Opiate Withdrawal Timelines, Symptoms, and Treatment

The National Institute on Drug Abuse (NIDA) stated that about 26.4 million to 36 million people abuse opioids all around the world. In 2012 in the United States, 2.1 million people struggled with substance use disorders that were caused by prescription opioid pain relievers, and 467,000 people were addicted to heroin. These statistics show how addictive opioids can be.

Opioids are a family of drugs that are used to treat moderate to severe pain. Opioids can be found either in their natural form, derived from the seeds of a poppy plant, or in a manmade form. A few common opioids are morphine, codeine, heroin, oxycontin, hydrochloride, and methadone. When a person takes opioids they may experience pain relief, mental relaxation, and euphoric feelings. Prolonged use of opioids can lead to addiction. When a person suddenly tries to stop using opioids they might experience opioid withdrawal symptoms. Opioid withdrawal is a direct result of opioid addiction and dependence. Without proper support, opioid withdrawal might not be life-threatening but it could be extremely painful and result in relapse. Treatment facilities will provide the medication, therapy, and support necessary to maintain abstinence and prevent relapse.

Signs of Opiate Withdrawal

When a person develops an opioid dependence it means they rely on the substance to prevent withdrawal symptoms. As time goes on, they develop a drug tolerance meaning that they need more of the drug to get the desired effects. When a person stops taking the opioid, the body needs time to recover which creates withdrawal signs. A few signs of opioid withdrawal are a fast pulse, high blood pressure, high body temperature, muscle spasms, tearing, and abnormally heightened reflexes.

The opioid withdrawal timeline is different depending on the type of opioid a person is using. Withdrawal from heroin typically begins with people experiencing anxiety and cravings about 8 to 12 hours after the last dose. Withdrawal symptoms reach their peak between 36 to 72 hours, and typically the symptoms lessen within 5 days. The methadone withdrawal timeline is a bit longer. Withdrawal symptoms typically start 24 to 36 hours after the last dose was taken, peak at 4 to 6 days, and symptoms may last for weeks. People may even experience fatigue, feeling unwell, insomnia, and irritability for 6 to 8 months after abstinence from the drug.

Early Withdrawal Symptoms

Early symptoms of opioid withdrawal start within 8 to 12 hours for short-acting opioids and within 24 to 36 hours for long-acting ones after the last dose was taken. Some of the early opioid withdrawal symptoms are yawning, runny nose, agitation, muscle aches, bone pain, anxiety, increased tearing, insomnia, and sweating.

Late Withdrawal Symptoms

Late symptoms of opioid withdrawal usually peak within 3 to 6 days depending on the type of opioid taken. These symptoms generally include vomiting, nausea, diarrhea, abdominal cramping, dilated pupils, and goosebumps. These symptoms of opioid withdrawal are extremely uncomfortable but they are not life-threatening.

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Detox Options

If you decide you are ready to begin your recovery journey detox is the first step. Withdrawal from opioid drugs can be very difficult and even dangerous. There is no single detox option that is guaranteed to work well for all people. Therefore, it is important to discuss your treatment goals with your family doctor.

Effective treatment for a detox often includes the combination of medicine, counseling, and support. One option for an opioid detox is at-home. Do not attempt an at-home detox without first consulting your family doctor or a trained medical professional. An at-home detox involves the use of medicine and a strong support team. It needs to be done by slowly dwindling off the opioid drug. Lastly, a person going through withdrawal will be in a lot of pain. To try to ease their pain they may relapse and go back to taking their drug. Therefore, an at-home detox can be extremely difficult if you do not have a strong support system to keep you on track to reach your goals.

Medical Detox

The other, safer option for detox is medical detox. Finding a high quality-rehab clinic can greatly assist with a medical detox by providing additional support in a comfortable environment. Medical detox provides support from trained medical professions who will check your vitals and provide medications to lessen your withdrawal symptoms. Medical detoxes also incorporate trained mental health professionals who will provide counseling services to help you get to the bottom of your addiction. This type of detox can be performed at rehab clinics or in a hospital setting. In an inpatient environment, a person will spend 24 hours a day and 7 days a week in the facility. If symptoms are severe, a regular hospital is the best place to go to ensure you are given the best treatment to get through your withdrawal.

Medications that are typically used during medical detox to ease the symptoms associated with opioid withdrawal are methadone and buprenorphine. Opiate withdrawal medications work by blocking the receptors in the brain that opioids usually stick to. They do not cause a euphoric effect like opioids though. These medications restore balance to the brain, allowing it to heal so you can focus on recovering from your addiction.

Therapy is also used during a medical detox and works to help change your attitudes and behaviors related to opioid use, develop healthy life skills, and helps you stick with other forms of treatment, such as medication. Counseling services available to treat opioid addiction includes individual counseling, cognitive-behavioral therapy, motivational enhancement therapy, group counseling, and family counseling.

As mentioned above, people may experience opioid withdrawal symptoms for months after they take their last dose of an opioid. Due to the chronic relapsing nature of opioids, most people need long-term treatment to remain abstinent. Detox followed with counseling, education, therapy, and support groups provide a person with the tools they need for long-term abstinence. Depending on the severity of a person’s opioid addiction, some people are given the medication naltrexone to prevent relapse. Additional aftercare can be received from self-help groups like Narcotics Anonymous or Smart Recovery, spiritual and faith-based groups, and outpatient counseling or at inpatient clinics.


Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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