Opioid Withdrawal | Symptoms, Timeline, Dangers, & Treatment

Those who use opioids will naturally become dependent on them over time, leading to uncomfortable and potentially dangerous withdrawal symptoms upon discontinuation. This can be a major obstacle for opioid addiction recovery, though withdrawal can be managed with professional tapering/medical detoxification programs.

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Opioid-class drugs include both naturally-occurring opiates and a wide variety of man-made synthetic and semi-synthetic opioid drugs, all of which are regulated as controlled substances.

While prescription opioids like oxycodone (OxyContin) are prescribed to treat acute and chronic pain, illicit opioids like heroin and fentanyl are notoriously addictive and lethal street drugs abused for their euphoric effects.

Regardless of the specific opioid drug a person takes, the longer they regularly use it the more the body will begin to adapt and become reliant on that drug’s effects.

This is known as opioid dependence, and after it develops a person will not be able to stop using opioids without experiencing uncomfortable and potentially hazardous opioid withdrawal symptoms.

Opioid Withdrawal Symptoms

All opioids work by binding to opioid receptors in the central nervous system to produce analgesic (pain-relieving), anxiolytic (anxiety-relieving), and euphoric effects.

However, different drugs and formulations can vary wildly in potency, duration of effect, medical application, and potential risk.

These differences also impact the potential withdrawal symptoms different opioids are most likely to produce after prolonged use.

For example, immediate-release or short-acting opioids produce withdrawal symptoms with a shorter onset and greater intensity, but shorter duration than long-acting or extended-release opioid medications.

The most common symptoms associated with opioid withdrawal syndrome include:

  • drug cravings
  • nausea and vomiting
  • irritability
  • anxiety
  • restlessness
  • depression
  • trouble sleeping
  • watery eyes
  • blurry vision
  • runny nose
  • sweating
  • yawning
  • shortness of breath
  • stomach cramping
  • diarrhea
  • heart palpitations
  • goosebumps
  • muscle twitching
  • muscle aches

Opioid Withdrawal Timeline

The symptoms and timeline of opiate withdrawal can vary from person to person depending on a variety of factors. These include the type of opioid drug a person was using, their dosage and frequency of drug use, their overall health, and the emotional and social support they have on-hand.

Early Withdrawal

The first symptoms of opioid withdrawal usually begin sometime during the first 1-2 days after a person’s last dose and may involve a sense of anxiety, irritability, feelings of illness, a desire to take more opioid drugs, and gradually increasing physical withdrawal symptoms.

Peak Withdrawal

Physical and mental withdrawal symptoms increase as the drug in the person’s body is fully metabolized and removed from their system.

This stage of withdrawal usually begins 1-3 days after early withdrawal and lasts for 2-4 days. It often features flu-like symptoms including nausea, vomiting, diarrhea, muscle aches, changes in blood pressure, sweating, chills, insomnia, agitation, and depression.

Late Withdrawal

Withdrawal symptoms will tend to ease and lighten as the body reestablishes its normal internal chemistry. Acute withdrawal is generally finished after 1-2 weeks, though some lingering fatigue, cravings, and mood swings are possible.

Post-Acute Withdrawal Syndrome

After withdrawing from an opioid drug, a person will sometimes experience long-term recurrent psychological withdrawal symptoms including cravings, concentration problems, anxiety, or depression. This condition is known as post-acute withdrawal syndrome, or PAWS.

PAWS can be long-lasting but will improve and resolve with time and continued abstinence from opioid abuse.

Dangers Of Opioid Withdrawal

Opioid withdrawal symptoms can be extremely uncomfortable and mentally, emotionally, and physically challenging. However, they are generally not life threatening on their own.

However, withdrawing from an opioid drug cold turkey and without help can put a person at an increased risk of hazards, including:

  • severe dehydration
  • mental health crises
  • suicide
  • relapsing drug abuse
  • drug overdose

For this reason, clinicians and other healthcare professionals strongly advise participation in medical detox or tapering programs for those who want to discontinue their use of opioids after physical dependence has set in.

Opioid Addiction Treatment Options

Opioid use disorder (opioid addiction) is a serious condition that can cause a wide variety of other long-term mental and physical issues for those who experience it. It is also strongly associated with opioid overdose, which can be reversed using naloxone.

A number of evidence-based treatment options have been developed to treat opioid dependence and opioid use disorder in modern recovery centers, including:

  • tapering programs, in which a participant’s dosage is slowly reduced over time to give the body a chance to adjust and prevent the most severe withdrawal symptoms
  • medical detoxification, in which a participant is closely monitored and supported by healthcare providers as they work through the process of acute opiate withdrawal
  • outpatient care, offering flexible treatment for those who prefer to continue living at home while commuting to scheduled treatment
  • appointments for individual or group counseling and other interventions
  • inpatient care, a highly regimented and intensive treatment format that brings participants into a comfortable residential treatment facility for extensive counseling, behavioral therapy, peer support, dual diagnosis care for co-occurring mental health issues, and other treatment options
  • medication-assisted treatment options, including naltrexone (an opioid-receptor antagonist), methadone maintenance therapy (a long-acting opioid), or buprenorphine (Suboxone) maintenance therapy (a partial opioid-receptor agonist)
  • aftercare support services

Located in Canton, Massachusetts, Bedrock Recovery Center offers leading treatment programs for all forms of substance use disorder, including opioid addiction and abuse. Contact us today to begin or continue your recovery journey.

  1. Journal of Addiction Medicine — Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590307/
  2. Food and Drug Administration (FDA) — FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes
  3. National Institute on Drug Abuse (NIDA) — Medications for Opioid Overdose, Withdrawal, & Addiction https://nida.nih.gov/research-topics/opioids/medications-opioid-overdose-withdrawal-addiction-infographic
  4. Substance Abuse and Mental Health Services Administration (SAMHSA) — Medications for Substance Use Disorders https://www.samhsa.gov/medications-substance-use-disorders

Written by Bedrock Recovery Center Editorial Team

Published on: August 23, 2023

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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