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Opioid Withdrawal

America’s opioid crisis has reached epidemic levels in recent years, and has claimed so many lives, that President Donald Trump declared it a public health emergency in October 2017. That same year,  opioids were reported to be involved in at least 50,000 U.S. adult deaths in 2016, according to a government preliminary count

Every day, 91 Americans die from an opioid overdose, according to the U.S. Centers for Disease Control and Prevention. Some of them likely experienced a seemingly endless cycle of addiction, withdrawal, and relapse that eventually led to their deaths. This doesn’t have to be. Below, we explain what opioid withdrawal is and what can be done about it.

What Are Opioids?

Opioids are a class of prescription medications that doctors prescribe for patients who have moderate-to-severe pain.

These drugs, designed for short-term use because of their addictive nature,  grew in popularity in the 1990s, when physicians started treating pain as a serious medical issue. OxyContin and Percocet were issued to chronic pain sufferers.

This group of drugs, which includes the illegal drug heroin, changes how the brain receives messages about pain. This happens when opioids interact and binds with opioid receptors on the nerve cells in the body and brain. 

Opioids include narcotic pain relievers such as:

  • Codeine
  • Fentanyl
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Methadone
  • Meperidine (Demerol)
  • Morphine
  • Oxycodone (Percocet or OxyContin)

Opioids can be administered in a number of ways, including:

  • Pill
  • Liquid solution
  • Dissolving tablet
  • Implanted intrathecal pump
  • Intramuscular injection
  • Intravenous injection
  • Skin patch
  • Suppository

Chronic opioid users, which includes people who use the illegal drug heroin, seek out the drugs over and over again to achieve the high that occurs when the brain’s pleasure center is flooded with dopamine. This feeling is why users experience euphoria when they take it. Repeated opioid use also can flood the brain with artificial endorphins. Over time, the brain will stop producing them as it increasingly relies on  these artificial endorphins.

Opioid medications are viewed as safe when taken as prescribed by a doctor for a limited time. However, because of their potent effects, opioids can cause serious medical complications when people misuse or abuse them. Prolonged abuse, which includes practices using opioid drugs in ways that are inconsistent with their intended use, often does lead to opioid addiction.

What Are Opioid Withdrawal Symptoms?

When you are in opioid withdrawal (also referred to as opiate withdrawal), you will notice changes in how you think, feel, or behave that will appear after you’ve reduced or entirely stopped using the drugs. These changes signal that withdrawal is either beginning or are underway. This period is characterized by uncomfortable or painful physical and psychological symptoms. 

Early Opioid Withdrawal Symptoms (6-12 hours for short-acting opioids; within 30 hours for longer-acting opioids):

  • Muscle aches
  • Agitation
  • Anxiety
  • Irritability
  • Fast heart rate
  • Increased drowsiness/excessive yawning
  • High body temperature
  • High blood pressure
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating

Late Opioid Withdrawal Symptoms (Peak within 72 hours and could last at least up to a week):

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Nausea
  • Cramps
  • Goosebumps
  • Depression
  • Cravings
  • Vomiting

In some instances, depression can result in thoughts of suicide in which case it is essential to seek help from a doctor or addiction specialist.

Some people who are in opioid withdrawal will just abruptly stop using after doing so for a long time. This is strongly not recommended. Going “cold turkey” is a practice that may sound like a good idea at first, particularly to people who just want to end their opioid dependence once and for all, but it isn’t. Instead, it can lead to relapse, overdose, and death. People who seriously want to get off opioids without risking their health or their lives may want to strongly consider going to treatment center where trained addiction specialists and medical professionals can help end dependence on drugs and alcohol in a safe manner.

How Long Does Opioid Withdrawal Last?

The opioid withdrawal timeline will vary according to the individual. Several factors are considered when determining a timeline. Among them are:

  • Age, sex, health, medical history, and lifestyle
  • Your weight and body fat percentage
  • Duration opioid use
  • Opioid consumption and frequency of consumption
  • Opioid tolerance
  • The manner in which opioids are used (snorted, smoked, injected);
  • If opioid use has occurred with other drugs and substances; opioids are commonly abused with benzodiazepines and, in some cases, alcohol
  • Co-occurring disorders (when a substance use disorder and a mental health disorder are present at the same time)

The following is a general overview of what happens when a person experiences withdrawal from opioids. Experiences will vary by the person, so consult with a doctor to get the clearest understanding for your situation. 

As noted above, opioid withdrawal symptoms can occur in two phases. The first phase, which can run between 12 hours and 30 hours, is akin to symptoms that are experienced when one has the flu. In the second phase, symptoms tend to peak and can become increasingly uncomfortable, particularly the psychological symptoms. The overall withdrawal period can run anywhere from three and 10 days. For a longer-acting opioid such as methadone, The acute part of withdrawal can run as long as three weeks.  Some people also will experience Post-acute withdrawal syndrome, known as PAWS, after the last use of drugs, and that syndrome can last much longer, for weeks and even years.

PAWS symptoms include:

  • Appetite changes
  • Change in sleeping schedules
  • Feeling more tired than usual, fatigue
  • Anxiety
  • Depression
  • Stress

You do not have to handle PAWS symptoms by yourself. Professional treatment is recommended to manage this period and recover from it. Adequate rest, practicing habits that promote health and wellness, and having a supportive network of people are effective ways to manage PAWS. Consult with your physician to come up with a plan that works for you.

Why Should I Detox from Opioids? 

Getting a professional medical detox for opioid withdrawal is a personal decision. However, should you decide to go this route, there are benefits to doing so.

This kind of detox ensures that all traces of drugs, alcohol, and other toxins are safely removed from the body to bring about the physical and psychological stability needed before a treatment program can start. It also helps prevent the complications that commonly happen during withdrawal. If any medical emergencies arise, health care professionals can address them right away. Thirdly, detox is just the first step in a process designed to link users with the therapies and treatments needed to prevent opioid use and relapse. 

If someone has resorted to frequently abusing benzos, it will take a change in behavior and support to stay true sobriety. Post-detox therapy and counseling can help recovering users achieve those results.

During this time, recovering opioid users may undergo a controlled tapering schedule that gradually lowers the dosage of the drug they were using until the substance is completely removed from the body. It is up to the health professionals who review the client’s needs to set the tapering schedule. They also determine whether medications will be be used during the tapering process or the detox process.

Some common medications used to treat opioid addiction include:

This prescription opioid helps stabilize people in opioid addiction who are experiencing cravings and other withdrawal symptoms. Methadone therapy must be followed with care. People in recovery can develop a dependence on the drug and end up being addicted to it.



This is a prescription opioid medication that affects the same receptors in the brain like heroin, codeine, and morphine do, but don’t give the same high as those drugs. It also helps prevent or reduce withdrawal symptoms caused when people quit these drugs and are in withdrawal. It is prescribed as Subutex or Suboxone, which is a combination of buprenorphine and naloxone.



A medication in the antihypertensives class that blocks brain chemicals that trigger the sympathetic nervous system activity. It lowers anxiety and helps reduce sweating, hot flashes, and other uncomfortable symptoms of opioid withdrawal.


This buprenorphine implant device is used for maintenance treatment and helps block withdrawal symptoms experienced in opioid addiction, such as cravings and other physical ailments.

A medical detox can last anywhere from three to seven days or longer, depending on how severe the situation is. Mild situations may be managed outside of a rehab center. However, even in that case, a physician’s assessment should be sought to determine what at-home treatment and medications are needed for an at-home recovery program.

During a health examination, the physician will perform a physical exam that will check for things such as a rapid heart rate, shaky hands, dehydration, fever, abnormal eye movements, and abnormal heart rhythms among other signs and conditions.

What Comes After a Medical Detox from Opioids?

A medical detox is the first in a series of steps to recovery. After this process takes place, entering a licensed alcohol or drug treatment center is the next step. Such a place promotes ending problematic drug use addiction by beginning to understand and address the underlying reasons for their dependence.  Addiction is a chronic, relapsing brain disease, according to the National Institute on Drug Abuse. The government agency also says addiction is treatable. Research shows that at least 90 days or more are needed to treat a substance addiction.

Before a treatment center is chosen, the needs and preferences of the person in recovery must be reviewed. Addiction treatment won’t don’t look the same for everyone, so this is an important step.

After it is determined what kind of arrangement is beneficial, recovering opioid/opiate users can choose from:

Residential programs, also known as inpatient programs, provide clients with a safe, supportive, and supervised environment that allows them to focus on their addiction with minimal distractions. Clients are required to stay on site from 30 days to three months or longer, depending on their needs and severity of their situation. They are typically supervised 24 hours of the day to ensure they get the care they need on all levels. Research supports that the longer someone stays in treatment (at least 90 days), the better their chances are of achieving long-term recovery. 


Intensive outpatient programs (IOPs) provide strong support for people in opioid recovery without requiring them to stay overnight or at a rehab facility for extended periods. IOPs are viewed as an affordable option for people who are recovering from substance addiction. The length of an IOP depends on the individual, but the program can run at least up to three months. Clients can receive intensive therapies for a set number of hours each week.



Partial hospitalization programs (PHPs) provide services that are similar to those of inpatient or outpatient programs. In a PHP, individuals in active opioid addiction must meet set criteria to help ensure they can successfully complete the program. PHPs can be used for people who need a place to live as they step down from a higher level of care and transition back into society. Partial hospitalization can serve as a substitute for inpatient care or be a form of intensive outpatient treatment.

Outpatient patient treatment offers the most flexibility while inpatient and residential typically means you’ll be required to complete a 30-day or longer stay at the treatment facility. During your time in any of these programs, you will have various therapies and counseling opportunities to help you put your life back together after addiction. These include holistic therapy, behavior therapy, trauma therapy, and others. There’s also individual, group, and family counseling, 12-step programs such as Alcoholics Anonymous, life skills management, relapse prevention training, and more.

Recovery from Opioid Addiction in Florida

If you or someone you know has tried everything to end a dependence on opioids or opiates but can’t seem to quit, Pathway to Hope, based in Fort Lauderdale, Florida, can help you find the peace you’re seeking. Call us at 844-557-8575 today so we can help you find the right treatment program for you or someone you know. We also can walk you through the process to discuss your insurance needs and what treatment programs you are interested in. Don’t delay. If you need addiction treatment, now’s a good time to get it.

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