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Opioid Withdrawal

Learn about the symptoms, timeline, and treatment of opioid withdrawal.

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.

Common symptoms of opioid withdrawal

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:


  • Bone and muscle pain
  • Diarrhea
  • Difficulty sleeping
  • Dilated pupils
  • Goose bumps
  • Hot and cold flashes
  • Runny nose
  • Severe cravings
  • Uncontrolled leg movements
  • Vomiting
  • Watery eyes
  • Yawning


  • Anxiety
  • Depression
  • Irritability
  • Mania
  • Psychosis

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.

Can you die from opioid withdrawal?

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.

Opioid withdrawal timeline

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.

Opioid withdrawal timelines vary depending on the type of opioid:

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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Fentanyl withdrawal

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:

  • The duration of your substance use.
  • Whether you used more than one drug.
  • Whether you stop using the drug at once or gradually reduce the dosage.
  • Your overall health, including whether you require treatment for co-occurring physical or mental health issues.
  • Your withdrawal setting (e.g., at home, at a treatment facility, in a hospital) and level of medical care.
  • Your other support systems.

Prevent opioid overdose

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.

Protocol for treating opioid withdrawal

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:

  • What drugs have you been you taking? This includes opioids, alcohol, and other drugs.
  • When did you last take any drugs?
  • What symptoms are you experiencing?
  • Have you experienced withdrawal in the past? If so, did the withdrawal require treatment in a hospital?
  • Do you have any physical or mental health conditions?
  • Are you pregnant? Regardless of your answer, you may be asked to give a urine sample for a precautionary pregnancy test.
  • Do you have any friends or family members who would be either helpful or unhelpful to you during treatment?
  • What are your goals after you complete the withdrawal phase?

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:

  • Withdrawal management setting. Your medical assessment helps determine which type of withdrawal management setting is best for you. This can include outpatient or inpatient care.
  • Medications for opioid use disorder. Several medications — including buprenorphine, methadone, and extended-release naltrexone — can help people who are experiencing opioid withdrawal. Medication treatment for opioid use disorder may involve receiving a medication at a pharmacy or facility, with appropriate counseling on how to take the medication.

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.

Find treatment for opioid withdrawal.