Opioid Withdrawal Symptoms and Timeline

Opioid withdrawal symptoms develop after the cessation of the regular use of opioids.⁸. It can occur after therapeutic use (i.e., after a doctor has prescribed them and you use them as directed) and also when used without a doctor’s supervision (e.g., misuse of prescriptions, or using illicit opioids like heroin or OxyContin that are bought “on the streets.”

Some common opioids include: ⁴

• Heroin.
• Fentanyl.
• Oxycontin.
• Hydrocodone.
• Morphine.

Opioid Withdrawal Timeline

Opioid withdrawal symptoms vary greatly and the there are many factors that affect an individual’s withdrawal experience. These include: the specific opioid(s) used, the duration of use, the dose or amount taken, the frequency of use, individual factors (overall health and genetic makeup, medical conditions, co-occurring mental health conditions, etc.), other substances or medications taken.³

Early Opioid Withdrawal

Opioid withdrawal symptoms generally begin as soon as 8 to 12 hours after stopping use.⁸ The speed with which symptoms appear and the severity of the symptoms on onset can heavily depend on the half-life of the opioid used.⁸ Symptoms after taking extended-release formulations may not begin for 12-24 hours and symptoms after taking opioids with a longer half-life may take 2 to 4 days to appear.⁸ Heroin withdrawal symptoms generally appear within 8 to 12 hours.³

The symptoms of early opioid withdrawal can vary greatly, but may include:⁷

• Runny nose or tearing eyes (or both).
• Sweating.
• Restlessness.
• Insomnia.
• Abdominal cramps.
• Nausea.
• Bone, muscle and joint pain.
• Chills and piloerection (goose bumps).
• Muscle spasms.

Not everyone will experience all the symptoms and severity of some may be worse than others. There are a variety of opioid withdrawal medications that can be used to lessen the severity of symptoms or eliminate withdrawal symptoms altogether, which can also significantly reduce the risk of returning to opioid use or relapse.⁷

Fully Developed Opioid Withdrawal

Opioid withdrawal symptoms for short acting opioids (including extended-release formulations) are fully developed 1 to 3 days after last opioid use.⁷ Withdrawal symptoms from long-acting opioids are fully developed roughly 3 to 4 days after cessation of use.⁷

Symptoms of fully developed opioid withdrawal may include symptoms of early withdrawal as well as:⁷

• Anxiety or extreme restlessness
• Decreased appetite
• Tachycardia (increased pulse)
• Hypertension (increased blood pressure)
• Fever
• Increased respiratory rate (faster breathing)
• Vomiting
• Diarrhea
• Dehydration

Not everyone will experience all symptoms, and some people will experience them with greater severity. Medical management of withdrawal can significantly reduce the severity of symptoms and may even eliminate withdrawal symptoms.⁷

Resolution of Initial/Acute Opioid Withdrawal

After withdrawal symptoms are fully developed, they will gradually subside. For short-acting opioids, this will occur within 7 to 10 days after stopping opioid use.⁷  For long-acting opioids this may take 2 to 4 weeks.⁷

How Long Does Opioid Withdrawal Last?

As stated previously, acute withdrawal symptoms generally subside after 7 to 10 days for short-acting opioids and after 2 to 4 weeks for long-acting opioids.⁷ Many people experience a prolonged phase of symptoms that include dysphoria (i.e., general dissatisfaction or uneasiness about life), craving, insomnia, and a heightened sensitivity to pain (i.e., hyperalgesia) that may last several months after initial withdrawal symptoms subside.⁷

Medications for Opioid Withdrawal

Experiencing opioid withdrawal symptoms without medical assistance can produce needless suffering in people who are already vulnerable emotionally and physically and can increase the risk of returning to opioid use or relapse.³ There are two medications, methadone and buprenorphine, that are FDA-approved to treat opioid use disorder and can help manage the intensity and discomfort of opioid withdrawal.^3. 

The resolution of acute withdrawal symptoms does not mean the end of treatment for opioid use disorder. Opioid detox is an important first step in the treatment process but is rarely sufficient in supporting long-term abstinence from illicit opioid use or opioid misuse.⁶

In addition to alleviating and sometimes even eliminating withdrawal symptoms, some of the medications used during withdrawal management can be continued in the ongoing treatment and management of opioid use disorders. Both methadone and buprenorphine, as well as naltrexone, blunt or block the effects of illicit opioids and reduce or eliminate cravings, helping a person to focus on their recovery and management of opioid use disorder.⁷ A physician or trained clinician can provide a proper assessment or evaluation to help determine the appropriate level of care after detox and any medications that will be part of your individualized treatment plan. Inpatient or outpatient care, in addition to medications, may be recommended following detox. Group and individual counseling, as well as other behavioral therapies can provide you with additional support and relapse prevention skills that will be invaluable during your recovery.⁶

Finding Opioid Detox Programs Near Me

If you’re struggling with opioid use and are ready to take a first step toward recovery, it may be time to learn about an opioid detox or addiction treatment program. A good first step would be to reach out to a doctor or trusted medical professional. They may be able to help determine your medical needs and possibly refer you to a nearby opioid detox facility.

If you don’t already have a physician to consult, the Substance Abuse and Mental Health Services Administration has a treatment locator on their website to help you find available treatment centers in your local area.

American Addiction Centers (AAC) has an addiction helpline that can help answer your questions about opioid detox, treatment insurance coverage, and more. Our admissions navigators on staff 24 hours a day, 7 days a week to help guide you through the process and answer any questions you may have. Call to talk to someone today.

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