How Long Does Opiate Withdrawal Last? Signs, Symptoms & When to Seek Help

Opiate withdrawal may take 10 days or less, depending on how long you struggled with addiction, how large the dose was, and which opioid you abused.

This process can be very risky, as the intensity of withdrawal symptoms often triggers relapse in substance abuse, which can cause an overdose. Dehydration may also increase the risk of hospitalization or death.

Medication-Assisted Treatment (MAT) makes the process safer.

How Long Does Opiate Withdrawal Last?

Opiate withdrawal has no clear timeframe, as the duration can change depending on the type of opioid consumed, how long you took the substance, whether you developed a tolerance to the substance, and how large each dose was.

However, some estimates suggest that withdrawal symptoms typically begin between 12 and 48 hours after the final dose. Short-acting opioids like heroin typically metabolize out of the body in 12 hours or less, while long-acting opioids like methadone take two to three days.

Once the final dose of opioids has completely metabolized out of the body, withdrawal symptoms peak in intensity in one to four days. Symptoms generally clear up in 5 to 10 days without any Medication-Assisted Treatment (MAT).

However, peak opiate withdrawal symptoms can be extremely uncomfortable and intense. Unfortunately, many people who attempt to quit opiates “cold turkey” succumb because of these intense feelings and cravings, and relapse back into opiate abuse. Since their body has a lower tolerance, there is a greater risk of overdosing on opiates, which can lead to death.

Medication-Assisted Treatment (MAT) greatly reduces the risk of relapse, improves treatment retention, and helps many people develop new daily habits that do not involve substance abuse. MAT may be needed for months or even years to fully overcome the brain’s dependence on opiates; however, this process ensures the body safely finds physiological equilibrium.

How Does Addiction to Opiates Occur?

Opiates are a class of drugs derived from opium, a narcotic chemical found in the opium poppy. While opium is considered a naturally occurring drug, most of the infamous opiates are synthetic and are called opioids. These include the following:

• Morphine
• Heroin
• Oxycodone
• Hydrocodone
• Codeine
• Fentanyl
• Carfentanil
• Methadone

Some opioids are considered Schedule II drugs, meaning they are tightly controlled but have important medical uses, predominantly to treat severe, chronic pain. Although heroin was originally developed as a prescription painkiller, it is now a Schedule I drug, meaning the Drug Enforcement Administration (DEA) does not consider it to have a medical use. Although it is one of the most commonly abused drugs, heroin is illegal to use.

The number of drug overdoses and deaths in the United States has quadrupled since the beginning of the current epidemic in 1999. Between 2018 and 2019, overdose deaths increased 5 percent.

About 70 percent of these deaths involved at least one opioid drug, and prescription opioid overdose deaths alone increased 7 percent. Heroin overdose deaths decreased about 6 percent, but fentanyl is now the driving force behind opioid overdose deaths.

Detox and rehabilitation treatment are vital to helping people overcome their addiction to opioids. Attempting to withdraw without medical supervision can be dangerous and may lead to relapse and death.

Signs, Symptoms & Risks of Opiate Withdrawal

There are two basic stages of opiate withdrawal. Early symptoms include the following:

• Cravings
• Agitation
• Anxiety
• Insomnia
• Muscle aches
• Increased watering of the eyes
• Runny nose
• Sweating
• Yawning

After the first few days, symptoms will become more intense, and new symptoms will emerge in the later stages of opiate withdrawal, including these:

• Abdominal cramping
• Nausea and sometimes vomiting
• Diarrhea
• Goosebumps or cold shivers
• Dilated pupils

Without medication intervention, these intense symptoms can be debilitating. It is rare for opioid withdrawal symptoms to become life-threatening. However, relapse can cause an overdose, which can be fatal.

There are some potentially deadly complications associated with opioid withdrawal. Excessive vomiting and diarrhea can cause dehydration and elevated sodium in the blood, which can lead to heart failure. Although this is rare, it is another reason that getting medical supervision and treatment during withdrawal is key to overcoming opioid abuse.

Can You Self-Medicate Opiate Withdrawal?

People who take opioids as prescribed may still develop a tolerance to their medication, and they need to slowly withdraw from the substance.

With a doctor’s supervision, they can often taper their dose once they no longer need pain management, or they can simply stop taking the medication if their doctor determines it is safe. They may experience mild withdrawal symptoms, but the mildness is a sign that the dose of their medication was lower than the dose taken by someone who struggles with addiction to these drugs.

When stopping a low prescription dose of opioids, doctors might recommend:

• Taking time away from work or school to get enough rest.
• Drinking water or electrolyte-filled drinks.
• Staying active at a low level.
• Eating a healthy diet.
• Taking over-the-counter pain medications like nonsteroidal anti-inflammatory drugs (NSAIDs) to manage any muscle aches or joint pain.

Sometimes, people struggling with opioid addiction seek self-medication to manage their symptoms or ease the experience of withdrawal. Kratom is currently one of the most common forms of self-medicating opioid withdrawal symptoms.

A survey of people who took kratom found that, of 19,478,180 views and 134,863 comments on 500 kratom-related YouTube videos, 83.4 percent took kratom to self-manage their withdrawal experience. It was undetermined from the comments whether withdrawal worked. It is believed that kratom does not help with the withdrawal process, but instead may replace one addiction with another.

MAT: The Best Medical Approach to End Opiate Addiction

The safest approach to overcoming opioid addiction is to find a rehabilitation program that starts with Medication-Assisted Treatment (MAT) to help you slowly detox. MAT uses either a buprenorphine-based medicine, like Suboxone, or methadone to ease cravings and withdrawal symptoms, allowing you to stop compulsively taking opioids and focus on other aspects of the rehabilitation process.

It may take several months, but once you have physically stabilized, your doctor will help you develop a plan to taper yourself off MAT at a steady and slow pace. This occurs alongside inpatient or outpatient therapy and support group participation.