Medically Reviewed

Fentanyl Withdrawal Symptoms, Timeline, and Detox Treatment

3 min read · 6 sections
Evidence-Based Care
Expert Staff

What is Fentanyl Withdrawal?

Fentanyl is a synthetic opioid that is similar to morphine but up to 100 times more potent.1 Prescribed to treat severe pain—such as that experienced immediately following surgery—fentanyl and other synthetic opioids are also manufactured and used illicitly.1

Fentanyl can be highly addictive due to its potency.1 It is among the most common drugs involved in overdose deaths in the United States.1 In fact, new data shows that overdose deaths involving synthetic opioids—and primarily fentanyl—increased from an estimated 70,029 in 2020 to 80,816 in 2021.2

Symptoms of Fentanyl Withdrawal

Individuals who become addicted to fentanyl and try to abruptly discontinue use of the drug or drastically reduce their dose can experience fentanyl withdrawal symptoms, which may range from mild to severe, and include:3,4

  • Diarrhea and vomiting.
  • Nausea.
  • Tachycardia (increased heart rate).
  • Muscle or bone pain.
  • Hypertension (high blood pressure).
  • Insomnia.
  • Anxiety.
  • Increased body temperature.
  • Sweating.
  • Chills.

While typically not life-threatening, fentanyl withdrawal can be extremely uncomfortable, and the severity of symptoms depends on the amount, duration, type of opioid drug used, and any underlying physical and mental health conditions.3

In some cases, complications from opioid withdrawal can occur. For instance, detoxing at home or without medical oversight can leave a person severely dehydrated, causing elevated sodium levels in the blood, and potentially leading to heart failure if persistent vomiting and diarrhea go untreated.5

Additionally, there is an increased risk of overdose for individuals who return to fentanyl use after a period of abstinence due to reduced opioid tolerance.6

Fentanyl Withdrawal Timeline

The severity of fentanyl withdrawal symptoms and the onset and duration of those symptoms depend on the extent of fentanyl use (how long it was used), the dose taken, and the frequency with which it was used.7,8

Short-acting opioids, such as morphine, and immediate-release formulations of medications like fentanyl, hydrocodone, and oxycodone result in the onset of withdrawal symptoms 8 to 24 hours after the last use.3 These symptoms usually peak in intensity 36 to 72 hours after the last dose and typically continue for 7 to 10 days but may last for a few weeks.8,9

Medications such as methadone and buprenorphine can help alleviate some of the symptoms of acute opioid withdrawal. Discuss options with your healthcare provider if you or a loved one is ready to get help for an opioid use disorder (OUD).8

Take Our Substance Misuse Self-Assessment

Take our free, 5-minute substance misuse self-assessment below if you think you or someone you love might be struggling with substance misuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

Risk Factors and Causes of Fentanyl Withdrawal

Like many opioids, fentanyl’s reinforcing effects can make misuse—among illicit and prescription forms of the drug—more likely. That’s because fentanyl binds to the body’s opioid receptors, which are found in areas of the brain that control pain and emotion. Prolonged use of fentanyl can cause the brain to adapt to the drug and lead to tolerance (needing more of the drug to achieve the desired effect) and dependence.10 As an individual builds a tolerance to fentanyl, they require larger doses to get the same sensations, which leads them to take higher doses of fentanyl.10 Eventually, an individual may become physically dependent on fentanyl.11

Dependence is a physiological adaptation of the body to a substance, wherein the body becomes so used to the drug in the system that when the individual cuts back on their use or quits, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.

Research indicates that several factors impact fentanyl withdrawal and put individuals at a greater risk of repeated withdrawal episodes and more severe symptoms. These factors include:3,12

  • The frequency of fentanyl use, the dose, and the duration of use.
  • The method of administration.
  • Polysubstance use, meaning fentanyl was taken in conjunction with other substances.
  • Underlying medical and/or mental health conditions.

Fentanyl Detox and Withdrawal Treatment 

Detoxification, or medically managed withdrawal, ensures an individual stays safe and remains as comfortable as possible while their body rids itself of fentanyl and any other substances.13

Medical detox from opioids is often the first step in a more comprehensive treatment plan since detox alone is not typically sufficient to sustain long-term recovery.13

Treatment varies depending on the unique needs of each person and the severity of their opioid use disorder but addresses the multiple needs of the individual and utilizes evidence-based behavioral therapies, individual and group counseling, and medications for addiction treatment to help individuals find lasting recovery beyond detoxification and withdrawal.4,8,13

How Long is Fentanyl Detox?

The length of time it takes the body to detox from fentanyl differs from person to person. Many variables affect symptom severity, including the amount, frequency, and duration of one’s use as well as the potency of the fentanyl used.14

Medications Used in Fentanyl Detox

There are safe, effective ways to manage the symptoms of withdrawal and help control cravings.

Healthcare professionals may prescribe medications to alleviate the symptoms of withdrawal but also long term to help keep cravings under control, maintain abstinence from prescription and illicit opioids, and reduce the risk of overdose.9 These medications include:9

  • An opioid agonist, methadone stimulates the same receptors in the brain as fentanyl but does not create the high associated with fentanyl. Instead, when taken as prescribed, methadone blocks cravings and alleviates withdrawal symptoms.
  • A partial opioid agonist, buprenorphine attaches to the same receptors that fentanyl does but only partially activates, which helps ease withdrawal symptoms and cravings.

Additionally, lofexidine hydrochloride, a non-opioid treatment, approved by the FDA in 2018, can lessen the severity of withdrawal symptoms to help facilitate the discontinuation of fentanyl.15

If you or someone you love struggles with fentanyl misuse or addiction, don’t wait. Call American Addiction Centers today .

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