At Into Action Recovery, we know that the fear of withdrawal from opiates is one of the biggest barriers preventing people from seeking help. You’ve likely heard stories, and you’re asking yourself: What does it really feel like? Can it be managed? The unknown is terrifying, but knowledge is power. The process is undeniably difficult, but it is a temporary and, most importantly, manageable journey with the right support.
This guide will walk you through the reality of opiate withdrawal. We will demystify the opioid withdrawal syndrome, provide an honest look at the symptoms of opioid withdrawal day by day, and explain why attempting to go through it alone is not only incredibly difficult but also risky. Understanding this process is the first step toward overcoming the fear and making the life-saving decision to seek help for drug addiction.
Quick Takeaways
- Withdrawal is temporary and manageable: While opioid withdrawal causes intense flu-like physical symptoms and psychological distress, it typically lasts 5-7+ days for short-acting opioids and up to two weeks for longer-acting ones, and with professional support, the process is safer and more tolerable.
- Medical supervision is essential for safety: Though rarely fatal on its own, withdrawal can lead to dangerous complications like severe dehydration, cardiac distress, and extremely high relapse risk. Professional monitoring provides 24/7 care, symptomatic medication, and a safe environment.
- Fear shouldn’t prevent treatment: The fear of withdrawal is one of the biggest barriers to seeking help, but understanding the process and knowing that medical professionals can manage symptoms makes recovery achievable and removes the unknown.
The Foundation of Withdrawal: Opioid Dependence
Before withdrawal can occur, a person must first have developed an opioid dependence. This happens when the brain adapts to the constant presence of opioid medicines, whether they are prescription opioids for chronic pain or illicit substances. After an extended period of taking opioids, the body becomes physically dependent, meaning it needs the drug simply to function normally. With ongoing opioid exposure, the nervous system adapts (tolerance and physical dependence). When opioids are reduced or stopped, withdrawal symptoms can occur. This physical dependence is not the same as an opioid use disorder (SUD), but it is the biological state that triggers withdrawal when the last dose wears off.
The Reality of Opioid Withdrawal Symptoms
When a physically dependent person stops or drastically reduces their opioid use, their body enters a state of acute crisis known as the opioid withdrawal syndrome. This is not just “in your head”; it is a cascade of severe physical and psychological symptoms.
Health professionals use standardized tools like the Clinical Opiate Withdrawal Scale (COWS) or a similar opiate withdrawal scale to measure the severity of these specific symptoms and guide treatment. The withdrawal scale helps track the intensity of the experience, ensuring patients treated receive the appropriate level of care. These tools, which have undergone concurrent validation through research, are a critical part of a clinical assessment, sometimes referred to as a clinical institute narcotic assessment or opioid withdrawal instrument. The early symptoms often feel like a bad case of the flu, but they quickly escalate.
Common Physical Symptoms:
- Intense muscle aches and deep muscle pain.
- Severe stomach cramps and abdominal pain.
- Nausea, vomiting, and diarrhea.
- A persistent runny nose, watery eyes, and excessive yawning.
- Fever, chills, and goosebumps (the origin of the term “cold turkey”).
- High blood pressure and a rapid heart rate.
- Disturbed sleep and profound fatigue.
Common Psychological Symptoms:
- Severe anxiety, agitation, and irritability.
- Depression and feelings of hopelessness.
- Intense cravings for the opioid.
- Inability to feel pleasure (anhedonia).
The Opioid Withdrawal Timeline
A common question people have during recovery is, “How long does it take to withdraw from opiates?” The timeline depends heavily on the type of opioid used.
- Short-Acting Opioids: For fast-acting opioids like heroin or immediate-release opioid medicines in pill form, withdrawal symptoms typically begin 6-12 hours after the last dose. They peak in intensity over the next 1-3 days and gradually subside over 5-7 days.
- Longer-Acting Opioids: With long-acting opioids (e.g., methadone), symptoms can start later (often 1–3 days after the last dose) and may last longer (often 1–2+ weeks).
While the most acute severe symptoms pass, some psychological symptoms and general feelings of malaise can linger for an extended period. If someone has taken opioids regularly, clinicians may recommend a gradual taper rather than abrupt stopping, based on individual circumstances. Providing withdrawal management in a way that reduces the discomfort of patients and shows empathy for patients can help to build trust between patients and treatment staff.
The Critical Need for Opioid Withdrawal Management
While opiate withdrawal is rarely life-threatening on its own, the severe symptoms can lead to dangerous complications like dehydration from vomiting or cardiac distress due to high blood pressure. The immense discomfort also creates an incredibly high risk of relapse. This is why professional opioid withdrawal management is essential.
The goal of management is not to eliminate all discomfort but to manage symptoms safely and make the process tolerable. This involves:
- Medical Supervision: 24/7 monitoring by health professionals to manage complications.
- Symptomatic Treatment: Providing symptomatic medications to address specific issues, such as medication for nausea or to lower blood pressure. This approach helps reduce pain and discomfort significantly.
- Hydration and Nutrition: Ensuring the body stays hydrated and nourished, which can be difficult during acute withdrawal.
- A Safe Environment: Removing the person from an environment where drug use is possible.
During withdrawal, some patients may become disruptive and difficult to manage due to fear or confusion about their situation. For some individuals, especially those with a severe substance use disorder or a long history of chronic opioid use, treatment may involve opioid tapering (a slow, managed reduction of the opioid dose) or transitioning to a medication like buprenorphine to have the same effect of preventing withdrawal without producing a high. These are crucial treatment options for long-term success.
Acute opioid withdrawal is followed by a protracted withdrawal phase that lasts for up to six months and is characterized by cravings for opioids. Patients should drink at least 2-3 litres of water per day during withdrawal to replace fluids lost through perspiration and diarrhea.
Co-Occurring Alcohol Dependence and Other Risk Factors
It’s important to note that withdrawal can be much more dangerous for individuals with a co-occurring alcohol dependence. Unlike opiate withdrawal, withdrawal from alcohol or benzodiazepines can be life-threatening. If there is a history of drug or alcohol dependence, it is absolutely critical that detox occurs under strict medical supervision.
FAQs About Withdrawal From Opiates
Can you die from opiate withdrawal?
Directly, it is rarely life-threatening for a healthy individual. However, complications like dehydration, aspiration from vomiting, or cardiac arrest from extreme stress on the body can be fatal. Furthermore, the risk of a fatal overdose immediately following withdrawal is exceptionally high because a person’s tolerance is dramatically reduced.
What are the main side effects from opiate withdrawal?
Opiate withdrawal causes flu-like symptoms, including muscle aches, sweating, chills, nausea, vomiting, and diarrhea. Psychological effects include anxiety, irritability, depression, and intense cravings. Physical symptoms include dilated pupils, rapid heartbeat, insomnia, restlessness, and abdominal cramping. While extremely uncomfortable and lasting several days to weeks, withdrawal is rarely life-threatening when medically supervised.
Is fever from opioid withdrawal a common symptom?
Yes, fever is a common symptom of opioid withdrawal, though typically mild. Body temperature regulation becomes disrupted when opioid use stops abruptly. Patients often experience alternating chills and sweating alongside the fever. While uncomfortable, withdrawal-related fever is rarely dangerous. However,a high fever combined with severe symptoms warrants medical evaluation to rule out complications or infections.
When to Get Help: The Answer is Now
If you or someone you care about is trapped in a cycle of opioid use, whether from prescription opioids for chronic pain or from illicit drugs, and is afraid to stop because of withdrawal, the time to get help is now. You do not have to experience withdrawal symptoms alone.
At Into Action Recovery, we specialize in providing safe, compassionate, and medically supervised opioid withdrawal management. Our team of health professionals is dedicated to helping you manage symptoms comfortably and safely, providing the crucial first step on the road to a lasting recovery. We understand the fear, and we have the treatment options to help you overcome it.
Don’t let the fear of withdrawal hold you back from the life you deserve. Contact Into Action Recovery today. Our admissions team is available to talk you through the process and help you begin your journey to healing.
