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Opiate Withdrawal Timelines, Symptoms and Treatment

What Are Opiate Withdrawal Symptoms?

Opiate drugs, including prescription painkillers and heroin, can produce withdrawal symptoms just hours after the last dose, and the symptoms can last for a week or more.

Unassisted withdrawal may not be life-threatening, but it can lead to relapse. Medications and therapy, accessed in medical detox, may make relapse less likely.

Withdrawal Symptoms:

  • Nausea
  • Muscle cramping
  • Depression
  • Agitation
  • Anxiety
  • Opiate cravings

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The National Institute on Drug Abuse (NIDA) publishes that between 26.4 million and 36 million people around the globe abuse opiate drugs, which includes prescription pain relievers and the illegal drug heroin.


Opiates change the way the brain responds to pain stimuli and can also produce a “high” feeling by disrupting the reward and pleasure centers in the brain.The central nervous system, which includes the brain, cardiovascular and respiratory systems, has opioid receptors that receive opiate drugs, and these drugs bring a variety of physical and emotional effects. Heart rate, respiration, blood pressure, and body temperature are lowered while pleasant feelings are increased.

Repeated use or abuse of an opioid drug can actually change the way an individual’s brain chemistry works and lead to physical and psychological dependence. The body may not feel “normal” anymore without the drug’s interaction, and withdrawal symptoms may start in between doses or when an individual stops taking the opiate.

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Signs of Opiate Withdrawal

Opiate withdrawal symptoms may range from mild to severe, depending on how dependent the individual is on an opioid drug. Dependency can be directly tied to the length of time taking a particular drug, dosage amount, which drug was taken, how the drug was taken, underlying medical conditions, the co-occurring presence of a mental health issue, and certain biological and environmental factors, such as family history of addiction, previous trauma, or highly stressful and unsupportive surroundings. Withdrawal from an opioid drug may roughly adhere to the following timeline, although it can vary from person to person.

Early Withdrawal Symptoms

These usually start within 6-12 hours for short-acting opiates, and they start within 30 hours for longer-acting ones:

  • Tearing up
  • Muscle aches
  • Agitation
  • Trouble falling and staying asleep
  • Excessive yawning
  • Anxiety
  • Nose running
  • Sweats
  • Racing heart
  • Hypertension
  • Fever

Late Withdrawal Symptoms

These peak within 72 hours and usually last a week or so:

  • Nausea and vomiting
  • Diarrhea
  • Goosebumps
  • Stomach cramps
  • Depression
  • Drug cravings

Some of the psychological withdrawal symptoms and cravings for opioid drugs may continue longer than a week in some cases. Therapy and psychological support provided by a mental health professional as a part of a complete substance abuse treatment program can decrease the symptoms and side effects of withdrawal.

There are several treatment and detox options for the removal of opioids from the body, and some may provide a more comprehensive model than others. Medical detox, for instance, encompasses both pharmacological and psychological treatment methodologies while under close supervision of both medical and mental health specialists in a safe and comforting residential setting, while standard detox may be performed in an outpatient basis.Opiate withdrawal symptoms can be very uncomfortable, and medical detox may provide the safest and smoothest way to detox. Vital signs, such as blood pressure, respiration levels, body temperature, and heart rate, can all be closely monitored in a medical detox center that may utilize medications to regulate brain and body functions.Mental health professionals can also evaluate and stabilize individuals during medical detox. While there is no specific timeline for detox, as each individual will likely experience withdrawal from opiates differently, medical detox usually lasts 5-7 days.

Medical Detox as Part of a Whole Treatment Plan

Since addiction is a chronic and relapsing disease, with both physical and emotional side effects and symptoms, treatment needs to be comprehensive. Medical detox is relatively short and can provide the stepping stones for a more stable recovery. Relapse is common for individuals struggling with addiction as it may seem like a return to drug abuse may offer relief. After a period of not using drugs, tolerance to certain levels of drugs may be reduced, however, and relapse after detox can be especially dangerous as it may increase the risk for a fatal overdose.
Drug overdose is the leading cause of injury death in America. The American Society of Addiction Medicine (ASAM) estimates that 100 Americans die of a drug overdose every day, and 46 people in the United States die daily due to prescription opioid overdose. The New York Times reports that opioids are responsible for more deaths than any other medication or drug. Medical detox may help smooth out withdrawal, reducing side effects, preventing serious complications, and reducing drug cravings. This can provide a good start toward recovery and help to maintain sobriety long-term.

Detox followed with counseling, education, family and individual therapy, and support groups can help an individual stop using drugs and maintain sobriety.

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