Opioid Withdrawal & Detox

The term opioid refers to a class of drugs commonly used to relieve pain. Prescription opioids like oxycodone, hydrocodone, and morphine are widely used in clinical settings, while synthetic opioids such as fentanyl are also prescribed but carry significant risks.

Unfortunately, opioids are frequently misused and illegally distributed, with many people seeking the euphoric high these pain-killing drugs can produce. This widespread misuse has contributed to the ongoing opioid epidemic in the United States.

Even when taken as prescribed, opioids can lead to physical dependence, meaning the body adapts to the drug and requires it to feel and function normally. When the drug is reduced or absent, unpleasant withdrawal symptoms are likely to emerge.

Over time, people may develop both physical dependence and psychological addiction, leading them to seek out opioids through concerning or unsafe methods. In many cases, opioid dependent patients benefit from a medically supervised opioid withdrawal and detox program to taper safely, avoid dangerous complications, and reduce the risk of relapse.

Symptoms & Timeline for Opioid Withdrawal & Detox

When you take opioids, you’ll experience a range of effects, including pain relief, relaxation, drowsiness, and a slowed breathing rate. Many people also feel a euphoric surge of pleasure, which is one of the main reasons opioids carry such a high potential for misuse and addiction.

Opioids attach to receptors in the brain, gastrointestinal tract, and spinal cord, producing both pain relief and pleasurable feelings. Over time, the brain adapts to this heightened dopamine stimulation, reinforcing the reward system and increasing the drive to continue use.

For many, this cycle leads to physical dependence, making withdrawal symptoms unavoidable once use is reduced or stopped. Symptoms and timelines may vary from person to person, but below, we outline the most commonly reported experiences and the typical duration of the detox process.

Understanding Opioid Withdrawal

Taking opioids exactly as prescribed by your healthcare provider can offer a safe and effective approach to managing the pain associated with surgery, as well as other types of chronic physical pain.

That said, taking opioids long-term, or misusing them, usually leads to tolerance and opioid dependence. When you become physically dependent on opioids, you will experience severely unpleasant withdrawal symptoms if you decrease the dose or abruptly discontinue use. Taking more opioid medicines relieves withdrawal symptoms, which can easily perpetuate a cycle of drug abuse.

Understanding Opioid Withdrawal Symptoms

If you continue taking opioids long-term, your body will gradually become desensitized to the effects of this drug. As tolerance builds, you’ll need increasingly higher doses of opioids to achieve the same effects.

Sustained opioid abuse will trigger changes to the functioning of your brain’s nerve receptors. These receptors will become dependent on opioids, with their absence bringing about withdrawal symptoms.

The signs of opioid withdrawal are generally consistent across different types of opioids. Clinicians often use the clinical opiate withdrawal scale to evaluate the severity of these symptoms. The most common clinical manifestations include:

• Vomiting
• Nausea
• Diarrhea
• Increased body temperature
• Anxiety
• Insomnia
• Racing heart
• Chills
• Sweating
• Muscle pain
• Bone pain
• High blood pressure

Opioid Withdrawal Timeline

The opioid withdrawal timeline usually begins somewhere between 8 and 30 hours after the last dosage. The precise timing depends on the type of opiate abused, as well as other variables, including dosage and length of use.

Once underway, withdrawal typically lasts from 4 to 10 days. This is variable, and in some cases, opioid withdrawal symptoms remain for more than a month. Here is a typical opioid withdrawal timeline:

First Day After Use (24 hours)

With short-acting opioids like heroin, codeine, and fentanyl, withdrawal starts from 8 to 24 hours after the last dose of opioids.

The most common symptoms of opioid withdrawal during this period include:

• Headaches
• Anxiety
• Irritability
• Aggression
• Muscular pains
• Disrupted sleep patterns
• Loss of appetite
• Cravings for opioids

Second Day After Use (24-48 hours)

With long-acting opioids, such as oxycodone extended-release tablets, withdrawal starts 24 to 48 hours after the last dose.

The most common physical symptoms include all of those listed above in addition to:

• Panic attacks
• Runny nose
• Excessive sweating
• Insomnia
• Stomach problems

Third Day After Use (72+ hours)

For short-acting opioids, withdrawal peaks during the third day after last use.

The most common withdrawal symptoms in this phase include:

• Vomiting and diarrhea
• Muscle aches
• Nausea

You can also expect any or all of the symptoms from the first two days (listed above).

Fourth Day After Use

You’ll find the withdrawal symptoms for long-acting opioids peak during the fourth day of detox.

As well as all of the symptoms listed above, you can also expect the following side effects:

• Cramping
• Enlarged pupils
• Fatigue
• Shivering
• Gastrointestinal discomfort

Seventh Day After Use

Withdrawal symptoms start to subside, with insomnia, depression, and fatigue being the last lingering aftereffects.

PAWS (post-acute withdrawal symptoms) can last for months after the last opioid use, with common symptoms including:

• Depressed or irritable mood
• Fatigue
• Sleep disturbances
• Opioid cravings

Opiate Withdrawal Treatment

While opioid withdrawal is uncomfortable, there are many ways you can make detox easier on yourself.

With medically-supervised detox, you’ll have 24/7 support on hand with FDA-approved medications available to soothe the intensity of withdrawal symptoms. This form of structured detox can also speed up the process and reduce risks that sometimes lead to visits to the emergency department.

Detox is not a cure for opioid addiction, though, and it should be followed up by ongoing medication-assisted treatment (MAT).

Some of the medications used to streamline opioid withdrawal include:

• Antidepressants
• Benzodiazepines
• Opioid agonists
• Partial opioid agonists
• Opioid antagonists
• Non-opioid agonists
• Tapering medications

Medication-Assisted Treatment for Opioid Withdrawal

Medications can alleviate the intensity of opioid withdrawal symptoms, while at the same time minimizing cravings for opioids. This strengthens your chance of avoiding relapse.

Methadone or buprenorphine are both proven effective for reducing opioid withdrawal symptoms.

Medications can also be effective beyond detox. Both buprenorphine and methadone can stabilize brain activity and continue reducing cravings for opioids throughout the early stages of recovery.

These medications are most effective when delivered in combination with psychological interventions like counseling and cognitive behavioral therapy (CBT) sessions.

Beyond this, other “comfort” medications can be used to relieve the following:

• Anxiety – medications like hydroxyzine or buspirone
• Nausea – anti-nausea drugs such as ondansetron (Zofran)
• Vomiting – agents like promethazine or metoclopramide
• Diarrhea – loperamide (Imodium)
• Abdominal cramps – antispasmodics like dicyclomine (Bentyl)

Opioid Detox

If you or a loved one is looking for opioid addiction treatment, it is critical to start with an opiate detox program.

During detox, clients will be medically monitored as they go through the uncomfortable, and sometimes life-threatening, symptoms of withdrawal and early sobriety. At an opioid detox center, medical professionals will monitor you or your loved one 24/7 while they go through the first few days of withdrawal. The length of detox will be different for everyone, but it typically lasts around 7-10 days.

During this time, the client can learn more about opioid use disorder (OUD) and addiction, which can improve recovery outcomes following detox. After detox, you will have the option to step down into lower levels of care, including inpatient rehab, partial hospitalization, or intensive outpatient programs. Detox provides the safety you or a loved one needs to navigate the uncomfortable stages of early sobriety, while setting the stage for a focused recovery and long-term sobriety.

Find Opioid Withdrawal Treatment at Renaissance Recovery

If opioid addiction has disrupted your life, Renaissance Recovery is here to help. Our personalized outpatient opiate addiction treatment programs provide a strong foundation for lasting recovery and support you through the challenges of withdrawal.

While Renaissance Recovery’s rehab centers don’t include detox or residential programming, we have trusted connections in the area to ensure you can get the support you need for any situation.

Following a medical detox, you can step into one of our outpatient levels of care:

• Partial Hospitalization Program (PHP)
• Intensive Outpatient Program (IOP)
• Outpatient Program (OP)

At every level, treatment may include MAT with FDA-approved medications, evidence-based therapies like CBT or DBT, holistic options, and both individual and group counseling.

If you’re ready to stop using opioids safely and start building lasting recovery, call us today at 866-330-9449.