Opioid withdrawal symptoms happen when a person stops using opioids after a long time of taking them. The symptoms can be severe and look like a bad flu. For the person experiencing the symptoms, the process can be very uncomfortable and worrying, however, the symptoms are generally not considered life-threatening and do eventually pass.
Here’s what you need to know about opioid withdrawal symptoms for heroin, Fentanyl, and prescription opioids.
What are Opioid Withdrawal Symptoms?
Opioid withdrawal symptoms are the physical and mental effects that somebody who is dependent on opioids experiences when they stop consuming opioids. The symptoms can happen to anyone who has a sudden reduction in opioids after long-term use.
Heroin, Fentanyl, and prescription opioids like hydrocodone (Vicodin) and oxycodone (OxyContin/Percocet) are all types of opioids that can cause withdrawal symptoms if a dependent person stops or dramatically lowers the amount they have been taking.
Symptoms include (but are not limited to):
- Intense craving for opioids
- Muscle and joint aches
- High fever
- Chills and goosebumps
- Diarrhea, nausea, vomiting
- Decreased appetite
- Anxiety
- Tremors
- High blood pressure and heartbeat
- Difficulty falling asleep and staying asleep
- Crying
- Runny nose and sneezing
- Watery eyes
- Yawning
Many people describe opioid withdrawal as like having a bad flu or an upset stomach. In one study, where people with Prescription Opioid Use Disorder rated the severity of different withdrawal symptoms, the top five were painful joints, weak knees, feeling tense and jittery, fitful sleep, and trouble getting to sleep [1].
The chances of having opioid withdrawal symptoms are high among users, due to the highly addictive nature of opioids. In fact, 85% of people who inject opioids report having opioid withdrawal [2]. Withdrawal symptoms are also very common among people who regularly use Fentanyl and opioid prescription drugs.
The intensity and duration of withdrawal symptoms, though, can vary depending on the type of opioid. Effects can also differ from person to person. For example, having a pre-existing condition like depression could influence a person’s experience of the withdrawal phase [3].
How Long Do Opioid Withdrawal Symptoms Last?
Symptoms tend to be at their worst 2-3 days after a person stops taking opioids. Withdrawal symptoms can begin as early as 6 hours after the last dose. The whole process of withdrawal, on average, takes between 5 and 7 days [4].
When opioid symptoms start, and how long they last, depends on the type of opioid and the dose amount that’s been consumed. How long the person has been using opioids for is also a factor.
Opioid Withdrawal Symptoms Timeline
Below is a rough guide to the types of symptoms and when they show during withdrawal from opioids.
Withdrawal start
Heroin – 6 to 12 hours
Fentanyl – 6 to 8 hours
Prescriptions opioids (Vicodin, OxyContin, Percocet) – 8 to 24 hours
Day 1
The person begins to show distress, cravings start, and symptoms like anxiety, restlessness, sweating, insomnia, and stomach issues may surface.
Day 2 to 4
This time is typically the peak of withdrawal. The nervous system is highly activated and symptoms manifest like vomiting, fast heart rate, chills, and muscle ache. This period brings the highest risk of relapse because of the physical and mental stress the person experiences.
Day 5
Symptoms start to reduce but the person will probably still have fatigue, problems sleeping, and feel irritable.
Week 1 onwards
At this stage, physical withdrawal symptoms will have passed but the person may have low energy, mood swings, and difficulty concentrating.
Do Withdrawal Symptoms Change Depending on the Drug and Dose?
Heroin, Fentanyl, and some opioid prescription drugs are short-acting opioids, which means they are quickly metabolized and the body can enter into a state of withdrawal fast, so withdrawal symptoms can show within a matter of hours after the last dose.
That said, withdrawal symptoms are not the same, nor do they appear, last or manifest in the exactly the same way for the three types of opioids.
For instance, some people who transitioned from using heroin to Fentanyl reported having more frequent, painful, and faster onset of withdrawal symptoms [5]. This nuance may be because Fentanyl is very potent (50 times stronger than heroin [6]) and can trigger a “precipitated withdrawal” – which is a fast, intensified experience of withdrawal symptoms [7].
Why Do Opioid Withdrawal Symptoms Happen?
Opioid withdrawal is not something that people with an opioid dependency can avoid, nor control. It’s not a punishment, and it’s not a reflection of their worth. Withdrawal is a physiological response where the body tries to regain homeostasis (regulation) after having adapted to high levels of a substance [8].
How to Safely Manage Opioid Withdrawal Symptoms
Opioid withdrawal symptoms can be strong and unpleasant, and it’s important that people experiencing them have ways to safely manage the process. Working with healthcare professionals and detox centers means accessing personalized clinical care that ensures a calm environment, physical and mental health support, and a greater chance of long-term rehabilitation.
Professionals can conduct 24/7 monitoring, as well as teach coping mechanisms that help people in withdrawal learn to regulate. In some cases, professionals may also administer medications that reduce pain and ease cravings.
Opioid withdrawal shouldn’t be a solo journey – professional guidance in a dedicated space for recovery eases withdrawal symptoms and the damaging behaviors that can fuel substance abuse.
Medical Detox and Opioid Addiction Treatment in Costa Mesa
At Renu Healthcare, we provide addiction treatment built around restoring balance across the mind, body, and nervous system. Our holistic care includes comfort-first opioid detox programs, where we offer a secure, drug-free environment during the toughest stage of recovery. Our staff are trained to help alleviate opioid cravings and emotional distress, and make the transition into ongoing treatment as smooth as possible.
Get in touch with our admissions team and start healing from day one.
FAQs
How long does opioid withdrawal last?
The duration of opioid withdrawal varies depending on the opioid that has been taken, the dose, and other factors.
On average, opioid withdrawal lasts between 5-7 days. Symptoms peak 2-3 days after a person stops taking opioids. Heroin and Fentanyl withdrawal symptoms can begin showing as early as 6 hours after the last dose. Prescription opioid withdrawal symptoms can show after 8 hours.
Is opioid withdrawal dangerous?
Opioid withdrawal can be painful and distressing, but it’s generally not considered life-threatening. However, people undergoing opioid withdrawal should seek support from medical professionals and rehab centers to safely, and successfully pass through the difficult stage of recovery.
What’s the difference between heroin, Fentanyl, and prescription opioid withdrawal?
Heroin, Fentanyl, and some opioid prescription drugs have similar withdrawal symptoms and timings. These substances are short-acting opioids, meaning they are quickly metabolized and their withdrawal symptoms manifest quickly.
However, the withdrawal experience can vary depending on the opioid and the person. For example, some people report more frequent, painful, and earlier withdrawal symptoms from Fentanyl compared to heroin.
Can opioid withdrawal be managed at home?
Withdrawal is extremely challenging. To ensure that people detoxing from opioids are safe and develop coping mechanisms to continue recovery, working with medical professionals and rehab centers can help.
Sources
[1] Drug and Alcohol Dependence, Volume 211, (1 June 2020), Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs, Science Direct
[2] Drug and Alcohol Dependence, Volume 211, (1 June 2020), Opioid withdrawal symptoms, frequency, and pain characteristics as correlates of health risk among people who inject drugs, Science Direct
[3] The Journal of Pain, Volume 25, Issue 4, (April 2024), Impact of Opioid Dose Reductions on Patient-Reported Mental Health and Suicide-Related Behavior and Relationship to Patient Choice in Tapering Decisions, Science Direct
[4] Health Direct, Opioid withdrawal symptoms
[5] Substance Use & Misuse , Volume 59, (2024), Characterizing Opioid Withdrawal Experiences and Consequences Among a Community Sample of People Who Use Opioids, Taylor & Francis Online
[6] Texas Health and Human Services, Fentanyl: One Pill Kills
[7] Stat News, Fentanyl isn’t just causing overdoses. It’s making it harder to start addiction treatment
[8] Stat Pearls [Internet], (September 2024), Withdrawal Syndromes