Fentanyl Detox: How to Detox Safely

Fentanyl is a highly potent opioid pain killer. Since it is up to 50 times stronger than heroin and 100 times stronger than morphine, fentanyl is highly addictive. Once dependent upon fentanyl, withdrawal symptoms will occur when use is suddenly stopped.

To ease discomfort and increase the likelihood of a successful withdrawal, specific techniques and medications can be used to reduce the severity of withdrawal symptoms. Detoxing from fentanyl is most safely done under the supervision of a medical professional, and it often involves the use of medication-assisted treatment (MAT). 

Detoxing From Fentanyl 

Detoxing from fentanyl is an individual process that depends on one’s own level of opioid use and response to withdrawal. Physical withdrawal symptoms are generally described as feeling like the flu. For opioids like fentanyl, withdrawal symptoms can present within six hours of last use and typically peak at approximately 72 hours. 

While most physical withdrawal symptoms resolve within a week or so, emotional and psychological symptoms, such as anxiety, depression, and cravings can last much longer. Detoxing under the supervision of a medical professional can involve treatment for both the physical and psychological symptoms of fentanyl withdrawal. Medical care will increase the safety and efficacy of detox. 

What Does Fentanyl Withdrawal Look Like? 

The severity of fentanyl withdrawal varies among individuals depending on the length and severity of opioid use. Opioid withdrawal symptoms typically begin within a day of last use and last for an average of five days. When the person detoxing maintains an adequate level of hydration and electrolytes, detoxing from opioids is typically not life-threatening. 

However, detoxing from fentanyl can be highly uncomfortable and challenging due to the potency of this opioid. Withdrawal symptoms include the following: 

• Runny nose and sneezing
• Yawning
• Sweating
• Hot and cold flashes
• Opioid cravings
• Anxiety 
• Restlessness and irritability  
• Poor sleep
• Abdominal pain
• Nausea and vomiting 
• Diarrhea 
• Aches and pains in muscles, joints, and bones 
• Headaches
• Muscle cramps
• Tremors 

People who have only used fentanyl intermittently and for a short period of time are unlikely to experience significant withdrawal symptoms. A higher consumption of opioids for more than six months is likely to cause a more severe withdrawal process. 

The exact severity of withdrawal symptoms depends on the individual’s history of substance use and response to medical interventions. But anyone who has been abusing fentanyl is likely dealing with a severe level of dependency.

Can I Detox at Home? 

Withdrawal from opioids like fentanyl can take place at home and on your own, though it is not recommended by medical and substance abuse treatment professionals. Detoxing on your own can be challenging and dangerous, and it is much more likely to result in complications and relapse. 

Detox can only occur at home if a strong support system is present. Medications can be prescribed on an outpatient basis and used to alleviate symptoms. Medications and counseling are essential components of the withdrawal and recovery process. Since fentanyl is such a potent drug, support is best delivered in a detox facility or hospital. 

A risk of detoxing without medical supervision is relapse. During withdrawal, the individual’s tolerance for fentanyl or other opioids decreases. If they relapse, they may take more of the drug than the body can handle, based on their prior levels of drug use, resulting in an accidental overdose. 

Additional complications of opioid withdrawal include possible dehydration, electrolyte imbalances, vomiting, and inhaling stomach contents into the lungs. Lung infection can then occur, requiring medical treatment. 

Detoxing on your own may also prevent additional medical and mental health issues from being properly addressed. Many people struggling with substance abuse also struggle with mental health issues, like anxiety and depression. In a treatment setting, medications (like antidepressants) and therapy can be provided to reduce the risk of relapse and address underlying causes of substance abuse. 

Can I Die From Opioid Withdrawal?

In the past, opioid withdrawal was not viewed as life-threatening, but this view has changed. 

In some cases, opioid withdrawal syndrome can be very dangerous and even life-threatening. Severe vomiting and diarrhea, two symptoms of opioid withdrawal, can lead to dehydration and elevated blood sodium levels, which can result in heart failure and death. It is easy to underestimate one’s level of dehydration and the serious health complications that could follow. 

With appropriate medical treatment, these deaths are entirely preventable. 

Fentanyl Withdrawal Treatment Options 

MAT is considered the best treatment for fentanyl addiction. When MAT is used, individuals largely bypass the withdrawal process since the medications used keep withdrawal symptoms and cravings under control.

Still, some people opt to participate in traditional detox. To manage fentanyl withdrawal symptoms, individuals are recommended to gradually reduce their dosage of fentanyl. This technique, known as tapering, allows the body to slowly adjust to less and less of the substance that the body has become dependent upon. 

People who effectively taper off a drug they have become addicted to are likely to experience much milder withdrawal symptoms compared to people who decide to quit cold turkey. In some cases, people don’t experience any withdrawal symptoms when they taper slowly enough.

While detoxing, it is important to drink lots of water to reduce the risk of dehydration. Dehydration can make some withdrawal symptoms feel worse, and water is a simple treatment. 

People going through detox are also encouraged to engage in mind-body therapies, such as yoga, meditation, and relaxation techniques to support mental health throughout the process. In many cases, medications can also be utilized to target specific withdrawal symptoms, such as sleep aids to address insomnia or anti-nausea medications to address nausea and vomiting. 

Medications Used for Fentanyl Detox 

To prevent withdrawal symptoms during fentanyl detox, MAT can be utilized in both outpatient and inpatient settings. Certain medications can be used for short-term and long-term fentanyl use management. 

Methadone

Methadone can be prescribed to reduce the intensity of withdrawal symptoms and support a successful detox. It is also safe to take for the long-term management of opioid dependence. After an initial period of taking methadone to manage withdrawal symptoms, individuals can be tapered off methadone, if appropriate. 

Buprenorphine 

Buprenorphine can manage opioid withdrawal symptoms, often fully eliminating the discomfort of withdrawal. Similar to methadone but with less misuse potential, buprenorphine is safe to take for long-term treatment of opioid use disorder. It is often combined with naloxone in the combination medication Suboxone to prevent misuse. 

Clonidine

Clonidine targets specific symptoms caused by opioid withdrawal. It can reduce anxiety, agitation, muscle aches and pains, sweating, runny nose, and cramps. Unlike other medications, it does not help to reduce opioid cravings. 

Naltrexone 

Naltrexone supports OUD recovery by reducing drug cravings. By reducing or eliminating cravings for opioids like fentanyl, naltrexone helps to prevent relapse. Sudden and severe withdrawal symptoms can occur if naltrexone is taken while opioids are still in the individual’s system. 

Other Medications 

Additional medications can also be used to relieve opioid withdrawal symptoms that are not necessarily opioid specific. 

To relieve aches and pains, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, are available. To reduce nausea and vomiting, antiemetics can be taken. Antidiarrheal medicines can also be taken. Anti-anxiety and antidepressant medications may also be appropriate. 

Why Use Medications for Detox?

The goal of using medications during detox is to reduce the severity of symptoms, thereby increasing the chances of completing the withdrawal process. Detoxing under the care of a medical professional can ensure appropriate medications are being used during withdrawal. 

None of the above medications cause any euphoric effects or highs, so they are not addictive. Using these medications is not substituting one addiction for another. 

Getting Help for Fentanyl Detox

Fentanyl is a serious drug that is incredibly addictive. Because of this, professional treatment is needed to successfully stop abusing it and other opioids. 

Detoxing from fentanyl is a physically and emotionally challenging process. Accessing help from medical professionals is the best way to reduce the severity of withdrawal symptoms, increase the chances of a successful detox, ensure your safety throughout the process, and connect you with addiction treatment services to support long-term sobriety. 

Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More