sobriety is still fragile.
Navigating Promethazine Withdrawal
Whenever a person goes through withdrawal from any drug, it is best to have a medical professional available to help with any potential adverse effects. In the case of promethazine, physical withdrawal symptoms are not life-threatening though they may be very uncomfortable.
Nevertheless, having an addiction specialist or other health provider available for the individual going through withdrawal is still valid. If the person becomes dehydrated, or even if the psychological symptoms begin to feel like too much, professional intervention can make a significant difference.
Regardless of whether an individual is experiencing withdrawal from promethazine, codeine, or other substances, it is essential to remember that this stage of recovery will eventually pass. The main discomfort should only last for a few days, and loved ones and clinical staff can be there to offer support during every step. After an individual has completed the withdrawal process, they can begin therapy in a comprehensive treatment program.