Opioid Detox Guide
Opioids are often used to treat pain.1–3 Though many opioids have legal, acceptable medical uses, long-term opioid use or misusing opioids can lead to physical dependence and withdrawal.1–4 Read on to learn more about opioid withdrawal symptoms, how long withdrawal lasts, and how to get help.
Opioid Withdrawal Symptoms
Using opioids can lead to dependence (having withdrawal symptoms when not taking the drug). Dependence may develop after repeated use, even if you take the medicine as told by your doctor.8 If you’ve become dependent on opioids of any type and stop taking them or suddenly reduce your dose, you may develop opioid withdrawal symptoms.4 These symptoms may include:2–7
- Watery eyes.
- Runny nose.
- Muscle and bone pain.
- Cold flashes and goosebumps.
- Dilated (enlarged) pupils.
- Hot flashes and sweating.
- Trouble falling or staying asleep (insomnia).
- Vomiting (throwing up) and diarrhea (loose, watery stools).
- Increased blood pressure, heart rate, and breathing rate.
Many of these symptoms can be unpleasant and upsetting, which may lead some users to start taking opioids again (relapse) to ease symptoms.4 Some people also have severe cravings during withdrawal.4 Both of these together may make quitting opioid use on your own especially hard.4
How Long Does Opioid Withdrawal Last?
How long withdrawal lasts, when it starts, and how bad symptoms are will differ from person to person. The timeline also depends on: 2,4,6
- The specific opioid you’re taking.
- How much you take each day.
- How long you’ve been taking it.
- How often you take it.
- If you have other physical or mental health issues.
Withdrawal symptoms for short-acting opioids, like heroin, often start within 6 to 12 hours after your last dose.4,6,7 Symptoms usually get worse until they peak in intensity around day 3, then improve over the next 5 to10 days.4,7
For longer-acting opioids, such as methadone, withdrawal symptoms can start between 36 hours and 4 days after the last dose and can take up to 3 weeks to improve.4,6,7
How to Cope with Opioid Withdrawal
Opioid withdrawal can be very uncomfortable, and you may be tempted to ease these symptoms by taking more opioids.4,6 Left untreated, in some cases symptoms can lead to certain health problems that may need medical attention.6 But you do not have to go through withdrawal alone. Medical detox can help reduce the discomfort of withdrawal while keeping you safe.6 Detox in an inpatient setting also has the benefit of staff being onsite 24 hours a day to check on you, make adjustments to the medicines that ease withdrawal symptoms, and offer other supportive care as needed.
After detox, many people continue with additional treatment and recovery work.11 This may include treatment at an inpatient or outpatient rehabilitation center, counseling and behavioral therapy, and attending support groups such as Narcotics Anonymous.
Opioid Withdrawal Medicines
During opioid detox, your care team may give you medicines to ease symptoms and help control cravings.6,12 These medicines may also play an important role in ongoing treatment after detox.5,6,9
Methadone and buprenorphine help ease or prevent withdrawal symptoms and control cravings.11,12 Many patients take smaller and smaller doses of these medicines over the course of detox, which is called tapering.11,12 But some people in recovery stay on these medicines for months or even years to help prevent relapse.11
Clonidine helps reduce some of the more distressing symptoms of withdrawal, such as anxiety, diarrhea, vomiting, and stomach cramps.6,7
Lofexidine is a newer medicine. Though similar to clonidine, it is the first non-opioid medicine approved to manage opioid withdrawal.5 It also helps reduce withdrawal symptoms, but may need to be combined with other medicines to keep you comfortable during the detox process.10
Other medicines that may help manage symptoms include:6
- Sleep medicines.
- Over-the-counter pain medicine.
- Anti-nausea or anti-diarrheal medicines.
Is Opioid Withdrawal Dangerous?
While opioid withdrawal isn’t as dangerous as alcohol or sedative withdrawal, trying to detox at home can still be hard and may have risks.6,11 Talk to your doctor before trying to quit opioids on your own. They can help you assess the risks you may face during withdrawal and help you find the right treatment that will fit your needs while keeping you safe and comfortable.
Withdrawal symptoms can be very stressful, which may make it hard to stop taking opioids.4 If you were taking opioids to treat pain, your pain is likely to increase during withdrawal.6 Anxiety disorders, including panic disorder can get worse as well.6 After withdrawal, you may also be at a higher risk of overdose if you start taking opioids again.7,11 This is because your body will naturally have a lower tolerance for opioids after you stop taking them for a period of time. So the same dose you took before could be too much.7,11
Professional detox centers offer support for each of these issues. When you’re under medical care, any problems can be addressed right away, increasing the chances that you’ll recover safely. Treatment centers can also help you find other ways to manage pain so you can stay off opioids.
Finding Opioid Detox Treatment
During detox, you will have to face withdrawal symptoms. But this may be easier to do with physical and mental health support from qualified treatment professionals. Going through a supervised opioid medical detox means you do not have to face symptoms alone. Treatment staff can look after you day and night to help you manage symptoms, ease cravings, and keep you safe while you are in early recovery.
American Addiction Centers can help you get through opioid withdrawal at one of our medically supervised detox and addiction treatment centers. To learn more about how we can help, call our 24/7 confidential detox hotline at .
- Centers for Disease Control and Prevention. (2021). Opioid basics.
- Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide.
- National Institute on Drug Abuse. (2020). Misuse of prescription drugs research report.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Shah, M., & Huecker, M.R. (2020). Opioid withdrawal. Treasure Island, FL: StatPearls Publishing.
- Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment.
- World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings.
- National Institute on Drug Abuse. (2020). Prescription Opioids DrugFacts.
- National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition).
- Renfro, M.L., Loera, L.J., Tirado, C.F., & Hill, L.G. (2020). Lofexidine for acute opioid withdrawal: A clinical case series. Mental Health Clinician, 10(5), 259–263.
- MedlinePlus. (2021). Opiate and opioid withdrawal.
- Substance Abuse and Mental Health Treatment Services Administration. (2020). TIP 63: Medications for Opioid Use Disorder.