Nausea, sweating, and diarrhea are just some of the possible symptoms of opioid withdrawal. How soon those symptoms start and how long they last can vary by person, but the general opioid withdrawal timeline can last 1 to 3 weeks.
Opioids are a class of drugs originally developed to manage pain. They bind to opioid receptors in your body, which are responsible for many different processes related to sensory perception, mood, and behavior reinforcement.
Opioids include opiates, drugs made from natural opium, and synthetic or semi-synthetic substances made to replicate the effects of opiates. In other words, all opiates are opioids , but not all opioids are opiates.
Common opioids include:
If you suddenly stop taking opioids or decrease your dose too quickly, your body can go through withdrawal. Withdrawal can be intense and sometimes life threatening, and how long it lasts will depend on the opioid you’ve been taking, your history of opioid use, and individual factors like your metabolism.
Typical timeline for opioid withdrawal
The opioid withdrawal timeline can vary. It depends on how long you’ve been using opioids, how frequently, and at what dose. Using multiple substances also adds complexity to withdrawal, as does your overall health and individual physical characteristics.
Generally speaking, an opioid withdrawal timeline can be gauged by the type of opioid you’ve taken: short-acting or long-acting .
Short-acting opioids
Short-acting opioids are those with rapid effects that have to be taken multiple times a day. They’re commonly used for short-term pain management or breakthrough pain in chronic conditions.
Short-acting opioid withdrawal typically begins within 8 to 24 hours of final use, and the acute or most intense symptoms last between 4 and 10 days.
Examples of short-acting opioids include:
Long-acting opioids
Long-acting opioids have prolonged effects compared with short-acting opioids. They’re often a part of chronic pain management when 24/7 therapy is necessary. Many long-acting opioids are the same base substance as short-acting opioids, just modified to have a longer duration of effect.
Long-acting opioid withdrawal typically begins within 12 to 48 hours of final use and lasts between 10 and 20 days.
Examples of long-acting opioids include:
- methadone
- morphine extended release
- oxycodone extended release
The opioid withdrawal timeline can be different for everyone. For example, you may experience symptoms sooner than expected or experience them for a longer (or shorter) time.
How long does opioid withdrawal last?
The duration of opioid withdrawal varies by individual but can generally be estimated by the type of opioid being used.
Short-acting opioid withdrawal usually starts within 8 to 24 hours of final use and lasts between 4 and 10 days. Long-acting opioid withdrawal usually starts within 12 to 48 hours of final use and lasts between 10 and 20 days.
How long you’ve been taking opioids, the dose you use, how frequently you take them, and your individual physiology can all affect your withdrawal experience.
Some symptoms of post-withdrawal, such as anxiety or depression , may last for weeks or months after your initial recovery.
Why does opioid withdrawal happen?
Opioid withdrawal occurs when your body builds up a tolerance and dependence on opioids.
After prolonged opioid use, your opioid receptors become less responsive, requiring higher doses to achieve the desired effects. This is your body’s way of maintaining internal balance or homeostasis. Because you’re supplying it with an abundance of opioids — much more than it needs — it adapts its responsiveness and function.
Abruptly stopping or decreasing opioid use throws your body out of balance again. Now, suddenly, without enough opioids to function as “normal,” withdrawal symptoms emerge as your body readjusts.
What are the signs and symptoms of opioid withdrawal?
The first symptoms you experience in opioid withdrawal can vary for the same reasons your withdrawal timeline can vary. Generally speaking, symptoms are progressive , starting mild at first and resembling those of the flu.
Within the first 24 hours, you may notice:
As you pass the 24-hour mark, current symptoms may worsen, or new ones might appear. You may also experience:
Post-acute withdrawal can last for weeks or months and typically includes mostly mental health symptoms such as:
Can opiate withdrawal be life threatening?
Although uncommon, opioid withdrawal can be life threatening . If left untreated, vomiting and diarrhea can result in severe dehydration, which can lead to dangerously elevated blood sodium levels (hypernatremia).
When blood sodium is too high, it can increase the volume of blood, increase blood pressure, cause fluid retention, and disrupt the balance of electrolytes essential to heart function. Hypernatremia can also have directly toxic effects on the heart muscle.
If blood sodium levels remain high for too long from opioid withdrawal, it can lead to heart failure.
If left untreated, the mental health symptoms of post-acute withdrawal can lead to debilitating or life threatening conditions. Check out this article to learn more about how therapy can support you during withdrawal.
How do you prevent withdrawal symptoms?
Preventing withdrawal symptoms from opioids is best done under the guidance of a medical professional. Your primary doctor, addiction specialist, or pain specialist can create a structured plan for how to safely — and gradually — decrease opioid use to minimize side effects.
For those with a risk for severe withdrawal, such as those with plan opioid use disorder, you may benefit from a stay in a care facility during guided opioid withdrawal. It’s possible to experience withdrawal symptoms even with medical guidance. Being under supervised care can also provide the opportunity to receive beneficial counseling for substance use prevention and coping.
Check out this article to learn more about resources for those going through opioid withdrawal.
Takeaway
Opioid withdrawal occurs when you suddenly stop or decrease an opioid your body has become dependent on. While the exact opioid withdrawal timeline will vary for everyone, symptoms usually begin within the first 2 days and can last for several weeks.
Your withdrawal experience will depend on the type of opioid you’ve been using, how much and how frequently you take it, and other factors like your overall health and individual physiology.
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