Opioid Withdrawal Timeline

An image of a woman on a beach going through the Opioid Withdrawal Timeline
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By: Renaissance Recovery

Clinically Reviewed by: Diana Vo, LMFT

Last Updated:


Authored By: Joe Gilmore

Table of Contents

The opioid withdrawal timeline is similar regardless of the type of opioids involved, typically lasting for between four and ten days.

Opioid withdrawal can be uncomfortable, and you may also experience intense cravings for opioids during detox. The process can be streamlined, and symptoms alleviated if you engage with a supervised medical detox.

Timeline of Opioid Withdrawal

The long-term use of opioids, even when used as prescribed, causes tolerance to build rapidly. Tolerance forms as a result of your body becoming desensitized to the rewarding and pain-relieving properties of opioids. This often triggers a vicious cycle with people using more and more opioids to achieve the same effect.

The sustained abuse of any type of opioid, whether prescription painkillers or heroin, causes changes to brain chemistry as the brain’s nerve receptors become dependent on opioids. When you become physically dependent on opioids, you will need the substance to function normally, and adverse withdrawal symptoms will present in the absence of opioids.

Regardless of what type of opioid is abused, withdrawal symptoms are broadly similar. Expect any of the following symptoms to manifest during detox:

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

The opioid withdrawal symptoms timeline varies depending on the following factors:

  • Type of opioid being abused
  • Duration of opioid abuse
  • Amount of opioid being abused

The first withdrawal symptoms present from 8 to 36 hours after last opioid use.

Following the onset of withdrawal symptoms, opioid detox typically takes from four to ten days. In some cases, the acute opioid withdrawal timeline may occur over a month or so – more on this below.

First, here is the standard opioid detox and withdrawal timeline:

Day 1 of opioid withdrawal

Withdrawal symptoms from short-acting opioids – codeine, fentanyl, and heroin – normally appear after 8 hours to 12 hours from the last dose.

Immediate withdrawal symptoms include:

  • Aggression
  • Irritability
  • Anxiety
  • Cravings for opioids
  • Headaches
  • Muscular aches and pains
  • Insomnia
  • Appetite loss

Day 2 of opioid withdrawal

If you are detoxing from long-acting opioids such as extended-release oxycodone pills, on the other hand, withdrawal symptoms present after 24 to 48 hours of abstinence from opioids.

Alongside the above symptoms, you may also experience:

  • Runny nose
  • Excessive sweating
  • Upset stomach
  • Disrupted sleep patterns
  • Panic attacks

Day 3 of opioid withdrawal

During the third day of opioid withdrawal, symptoms peak if short-acting opioids are involved.

This phase of withdrawal is characterized by nausea, vomiting, and diarrhea.

You may find that the above symptoms also persist.

Day 4 of opioid withdrawal

If you are detoxing from long-acting opioids, withdrawal symptoms should peak during the fourth day.

In addition to the above symptoms, you may encounter the following symptoms:

  • Fatigue
  • Tremors
  • GI disturbances
  • Cramps
  • Enlarged pupils

Day 7 of opioid withdrawal

After a week of opioid withdrawal, symptoms should subside. Feelings of depression, fatigue may linger. It may also take a few weeks for your sleeping patterns to normalize.

For those who experience PAWS (post-acute withdrawal syndrome), opioids withdrawal symptoms linger for months after becoming abstinent. Symptoms of PAWS often include:

  • Episodes of depression
  • Fatigue
  • Irritability
  • Sleep disturbances
  • Intense cravings for opioids
An image of a man going through the Opioid Withdrawal Timeline

How Long Does Opioid Withdrawal Last?

The duration and onset of opioid withdrawal is contingent on the following variables:

  • Type of opioid being abused
  • Duration of opioid abuse
  • Time between opioid doses
  • Onset of symptoms
  • Severity of symptoms

When detoxing from short-acting opioid painkillers or illicit narcotic heroin, the presentation of symptoms occurs within a few hours of the last dose, continuing for a week or so.

The onset of withdrawal is delayed with long-acting opioids. Withdrawal is also more protracted with this type of opioid.

The following factors can also influence the duration of opioid withdrawal:

  • Your physical and mental health
  • Levels of opioids in your system
  • Extent and duration of opioid abuse
  • Genetics
  • Type of detox (clinical or home)

Opioid Addiction Treatment at Renaissance Recovery

While opioids are fiercely addictive, opioid use disorder responds favorably to treatment with a combination of MAT (medication-assisted treatment) and behavioral interventions like CBT (cognitive behavioral therapy). We can help you kickstart your recovery here at Renaissance Recovery.

We specialize in the outpatient treatment of opioid addiction, offering you a more flexible and affordable route to recovery than residential rehab. If you require more time commitment than a traditional outpatient program provides, we also offer an IOP (intensive outpatient program) and a PHP (partial hospitalization program) for opioid addiction here at our luxury Orange County rehab.

All of our opioid use disorder treatment programs draw from these research-backed therapies:

Once you complete your treatment program, you may step down to a less intensive form of therapy or you might be ready to transition directly into sober living.

We can connect you with supervised medical detox centers throughout Southern California to streamline your opioid withdrawal. We can then deliver comprehensive and evidence-based treatment to help you build a solid foundation for continued abstinence after rehab.

Start moving away from opioid addiction today by reaching out to Renaissance at 866.330.9449.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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