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Opioid Withdrawal: Symptoms, Timeline, & Medical Detox

The opioid class of substances includes several prescription painkillers, including hydrocodone and oxycodone, and certain illegal drugs, such as heroin and illicitly manufactured fentanyl.1

All opioids expose users to various risks, including the development of physiological dependence. People with significant dependence may experience withdrawal symptoms when they reduce or stop taking opioids.2 Opioid withdrawal can be extremely unpleasant and lead to certain complications, which is why medications are often used for managing significant opioid withdrawal symptoms.3 Medically supervised detox allows for close monitoring during this difficult time and medical intervention to ease opioid withdrawal symptoms more comfortably and safely.3

What Happens During Opioid Withdrawal?

Repeated use of opioids, even those prescribed by a doctor, can lead to a physiological development known as opioid dependence.2 Opioid dependence develops as the brain adapts to the presence of these drugs. As a result, people come to rely on the drug to function relatively normally.2 When someone is dependent on opioids, the absence of these drugs can result in physiological changes that underlie what’s known as opioid withdrawal.2 People with significant dependence on opioid drugs may experience withdrawal symptoms as quickly as a few hours after the drug was last taken.2

Symptoms of Opioid Withdrawal

Symptoms of opioid withdrawal may include:2, 3

  • Muscle and bone pain.
  • Abdominal cramps.
  • Diarrhea.
  • Nausea and/or vomiting.
  • Problems with sleep.
  • Cold flashes and goosebumps.
  • Uncontrollable leg movements.
  • Anxiety.
  • Intense cravings.

Is Opioid Withdrawal Dangerous?

Left unmanaged, opioid withdrawal can become increasingly severe and unpleasant. Though opioid withdrawal is seldom life-threatening, certain medical complications can develop. These complications, should they arise, may require more emergent attention and medical management.3

Potential opioid withdrawal complications include pronounced dehydration and electrolyte disturbances because of severe gastrointestinal distress and resultant diarrhea and/or vomiting. Opioid withdrawal may also exacerbate underlying cardiac illnesses as a result of abnormally elevated nervous system arousal, as evidenced by signs such as profuse sweating, tachycardia (e.g., rapid heart rate), and hypertension (e.g., high blood pressure).3

Opioid Withdrawal Treatment

Because opioid withdrawal can be distressing and unpleasant and can lead to certain complications, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends hospitalization or another form of 24-hour medical care.3 Professional detox can help manage the physical symptoms of opioid withdrawal and address any acute symptoms or complications that may arise.3

Opioid Withdrawal Medications

Opioid withdrawal is often managed with medications, which can help reduce physical withdrawal symptoms.4 Medications for opioid withdrawal include:4, 5, 6

  • Buprenorphine: A partial opioid agonist, buprenorphine can help diminish withdrawal symptoms and cravings, with less risk of eliciting rewarding euphoric effects of its own, less potential for misuse, and an increased margin of safety in terms of overdose.
  • Methadone: A long-acting full opioid agonist, methadone helps to reduce cravings and prevent the onset of opioid withdrawal. Via the development of cross-tolerance, methadone blunts or altogether blocks the effects of any other opioids in the brain, should they be used while on treatment. 

Ongoing Treatment for Opioid Use Disorder

While the short-term use of opioids can be safe and effective for pain management and certain other medical issues, people commonly divert prescription opioids for non-medical misuse.2 Because of the reinforcing effects of opioids, continued misuse may lay the groundwork for the eventual development of compulsive patterns of use associated with opioid addiction, also known as opioid use disorder (OUD). OUD is a condition marked by continued opioid use despite the clinically significant distress or impairment use leads to.2

While detox can help manage acute intoxication and withdrawal, it is not a substitute for more comprehensive treatment.7 Following detox with treatment in an inpatient or outpatient setting can help patients identify and modify behaviors that may have contributed to their opioid misuse or addiction.7 Treatment varies depending on a patient’s needs but may include a combination of:2, 8

  • Behavioral counseling and therapy (e.g., cognitive behavioral therapy and multidimensional family therapy).
  • Medication.
  • Evaluation and treatment for co-occurring mental health issues (e.g., anxiety, depression).
  • Long-term follow-up to prevent relapse (e.g., continuing care).

There are several FDA-approved medications for opioid use disorder (MOUDs). In addition to buprenorphine and methadone, naltrexone may be used in treatment.4 Naltrexone is an opioid antagonist that binds to and prevents the activation of opioid receptors in the brain. This blocks the euphoric and sedative effects of opioids while reducing and suppressing cravings.9

Don’t Stop After Detox

Detox is just the first step in recovery and is not a substitute for more comprehensive rehabilitation efforts. Sticking with treatment after detox for an adequate period may help an individual in their long-term success with sobriety.7 If you’re ready to learn more about opioid addiction treatment, contact us at to learn more about the rehab admissions process. Your information is kept 100% confidential, and there is no obligation to enter treatment.

If you are not ready to talk, but are interested in making a connection with our AAC facilities, sign up for our text helpline for addiction right now.

See If Your Insurance Covers Opioid Addiction Treatment

American Addiction Centers provides services to those in recovery from opioid misuse and opioid use disorder (OUD). To learn if your insurance covers treatment at an American Addiction Centers facility, verify your insurance by filling out the form below. If you are uninsured, you can still get treated. Learn more about payment options for rehab now.


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