Opioid Withdrawal: Signs, Symptoms & Addiction Treatment
People who are dependent on opioids can experience unpleasant and uncomfortable withdrawal symptoms when they stop using them. If you or someone you care about are struggling with opioid abuse or addiction, you may wish to learn more about opioid withdrawal and the steps you can take to minimize and cope with opioid withdrawal symptoms.
In this article, you will learn how opioids affect the brain, the signs of opioid withdrawal, the typical withdrawal timeline, and your options for opioid use disorder treatment including opioid withdrawal medications.
What Are Opioids?
Opioids are a class of drugs that include illegal substances like heroin as well as prescription painkillers, such as oxycodone, that doctors may prescribe to treat serious and/or chronic pain.1 Even when used as prescribed, prolonged opioid use can lead to dependence, which means that individuals can develop uncomfortable withdrawal symptoms when they stop using them.2
Individuals who use illicit opioids or who misuse prescription opioids, meaning they take them in ways not originally intended—such as using someone else’s prescription or taking larger quantities of the substance than was prescribed—have a greater risk of developing an opioid use disorder, a medical condition defined by the continued use of opioids despite its negative consequences on the individual’s life.2
How Do Opioids Affect the Brain?
When an individual takes an opioid, they may feel a variety of effects, including drowsiness, relaxation, and slowed breathing.3 Many people also experience a rush of pleasure, also referred to as euphoria, that they find intensely rewarding.3
Opioids bind to specific receptors in the brain and disrupt the pain signals transmitted between the body and the brain, dulling the perception of painful stimuli.4 Opioids also increase the activity of dopamine, a brain-signaling molecule with an important role in reward and reinforcing behaviors.5 This release of dopamine is associated with producing pleasure, leading to repeated drug use.3 Dopamine helps to reinforce pleasurable activities, such as exercising, engaging in a fun hobby, and spending time with friends and loved ones. So, in a sense, when dopamine is released as a result of an opioid, the drug “tells” the brain to continue behaving in the same way, which is a contributing factor to what makes opioids addictive.3
List of Commonly Prescribed Opioid Painkillers
Opioids are typically intended for short-term use, such as for pain after dental surgery, but may sometimes be prescribed for chronic pain caused by diseases like cancer as well.6 Commonly prescribed opioids include: 6
- Oxycodone (OxyContin or Percocet).
- Hydrocodone (Vicodin).
- Oxymorphone (Opana).
- Hydromorphone (Dilaudid).
- Fentanyl (Actiq, Duragesic, Sublimaze).
- Tramadol (Ultram).
- Tapentadol (Nucynta).
- Meperidine (Demerol).
Signs of Opioid Withdrawal
Opioid withdrawal can occur in anyone who is dependent on the drug, especially if they suddenly reduce their dose or stop using it altogether.7 Opioid withdrawal symptoms can range from mild to severe and may include:7-8
- Nausea and vomiting.
- Increased body temperature.
- Racing heart.
- Muscle and bone pain.
- High blood pressure.
What Causes Opioid Withdrawal and Dependence?
When taken as prescribed by a physician, opioids can safely and significantly reduce pain associated with surgery or any type of intense physical pain.5 However, taking an opioid over a long period of time can lead to tolerance (needing to take more of the drug to achieve the same desired effect) and dependence.5 As an individual builds tolerance to opioids, they need a larger dose to get the same sensations, which often leads to taking more larger quantities of opioids.5 Eventually, an individual could become physically dependent on the drug.9 A person who is dependent on opioids will experience symptoms of withdrawal if they reduce or suddenly stop taking opioids. This can cause a vicious cycle—a person might try to cut back or stop using, and upon suffering uncomfortable withdrawal symptoms, they will begin taking the drug again to relieve the symptoms.5
Furthermore, opioids can be dangerous or even deadly if taken at too high of a dose, which can lead to extreme drowsiness, nausea, euphoria, and slowed breathing.9
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How Long Does Opioid Withdrawal Last?
Some types of opioids will cause signs of withdrawal sooner than other types of opioids; and withdrawal from some opioids will last longer than others.10-11 Withdrawal depends on the type of opioid taken—including heroin, short-acting prescription opioids, or long-acting prescription opioids—the severity of symptoms, the time of onset and duration of symptoms, the duration of opioid use, the dose taken, and the time between doses.10-11
Heroin and short-acting opioid withdrawal symptoms can typically be seen within the first 8-12 hours after last used, peak within 1-3 days and continue up to 7 days.11-12 Short-acting opioids, such as morphine and immediate-release formulations of the medications oxycodone, hydrocodone, and fentanyl, will result in withdrawal symptoms within the first 8-24 hours after the last use, and withdrawal symptoms can continue up to 10 days.13 Long-acting opioids, such as methadone and extended- or controlled-release formulations of the medications morphine, oxycodone, hydrocodone, and fentanyl will result in the first withdrawal symptoms appearing up to 36 hours after last use and can continue up to 14 days or more.13
Can Opioid Withdrawal Cause Death?
While withdrawal symptoms can be extremely uncomfortable, opioid withdrawal symptoms are not typically life-threatening.8 In some cases, complications resulting from preexisting medical conditions or health complications as a result of injection drug use could become life-threatening. There is an increased risk of overdose for individuals who return to opioid use after a period of abstinence. Someone detoxing at home or without medical oversight could experience dehydration and heart failure as a result of untreated diarrhea and vomiting.14
Opioid Detox Options & Withdrawal Treatment
Opioid withdrawal symptoms can be intensely uncomfortable and, in certain situations, there can be complications that may be dangerous and even life-threatening.7 The opioid withdrawal timeline varies from a few days to a few weeks, depending on the type of opioid that was used, how long it was used, and any other substances that may have been used in conjunction with opioids as well.15 Medically managed withdrawal, or detoxification ensures the individual remains safe and stays as comfortable as possible.
Buprenorphine and methadone may be used to alleviate symptoms of opioid withdrawal and help control cravings.13 Buprenorphine can be used to help taper someone off an opioid. Methadone and buprenorphine, as well as Suboxone—a combination of buprenorphine and naloxone—may be prescribed long term to help keep cravings under control, maintain abstinence from other illicit or prescription opioids, and reduce the risk of overdose.13
Other ancillary medications may also be used to provide relief from withdrawal symptoms, such as Clonidine for anxiety or Loperamide for diarrhea.13
It’s important to note that detoxification from opioids and being prescribed a medication to help treat opioid use disorder may only be the first step on the path to recovery.13 While, for some, medically managed detoxification can pave the way for effective, long-term addition treatment, detoxification alone is rarely sufficient to help addicted individuals achieve lasting abstinence. Thus, individuals should be encouraged to continue with some form of treatment that includes medication, counseling, and therapy for opioid use disorder.13,17
At American Addiction Centers (AAC), a leading substance abuse treatment provider with treatment centers throughout the United States, you will find a caring and knowledgeable staff that can provide you with supervised medical detox and the counseling, therapy and aftercare needed to support long-term abstinence from opioids and other drugs. Free detox treatment may be possible with insurance coverage.
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Tips for Coping with Opioid Withdrawal Symptoms
Opioid withdrawal can be painful and uncomfortable. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “hospitalization (or some form of 24-hour medical care) is generally the preferred setting for detoxification from opioids, based on principles of safety and humanitarian concerns.”
A professional medical detox can provide medication and monitoring to keep patients as safe and as comfortable as possible, as well as address any potential complications that can arise.7
Co-Occurring Mental Health Disorders and Opioid Withdrawal
Research indicates that people with mental, personality, and substance use disorders are at an increased risk for non-medical use of prescription opioids.18
Each person who needs opioid detox and treatment for an opioid use disorder will have a different treatment plan, depending on their needs.
At AAC, our staff creates an individualized treatment plan that fits your specific needs. We can help you detox from opioids with the help and guidance of our medical staff. Give us a call today at and learn more about how we can help you on your road to recovery.
Most people experience opioid withdrawal for a few days, but for others it may take several weeks. Your opioid withdrawal timeline will vary based on many different factors, including the type of opioids you have been using, whether or not you used other drugs in addition to opioids, and how long you’ve been using opioids.
Opioid withdrawal symptoms are often highly uncomfortable and can be difficult to manage without oversight in a medical detox program. Fortunately, a medical detox program can help you more safely and comfortably through opioid withdrawal, which is the first step to on the road of your recovery journey. Call our 24 hour drug hotline to explore your options for same-day admission rehab at available locations.