Opioid withdrawal symptoms include cravings, nausea, and vomiting.
Most people experience opioid withdrawal in stages. Symptoms often start within three days and can last up to two weeks.
Withdrawal management is a first step in the process of treating opioid use disorder. Medical care can help people end their dependence on opioids safely and in relative comfort.
Stopping use of any type of opioid — including prescription pain relievers such as oxycontin (“oxy”) and synthetic opioids like fentanyl and heroin — can cause intense, flu-like symptoms. The unpleasant experience of opioid withdrawal is one reason that ending opioid use is challenging — and why many people return to using opioids if they don’t receive treatment.
There are many options to help you prepare for, manage, and treat opioid withdrawal symptoms.
Recovery from dependence on opioids is possible, and withdrawal management can be a first step.
People who abruptly stop or significantly reduce their opioid use may experience withdrawal symptoms. In almost all circumstances, withdrawal symptoms from stopping opioids are very uncomfortable but not fatal. Symptoms may be treated under the care of a medical professional in a withdrawal management or detox setting.
Here are some common physical and mental symptoms of opioid withdrawal:
People who have taken higher doses or used opioids for longer may experience stronger withdrawal symptoms. In rare cases, including among older adults and those with serious underlying health conditions, severe symptoms of withdrawal from long-term opioid use can become life-threatening. A medical professional may use an opioid withdrawal scale to measure the severity of your symptoms and determine the best way to treat them.
The discomfort of opioid withdrawal can be a barrier to stopping use of these substances. But the symptoms of opioid withdrawal are temporary and rarely life-threatening. The most unpleasant symptoms — vomiting and diarrhea — become life-threatening only if you are unable to stay hydrated. Locate a health care provider near you who can help you safely manage opioid withdrawal, receive ongoing treatment, and thrive in recovery.
When you stop using any type of opioid, you may start to feel withdrawal symptoms within eight hours of the last dose. The early signs of opioid withdrawal are sometimes compared to a bad flu. You may also become anxious or irritable.
Fast-acting opioids (e.g., heroin, illicit fentanyl, immediate-release versions of prescription opioids): Withdrawal symptoms typically start in eight to 12 hours, peak at 36 to 72 hours, and last for seven to 10 days.
Long-acting opioids (e.g., methadone and extended-release versions of prescription opioids): Withdrawal symptoms start in one to three days, peak at four to six days, and last for up to 21 days.
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Illicit fentanyl takes longer than pharmaceutical fentanyl to leave the body. Withdrawal from illicit fentanyl lasts for up to 10 days, compared with four to five days for pharmaceutical fentanyl.
Because fentanyl lingers in the fatty tissues of the body, the longer someone has used fentanyl, the longer their withdrawal can last. Some people have reported withdrawal symptoms lasting for weeks or even months, a phenomenon known as protracted withdrawal. Generally, the longer-lasting symptoms are those related to mood and sleep.
Withdrawal symptoms, especially if they are long-lasting, can cause you to feel broadly unwell and strongly crave opioids. If you experience these symptoms, it is important to remain in treatment. If you resume use of an opioid after a long period of abstaining, you will have lower tolerance for the opioid and be at higher risk of overdose.
Along with the type of opioids, other factors that affect how long withdrawal lasts include:
If you or a loved one is dependent on opioids, you should be prepared to reverse the effects of an overdose. Carry naloxone, which comes in an over-the-counter nasal spray and can reverse an opioid overdose. If you suspect someone is experiencing an opioid overdose, call 911 and administer naloxone. Keep the person awake and lying on their side until first responders arrive. Learn more about preventing an opioid overdose.
Fentanyl test strips can also help you detect whether drugs have been mixed with fentanyl, a highly dangerous opioid that can lead to a fatal overdose. Learn about using fentanyl test strips.
People from all walks of life can misuse opioids. When a person’s opioid dependence causes serious consequences to their health or social relationships, a medical professional may diagnose them with an opioid use disorder (OUD). But like other health conditions, an OUD is treatable.
If you or a loved one needs treatment, seek out a health care professional to create a recovery plan.
Withdrawal management, also known as detox, is one step in treating and recovering from opioid misuse. Advances in withdrawal management care mean that most people can end their opioid dependence safely and in relative comfort.
When you seek treatment for opioid withdrawal symptoms, a medical provider will conduct a comprehensive medical assessment, determine how best to stabilize your withdrawal symptoms, and help you find ongoing treatment.
Medical assessment. This will help your provider determine your treatment needs. Be prepared to answer questions such as:
Your provider may use a scale, such as the Clinical Opiate Withdrawal Scale, to assess the severity of your withdrawal symptoms.
Stabilizing your withdrawal symptoms. This includes determining what setting and what type of treatment would be best for you:
Finding ongoing treatment. Once stabilization is complete, your provider will connect you with post-withdrawal treatment or rehabilitation to continue your care. Ongoing treatment reduces the likelihood that you resume opioid use or experience an overdose.
After treatment concludes, providers may also recommend counseling, therapy, or a 12-step program. Learn more about sustaining your recovery after treatment.
Content reviewed by Jasleen Salwan, M.D., MPH, FASAM, June 2023.