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Opiate Withdrawal Timeline: What Is Detox Like?


The opiate withdrawal timeline may seem long and arduous for anyone coping with substance abuse issues. Who really wants to endure such a drastic change with their body?

Within the first 12 hours, withdrawal symptoms usually kick in. This is one reason a person with substance abuse issues wants to abuse drugs every single day.

The first step to opiate withdrawal involves resisting temptations and committing to a drug-free life. If you or a loved one is struggling with opioid addiction, it’s crucial to stay focused during this process.

So what are the symptoms of opiate withdrawal and how long do they last? What must you do during the short- and long-term stages of the withdrawal timeline, starting with the first 24 hours? The answers are here.

Why Is Opiate Withdrawal Difficult?

Opiate withdrawal is a difficult and often painful ordeal for most recovering drug users. It’s a necessary yet challenging step on the road to recovery from an unhealthy addiction. There are physical and mental struggles that you might have to cope with during a period of withdrawal, but knowing what they are puts you one step ahead to fight off those uncomfortable feelings. These symptoms are your body’s way of coping with adjustment to a drug-free life. You just need to stick in there. You’re strong enough to do it!

The opiate withdrawal timeline can vary depending on the type of drug or drugs used. Withdrawal can also be affected by the length of the preceding addiction. If you start a withdrawal after a month of heavy opiate use, the hurdle could be longer and harder.

Opiate Withdrawal Stages

Once you resolve to stop using a short-acting opiate, the withdrawal symptoms could start within four hours after the last dose. This is true with a wide range of opiates, from prescription painkillers (hydrocodone (Vicodin) meloxicam, oxycodone) to illicit street drugs like heroin.

Within the first 6-12 hours of withdrawal, symptoms may include yawning, insomnia, irritation, sweats, fever, muscle pain and a racing heart.

The early-stage symptoms of opiate withdrawal typically last 72 hours for short-acting drugs. If the drug in question is a long-acting substance, the onset and passing of stage-one symptoms may be slower and longer.

After 72 hours, the aforementioned symptoms (irritation, sweats) will usually be replaced by the second phase of symptoms, which may include goosebumps, stomach cramps, diarrhea, cravings, depression, nausea and vomiting. This stage of withdrawal will typically last for a week or more.

Short- and Long-term Opiate Withdrawal

Anyone coping with opiate withdrawal symptoms can seek help at mental health facilities. If you or a loved one is fighting with addiction, the first step is to distance yourself from anyone or anything that could cause a relapse.

One of the most effective ways to cut drugs from your life is to disassociate from active users. If certain people in your social circle are addicts who are unwilling to change, break those contacts.

Mental health treatment programs for opiate withdrawal include group therapy and peer-support programs, many of which are based on the 12-step model.

Certain medications might also be prescribed to treat substance-abuse issues.

Withdrawal Timeline Day by Day

Within the first 30 hours of withdrawal, you are likely to encounter some of the symptoms detailed below. The following timeline details the first 7-10 days into the process:

Day 1

During the first 24 hours, withdrawal symptoms will generally kick in for codeine, heroin, fentanyl and other opioids on the short-acting end of the spectrum. During this time, you will likely feel strong urges to take the drug again. As your mind and body cope with treatment, symptoms like restlessness, muscle cramps, headaches and loss of appetite are likely to occur.

Day 2

The second day of withdrawal is when symptoms typically commence for long-acting opioids such as oxycodone. Somewhere between 24 and 48 hours in, you might experience sweating, runny nose and stomach problems. Day 1 symptoms might also start at this time.

Day 3

The withdrawal symptoms for short-acting opioids generally peak 48-72 hours out from the time of last use. On this third day, you may experience Day 1 and 2 symptoms, as well as flu-like symptoms such as diarrhea, nausea and vomiting.

Day 4

The withdrawal process generally peaks for long-acting opioids on the fourth day. At this point, symptoms could include cramps, fatigue, shaking, large pupils, intestinal discomfort, plus all the Day 1-3 symptoms.

Days 5 and 6

The withdrawal peak continues for the longer-acting opioids with all the aforementioned day 1-4 symptoms.

Day 7

A week out from the time of last use, withdrawal symptoms should slowly subside. At this point, you are most likely to feel fatigued yet still have difficulty sleeping. Feelings of depression and irritation are also common at this stage.

Long Term

Beyond that first week, users are generally passed the most difficult stage of opiate withdrawal. At this point, the stage of post-acute withdrawal syndrome (PAWS) begins. This can last for months and may involve symptoms like disturbed sleep, fatigue, depression and irritation. Drug cravings will likely persist during this time.

Factors That Impact Opiate Withdrawal

When you first commit to opiate withdrawal, that first week and the months that follow will likely be impacted by the level of opioids you consume just prior to quitting. Other factors include the length of your addiction and mental-health state at the time of withdrawal. Genetics can also factor.

If you decide to quit cold turkey, the process might be more challenging than if you enter a detox treatment program.

Why Are Opioids Addictive?

To understand opiate withdrawal, it’s important to know how opioids become addictive in the first place. Addiction is triggered by the dopamine chemical in your brain, which reinforces cravings.

When you grow accustomed to a pleasurable activity, such as a hobby or physical preoccupation, it releases that dopamine. Those activities become habits because you want to repeat those sensations over and over again.

Opioids are addictive because they trigger the same receptors in your brain as all of life’s most enjoyable activities. You could take a drug for recreational purposes and gradually find yourself using the substance with greater frequency.

After a certain point, the habit could seem physically binding. That’s where addiction takes hold. It’s no longer something you simply do for fun; the mind is now telling you that your body needs the drug.

What Triggers Opiate Use Disorder?

In times of stress, you might reach for the drug to recreate that same sense of leisurely euphoria that you initially felt at a party. You could find yourself in a vicious cycle where opiate-drug abuse becomes your coping mechanism for all of life’s problems.

As your drug use increases, the problems in your personal life (finances, relationships, health) could rapidly escalate in tandem with addiction.

Sometimes, opiate addictions don’t even start from recreational drug use. Opiate-based prescription drugs can also become addictive. A lot of people who suffer from chronic pain often became addicted to prescription pain relievers.

Some people start on certain drugs because the initial feeling inspires them. At first, an opiate might seem helpful if it stirs your energy and productivity. This is often true with musicians, producers and other people who spend long months on the road and many late nights in the studio.

Opiate-drug abuse is self-perpetuating because your body will gradually develop a tolerance for opioids. The high that you felt when you first took a hit will only repeat itself so many times before it loses its effect. From there, you might take stronger doses just to recreate that sensation.

This same pattern could escalate to the point of dangerous and possibly lethal over-consumption.

Once you try to pull yourself back from the brink, the pains of opiate withdrawal are often just as bad, if not worse, than the ups and downs of drug abuse. Withdrawal symptoms can be mentally trying and psychically painful.

Common Opiate Withdrawal Symptoms

As you cope with withdrawal symptoms, the challenges associated with this stage of recovery can tear at your resolve and will power. It’s important to stay focused during this stage. Remember, the inevitable consequences of a relapse could be far worse than any withdrawal symptoms. People who fatally overdose often do so during moments of temptation after a long withdrawal.

Agitation, Irritability

Agitation is one of the most common withdrawal symptoms experienced by recovering opiate users. As you get through the first week or two without the drug in question, you might get irritable at the most benign things. Opioids often have a calming effect because they depress the nervous system. Part of opiate withdrawal is learning how to cope with mood swings without nerve depressants.


Another common withdrawal symptom during the early stages of recovery is anxiety. Drugs provide a high that addicts often use to escape from stress. Once you resolve to come clean, you must commit to healthier, drug-free ways to cope with difficulties. It can be scary at first and a lot of recovering addicts relapse for this very reason. It takes tremendous strength and will power to overcome this stage.

Muscle Cramps

Muscle aches are common among people who cope with withdrawal symptoms. If you’re struggling to overcome an addiction to prescription pain killers, your body is learning to cope without the constant nerve sedation.

Restlessness, Insomnia

Many people have trouble sleeping during the first few weeks of opiate withdrawal. If you stop taking drugs cold turkey after a lengthy dependency, your mind and body must readjust to a new regimen. Now that your body is living without the sedative effects of depressant drugs, withdrawal symptoms like anxiety, agitation and depression could easily keep you up at night.

High Blood Pressure

If you’ve taken opiates to deal with hypertension, you may experience high blood pressure during withdrawal. This could be compounded by mood swings and feelings of anger and anxiety as your mind and body adjust to healthier, opiate-free alternative treatments.


Cravings are common during phase two of the opioid withdrawal process. Opiate abusers often lose weight due to the depressing effects of certain drugs. If you’re feeling tired, light-headed and unnaturally euphoric, you’re less likely to have an appetite.

Drugs can also have side effects like nausea, constipation, vomiting and diarrhea, none of which are appetizing. Consequently, a lot of addicts drop to dangerously low weight levels.

Once you withdrawal from drugs, you might feel insatiable food cravings. The reasons for this are twofold. You no longer have drugs to suppress your nerves, so your body feels restless and agitated. Moreover, your mind and body might seek a way to compensate for the lack of drugs.

A lot of recovering users compensate drug cravings with food cravings and gain tremendous amounts of weight after coming clean. Basically, one compulsion gives way to another.

Withdrawal symptoms can also include sweating, tearing, goosebumps, runny nose and sneezing.

Opiate Withdrawal Treatment Drugs

According to the National Institute on Drug Abuse, an average of 115 Americans died per day from opioid overdoses during 2016. Despite the efforts of many users to overcome opioid addiction, withdrawal symptoms often lure people back into the habit, sometimes even worse than before.

In 2018, the United States Food and Drug Administration green-lighted lofexidine, a medication that helps opioid addicts overcome the physical and emotional challenges of withdrawal. The medication is formulated to aid in detox treatment and keep recovering addicts focused on their regimens.

Lofexidine is one of the first medications to help recovering addicts during the detox stages. In the past, methadone and buprenorphine were two of the more commonly administered treatment medications for opiate withdrawal, but these were often difficult to access.

Methadone is an opioid that doctors prescribe for the treatment of moderate and severe pain. The drug can also help addicts of other opioids conquer those addictions. Buprenorphine is a partial opioid that is used for pain treatment and to curb cravings for harder opioids.

Another drug used for withdrawal treatment is naloxone (Narcan), which is formulated to block opioid effects in the body. When taken intravenously into the bloodstream, naloxone usually takes effect within the first two minutes.

Naltrexone is another medication that aids recovery and prevents relapse. However, it only works after the detox stage.

Steps to Opiate Withdrawal Treatment

Once you get past the detox phase of the treatment timeline, it’s crucial to have a support network to help you along in your journey forward. Support groups exist throughout the United States that cover all stages of addiction treatment, from the medical detox process itself through the long recovery that comes afterward.

Most withdrawal programs cover the following areas of treatment:


To help free people from opioid dependence, treatment programs generally involve some form of community activity. This way, you can be surrounded by other people who share the same struggles and goals. The people that you meet and interact within these programs are at all stages of the process, some of them years beyond their last instance of drug use.

It puts you in an environment where others share their stories and methods for conquering addiction. By being around individuals who’ve already kicked the habit, it helps to reinforce drug-free behavior in your own mind. This is especially important if your habit originated for your peer group or social surroundings.

Removal from Temptation

Another part of every treatment plan is to keep you away from further temptation. Beyond the initial withdrawal, the months that follow can be difficult if you’re still surrounded by opioids and active users. At a treatment center, you won’t have access to further supplies and dealers. Instead, you’ll have a supportive environment full of healthier options.


After you complete the initial steps of a detox program, the weeks and months that follow include goal-setting for a drug-free life. A well-rounded treatment program covers more than just the addiction itself. It also focuses on the way you live your life.

In some cases, this means prioritizing the positive aspects of your preexisting life (family, work, hobbies, civil engagement). If your preexisting factors are negative (abusive surroundings, opioid access), mental-health counselors will help you set new priorities and break former habits.

New Hobbies

Healthcare professionals understand that you are likeliest to break old cycles if you have new activities to center your life on. At a treatment center, counselors will help you discover new interests and talents and also tap into preexisting, long-neglected ones. A lot of people come out of these programs with a newfound vigor in life.

Social/Environmental Connecting

American addiction centers provide a support system that helps you reconnect to positive energies in the world around you. By surrounding yourself with others who conquer opiate addiction, you grow accustomed to positive, healthy surroundings.

You also learn to appreciate the natural beauty in life, including animals and the great outdoors. Treatment programs can also help you find healthier ways to eat and maintain yourself physically.

Get Help Today

Once you commit to a life without opioid use, it’s crucial to overcome the physical symptoms of withdrawal and any cravings you might feel in the months that follow. With opiate withdrawal support, you can find the path to a clean, productive, opioid-free life. Get help from several rehab centers that have your best interest at heart.

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