How Long Does Opiate Withdrawal Last? Timeline, Symptoms & More

One major factor is whether the drug was long-acting or short-acting, with short-acting drugs generally having more intense symptoms and shorter withdrawal timelines than long-acting drugs.

How Long Does Opiate Withdrawal Last?

The amount of time opiate withdrawal can take varies, but the World Health Organization suggests doctors expect a duration of 4 to 10 days for short-acting opioids, like heroin, and 10 to 20 days for long-lasting opioids, such as methadone.

These symptoms typically begin within 8 to 24 hours after cessation of use with short-acting opioids and 12 to 48 hours after cessation with long-acting opioids. 

Symptoms of Opioid Withdrawal

Opioid withdrawal is usually described as “flu-like,” with common symptoms like these:

• Agitation
• Anxiety
• Increased tearing
• Insomnia
• Muscle aches
• Runny nose
• Sweating
• Yawning

Late-stage withdrawal symptoms are typically worse and include the following:

• Abdominal cramping
• Diarrhea
• Nausea and vomiting
• Piloerection (goosebumps)
• Pupillary dilation

Generally speaking, symptoms will slowly worsen once a person stops taking opioids, hit a peak, and then begin to taper off.

Opiate Withdrawal Timeline

Short-Acting Opioids

Short-acting opioids include the following drugs:

• Heroin
• Codeine
• Hydrocodone
• Oxycodone (immediate-release)
• Oxymorphone (immediate-release)
• Morphine

Time After Cessation of Use	Experience
8–24 hours	Symptoms begin
4–10 days	Symptoms start to fade

Long-Acting Opioids

Long-acting opioids include the following drugs:

• Methadone
• Hydrocodone (extended-release)
• Oxycodone (controlled-release)
• Oxymorphone (extended-release)

Time After Cessation of Use	Experience
12–48 hours	Symptoms begin
10–20 days	Symptoms start to fade

Factors That Affect Opiate Withdrawal

One of the biggest factors affecting the severity of withdrawal is the length of time a person has been using opioids and in what dosages.

Generally speaking, people who have used opioids longer or in higher amounts have a harder time during the detox process. This means the people who often experience the most discomfort are those who have intentionally abused opioids over multiple years.

As a result, people with longstanding or high-dose opioid addictions need additional support during the withdrawal process.

How to Safely Detox From Opioids

Opioid withdrawal is not typically life-threatening, but it can be under the wrong circumstances.

The most dangerous symptoms associated with withdrawal are vomiting and diarrhea. These symptoms, if untreated and severe, can cause three life-threatening results, which cascade into each other:

• Dehydration
• Hypernatraemia (elevated blood sodium level) 
• Heart failure

Fortunately, addiction treatment professionals understand these risks, and reputable treatment facilities will be well-equipped to help a person undergo withdrawal safely. They can help to ease withdrawal symptoms with certain medications and make sure a patient stays generally hydrated.

If you cannot access a treatment facility while undergoing withdrawal, make sure to prioritize hydration. You lose water not only through vomiting and diarrhea but also through sweating.

Drink at least two to three liters of water each day and even more if you have severe symptoms. Consider taking vitamin B and vitamin C supplements as well.

While you may not want to, it is strongly recommended that you seek expert help while undergoing detox. Medical professionals can ensure you stay safe during the opioid withdrawal process, and they can make the process much more comfortable for you.

In an addiction treatment program, medical detox will begin the recovery process. The bulk of treatment will then take place in therapy, where the underlying issues that led to opiate abuse are addressed.

Post-Acute Withdrawal Syndrome (PAWS)

People who have detoxed from opioids and gone through acute withdrawal may experience lingering symptoms for up to one year—these are called post-acute or protracted withdrawal symptoms and may include:

• Depression
• Anxiety
• Panic
• Irritability
• Learning, memory, or problem-solving issues
• Sleep problems
• Apathy
• Opioid cravings
• Increased stress sensitivity

Not everybody will experience PAWS, and these symptoms can also come and go and fluctuate in severity. If you’re experiencing post-acute withdrawal symptoms, you’ll want to make sure to receive therapy and support during this difficult time.

Medications Used to Treat Opiate Withdrawal

A few medications are used to treat opiate withdrawal. Never take these drugs as a treatment for opiate withdrawal or addiction recovery unless instructed to by a doctor. 

Methadone

Somewhat paradoxically, methadone is a synthetic opioid often used in the treatment of opioid use disorder. When administered carefully, this long-lasting drug can help wean you off opioids of abuse with significantly lessened withdrawal symptoms.

Some people are on methadone for years. The controlled nature of its administration means you can keep progressing to an eventual drug-free life.

Buprenorphine

Buprenorphine is a partial opioid agonist, serving a somewhat similar role to methadone in the treatment of withdrawal symptoms and helping a person overcome opioid addiction.

In essence, this drug can almost be thought of as a weaker opioid that is designed to be more difficult to abuse. While all prescription medication should be handled carefully and buprenorphine has its dangers, it is considered safer than methadone and is easier to access in less structured settings.

Clonidine

Clonidine is a medication that can treat many of the flu-like symptoms caused by withdrawal, reducing anxiety, agitation, muscle aches, and more. It is often used in combination with other medications that treat nausea, diarrhea, and sleep problems.

Naltrexone

Naltrexone is a drug meant to help prevent relapse, essentially working to suppress the mechanism opioids use to act on the body. This means a person essentially can’t get high on the drug, although the drawback is this can cause sudden, severe withdrawal if used while you still have opioids in your system.

Naltrexone can temporarily reverse an opioid overdose, and most first responders carry this medication.

Getting Help With Opiate Withdrawal

Ultimately, the best path forward for opiate detox is to get professional assistance.

Relapse is highly likely for those who attempt opiate detox on their own. When withdrawal symptoms get intense, it’s simply too easy to return to opioid use.

With the right help and a good support system, you can effectively get through opiate withdrawal and embrace life in recovery. Reach out for that help today.