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Opiate Withdrawal Timeline, Symptoms, and Treatment

If you or a loved one has become dependent on opioids, you may be confused, frightened, and unsure about what to do to overcome dependence. You may be worried about managing opioid withdrawal symptoms and going through an opioid detox.

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.

How Do Opioids Affect the Brain?

When you take an opioid, you could feel a variety of effects, including drowsiness, relaxation, and slowed breathing.1 Many people also experience a rush of pleasure, also referred to as euphoria, that they find intensely rewarding.1

Opioids attach to the opioid receptors in various parts of the brain, leading to pain relief and feelings of pleasure.2 Dopamine, a chemical in the brain, is released in increased levels when the reward circuits in the brain are stimulated by opioids. This release of dopamine is associated with producing pleasure, leading to repeated drug use.1 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.1

When taken as prescribed by a physician, opioids can safely and significantly reduce pain associated with surgery or any type of intense physical pain.3 However, taking an opioid over a long period of time can lead to tolerance and dependence.3 As you build tolerance to opioids, you need a larger dose to get the same sensations as you used to, which often leads to taking more opioids than before.3 Eventually, you could become physically dependent on the drug.3 A person who is dependent on opioids will experience symptoms of withdrawal should 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 such symptoms. 3

Furthermore, opioids can be dangerous or even deadly if you take too high a dose, which can lead to extreme effects in terms of drowsiness, nausea, euphoria, and slowed breathing.4

Signs of Opioid Withdrawal

Regardless of the type of opioid used, signs of withdrawal are similar for all opioids and can include:5

  • Nausea and vomiting.
  • Diarrhea.
  • Insomnia.
  • Anxiety.
  • Increased body temperature.
  • Racing heart.
  • Muscle and bone pain.
  • Sweating.
  • Chills.
  • High blood pressure.

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.5, 6 In addition to the type of opioid taken, the severity of symptoms, time of onset and duration of symptoms, the course of withdrawal include the duration of use, the dose taken, and the time between doses.5, 6

Heroin and short-acting opioid withdrawal symptoms can typically be seen within the first 8-12 hours after last used, peaks within 1-3 days and continues up to 7 days.6, 7 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.8 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.8

timeline, symptoms and treatment for opioid withdrawal

Opioid Detox Options

Opioid withdrawal symptoms can be intensely uncomfortable and in certain situations withdrawal from opioids may be dangerous and even life-threatening.9 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 drugs that were used.Medically managed withdrawal, or detoxification, can help you make it through safely and comfortably.

One option for opioid detox is tapering, which means the dose is gradually reduced  until the person is no longer taking the drug or is maintained on an opioid maintenance drug such as buprenorphine or methadone.10 This is an option that’s typically available should you undergo a medical detox under the supervision of a physician, where you will also have the benefit of 24/7 oversight and emotional support from other staff members. Other ancillary medications may also be used to provide relief of symptoms such as Clonidine for anxiety or Loperamide for diarrhea.6, 8

Medication-assisted treatment is also helpful to control your cravings. Buprenorphine and methadone can both be used to alleviate symptoms of opioid withdrawal and control cravings. Buprenorphine can be used to help taper someone off of an opioid, and methadone and buprenorphine 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.8

It’s important to note that detoxification from opioids and being prescribed a medication to help treat opioid use disorder is only a first step on the path to recovery.8 In addition to medication, counseling and therapy are other important elements to effective treatment of opioid use disorder.8 Medication alone is not the cure.

At American Addiction Centers (AAC), a leading substance abuse treatment provider with 8 locations 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.

Did you know that your addiction treatment could be covered?

Co-Occurring Mental Health Disorders and Opioid Withdrawal

Research indicates that people with mental, personality, and substance use disorders are at increased risk for non-medical use of prescription opioids.11

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 will create 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 888-966-8152 and learn more about how we can help you on your road to recoveryIf you are a not able to call us right now, leave your contact information below and we’ll call you at your convince.

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.

 

Sources

  1. National Institute on Drug Abuse. (2020). Drugs and the brain.
  2. National Institute on Drug Abuse. (2020). Prescription opioids: DrugFacts.
  3. Kosten, T. R., & George, T. P. (2002). The neurobiology of opioid dependence: implications for treatment. Science & Practice Perspectives1(1), 13.
  4. National Institute on Drug Abuse. (2020). Prescription Opioids DrugFacts.
  5. World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings.
  6. Substance Abuse and Mental Health Treatment Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
  7. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington D.C.: American Psychiatric Association.
  8. Substance Abuse and Mental Health Treatment Services Administration. (2020). TIP 63: Medications for Opioid Use Disorder.
  9. U.S. National Library of Medicine. (2018). Opiate and opioid withdrawal.
  10. Centers for Disease Control. Pocket guide: Tapering opioids for chronic pain.
  11. National Institute on Drug Abuse. (2020). Part 1: The Connection Between Substance Use Disorders and Mental Illness.
Last Updated on July 23, 2020
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Ryan Kelley, NREMT
Industry Expert
Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS).
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