Opiate Withdrawal Timeline

How Long Does It Take?

How long opiate withdrawal lasts depends on several factors from opiate dosage and length of use to the age of the opiate user. Opiate withdrawal can be mild, moderate, moderately severe, or severe and this is usually determined by using a diagnostic tool, such as the Clinical Opiate Withdrawal Scales (COWS) to evaluate the specific symptoms and the opiate user’s history.

Stage 1: Acute Withdrawal

The early withdrawal symptoms in the first or acute withdrawal phase are predominantly physical and usually the worst; sometimes lasting only a matter of hours or a few days but can be as long as 4 weeks. These include:

Muscle aches and tearing up.
Anxiety and agitation.
Problems with sleeping and sleep patterns.
Excessive yawning.
Hypertension and a racing heart rate.
Fever and sweats.
Nose running.
Restless leg syndrome.
Digestive discomfort or pain.
Dilated pupils.

It is at this stage that most addicts may give up as the headaches, body pains and aggression elements of the withdrawal take effect.
Sleep may help and is a great cure-all but this might be difficult in the early stages of opiate withdrawal. The aim is for around eight hours of sleep a night but this may not be accomplished until the later stages of opiate withdrawal. However, the more the person can try to relax, rest and sleep, the more energy will be created to focus on opiate detox. If working, aim to reduce the workload for a short while to allow the body to recover from any physical symptoms.

Stage 2: Post-Acute Withdrawal

Withdrawal symptoms for the second phase of post-acute withdrawal, usually last a week to 10 days – although this phase can be as long as 2 years, and include:

Nausea, vomiting and diarrhea.
Goosebumps
Drug cravings
Stomach cramps
Depression

At this point, some of the psychological withdrawal symptoms start to appear and these may well continue far longer than the physical signs. It is important to ensure that there is plenty of therapy and mental health support for the opiate user in withdrawal. Over a short period of time, the physical pains will start to dissipate. Healthy foods will help as well as some form of light exercise and plenty of support. Withdrawing from opiate use can be a painful experience and some people may need the help of a medical detox program under close supervision, including the monitoring of blood pressure, body temperature, heart rate, and respiration levels, in order to regulate the body’s brain function.

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Opioid Withdrawal Symptoms

Opioid Symptoms

At first, the symptoms when withdrawing from opiates are fairly mild. These include:

Watery eyes
Runny nose
Sleeplessness
Restlessness

However, these symptoms may get worsen after a couple days and could include:

Vomiting
Diarrhea
Blurred vision
Rapid heartbeat

As with any addictive substance, the longer one has been using and the larger the amount used, the more dependent the body becomes on the substance. In severe cases, withdrawal from opiates can include extreme sweating and anxiety.

Heroin Symptoms

Cravings for heroin are much stronger when withdrawing from the drug. This is often why it’s so hard for addicts to get out of the using cycle. Withdrawal can be extremely unpleasant and may include:

Depression, anxiety and irritability
Aches and pains
Excessive sweating, tears and runny nose
Diarrhea and stomach pain
Nausea and vomiting
Fever
Restlessness

Factors That Contribute To The Opiate Withdrawal Timeline

The symptoms of opiate withdrawal can range from mild to severe, depending on how addicted to the drug the user is. A person’s dependency can be linked directly to a number of factors:

How long the drug user has been taking the opiate.

The level of the dose. Which particular opiate was being taken.

How the opiate was being taken.

Any underlying medical conditions and/or any mental health issues.

Some environmental and biological factors, i.e. any family history of addiction.

Any previous trauma experienced and/or unsupportive, stressful surroundings or lifestyle.
The age of the person. The older person may suffer withdrawal symptoms that are more severe and this could be down to their organs health and immune system.

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Medications To Help With Opiate Withdrawal

Over The Counter Medications

There are some over-the-counter medications that can help to treat the symptoms of opiate withdrawal if the other methods aren’t working. If you’re suffering from diarrhea, this could be relieved with a non-prescriptive medication like Imodium AD which contains loperamide. Others include:

Non-steroidal anti-inflammatory drugs (NSAIDs) include ibuprofen, naproxen, and aspirin.
Anti-nausea medications, such as Pepto Bismol.
Topical analgesics like Tiger Balm or Ben Gay.
Naturally-derived sleep supplements including melatonin or Valerian root.

However, be aware that these types of drugs may interact with any others you are taking to help with either a medical condition or opiate withdrawal so, always consult a doctor first.

In A Medically Assisted Detox

Methadone is the most well-known of these medications and is used to reduce the effects of the euphoric high that is experienced with the use of opiates, but not eliminate them entirely. Whilst the effects are similar to heroin, they are far less intense and last far longer, up to 24 hours. But there are side effects which include:
Lethargy causing reactions to be much slower and movements more exaggerated.
Mood swings ranging from depression to mania, particularly as the effect of Methadone wears off.
Pinpoint pupils
Nausea
Respiratory depression

It is possible to overdose when using Methadone and the symptoms can include breathing difficulties, low blood pressure, muscle twitches, vomiting and nausea, bluish lips and fingertips, and coma. Methadone should not be mixed with any other substances, including benzodiazepines and alcohol. Any misuse of Methadone can lead to dependency as the drug is similar to heroin.

Suboxone is similar to Methadone and has similar side effects. For some opiate addicts, coming off these medication drugs can be just as difficult as withdrawing from the opiates themselves and this may not be the best approach to opiate withdrawal.
Benzodiazepines are sedatives to dull senses, create a sense of calmness, and allows them to sleep.

Clonidine is also a type of sedative that reduces the intensity of the withdrawal symptoms.

Other Withdrawal Tips

Once you’ve taken the big step to break the cycle and ‘get clean’ from opiate addiction, get together with other people that are going through the same process. Joining groups such as Narcotics Anonymous and getting involved in their 12-step meetings to stop using opiates will help the recovering opiate user with vital support. Other tips include:

Have a strong support system and don’t be afraid to ask for help. Whether it’s family, friends, support groups, or a doctor, having a network of support is vital in sticking to a recovery plan.
Be honest and practice sharing the way you feel.
Avoid the high risk and/or stressful situations.
Learn ‘relapse prevention’ strategies for those difficult times.
Take one day at a time in the recovery process.
Stay hydrated
Take a hot bath
Many recovery programs recommend taking light exercise.

For some, the withdrawal symptoms don’t always disappear and the withdrawal timeline may well go far beyond the average, sometimes long after the opiates have been processed and removed from the body. When all acute symptoms have gone and only persisting symptoms remain, it can be known as post-acute withdrawal syndrome or PAWS. These symptoms include depression, fatigue, and poor sleep, irritability, anxiety, and not able to make decisions clearly.

Nutrient Deficiency
During the opiate addiction withdrawal phase, the body will be nutrient deficient. The Iranian Journal of Public Health’s study indicated that opiate users were likely to have reduced levels of calcium and magnesium, which may contribute to muscle spasms and pain. Low levels of potassium indicate restless leg syndrome and eating bananas will increase potassium levels and alleviate this symptom. It’s highly likely that whilst being dependent on opiates, a healthy diet was not high on the agenda. It is also likely that during the first phase of withdrawal, there is a loss of appetite but it will return and when it does, make sure healthy foods and liquids are on the menu. Avoid processed foods, eat plenty of vegetables, beans, legumes, and protein, and drink plenty of water to aid liver support. The types of healthy foods include:
Artichoke.
Broccoli.
Leafy greens.
Wild fish.
Nuts, seeds, and olive oil.

Taking multivitamins or supplements where nutrient levels are low will help to ease the symptoms of opiate withdrawal. For serious opiate addiction, it is worth going to a detox center, either as an outpatient or inpatient. These outpatient and inpatient rehab centers are well-equipped to help with the early phases of opiate withdrawal. In some severe cases of addiction, detox centers and/or physicians may recommend using medications that have been developed to help treat opiate addiction, particularly through the first phase of withdrawal, in order to slowly taper the removal of opiates from the body.

Our Medical Detox

Opioid Addiction Treatment Options

Like other chronic diseases, addiction takes ongoing care and attention to prevent relapse.

Individuals who go through and complete at least a 30-day addiction treatment program have a higher success rate in achieving long term recovery. Those who leave a treatment program with a comprehensive aftercare plan, such as sober living, outpatient program, or AA will transition to long-term recovery more successfully.

Opioid Detox

Opioid Rehab

Can You Quit Opioids Cold Turkey?

Suddenly stopping opioid or heroin use is not recommended. It can cause an onset of very severe withdrawal symptoms. Those who do try to taper off of these types of drugs seldomly succeed. Relapsing during withdrawal is one of the causes of overdose. If is important to experience withdrawal in a medically assisted detox where it is safe.

Opioid Rehab Services

Detoxing from opioids or heroin is the first step toward recovery. However, the evidence is clear that the longer a person distances themselves from their last use of opioids or heroin, the greater chance of recovery. At Peaks Recovery Centers, the next step in our recovery process is transitioning into our residential inpatient rehab.

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Evie Rayfifield
April 4, 2021 at 4:03 pm

I’ve only used for 3 days by smoking it. Will I go through withdrawals?

1. Peaks Recovery Centers
  April 5, 2021 at 10:15 am
  
  Hello Evie, and thank you for reaching out. In respect of your privacy, we will be happy to respond to you in a private email. Please look for us in your email inbox, or feel free to reach out to us at 855-608-1222.
  
2. Nancy Schwinck
  April 7, 2021 at 10:15 am
  
  I doubt it
  
3. Dillon
  June 5, 2021 at 6:40 pm
  
  You will get a little restless but nothing major if only 3 days. Please consider the toll it takes on your health. I’ve been in methadone for 12 years, yes it has helped me live a “ normal” life. But it’s a leash, and it’s always the clinic visits are always having to be planned for.
  
Nikki
April 12, 2021 at 2:44 pm

I’m on day 6 of methadone detox. Been taking 4 gabapentin & 1 tramadol during the day, and a xanaflex & 1 gabapentin at night to sleep. This is the best day I’ve had yet. I’m still weak, weak, weak, but I was actually able to get up & walk around & eat a little today. The first three days are always the worst for me, then it seems to ease off a little except for the diarrhea which I’m now controlling with Imodium AD. (And a really cool best friend to help me thru the hardest days!)
For anyone who really wants to get clean, it ain’t easy, but it does get better! You can do it!