One of the biggest reasons people avoid treatment for opioid use disorder is withdrawal. Those who have never had a substance abuse problem often don’t understand that “quitting cold turkey” isn’t a viable option. Aside from feeling awful, withdrawal can cause many other issues, making it nearly impossible for a person to function. Recovering from opioid use disorder takes time, commitment, and most importantly, support.
In this article, we break down the pitfalls of opioid withdrawal to help you better understand what those with addictions are going through. While Community Medical Services can help them with rehabilitation, it’s important to remember that the best thing you can do for loved ones suffering from opioid use disorder is to be there for them.
What is Opioid Withdrawal?
When a person uses any substance over a long period of time, whether it’s alcohol, drugs, or even some prescription medications, the brain adapts to the presence of the substance. This process is called “neuroadaptation.” Once these brain changes have occurred, people may not feel normal unless the substance is in their system. When you stop using this substance, you may experience uncomfortable or dangerous symptoms.
The symptoms of opioid withdrawal are severe and intense, and it can be especially difficult for someone who has not experienced opioid withdrawal to understand how uncomfortable it can be. People describe opioid withdrawal as “the worst I have ever felt in my whole life.” Sometimes they use words like “horrible” or “terrible.” These symptoms are often so terrible that they can drive people to do things they typically never would just to find relief.
What are the Symptoms of Opioid Withdrawal?
There are many possible symptoms of opioid withdrawal, but the most common are:
- Severe fatigue
- Hot/cold flashes and sweating
- Nausea, vomiting, and diarrhea
- Muscle and joint aches all over, with a worsening intensity of chronic pain issues
- Runny nose, sneezing, and watery eyes
- Insomnia
- A severe sense of restlessness
While these symptoms are rarely considered medically dangerous (with some exceptions in severe cases if standard medical treatment is unavailable), they are bad enough to prevent many people from successfully stopping opioids. It is not enough to “just say no” or “just quit.” For many, it is not humanly possible to stop opioids without help.
How Long Do Opioid Withdrawal Symptoms Last?
If a person has been using short-acting opioids such as oxycodone, heroin, or fentanyl, opioid withdrawal symptoms usually start within 12-24 hours of the last dose. These symptoms continue to worsen, usually peaking at 2-3 days. By day 5-7, most people start to feel somewhat better but still don’t feel normal. Once the “acute” phase of opioid withdrawal is over (about one week), people enter the “chronic” phase of withdrawal.
During the chronic phase, people may experience fatigue, depression, insomnia, and unease. These symptoms can persist for months. The long-term withdrawal symptoms are one reason it is so hard for many people to stay off opioids – even after they make it through the acute phase, the chronic symptoms may wear down their resolve over time.
Opioid Withdrawal Symptoms: A Timeline
Because different opioids leave the body at different speeds, withdrawal can start sooner or later depending on what someone has been using. Here’s a general timeline of how symptoms often progress.
| Stage | Typical Timing After Last Use | Common Symptoms |
| Early Withdrawal | Short-Acting Opioids: 8-24 hours Long-Acting Opioids: Up to 36 hours | Runny nose/watery eyes, sweating, yawning, chills, anxiety, restlessness, trouble sleeping |
| Symptoms Intensify | Short-Acting Opioids: 8-24 hours Long-Acting Opioids: Up to 36 hours | Dilated pupils, goosebumps, muscle twitching, worsening body aches/joint pain, stomach cramps |
| Fully Developed Withdrawal | Short-Acting Opioids: 1-3 days Long-Acting Opioids: 72-96 hours | Nausea/loss of appetite, faster heart rate, elevated blood pressure, fever, extreme restlessness |
| GI Symptoms Peak | Short-Acting Opioids: 1-3 days Long-Acting Opioids: 72-96 hours | Vomiting and/or diarrhea, dehydration risk, weakness, severe fatigue |
| Acute Symptoms | Typical Total Duration Short-acting opioids: 7-10 days Long-acting opioids: 14 days or more | Many symptoms gradually improve, but sleep, energy, and mood can take longer to stabilize |
| Post-Acute Symptoms | Weeks to months (both short- and long-acting opioids) | Low mood, cravings, insomnia, and increased pain sensitivity |
Can You Stop Opioid Withdrawal Symptoms?
The only effective method of making opioid withdrawal symptoms go away is to give someone an opioid. By giving a long-acting opioid, you can relieve withdrawal symptoms without making someone drowsy or “high.” Once someone has become physically dependent on opioids through long-term use, they need some opioids to feel normal.
Some medications can take the edge off opioid withdrawal symptoms (such as clonidine, ibuprofen, ondansetron, or others), but they are only mildly effective. If someone is trying to stop opioids “cold turkey,” these medications can help a little, but they will probably still feel miserable.
Examples of Safe Medication-Assisted Treatment
The most reliable way to quickly relieve withdrawal is with an FDA-approved medication for opioid use disorder (MOUD), especially longer-acting medications like methadone or buprenorphine that can reduce withdrawal symptoms and cravings and help the body stabilize.
Community Medical Services offers a few effective medications, including:
- Methadone is a long-acting opioid medication used in structured treatment to help stabilize the body. It can reduce withdrawal symptoms and cravings so people can function normally while they work on recovery.
- Buprenorphine medications (like Sublocade® and Brixadi) are partial opioid agonists that can relieve withdrawal symptoms and reduce cravings without producing the same effects associated with full opioids. For many patients, it supports daily stability while lowering the risk of relapse.
- Suboxone® (buprenorphine + naloxone) combines buprenorphine to ease withdrawal and cravings with naloxone to help discourage misuse. It’s commonly used as part of a supervised treatment plan that includes ongoing support.
- Naltrexone works differently than methadone or buprenorphine because it blocks opioid effects rather than relieving withdrawal. It’s typically used after someone is fully off opioids, and it may help reduce cravings and support relapse prevention.
How is Opioid Addiction Treated?
The best method for people with an addiction to opioids is for them to regularly take an FDA-approved medication such as methadone or buprenorphine so that they don’t have withdrawal symptoms and feel normal. These medications do not have any long-term medical toxicity, instead helping people feel normal and partake in all their usual activities without feeling “high.”
Once patients are ready to seek care for their opioid addiction, starting medication is the first step. This can be followed by a slow taper, helping stop taking opioids entirely without quitting “cold turkey.” Some people, however, may need to stay on methadone or buprenorphine for years, but since the medications have no adverse effects in the short or long term, staying on them may be the best option for many people.
Everyone is different, and the best way to address their opioid addiction must be individualized. A patient working with their counselor and medical provider is the best method to know what will work for them.
Frequently Asked Questions About Opioid Withdrawal
How quickly does opioid withdrawal start?
Withdrawal often begins within hours to a day after the last dose, depending on the opioid and how long it stays in the body. In general, symptoms can start sooner with short-acting opioids and later with long-acting opioids.
What’s the “worst day” of opioid withdrawal?
For many people, symptoms build over the first 1–2 days and peak around days 2–3, especially with short-acting opioids. After the peak, symptoms often start easing by days 5–7, though people may still not feel “normal” yet.
Is opioid withdrawal dangerous?
Opioid withdrawal is often not life-threatening, but it can still be medically risky, especially if someone becomes dehydrated from vomiting/diarrhea or has other health conditions. If someone can’t keep fluids down, has severe weakness/confusion, chest pain, or trouble breathing, they should seek urgent medical care.
Can you detox from opioids at home?
Some people try, but detoxing without medical supervision can be dangerous, not only during withdrawal but also afterward. Cravings combined with decreased tolerance can raise the chance of returning to use and overdose.
What is precipitated withdrawal?
Precipitated withdrawal can happen when medications like buprenorphine displace other opioids from receptors while opioids are still in the system. It’s one reason supervised treatment can be helpful; dosing and timing are tailored to reduce that risk.
Seek Help for Opioid Addiction from Community Medical Services
We know opioid addiction is difficult to get away from. We also know the pain that living with addiction can cause. If you or someone you know is ready to take their life back, Community Medical Services is here to help.
We operate more than 60 clinics across eleven states and have over 30 years of experience helping individuals fight their opioid addiction and get back to living their best life.
You are never in this alone, and we want to help you reclaim your life. We’re only ever a call or click away. Contact Community Medical Services today or find a clinic near you, and let’s move past your opioid addiction together.
