Opioid Withdrawal Symptoms, Timeline, & Treatment

Opioid Withdrawal Symptoms, Timeline, & Treatment Addiction Drug Use Opioids Print How Long Does Withdrawal From Opioids Last? By Erica Jacques Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center. Learn about our editorial policy Erica Jacques Medically reviewed by Medically reviewed by Steven Gans, MD on September 03, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on February 23, 2020 smartboy10 / DigitalVision Vectors / Getty Images More in Addiction Drug Use Opioids Cocaine Heroin Marijuana Meth Ecstasy/MDMA Hallucinogens Prescription Medications Alcohol Use Addictive Behaviors Nicotine Use Coping and Recovery In This Article Table of Contents Expand Overview Signs & Symptoms Coping & Relief Warnings Long-Term Treatment View All Back To Top If youre taking opioids for chronic pain, you may experience withdrawal symptoms when you stop using the medication. Opiate drugs are extremely habit-forming; tolerance, physical dependence, addiction, and withdrawal symptoms are all possible.?? As a result, there is a high potential for misuse and addiction, even when use begins with a prescription. Prescription opioids include: CodeineDemerol (meperidine)Dilaudid (hydromorphone)MethadoneMorphineOxycontin (oxycodone)Percocet (acetaminophen/oxycodone)Vicodin (hydrocodone)Fentanyl The illicit drug heroin is also an opioid. Cutting out opioids safely involves gradually reducing the painkiller dosage as opposed to stopping the medication outright. Your best bet is to consult with your physician before you stop taking these medications. Overview Opioid withdrawal is not pleasant, but in most cases, it’s not life-threatening. In fact, many people describe it like having a bad flu, with fever and sweating, nausea and vomiting, muscle aches and pain, and insomnia.?? These symptoms can occur if you try to quit cold turkey” (suddenly stop the medication)â€"even if youre only taking the amount prescribed by your doctor. Tapering off the drugs slowly can help avoid some unpleasant withdrawal symptoms. Unfortunately, opioid tolerance builds quickly and the risk of physical dependence with opioids is high. For some, dependence can develop in a mere two weeks, especially if youre taking a large dose. Signs Symptoms Withdrawal symptoms can range from mild to very severe, depending on the type of drug, frequency of use, severity of dependence, and your overall health. Symptoms of withdrawal can begin six to 30 hours after last use of the drug and can last anywhere from five to 10 days, depending on the type of opioid. Symptoms can include: Early symptoms (within 24 hours of stopping the drug): AnxietyMuscle aches and painsRestless legsEyes tearing (lacrimation)Excessive sweatingInsomniaFrequent yawning Later symptoms: Abdominal crampingDiarrheaDilated pupilsNausea and vomitingRapid heart rateHigher blood pressure If you notice any of these symptoms, or if your withdrawal symptoms become worse, be sure to inform your healthcare provider immediately. Your provider may use tools like the Clinical Opiate Withdrawal Scale (COWS) to determine the stage of withdrawal and assess your level of physical dependence on the drug. Opioid Withdrawal Timeline Withdrawal symptoms begin (short-acting opioids) 6â€"12 hours after last dose Withdrawal symptoms begin (long-acting opioids) 30 hours after last dose Withdrawal symptoms peak 72 hours after last dose Withdrawal symptoms dissipate Up to 10 days after last dose Coping Relief You may be able to go through opioid withdrawal at home under the direction of your doctor if you have a strong support system and the appropriate medications. But many people need the support of an inpatient detoxification program or local hospital. To help your physician determine the best route for cutting out opioids, consider keeping a pain journal and track everything related to your painkillers, including: DosageFrequency of usePositive and negative effects Do your best to have a plan before visiting your physician. If you are taking opioids for pain, consider asking yourself questions like the following: What are your expectations? Do you want to simply switch painkillers, or do you want to try and live painkiller free? Traditional and Alternative Pain Management When transitioning off of narcotic painkillers, your doctor may prescribe other pain-relieving medications to ease withdrawal symptoms and prevent breakthrough pain.?? Opiate/opioid addiction may also be treated with other drugs that help shorten and alleviate symptoms of withdrawal, including: Acetaminophen (Tylenol), aspirin, or NSAIDs (Ibuprofen) for mild symptomsLoperamide (Imodium) for diarrheaHydroxyzine (Vistaril, Atarax) for nauseaClonidine for symptoms of withdrawalMethadone for long-term maintenanceAntidepressant for co-occurring depression or anxiety Warnings Although the symptoms may not be life-threatening, there are dangerous withdrawal complications that can occur if left untreated. Withdrawal symptoms may include dehydration, hypernatremia (elevated blood sodium level), and heart failure from persistent vomiting and diarrhea.?? Aspiration, which can cause choking or lung infection, can also occur if you vomit and then breathe in stomach contents into your lungs. Perhaps the biggest danger of withdrawal is a relapse. The opioid withdrawal and detox process reduces your tolerance to the drug, so if you go back to taking the same amount of opioids you previously took, overdose can easily occur. Understanding Opioid Overdoses Long-Term Treatment For most people, symptoms of withdrawal should markedly improve within a few days or weeks. If your symptoms are lingering or getting worse, it’s important to get medical help. Quitting opioids is not easy and you may need long-term recovery support or addiction treatment following withdrawal to stay off the drugs, including: Maintenance medicationSupport groups (such as Narcotics Anonymous or SMART Recovery)Outpatient therapyIntensive outpatient treatmentInpatient treatment Resources No one expects you to stop taking opioids on your own; help is encouraged and readily available. Even if you have been using a narcotic painkiller for a brief time, you may still be at risk for developing withdrawal symptoms if you quit on your own. If youre taking opioids for pain, talk to your physician about why you want to make a change with your pain medication, and let them help you do it the right (and safe) way. If you need treatment for opioid addiction, you can find a treatment program near you using the Department of Health and Human Services (HHS) treatment locator tool. A Word From Verywell Experiencing the symptoms of opioid withdrawal can be unpleasant and require proper aftercare to ensure lasting recovery. People who take opioids over a long period of time are at high risk of physical dependence and should consult a doctor about managing withdrawal symptoms should they decide to stop taking the drug. If you or a loved one experiences negative consequences of opioid dependence, you should also talk to your doctor about treatment for opioid use disorder.