Opioid Withdrawal: Symptoms & Treatment Medications

Opioids can cause powerful physiological dependence, meaning that someone who has used them chronically for an extended period will likely experience withdrawal when they quit or reduce use.¹

This page will discuss opioid withdrawal syndrome, common opioid withdrawal symptoms, and how opioid withdrawal is treated.

What Is Opioid Withdrawal Syndrome?

Opioid withdrawal occurs when an opioid-dependent person significantly decreases their usual dose or stops using opioids completely.¹ Physical dependence on opioids can develop quickly, as little as 4-8 weeks.²

Withdrawal symptoms can range from mild to severe and may even be debilitating.¹ Symptoms are uncomfortable and distressing, but they are rarely life-threatening.³

Opioid Withdrawal Symptoms

Symptoms of opioid withdrawal may include:^1,3,4

• Generalized aches/pains.
• Muscle spasms/twitching/tension/cramps.
• Tremor or shaking.
• Abdominal cramps and/or nausea/vomiting/diarrhea.
• Anxiety/restlessness and/or irritability.
• Yawning and/or insomnia, or trouble sleeping.
• Hot flashes, sweating, chills, or gooseflesh.
• Tearing up of the eyes.
• Runny nose.
• Dilated pupils.
• Heart pounding.

Intense cravings and a strong desire to use opioids typically accompany withdrawal, especially for those with an opioid use disorder.^2,4 Cravings, along with other psychological and physiological symptoms, may continue even after acute withdrawal and detoxification.⁵ Extended symptoms that may continue for several weeks and up to six months include:⁵

• Insomnia or sleep disturbances.
• Fatigue, anhedonia, or dysphoria (inability to feel pleasure or feeling emotionally blunted).
• Decreased cognitive abilities.
• Inability to focus.
• Cravings.
• Increased sensitivity to physical pain.

How Long Does Opioid Withdrawal Last?

The duration and severity of opioid withdrawal, as well as the symptoms that someone will experience, varies from person to person and is dependent on the type of opioid taken, the dose taken, and the duration of opioid use.^4,6

Withdrawal from opioids begins 8-24 hours after last use and lasts anywhere from 5 days to 2 weeks.^1,3,7 More specific withdrawal timelines based on the type of opioid taken are below:

• Heroin: First symptoms arrive within 12 hours of last use, peak within 1-3 days, then gradually resolve over 5-7 days.^1,3
• Short-acting opioid medications (immediate-release morphine, hydromorphone, oxycodone, hydrocodone, oxymorphone, codeine, fentanyl): First symptoms arrive 8-24 hours after last use. Fully developed withdrawal begins 1-3 days after last use with the total duration of withdrawal being 7-10 days.⁷
• Long-acting opioid medications (methadone, levorphanol, and extended-release/sustained-release/controlled-release formulations of short-acting opioids): First symptoms arrive up to 36 hours after the last use with fully developed withdrawal 72-96 hours after the last use. The total duration of withdrawal is 14 days or more.⁷

How to Treat Opioid Withdrawal

People who have developed physical dependence on opioids or who have been diagnosed with an opioid use disorder may benefit from medically supervised opioid withdrawal management. Studies have shown that without medical supervision, many people are unable to complete discontinuation of opioids, as avoiding withdrawal symptoms often becomes a driving force for continuing use.⁴

Medical Detox for Opioid Withdrawal

Medically managed detoxification can make the withdrawal experience more comfortable, as doctors can prescribe medications to help reduce the severity of symptoms. In many cases, medical management of opioid withdrawal is an important first step for those overcoming an addiction to opioids and serves as a bridge to longer-term treatment of opioid use disorder.^1,3,6

Opioid Withdrawal Medications

Common medications for opioid withdrawal include methadone or buprenorphine, which are opioid agonists and partial agonists, respectively. These drugs bind to opioid receptors and reduce withdrawal symptoms without eliciting euphoria in people with opioid dependency.^4,6,7

Buprenorphine and methadone help significantly in reducing a person’s cravings for opioids, and these medications are usually continued through long-term treatment, which will also include psychosocial counseling (e.g., individual and/or group therapy) as well as self-help, or mutual-help, groups.⁸

Opioid Detox Near Dallas/Fort Worth

Greenhouse Treatment Center provides safe medical detox with medications to relieve symptoms and ensure your safety. Most people require continued treatment after the acute withdrawal stage to remain in long-term recovery, which is why Greenhouse offers multiple levels of addiction treatment, including:

• Residential treatment.
• Partial hospitalization program (PHP).
• Intensive outpatient program (IOP).
• Standard outpatient care.
• Sober living.

For information, call us at to learn more about substance abuse treatment in Texas at Greenhouse Treatment Center. Compassionate admissions navigators help you start treatment today or answer questions about using insurance to pay for addiction treatment and other ways to pay for rehab.