What Happens During Opioid Withdrawal? Symptoms, Timeline, and Treatment

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What Happens During Opioid Withdrawal

People who become addicted to opioids, including illegal drugs like heroin and prescription painkillers like oxycodone, experience withdrawal symptoms if they abruptly stop taking them. Opioid withdrawal can range from mild to severe, causing significantly uncomfortable symptoms.

In this article, you will learn how opioid addiction leads to withdrawal, what symptoms to expect, and an overview of the average withdrawal timeline. If you or someone you love are struggling with opioid addiction, a detox and treatment program like Archstone Behavioral Health can help you cope with your symptoms and begin your recovery.

What Causes Opioid Withdrawal?

When a person who is physically dependent stops taking opioids, the body reacts in the form of withdrawal. Physical dependence develops when the body adapts to the presence of opioids and requires them to function normally.

Opioids suppress the central nervous system (CNS), causing sedation and respiratory depression. The body responds to these effects by increasing CNS activity. After regular opioid use, the body adapts to functioning in this manner. Then, when the person stops taking opioids, the body reacts in an over-excited state, causing unpleasant, flu-like withdrawal symptoms.

Opioid withdrawal is generally not life-threatening. However, symptoms can be difficult to cope with alone. The best way to manage withdrawal symptoms and prevent further opioid use is to detox while under medical supervision.

Symptoms of Opioid Withdrawal

The severity and duration of withdrawal symptoms can vary depending on factors such as the type of opioid used, the dosage, the duration of use, and individual differences in physiology.

Common opioid withdrawal symptoms include:

  • Watery eyes
  • Runny nose
  • Yawning
  • Nausea, vomiting, and diarrhea
  • Insomnia
  • Anxiety
  • Cravings
  • Restlessness
  • Increased body temperature
  • Racing heart
  • Muscle aches
  • Abdominal cramping
  • Sweating
  • Chills
  • Insomnia
  • High blood pressure

How Long Does Opioid Withdrawal Last?

The length of withdrawal can vary based on the extent of use, type of opioid abused, and individual physiological factors. Short-acting opioids like heroin may produce withdrawal symptoms that begin 6-12 hours after the last dose and resolve within 5-6 days. However, when someone has been abusing long-acting opioids like methadone, it may take symptoms 2-4 days to appear and over a week to resolve.

Opioid Withdrawal Timeline

The opioid withdrawal timeline can look different from one person to the next, however, one important factor is the type of opioid someone is detoxing from.

Timeline for Short-Acting Opioids

Short-acting opioids include:

  • Heroin
  • Morphine
  • Oxycodone (Immediate-Release)
  • Hydrocodone (Immediate-Release)
  • Codeine
  • Fentanyl (Immediate-Release)


  • 6 to 12 hours after the last dose – Symptoms of withdrawal may appear as soon as six hours after the last dose of a short-acting opioid. Early symptoms include yawning, runny nose, chills, cravings, anxiety, and insomnia.
  • Days 1 to 3 – Peak withdrawal can occur as soon as 24 hours after the last dose. Physical symptoms may be at their worst and cravings are likely to be very intense.
  • Days 5 to 7 – Symptoms begin resolving after 5-7 days.

Timeline for Long-Acting Opioids

Common long-acting opioids are:

  • Oxycodone (Extended-Release)
  • Morphine (Extended-Release)
  • Hydromorphone (Extended-Release)
  • Methadone
  • Fentanyl (Extended-Release)


  • 2 to 4 days after the last dose – The withdrawal period for long-acting opioids typically begins 2-4 days after the last dose. Symptoms may get progressively worse over the first few days.
  • Days 3 to 5 – Withdrawal symptoms peak between days 3 and 5.
  • Up to 3 weeks – Symptoms usually resolve within a three-week period.

The Risks of Detoxing From Opioids Alone

Even though withdrawal doesn’t last very long, it can feel like a long time. Between physical discomfort and psychological cravings, enduring opioid withdrawal without professional support can prove challenging. Potential risks of trying to detox from opioids alone include:

  • Dehydration – Nausea, vomiting, and diarrhea can result in rehydration and electrolyte imbalances. Dehydration can be potentially life-threatening without medical treatment.
  • Relapse – Without support, many people fail to complete their opioid detox because of how uncomfortable their symptoms become. Instead, people often return to using opioids to alleviate their symptoms.
  • Cardiovascular problems – Increased blood pressure, heart rate, and body temperature during withdrawal can cause underlying heart problems to flare up.
  • Anxiety and panic attacks – Anxiety disorders can ramp up during withdrawal, sometimes leading to panic attacks.

Medical Detox

Individuals struggling with opioid use disorder can obtain the treatment they need at a medical detox center.

Medical detox for opioids can occur on an inpatient or outpatient basis. During inpatient treatment, individuals are monitored around the clock, which can promote their safety and eliminate the potential for relapse. Outpatient treatment, on the other hand, is designed for people with less severe opioid use disorders who can benefit from daily check-ins but don’t require residential care.

Opioid detox programs involve:

  • Assessment – The clinical team will evaluate your situation to determine your needs and provide an individually tailored treatment plan.
  • Medication-assisted treatment (MAT) – Medications, like Suboxone or methadone, may be prescribed to alleviate symptoms of opioid withdrawal.
  • Symptom management – Additional over-the-counter medications, such as pain medicines, may be used to alleviate any additional symptoms.
  • Therapy and counseling – Group and individual therapy sessions provide compassionate support during the detox process.

Before leaving detox, individuals will work with a counselor to set up a plan for continued treatment at an alcohol and drug rehab center. Attending treatment after detox can help reinforce sobriety.

Find Help for Opioid Abuse and Addiction

If you or a loved one are struggling with opioid addiction, Archstone Behavioral Health can help. Our complete detox and treatment programs are covered by insurance and now accepting new clients. To learn more about our programs or to get started with a confidential, risk-free assessment, please contact us today.