How long does withdrawal last?

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Drug and Alcohol Withdrawal Symptoms, Timelines, and Treatment

What Are Some Drug Withdrawal Symptoms?

The symptoms of drug withdrawal, and the length of that withdrawal, vary depending on the drug of abuse and the length of the addiction. These are a few withdrawal symptoms and timelines for major targets of abuse:

  • Heroin and prescription painkillers: flu-like symptoms lasting an average of 5 days
  • Benzodiazepines: anxiety and/or seizures lasting weeks or (in some cases) months
  • Cocaine: depression and restlessness lasting 7-10 days
  • Alcohol: tremors and/or seizures lasting three days to several weeks

In 2011, theNational Survey on Drug Use and Health(NSDUH) published that almost 25 million Americans over the age of 12, approaching 10 percent of this section of the population, had used an illicit drug in the month prior to the survey, classifying them as current drug users. Addictive drugs and alcohol make changes to the way the brain processes emotions and regulates mood. Many of these changes create a flood of neurotransmitters like dopamine and serotonin, which create an artificial feeling of pleasure, or a “high.”

Continued abuse of drugs or alcohol interferes with the motivation and reward chemistry and circuitry, resulting in drug cravings and dependence.

Once a dependence on a substance has formed, withdrawal symptoms will start when the substance is then removed.

Different drugs and substances will have different withdrawal symptoms and timelines, depending on how they interact with the brain and body. Drugs are absorbed and remain active in the body for differing amounts of time. This is often referred to as the drug’s “half-life,”which relates to the different withdrawal timelines for each substance.

The severity and duration of withdrawal is influenced by the level of dependency on the substance and a few other factors, including:

  • Length of time abusing the substance
  • Type of substance abused
  • Method of abuse (e.g., snorting, smoking, injecting, or swallowing)
  • Amount taken each time
  • Family history and genetic makeup
  • Medical and mental health factors

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For example, someone who has regularly injected large doses of heroin for several years, with a family history of addiction and underlying mental health problems, is likely to experience a longer withdrawal period with potentially more powerful symptoms than someone who has used smaller dosages for a shorter period of time.

A general overview of certain drugs and their withdrawal timeline is as follows:

  • Heroin: Withdrawal begins within 12 hours of the last dose, peaks within 24-48 hours, and lasts a week to up to a week (with some symptoms sometimes lasting months), per the National Institute on Drug Abuse.
  • Prescription opiates (such as Vicodin, OxyContin, methadone, and morphine): Withdrawal starts in 8-12 hours for most prescription opiates, peaks in 12-48 hours, and lasts 5-10 days usually. Methadone withdrawal begins within 24-48 hours, peaks in the first few days, and lasts 2-4 weeks, per Cambridge Health Alliance.
  • Benzodiazepines (such as Xanax, Valium, Klonopin, and Ativan): Withdrawal may begin within 1-4 days, peaking in the first two weeks. In some cases, protracted withdrawal can last months or even years without treatment, per the Comprehensive Handbook of Drug and Alcohol Addiction.
  • Cocaine: Withdrawal starts within hours of the last dose, peaking in a few days and lasting from a week to 10 weeks, per the Australian Government Department of Health.
  • Alcohol: Withdrawal usually begins between eight hours of last drink up to a few days after drinking, peaks within 24-72 hours, and can last a few weeks, according to the U.S. National Library of Medicine.

Heroin & Opiate Withdrawal

Opioid drugs increase feelings of pleasure while numbing symptoms of pain. These drugs include the illegal drug heroin and prescription opiates, such as OxyContin (oxycodone), Vicodin (hydrocodone and acetaminophen), morphine, codeine, Percocet (oxycodone and acetaminophen), and methadone.

Opiates are considered highly addictive, and in 2013, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that 517,000 people were classified with a heroin abuse disorder. An additional 1.8 million Americans suffered from an opioid use disorder involving prescription painkillers.

Opioid withdrawal produces both physical side effects that may mimic the flu and psychological symptoms, during two distinct phases, known as early and late withdrawal. Early on during opioid withdrawal, muscle aches, tearing, runny nose, yawning, insomnia, agitation, anxiety, and sweating are common, according to The New York Times. Later on, nausea and vomiting, chills or goose bumps, diarrhea, abdominal cramps, and dilated pupils occur during late withdrawal.

Heroin has the shortest half-life of all opiates, at only a few minutes, per the Mayo Clinic. Therefore, it takes effect the quickest, but also leaves the body quickly, according to the Drug Enforcement Administration, or DEA. To put it into perspective, OxyContin has a half-life of 3-4 hours for its immediate-release format and 12 hours for the extended-release form, while morphine has a half-life of 6-10 hours, the journal Clinical and Translational Oncology reports. While not technically considered to be life-threatening, opioid withdrawal can be dangerous and should be performed under medical supervision and guidance.

Benzodiazepine Withdrawal

Benzodiazepines, often called “benzos” for short, make up a class of prescription drug used primarily to treat anxiety, panic disorders, and seizures. They may also be used as sleep aids or muscle relaxants. These drugs are considered central nervous system depressants that work to dampen the “fight or flight” reflex that may be hyperactive in someone suffering from heightened levels of anxiety or stress by activating the inhibitory neuron gamma amino-butyric acid, or GABA, which acts as a natural sedative.

When the brain is dependent on a benzo, if the drug is suddenly removed, a rebound effect can occur.

This is when the brain is trying to regain its state of balance as GABA levels potentially drop, opening the door to heightened levels of anxiety and insomnia in the early stage of withdrawal.

The bulk of withdrawal symptoms will be present during the acute withdrawal phase and may include:

  • Tension
  • Panic attacks
  • Tremors
  • Difficulty concentrating
  • Short-term memory loss
  • Anxiety
  • Irritability
  • Disturbed sleep
  • Headache
  • Heart palpitations
  • Sweating
  • Nausea
  • Muscle pain and stiffness
  • Hypertension
  • Irregular heart rate

More serious side effects may also occur during benzo withdrawal, such as delirium, hallucinations, fever, and seizures. Benzodiazepine withdrawal can be life-threatening due to grand mal seizures that may result in coma or death in someone heavily dependent on benzodiazepines who stops taking them suddenly, the Journal of the Oklahoma State Medical Association states.

Anxiety and psychological withdrawal symptoms may continue for several month or even years in about 10 percent of those addicted to a benzodiazepine, ABC News reports. This is called “protracted withdrawal”and can be managed with therapy and mental health services.

Benzodiazepines are generally considered to be short-acting, intermediate-acting, or long-acting and the differing half-lives will dictate when withdrawal may start.

A short-acting benzo, for example, will have the shortest half-life and faster onset of withdrawal than a long-acting benzodiazepine. Short-acting benzodiazepines include Halcion (triazolam) and Serax (oxazepam). Ativan (lorazepam) and Xanax (alprazolam) are intermediate-acting, and Valium (diazepam), Klonopin (clonazepam), and Librium (chlordiazepoxide) are long-acting, per Primary Psychiatry. All three types of benzos produce similar withdrawal symptoms, and detox should be medically managed.

Cocaine Withdrawal

The stimulant drug cocaine has a very short half-life of less than an hour, meaning that it quickly takes effect and also rapidly leaves the bloodstream. Stimulant drugs elevate heart rate, temperature, and blood pressure. The “high” can produce extreme euphoria, heightened energy levels, and elevated self-confidence, although the feelings do not last very long. This often results in cocaine being abused repeatedly in a binge pattern. Cocaine is produced in two main forms: powdered cocaine that is smoked, snorted, or injected, and rock form or “crack” cocaine that is typically smoked. Smoking and injecting cocaine send it straight into the brain and may result in higher “highs” and quicker “crashes,” according to the DEA.

Cocaine withdrawal is usually manifested in three main phases: the initial crash, acute withdrawal, and extinction period.

  • Crash period: The crash may last between nine hours and four days, the National Highway Traffic Safety Administration (NHTSA) reports. The crash symptoms are generally the opposite of the stimulant effects. A person in the crash phase of cocaine withdrawal may sleep for days, notice an increase in appetite, and feel depressed and agitated.
  • Acute withdrawal: During acute withdrawal — which may continue for 1-3 weeks NHTSA publishes — irritability, fatigue, depression, insomnia, anxiety, and drug cravings are common.
  • Extinction period: Cravings for cocaine along with depressed moods and even potentially suicidal thoughts may continue for several months after stopping use of cocaine, per the National Library of Medicine.

Stimulant withdrawal is unlike withdrawal from most other substances, as there is a lack of many physical symptoms. As a result, withdrawal from cocaine is not considered to be life-threatening. Drug cravings and emotional turmoil associated with withdrawal may be best treated by a mental health professional trained in substance abuse and dependency who can provide necessary psychological support and care during detox and throughout recovery.

Alcohol Withdrawal

Alcohol is the most commonly abused substance in the US, with one in every 12 adults battling an alcohol dependency or abuse issue, according to the National Council on Alcoholism and Drug Dependence (NCADD). Alcohol withdrawal has a wide range of side effects, from mild hangover-type symptoms to coma and death. The more and longer an individual engages in patterns of heavy drinking, the more likely the brain is to become seriously dependent on alcohol and the more grave withdrawal symptoms may be during the detox process.

According to data published in the New England Journal of Medicine (NEJM), about half of those with an alcohol use disorder will experience some form of alcohol withdrawal symptoms when alcohol use is cut down or eliminated. Between 3 and 5 percent will suffer from the most serious form of alcohol withdrawal: delirium tremens, or DTs. Seizures, fever, severe confusion, agitation, hallucinations, and delirium may signify DTs, which can be fatal without swift medical intervention.

Other side effects of alcohol withdrawal include:

  • Anxiety
  • Insomnia
  • Headache
  • Nausea and vomiting
  • Irritability
  • Fatigue
  • Trouble concentrating or thinking clearly
  • Muscle aches
  • Loss of appetite
  • Clammy skin
  • Dizziness
  • Shakiness
  • Mood swings
  • Nightmares
  • Elevated heart rate
  • Tremors
  • Sweating
  • Loss of color in the face
  • Dehydration
  • Shallow breathing
  • Depression

Alcohol withdrawal is usually most intense in the first few days, with physical side effects typically tapering off in a few days to a week. The emotional effects and cravings for alcohol may continue for longer.

While alcohol withdrawal can start within the first few hours after the last drink, delirium tremens may not start for an additional few days, and appear suddenly, making alcohol withdrawal safest when monitored around the clock by a medical professional.

When Detox Is Necessary

Addiction is a disease with many symptoms that may affect each individual person in a unique way. Withdrawal from any substance of abuse after a dependency has formed is best performed in a substance abuse treatment center that offers medical detox.

Medical detox means that medical professionals are on hand to ensure the individual’s personal safety by monitoring vital signs and emotional states. The initial goal of detox is to achieve a safe and comfortable level of physical stability so the psychological manifestations of withdrawal can be addressed. Someone addicted to alcohol, opioids, or benzodiazepines should always undergo medical detox to safely manage withdrawal with the fewest number of adverse consequences. Many times, these substances will need to be weaned out of the body slowly under the direction of a medical professional.

Use of Medications in Detox

Medical detox may also use medications to help with the side effects of withdrawal. Buprenorphine products and methadone are supported by NIDA as effective treatments for opioid detox and dependency, for instance. Both buprenorphine and methadone are opioid agonists that activate opioid receptors in the brain. Buprenorphine is a partial agonist and only partially activates the receptors, lowering the potential for abuse. These drugs are long-lasting, meaning that they are effective for a longer period of time and in smaller doses, making them applicable in reducing withdrawal symptoms and drug cravings.

Naloxone, an opioid antagonist, is often added to buprenorphine products, like Suboxone and Zubsolv, in order to block opioid receptors from receiving other opioids. It usually lies dormant unless tampered with and injected. If these medications are abused, the naloxone may induce another form of opioid withdrawal called precipitated withdrawal, which is the rapid onset of more intense withdrawal symptoms. This may deter someone from attempting to abuse these medications or any other opioid agonists during detox and into recovery.

For someone addicted to benzodiazepines, a longer-acting benzodiazepine may be used during detox to control withdrawal and taper the drugs down slowly. Medications such as antidepressants or mood stabilizers may be used during medical detox from many addictive substances in order to target specific psychological symptoms, such as depression, anxiety, and panic. NIDA reports that the mild stimulant drug modafinil may help with cocaine withdrawal symptoms. Benzodiazepines are sometimes used to smooth out alcohol withdrawal and to help prevent seizures by calming the overactive nerves and neurons. Depending on the level of dependency and care needed, detox from illicit drugs may be done in either an outpatient or inpatient capacity. An assessment of physical and emotional symptoms should be first conducted by a trained professional in order to determine what level of care will produce the best results.

Different drugs have different withdrawal timelines and symptoms, and treatment should be tailored to the specific drug and its side effects. Mental health and medical issues can complicate withdrawal as can poly-drug abuse, and these issues should be considered during substance abuse treatment.

Residential, or inpatient, substance abuse treatment often provides the most comprehensive care, and medical detox is the optimal choice in helping to make withdrawal as smooth as possible for most addictive drugs.

How Long Does It Take to Withdraw From Alcohol or Drug Dependence?

Everyday Health: How long does withdrawal last?

David Sack, MD:Withdrawal generally lasts three to five days, though the length and severity depend on the particular drug or drugs of abuse. More severe problems and addictions to certain drugs, such as alcohol and benzodiazepines, may require one or two weeks of supervised detoxification.

John Mak, MD: Persons addicted to a medication can suffer from withdrawal symptoms if that medication is abruptly discontinued. The body and the brain will reactadversely. In the case of opioid addiction, the body stops producing its own natural painkillers – endorphins – because opioids look just like endorphins to nerve cells. The body becomes dependent on this imitation endorphin to function. Therefore the length of withdrawal symptoms will vary from weeks to months, depending on how long it takes the body to start producing its natural endorphins again. The amount of time the body requires to recover and start producing endorphins will in turn depend on the type of drug abused and the length of abuse.

Akikur Mohammad, MD:Withdrawal can last days to weeks, depending on the substance used, how long and how much the person used it, and the person’s overall health.

Dana E. Zalkind, MD:Withdrawal from a drug or alcohol can occur with abrupt cessation of the substance or decrease in the amount consumed. Drug detoxification is the removal of the offending drug from the body. Withdrawal symptoms can vary according to the drug that’s being stopped, as well as the amount of the drug that was consumed each day and the number of days the drug was used. The duration of physical withdrawal is typically three to five days; however, emotional withdrawal can be much longer. Some symptoms can be present for many months. Withdrawal symptoms can range widely and include depression, anxiety, anorexia, insomnia, and even suicidal thoughts or death. Withdrawal symptoms from alcohol can include nausea, vomiting, insomnia, anorexia, tremors, and rapid heart rate. Severe alcohol withdrawal usually requires a high level of medical attention: Fevers, seizures, tremors, hallucinations, and convulsions can be life threatening.

Withdrawal from benzodiazepines, such as Valium, can also entail medically significant complications. Withdrawal from opioid-based medications such as oxycodone usually doesn’t entail medical emergencies and is not life threatening; however, the symptoms can still be quite unpleasant. They can include abdominal cramping, diarrhea, confusion, sweating, muscle aches, flulike syndrome, chills, rhinitis, depression, dysphoria, cravings, and paranoia. Most of these symptoms improve in several days. If someone has been on a high-dose, long-acting opioid such as methadone, withdrawal symptoms could last for several months. There are other, nonopioid medications that can help mitigate or ease the symptoms of withdrawal, but they won’t eliminate them completely. Support groups and professional medical intervention can be an integral part of managing withdrawal and preventing a relapse in drug use.

John F. Natale, LCADC: This varies with the types of drugs and also with the length of time the drugs were used. But detoxification takes approximately five to fifteen days.

Opiate Withdrawal: What It Is and How to Cope with It

When you’re ready to kick your opiate habit, know that support is key to coping with opiate withdrawal. The more support you have, the more likely you’ll succeed in overcoming your addiction.

Professional care

Rather than going through withdrawal alone, consider going to a detox facility. There, you’ll be monitored closely by a team of healthcare providers who will help keep you safe and help relieve your withdrawal symptoms.

If you’d rather go through the withdrawal process at home, be sure to stay in close contact with your doctor. Tell them when you’re doing it, and before you start, discuss medications they could prescribe that might help you get through it. As you go through the process, be sure to report ongoing side effects to your doctor.

Emotional support

Be sure to tell your family and friends that you’re going through withdrawal. You’ll be facing a tough time, and having their support can make a big difference. If you’ll be at home, make sure at least one person checks on you every day.

Support groups and individual counseling are also options for emotional support. Narcotics Anonymous is one resource that could help you get off and stay off of opiates.

Preparation

Being prepared can make all the difference for your success in getting through withdrawal. If you’ll be at home, stock up on items you may need. These can include:

Fluids: If you have vomiting or diarrhea during withdrawal, you may be at risk of dehydration. So, it’s important to drink plenty of fluids. Consider purchasing drinks that contain electrolytes, such as Pedialyte.

Over-the-counter (OTC) medications: OTC drugs may help you battle side effects from withdrawal. These products may include:

  • dimenhydrinate (Dramamine) or meclizine (Bonine) for nausea
  • Imodium (loperamide) for diarrhea
  • ibuprofen (Motrin) or naproxen (Aleve) for muscle aches, chills, and fever

Activities: Be sure to have activities available to help keep you occupied. Books, movies, and music are all things that can help get your mind off of your withdrawal symptoms.

Support for the long haul

Withdrawal is just one step in the opiate recovery process. You’ll likely want to set up a plan for long-term success after opiate withdrawal. This can also include support groups, as well as mental health treatment. Other steps may help make your withdrawal experience easier. To find out more, read about remedies to ease opiate withdrawal symptoms.

Alcohol withdrawal is just as dangerous as alcoholism. Alcoholics and their loved ones often mistake it for a simple side effect associated with recovery. Withdrawal is life-threatening for many alcoholics, and the immediate risks often outweigh the benefits.

It seems counterintuitive to suggest those with an addiction to alcohol avoid quitting to minimize their risk of withdrawal, but medical professionals recommend detoxing in a supervised medical facility.

Withdrawal begins approximately 8 hours after the last drink, but can occur as quickly as two hours after a person gives up drinking. It lasts anywhere from a week to several weeks depending on the severity of its symptoms.

Alcohol Withdrawal Stages – Does Everyone Suffer from Withdrawal?

Understanding withdrawal is challenging. It’s not always the same for alcoholics. There are three stages to alcohol withdrawal, but not everyone experiences all of them, any of them, or a combination when they quit drinking. There are too many factors that work together to determine whether an alcoholic will experience any symptoms of alcohol withdrawal syndrome when quitting. These factors include:

  • Family history of alcohol abuse
  • How long someone has been an alcoholic
  • How much someone drinks
  • What someone drinks
  • Presence of other health issues
  • How much stress alcoholics suffer
  • Medical history

An alcoholic affected by alcohol addiction every day for more than a decade is more likely to be impacted by withdrawal symptoms than a person who has only had a dependence for a few months. Someone with mental health disorders is more likely to experience withdrawal symptoms than someone with a clean bill of health. It’s impossible to predict who will experience the symptoms of withdrawal, or if the side effects will be serious.

The First Stage of Alcohol Withdrawal Symptoms

Alcohol withdrawal symptoms begin when an alcoholic quits drinking. It might begin anywhere from two hours to a solid day after someone consumes that last beverage.

The average amount of time it takes someone to begin showing signs of withdrawal is 8 hours. The first stage is the least severe, but symptoms vary from person to person.

Alcohol withdrawal symptoms include various stages of severity of the following:

  • Anger
  • Anxiety
  • Fatigue
  • Loss of appetite
  • Abdominal pain
  • Vomiting
  • Insomnia
  • Nausea
  • Depression
  • Heart palpitations
  • Foggy brain
  • Tremors
  • Mood swings

While not everyone experiences the first stage, many people experience at least some degree of withdrawal from this stage. Some alcoholics experience very minor symptoms, while some experience them at their worst. Predicting what might occur when an alcoholic takes that last drink is impossible, but these are the most typical symptoms everyone experiences.

Alcohol is a depressant, so all people who quit will experience some feelings of sadness, melancholy, or depression. Nearly everyone who stops drinking feels tired once their good mood dissipates. Mood swings are common as a person comes down off their drunken high. Tremors aren’t as common, but long-term alcoholics tend to experience them.

The first stage often includes vomiting, which can induce dehydration. If an alcoholic is vomiting and not keeping liquids down, it’s imperative they seek medical attention. Dehydration is the first step in organ failure. Stage one usually lasts around a day once it begins.

The Second Stage of Withdrawal

As the withdrawal symptoms from stage one begin to subside, relief is still far off. The second stage of withdrawal is more serious. It usually begins one day after drinking ends, but it can take as many as three days to begin.

Stage Two Alcohol Withdrawal Symptoms can include:

  • Rise in body temperature
  • High blood pressure
  • Confusion
  • Abnormal heart rate
  • Sweating
  • Irritability
  • Breathing problems
  • Mood swings

Once an alcoholic begins experiencing stage two, symptoms can last two to three days. Just like the vomiting that comes with stage one, the sweating that occurs during this part of alcohol detox can cause dehydration. It’s dangerous, and it can lead to more serious health issues. Not all alcoholics experience all of these symptoms, but they’re all common. A doctor should monitor high blood pressure, body temperature, and abnormal heart rates. It’s imperative alcoholics find medical attention at this stage if they haven’t already.

The Final Stage – How Long Do Alcohol Withdrawal Symptoms Last?

This is the most dangerous stage of alcohol withdrawal. It’s the one that produces the most serious symptoms. It’s the one that might end in death. Symptoms begin approximately three days following the last drink an alcoholic takes, and they can last for weeks.

Final Symptoms include:

  • High fever
  • Hallucinations
  • Seizures

Each of these symptoms require medical attention. High fevers are dangerous by themselves, but they become even more dangerous when they are accompanied by hallucinations and seizures. In general, it’s the side effects of seizures that cause the most damage to your health. It’s the falling, the potential head injuries and trauma, and the choking that might occur in the middle of a seizure that pose the biggest threat to an alcoholic’s health.

Many people ask, “How long does alcohol withdrawal last?” It’s difficult to say for certain, as each person and circumstance is different, although symptoms typically begin to subside after a week, but they can last in a less dangerous capacity for many weeks.

Alcohol Detox

Medical professionals recommend professional alcohol detox for anyone looking to quit drinking. It’s less common for withdrawal to occur when an alcoholic slowly stops drinking. It’s most common to go through this when someone quits drinking all at once.

Because the side effects of withdrawal are so dangerous to a person’s health, professional supervision during alcohol detox is necessary.

Weaning a person slowly from alcohol provides fewer shocks to the alcoholic’s body. It’s one way to avoid going through withdrawal, but it’s not always the answer. Many don’t have the ability to give up drinking a little at a time without help, which is why cold-turkey quitting is the choice so many alcoholics make.

Finding an appropriate detox facility increases a person’s chances of minimizing the withdrawal symptoms that typically occur in the days following the end. Supervised dual diagnosis treatment makes the process safer, and it increases the likelihood it will work in the long run.

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How Long Do the Withdrawal Symptoms from Fentanyl Last?

Fentanyl is a powerful opioid painkiller with a high addiction potential. According to the National Institute on Drug Abuse, it is 50 to 100 times more potent than morphine.

Discontinuing fentanyl or any other opioid abruptly after regular use can result in withdrawal symptoms. Withdrawal symptoms can also occur if a person suddenly dramatically decreases their dose or dosing frequency.

Has your fentanyl use become unmanageable? Take our addiction assessment now. It’s free and confidential.

Difficulty Stopping Fentanyl Use

Fentanyl is a highly potent drug that is used to treat severe pain, postoperative pain, and sometimes chronic pain in people who are physically tolerant to other opioids. People who use it on a regular basis may develop dependence, meaning that stopping or drastically decreasing use can result in withdrawal symptoms, and tolerance, meaning that increased doses are needed to achieve the same effect.

Opioid withdrawal can be extremely uncomfortable.

Although opioid withdrawal itself is usually not dangerous, it can raise a person’s risk of overdosing if they restart opioids. Overdosing can be fatal. Relapse to opioid use will occur, research indicates, for the majority of individuals who have opioid use disorder and go through medically supervised withdrawal, though psychosocial strategies can be beneficial during and after.

Don’t Suffer Alone

If you want to stop using fentanyl or if you are already going through withdrawal, seek medical help.

If you’re worried about the cost, one option is to look into using your insurance, which may make it more affordable. For instance, Laguna Treatment Hospital is now part of the Anthem Blue Cross network. You can call to find out more about specific plan details and coverage. The cost of treatment may be much less than you expected when you utilize your insurance coverage.

Fentanyl Withdrawal Symptoms

Withdrawal symptoms from fentanyl are similar to those of other opioids. Possible symptoms include both physical and psychological symptoms. They may include:

  • Agitation, anxiety
  • Muscle aches
  • Increased tearing, runny nose
  • Trouble sleeping
  • Yawning
  • Sweating
  • Stomach cramping, diarrhea
  • Nausea, vomiting
  • Dilated pupils
  • Goose bumps

Another major symptom of withdrawal is craving the drug. Individuals going through opioid withdrawal are especially vulnerable to giving in to that craving due to the desire to stop the unpleasant withdrawal symptoms. Relapse during detox is not uncommon and can be fatal. Individuals who have detoxed from opioids are at increased risk of overdose because their opioid tolerance has decreased.

Fentanyl Withdrawal Timeline

The timeline of fentanyl withdrawal symptoms depends on many factors, including formulation and individual factors. However, a general timeline is as follows:

  • Hours 8-30: Mild symptoms typically begin.
  • Hours 36-72: The worst physical symptoms typically feel the most intense. After the peak, symptoms will begin to decrease.
  • Days 5-8: Primary withdrawal symptoms should end around this time, and the person will begin to feel more normal. However, in some individuals it can take a few weeks.
  • Several weeks or even months: A few physical symptoms (such as increased sensitivity to pain) and several psychological symptoms (such as cravings, depression, sleep disturbances, irritability, and anxiety) may persist, a phenomenon known as post-acute withdrawal syndrome or a protracted withdrawal phase. Some sources state this can last for years.

Withdrawal timelines and severity can vary for individuals based on the formulation used, the frequency and intensity of use, and other factors. If you are going through withdrawal or if you want to stop using fentanyl, talk with a medical professional.

Treatment

According to provisional 2017 counts, over 29,000 Americans died from overdoses involving synthetic opioids other than methadone, primarily fentanyl. If you think you or someone else may have overdosed, call 911 immediately.

If you are misusing fentanyl or if you are going through withdrawal, talk to a medical professional. You may not have an opioid use disorder but may still be dependent on opioids. You may have an opioid use disorder.

Medication-assisted treatment (MAT) may be beneficial for you. MAT can help prevent relapse, increase patient survival, improve treatment retention, and more.

Caffeine Withdrawal Symptoms: Top Fifteen

Caffeine withdrawal is no laughing matter and can be very debilitating for those who are suddenly without caffeine.

If you are or have been an avid coffee, tea, or energy drink consumer then you are aware of how addictive caffeinated beverages can be.

Just a few hours after missing your scheduled dose the caffeine withdrawal symptoms start to set in.

This phenomenon has become so prominent that caffeine withdrawal is now a recognized disorder and is listed in the DSM-5.

Here are the most common caffeine withdrawal symptoms. You’ll be comforted to know that you aren’t really dying but just detoxing from the caffeine.

Even if you aren’t normally a habitual caffeine drinker, you may experience negative symptoms when quitting caffeine even if you only consumed it for a few days in a row.

Top 15 Caffeine Withdrawal Symptoms

  1. Headaches
    A caffeine headache usually starts behind the eyes and then moves up the front of the head.
  2. Sleepiness
    This just isn’t your normal tiredness, this is sitting up straight but still can’t keep your eyes open tiredness.
  3. Irritability
    Everyone and everything gets on your last nerve. It’s best just to lock yourself in your room during this stage.
  4. Lethargy
    Forget about productivity at this stage because you’ll be unmotivated to do anything from the sudden drop in your dopamine levels.
  5. Constipation
    Caffeine stimulates the bowel, so without it, the colon gets a little cranky too.
  6. Depression
    Caffeine withdrawal can take away all hope for living. Temporary blues are one thing, but if you already struggle with depression this could be a big issue.
  7. Muscle Pain, Stiffness, Cramping
    Since caffeine has pain-relieving qualities, muscle pain will become very noticeable.
  8. Lack of Concentration
    Forget school, studying, brain surgery, or jet engine repair during this stage of withdrawal.
  9. Flu-like symptoms
    A stuffy nose, blocked sinuses, and sinus pressure have all been reported by people withdrawing from caffeine.
  10. Insomnia
    Some people actually can’t sleep when going through caffeine withdrawal even though physically they feel super tired.
  11. Nausea and Vomiting
    Some people can’t even think about food the first few days of withdrawal which compounds the feeling of lethargy.
  12. Anxiety
    In some people, caffeine actually causes anxiety, but in others, withdrawing from the drug can cause feelings of anxiety and panic attacks have even been reported by some.
  13. Brain Fog
    Withdrawal can cause some people to experience brain fog which is described as the difficulty of having coherent thoughts, difficulty thinking, and the difficulty of doing common tasks.
  14. Dizziness
    Caffeine withdrawal can cause some people to lose their sense of equilibrium and experience vertigo.
  15. Heart Rhythm Abnormalities
    Since caffeine also stimulates the heart muscle, some people experience changes in their heart rhythm during withdrawal. Both low blood pressure and even palpitations have been reported.

If you want to reduce your caffeine intake (or quit entirely), here’s how:
1.Download our book Awake(it’s free).
2. Do the Overcoming Caffeine Withdrawal course at Udemy.
3. Use the Wean Caffeine supplement (something we helped get to market). It helps you avoid the painful withdrawal symptoms that often come when quitting caffeine abruptly.

Detoxing is No Laughing Matter

Caffeine withdrawal is a very unpleasant experience, to say the least.

The symptoms of withdrawal usually last a few days to two weeks for light caffeine consumers but can last 2 months or more for those that had been consuming around 1000 mg or more daily. However, even for the most addicted, the worst symptoms subside after about a week’s time.

Even after the withdrawal period is over, many still feel never quite as good as they did when they were drinking caffeine all of the time. Some believe that caffeine permanently alters one’s brain chemistry. This is most likely due to the changes that occur with dopamine levels in the brain because of the daily caffeine use.

How addicted to caffeine are you?

You can take our Caffeine Addiction Diagnosis Quiz to see where you rank. This may explain why your caffeine withdrawal has been so rough.

Human beings can be addicted to anything – including caffeine. Whether dependency or addiction, the reality is that for many, stopping caffeine consumption is very difficult.

Whether you should quit or not depends on how your caffeine habit is affecting your own health, your relationships, and the people around you.

For some people, their regular coffee/caffeine habit may not affect any of those things and quitting need not be necessary.

The Science of Withdrawal

  1. Caffeine is addictive because the molecule itself fits so perfectly into our brain’s adenosine receptors.
  2. Adenosine is responsible for telling the brain when it is time to rest or sleep.
  3. Since these receptors are blocked with caffeine molecules, dopamine (the feel-good chemical) works more efficiently. The excess adenosine signals the adrenal glands to release adrenaline, which further perpetuates the feeling of alertness.
  4. Over time, the brain adds more adenosine receptors to compensate for the caffeine, which causes a “tolerance” to build-up to the caffeine molecule.
  5. When a person misses or decides to quit their usual caffeine dosage, the brain is then flooded with adenosine and dopamine levels drop drastically causing the brain’s chemistry to be out of balance.
  6. The increased adenosine plus a drop in adrenaline and dopamine levels lead to many of the caffeine withdrawal symptoms listed above.

Easing The Symptoms

For those that are going through caffeine withdrawal, there are a few things that can be done to ease the symptoms and allow for more productivity.

  • Gradually ease back – If you are consciously giving up caffeine, it may be wise to gradually wean yourself off of caffeine as opposed to going cold turkey. We recommend Wean Caffeine as a systematic and precise way to gradually reduce your caffeine consumption to zero over a 30 day period.
  • Take pain relievers – Taking aspirin, ibuprofen, or Tylenol can help ease headaches and muscle pain symptoms associated with withdrawal.
  • Drink plenty of water – Staying well hydrated is key during the withdrawal process and will help you feel better.
  • Get plenty of rest – It’s helpful to plan for your withdrawal during a weekend or a time when productivity isn’t a necessity. Sleeping a lot the first day or two is pretty common.
  • Exercise – Most people won’t feel like exercising, but it will actually make you feel better. Exercise causes the release of dopamine, which is now in short supply in the absence of caffeine. You’ll need all the dopamine you can get, so get moving.
  • Eating healthily – Improving your diet will also help. Eating plenty of fresh vegetables and fruit will provide your body with the nutrition it needs thus delivering natural energy and promoting a more positive frame of mind.

In any event, just remember that withdrawing from caffeine is hard and takes time. Soon you’ll be caffeine-free and will be able to experience life without the daily influence of caffeine.

You’re not alone!

Here are a few stories about people’s personal experiences with withdrawal from caffeine.

I gave up caffeine one week ago after my anxiety symptoms started having too much of an impact on my everyday life, panic attacks insomnia dizziness and the like, and I thought that giving up caffeine may be a good thing to do to help with these unpleasant symptoms. So far I have been completely exhausted, (even after choosing to start on a week when I’m off work) I feel “low” have absolutely no energy, irritable, over worrying about everything. Although I feel sad that you’re all going through similar things, it makes me feel better to know that it’s not just me.

-Anthea

The first 2- 2 1/2 weeks I could not focus for the life of me. At work and for an exam I was studying for. Spoiler alert: I failed it. I would read things over again and they wouldn’t sink in. My brain was in a constant dreamlike fog. It was terrible. But those severe (as I call them) symptoms have mostly gone away. I think I’m still riding the tail end of this so-called caffeine withdraw. I’m about 3-4weeks now (?) could be five. Everyone will have different experiences and times that it will last. I’m 30 and I’ve been drinking sodas, energy drinks, sports drinks, etc. most of my life. About 7 months ago I quit sodas and would only drink coffee, water, and tea. After quitting coffee cold turkey, that’s when all hell broke loose.

-Bran

I stopped drinking coffee, then one morning I felt completely out of it, disconnected, dreamlike. I had trouble retaining information, focusing, it was like my conscious mind was constantly clouded or like I was looking at life through a veil. There were days where I had anxiety attacks and I felt the fight or flight kick in. Another day I had a breakdown. It was like I was detoxing from a severe drug. I never felt like this before. After about two weeks it got much less severe. I’m almost to 2 1/2 weeks and I feel like I’m getting better but not 100% relief. But, I definitely can function basically normally, but for that first week and part of the 2nd week, it was a nightmare I couldn’t wake up from. It was so jarring that I went to see a doctor.

-Chris

Written by Ted Kallmyer, last updated on November 6, 2019

Opiate Withdrawal and Detox

What Is Opiate Withdrawal?

Opiates, or “opiate painkillers,” encompass a number of prescription drugs such as codeine, Dilaudid and tramadol. Individuals who take these drugs in larger doses, or for longer periods than initially prescribed, have a high risk of forming a physical dependence.

A person who becomes physically dependent on opioid painkillers will feel a need to continue using the drugs in order to function normally. If they quit taking the drug “cold turkey,” they will experience various uncomfortable symptoms as the body tries to adjust without the substance.

Withdrawal occurs when a person suddenly stops using a drug, or significantly reduces the amount they were taking. The symptoms of withdrawal depend on a number of factors, including the type of painkiller being abused, the person’s established tolerance to the drug the length of their addiction, whether they abused multiple substances, and their mental and medical history. Most symptoms of withdrawal are flu-like, such as fever, sweating and vomiting.

While withdrawal symptoms are generally not life-threatening, they can still cause tremendous physical and psychological distress to the person suffering. Because of the intensity of symptoms, people who are trying to end their drug use on their own may resort to using again to avoid the withdrawal process. However, the continuous cycle of stopping and resuming drug use can make it much more difficult to quit later on. This is because the cycle can spiral into uncontrollable abuse patterns.

Trying to quit painkillers “cold turkey” is difficult and dangerous to do on your own. It is highly recommended to seek the help of medical detox professionals in order to overcome opioids safely and effectively.

Medical detox programs are structured, safe environments designed to help guide patients through the withdrawal process. Doctors help patients overcome their symptoms by slowly easing them off an addictive drug until they are no longer physically dependent on it. In many cases, doctors may prescribe medications to reduce the severity of certain symptoms and curb cravings.

After a person finishes a detox program, their medical team may advise them to seek further treatment at an inpatient rehab center. This is a crucial step toward ensuring long-term sobriety and avoiding a relapse. Many detox programs are located inside inpatient rehab centers so that patients can make a smooth transition into further addiction treatment.

Opiate Withdrawal Symptoms

The symptoms of opiate withdrawal range from mild to severe. Symptoms are most intense in patients suffering from extensive drug abuse or addiction. This is defined by consuming large doses of a substance, over a significant period of time.

There are other factors that may also play a part in the types of withdrawal symptoms a person experiences. These factors include a person’s current health and well-being, any underlying mental or behavioral disorders, whether their family has a history of drug dependence, the length and severity of the addiction, and how they administered the substance.

Within 24 hours after their last dose, a person will typically begin to experience a combination of the following withdrawal symptoms below:

  • Agitation
  • Anxiety
  • Muscle spasms
  • Insomnia
  • Runny nose
  • Sweating
  • Abdominal cramps
  • Stomach aches
  • Diarrhea
  • Constricted pupils
  • Fluctuating blood pressure
  • Nausea
  • Tremors
  • Vomiting

How Long Does Opiate Withdrawal Last?

There are four stages of withdrawal from opiates: anticipatory, early acute, fully-developed acute, and post acute withdrawal syndrome (PAWS).

Depending on the type of addiction, acute withdrawal typically occurs within a few hours of a person’s last dose. The acute withdrawal period involves flu-like symptoms that are associated with painkiller withdrawal. After acute withdrawal ends, the protracted abstinence period sets in, which can last up to six months. This period is when people in recovery are most vulnerable to triggers that can lead to relapse.

Opiate Withdrawal Timeline

Stage of Withdrawal

When It Occurs

Description of Symptoms

Anticipatory 3 to 4 hours after last dose The anticipatory stage is marked by increased anxiety or fear related to oncoming symptoms of withdrawal. This stage is also characterized by cravings and drug-seeking behavior.
Early acute 8 to 10 hours after last dose Anxiety and restlessness begin to increase during this time. A person may experience flu-like symptoms such as nausea, vomiting, sweating and stomach aches. Cravings and drug-seeking behavior still persist.
Fully-developed acute 1 to 3 days after last dose Symptoms have reached their peak at this stage. Individuals will typically experience body tremors, muscle spasms, diarrhea, insomnia and increased blood pressure. Cravings are strongest during this period.
PAWS Up to 24 months after last dose Acute symptoms are no longer present in this stage. However, individuals may have mood-swings, cravings, drug dreams, anxiety, depression, irritability/agitation, insomnia, and poor concentration. A person is still highly susceptible to environmental triggers that may encourage them toward relapse.

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Medications Used in Opiate Detox

Doctors often prescribe medications during the detox process. These medications help treat the long-term issues associated with opiate withdrawal, such as drug cravings. Over time, a doctor will gradually taper down the dosage of these medications until the patient recovers from acute withdrawal symptoms. Medications may continue to be prescribed while the patient is continuing treatment in an inpatient rehab center.

Here are some of the most common medications used during opiate detox:

  • Clonidine

    Clonidine is often prescribed to suppress withdrawal symptoms and treat high blood pressure. It is especially useful in reducing symptoms of anxiety and stress. It is available as an oral tablet or patch that is worn on the skin. Clonidine does not cause the euphoric feelings commonly associated with opioid painkillers. As a result, the drug also has little potential for abuse and physical dependence. This makes it easier to discontinue the use of the drug once withdrawal symptoms subside.

  • Methadone

    Methadone was once widely used medication in detox settings, but has largely been replaced by buprenorphine. It is typically prescribed to help patients ease off of the drug they originally became dependent on. As a long-acting opioid, methadone is most effective as a long-term treatment method for patients struggling with chronic opiate addiction.

  • Buprenorphine

    Buprenorphine, also known as Suboxone or Subutex, is commonly used for the treatment of alcoholism, but this medication is also shown to be a highly effective treatment for opiate withdrawal. As a partial agonist, buprenorphine does not mimic the full effects of stronger opiates, such as hydrocodone. The drug helps to decrease symptoms of withdrawal and opioid cravings, which helps patients stay motivated in treatment.

  • Get Help for an Opiate Addiction

    Detox alone cannot help you gain freedom from an opiate addiction. After successfully completing a medical detox program, it is highly recommended to pursue further treatment at an inpatient rehab center.

Inpatient rehabs are equipped with resources that can help you understand the root cause of your addiction. Some treatments include cognitive behavioral therapy, 12-step programs, one-on-one and group counseling sessions, and creative expression activities such as art and music therapy. The services that inpatient rehab offers, combined with the high levels of around-the-clock care will help you stay focused and motivated during treatment and beyond.

  • PrintArticle Summary
  • Who Gets Withdrawal?
  • When Does Withdrawal Begin and End?
  • Is the Timeline the Same for Everyone?
  • What Is Protracted Withdrawal?
  • Do Medications Lessen the Duration?

Withdrawal can bring about a host of effects that, while not always dangerous, can be physically and/or mentally agonizing. For example, the withdrawal effects that arise when someone who is heroin-dependent tries to quit can be sufficiently painful to send them running back to heroin to relieve the discomfort.

However, the good news is that withdrawal won’t last forever, and with the help of professionals, the process can be completed with as little pain and as much emotional support as possible. There are various options for people seeking professional detox treatment, and attending an inpatient detox is not always required. Continue reading to discover more about withdrawal and which detox method is safest for you or a loved one.

Who Gets Withdrawal?

People who are physically dependent on alcohol or other substances are at risk of experiencing withdrawal symptoms.1 Many people believe that all addicts will go through withdrawal when they quit, but this isn’t always the case. Addiction is a disorder that involves compulsive drug-seeking despite the harm that it causes, and while many addicts are physically dependent on a drug or drugs, not all of them are. Physical dependence must be present for withdrawal to occur.1

Physical dependence refers to the changes that take place in the brain from regular substance use that make it so that the substance is needed for the person to feel “normal”. Both normal prescription drug use and recreational substance abuse can result in dependence.1

Someone who uses or abuses a substance sporadically is not usually in great danger of becoming dependent. In most cases, substance use needs to be consistent/chronic for a period of time to create the brain changes linked to dependence and withdrawal.1

When Does Withdrawal Begin and End?

Withdrawal refers to a set of unwanted physical and psychological symptoms that are unique to the specific substance used.1 Not only do the substances dictate the types of symptoms experienced but also the general timeline of those withdrawal symptoms.2

Opioids

As a class, opioids cover a wide range of substances, legal and illegal, that differ in terms of strength and purpose. Common opioids include heroin, morphine, hydrocodone, and methadone.3

Opioid withdrawal will be heavily influenced by the type of drug being used:

  • Someone dependent on a short-acting opioid like heroin may experience withdrawal symptoms that begin just a few hours after the last time they used, peak between at 36 and 72 hours, and continue for between 5 and 10 days.3
  • Longer-acting opioids aren’t cleared from the body as quickly so the symptoms of withdrawal may be delayed as compared to those of shorter-acting ones. For drugs like methadone, the onset of symptoms may begin as late as 48 hours after the last dose, peak around day 3, and take up to 21 days to diminish.4

As opioid withdrawal symptoms begin, a person may experience:4

  • Runny nose.
  • Watery eyes.
  • Excessive sweating.
  • Yawning.
  • Dilated pupils.
  • Fever.

As withdrawal progresses, more intense symptoms may begin and include:4

  • Loss of appetite.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Goosebumps.
  • Weakness.
  • Increases in blood pressure and heart rate.
  • Agitation and restlessness.
  • Bone and muscle pain.

Sedatives

As with opioids, the specific sedative abused will determine sedative withdrawal timelines— someone dependent on short-acting drugs like Ativan, for example, may experience the onset of effects within hours of quitting; with longer-acting sedatives, such as Valium, a person who quits may not experience significant withdrawal symptoms until a week after the last use.2

  • Short-acting sedative withdrawal symptoms will usually peak around day 2 and resolve on day 4 or 5.2
  • Long-acting sedative withdrawal symptoms may not peak until the second week and may take up to 4 weeks to decrease significantly.2

Quitting sedatives, specifically benzodiazepines, will tend to produce 3 stages of withdrawal.4

  • Early withdrawal:
    • GI distress.
    • Increases in pulse rate and blood pressure.
    • Anxiety.
    • Panic.
    • Restlessness.
  • Mid withdrawal may bring about more symptoms such as:
    • Fever.
    • Sweating.
    • Insomnia.
    • Shakiness.
    • Poor appetite.
    • Diarrhea.
  • Late withdrawal is associated with the more dangerous symptoms such as:
    • Hallucinations.
    • Agitation.
    • Changing/unstable heart rate and blood pressure.
    • Seizures.

Due to the dangers of late withdrawal, inpatient medical detox is the preferred option for sedative detox.

Alcohol

Alcohol is associated with a rapid onset of withdrawal—symptoms often begin just hours after the last drink, in some cases when the person still has a measurable blood alcohol level.5 Symptoms usually resolve within 10 days, but those days can be very precarious, especially as the symptoms peak (typically between 36 and 72 hours of quitting).3

Within 12 hours, a person may experience withdrawal symptoms that include:5

  • Anxiety.
  • Insomnia.
  • Headache.
  • Sweatiness.
  • Heart palpitations.
  • GI distress.
  • Poor appetite.

Alcoholic hallucinosis (visual, auditory, or tactile hallucinations) may arise within 12-24 hours of the last drink.5Alcohol withdrawal seizures represent one of the biggest dangers of alcohol withdrawal. They most commonly begin between 24 and 48 hours after the last drink.5

Some people will experience a very severe form of alcohol withdrawal, called delirium tremens, which typically arises within 2-3 days of the last drink. It is marked by:5

  • Hallucinations (primarily visual).
  • Severe disorientation.
  • Agitation.
  • Rapid heart rate.
  • High blood pressure.
  • Fever.
  • Sweating.

Stimulants

Stimulants—drugs like cocaine, methamphetamine, and amphetamines such as Adderall—all have similar withdrawal syndromes. Symptoms that often begin within 24 hours and last up to 5 days include:3

  • Exhaustion.
  • Increased need for sleep and food.
  • No interest in substance use.
  • Low mood.
  • Restlessness.
  • Irritability.

Psychosis, agitation, and thoughts of self-harm may also arise in some individuals going through withdrawal from stimulants, especially methamphetamine.3

Acute stimulant withdrawal is followed by a longer-lasting phase of protracted withdrawal. (See symptoms below.)

Is the Timeline the Same for Everyone?

The specific drug used and the method of use will be the major factors driving the timeline, so people using the same drug in the same way will generally be expected to withdraw on similar timelines.6

However, the detoxification process—including the specific onset of and resolution of withdrawal symptoms—is unique for each person due to individual differences in their substance use (duration and method), the severity of dependence, their physical and mental health, and whether there have been previous negative withdrawal experiences.

While the timelines may be similar, the experiences can vary widely. Also highly variable are the symptoms that last beyond the acute phase, known as protracted withdrawal.

What Is Protracted Withdrawal?

Acute withdrawal symptoms have a limited duration and are directly related to the reaction of the body and brain to the abrupt end to or decrease in substance use.7 These acute withdrawal symptoms do not always represent the absolute end of substance withdrawal, however.

Protracted withdrawal may endure after the acute symptoms conclude. Sometimes called post-acute withdrawal syndrome (PAWS), these symptoms are common among people recovering from dependence on: 7

  • Alcohol.
  • Opioids.
  • Stimulants.
  • Benzodiazepines.

Just like acute withdrawal, protracted withdrawal involves ongoing cravings and other symptoms specific to the substance used.3,7

PAWS Symptoms

PAWS symptoms associated with alcohol may last for months to several years and include:

  • Anxiety
  • Hostility
  • Irritability.
  • Depression
  • Mood instability.
  • Problems thinking and concentrating.
  • Lower quantity and quality of sleep.
  • Fatigue
  • Lower desire for sex.
  • Increased pain.

Symptoms related to opioids include:

  • Anxiety
  • Depression
  • Emotional numbness.
  • Irritability.
  • Poor sleep.
  • Low energy.
  • Decreased focus.
  • Impaired problem-solving skills.

Symptoms related to benzos may fluctuate for months and include:

  • Increased anxiety.
  • Panic attacks.
  • Obsessive thoughts or compulsive behaviors.

Stimulants like methamphetamine and cocaine can trigger PAWS symptoms that last for a month or more, such as:

  • Low energy.
  • Lower impulse control.
  • Anxiety.
  • Rapidly changing moods.
  • Poorer ability to manage feelings and emotions.
  • Decreased attention, focus, and concentration.
  • Worsening of problem-solving skills.

These symptoms may be very troublesome and, because they can be so long-lasting, they may lead a person otherwise committed to recovery to relapse back to their substance of choice to find some relief. Additional addiction treatment beyond detox can help in learning to cope with these symptoms, and the use of medications (see below) may provide relief both for the acute and the protracted symptoms of withdrawal.

Do Medications Lessen the Duration?

Professional detoxification services help people through the withdrawal process in the safest and most comfortable way possible.8 Many detoxes utilize medications to minimize the symptoms and side effects of the process.

At times, medications used to keep the patient safe and comfortable may actually increase the overall duration of withdrawal.8 Someone with a benzodiazepine dependence, for example, may be first switched to another, longer-lasting benzodiazepine. Once stabilized on the new benzo, the patient will be slowly tapered off the substituted benzodiazepine.8 This process results in a longer withdrawal period but one that is safer and much less intense.

Medications may also be used treat withdrawal from alcohol, opioids, and other sedatives. For opioids, methadone and buprenorphine are often used to decrease withdrawal severity. Alcohol withdrawal, like sedative withdrawal, can be managed with a benzodiazepine or phenobarbital.8 Medications don’t usually lessen the duration of withdrawal, but they can make it a much easier experience.

Rapid and ultrarapid detoxes for opioid dependence are sometimes advertised as an easier way to finish withdrawal in a very short period of time.8 In these treatments, the individual is given a medication called an opioid antagonist, like naloxone, during the early stages of withdrawal. These drugs increase the speed of onset and intensity of withdrawal symptoms.8 Detox professionals then provide a number of other medications like clonidine and benzodiazepines to treat the emergent symptoms until the resolution of withdrawal.8 In the case of ultrarapid detox, the patient is placed under general anesthesia throughout the majority of detox.8 Rapid and ultrarapid detoxes have numerous risks, especially when general anesthesia is utilized, and they may not actually ease the process of withdrawal.8,9

Withdrawing from a substance can be scary and painful. To help relieve the burden, be sure to contact a professional detox treatment program so that experts can guide you through the process.

Even after acute withdrawal ends, the symptoms of PAWS can make recovery difficult. This is when medication-assisted treatment (MAT)—the use of medications (such as methadone or naltrexone) to reduce cravings, reduce PAWS, and encourage recovery—can come in to help you maintain your sobriety.1 For assistance in starting your journey to a life no longer shackled to a substance, call today.

  1. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  3. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Setting.
  4. Federal Bureau of Prisons. (2018). Detoxification of Chemically Dependent Inmates.
  5. American Family Physician. (2004). Alcohol Withdrawal Syndrome.
  6. National Institute on Drug Abuse. (1997). Rate and Duration of Drug Activity Play Major Roles in Drug Abuse, Addiction, and Treatment.
  7. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
  8. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
  9. National Institute on Drug Abuse. (2006). Study Finds Withdrawal No Easier With Ultrarapid Opiate Detox.

Heroin Withdrawal

Author: Chris Elkins, MA | Last Updated: 5/25/18 | 7 sources

Withdrawal from heroin is one of the biggest obstacles to recovery from heroin addiction. People who are addicted to heroin often have no greater fear than dope sickness — the street name for heroin withdrawal.

The symptoms can be so severe that individuals going through withdrawal become figuratively paralyzed. Being dope sick can confine a person to a bedroom or a bathroom for days.

Early symptoms of heroin withdrawal include:

  • Sweating
  • Muscle ache
  • Runny nose
  • Yawning
  • Irritability
  • Anxiety
  • Sleep problems

Late withdrawal symptoms of heroin include:

  • Dilated pupils
  • Cramping
  • Goose bumps
  • Nausea
  • Vomiting
  • Diarrhea

The length and intensity of heroin withdrawal symptoms depend on several factors, including the way the drug is consumed and the duration, frequency and amount used.

Overcoming heroin withdrawal symptoms without professional help is difficult, and most people who try to quit on their own end up turning to heroin when withdrawal becomes too difficult. More comfortable and reliable ways to quit heroin are available if you decide to seek help.

What Causes Heroin Withdrawal?

Withdrawal from heroin can occur after a few uses. The hangover from first-time heroin use can be so intense that people decide to seek the drug to relieve their symptoms. While people generally don’t become addicted the first time they try heroin, the first try can trigger a dangerous pattern of use.

Most people become addicted to heroin over several days or weeks. Heroin affects parts of the brain that control pleasure and motivation. Repeated use causes changes in the body that make the brain rely on heroin to feel normal. This is called dependence, and it’s one reason why heroin is so addictive.

Heroin dependence occurs because opioids such as heroin are chemically similar to opiates that the brain produces naturally to control how we feel pain and pleasure. The difference between opioids and opiates is that opioids are man-made and opiates occur naturally.

The brain decreases the natural production of opiates when it’s exposed to heroin and other opioids. It starts to depend on heroin to feel normal. When a person who is dependent on heroin stops using the drug, the brain doesn’t have enough man-made or natural opioids to feel normal. As a result, it goes into withdrawal.

The time that it takes to experience withdrawal depends on how long it takes for the brain to restore natural opiate production.

How Long Do Heroin Withdrawal Symptoms Last?

The more heroin that a person is used to consuming, the worse the withdrawal symptoms will be. And the longer a person uses heroin, the longer the withdrawal symptoms will last. The length and severity of withdrawal also differ depending on whether a person quits cold turkey or tries to taper off of heroin.

Different types of heroin, such as black tar heroin or white powder heroin, may affect withdrawal length depending on the purity of the substances. Speedballing — mixing heroin with cocaine — or using heroin with other types of drugs may also complicate the withdrawal process.

The stages of heroin withdrawal can be divided into three categories:

Early symptoms The early symptoms of heroin withdrawal usually begin within 12 hours of last use. Some people may experience initial symptoms within eight hours, and others may not feel them for up to 24 hours. Symptoms usually begin with sweating, muscle aches and irritability. Peak symptoms Early symptoms slowly worsen for two to three days. The person usually has trouble sleeping during the first few days of heroin withdrawal. During the peak period, late symptoms of withdrawal such as cramping, diarrhea and vomiting begin. Late symptoms After the peak stage of withdrawal, early symptoms start to subside. People still feel late symptoms, but they slowly lessen in severity. Sleep problems tend to improve, but most people struggle to get a full night of rest during any stage of withdrawal. Late symptoms usually last for between four and seven days.

Heroin withdrawal usually lasts between four and 10 days. Some people may experience peak symptoms within one day and get through late symptoms within four days. Others may not experience peak symptoms until the third day, and they could feel late symptoms for more than a week.

It’s not possible to get through heroin withdrawal more quickly. The duration depends on the severity of your addiction. However, you can make heroin withdrawal less painful by going to a quality detox or treatment facility.

Struggling with heroin addiction?

Our recovery programs are designed for you.

Overcoming Heroin Withdrawal

Unlike other types of withdrawal, such as alcohol withdrawal, heroin withdrawal is rarely life-threatening. The only people at high risk for death during heroin withdrawal are people with other serious health conditions, such as high blood pressure or heart problems.

But health professionals don’t recommend overcoming heroin addiction and withdrawal on your own because the chances of success are so low. The symptoms are so painful that few people are capable of powering through opioid withdrawal.

Getting through withdrawal doesn’t help people addicted to heroin quit using the drug because addiction has several other causes. People addicted to heroin often relapse if they don’t receive counseling or therapy for addiction. You can find counseling, therapy and comprehensive treatment for heroin addiction by calling a heroin hotline.

How to Cope with Heroin Withdrawal Symptoms at Home

If you choose to try to quit heroin at home, try to make yourself as comfortable as possible. Ask for several days off work and make sure you have plenty of fluids, healthy food and hygiene necessities, such as toilet paper.

Consider contacting a rehab facility ahead of time in case you’re unable to get through withdrawal on your own.

Ask a trusted friend or family member to stay with you in case you experience a complication involving another health condition. A loved one may also be able to encourage you to get through withdrawal and avoid seeking heroin to alleviate your symptoms.

Create a list of nearby support group meetings you can attend to help you avoid relapse after you overcome withdrawal. You may want to consider contacting an addiction therapist or rehab facility ahead of time in case you’re unable to get through withdrawal on your own. This way, if you find you need help, you can attend rehab instead of returning to regular heroin use.

Detoxing from Heroin at Rehab

Overcoming heroin withdrawal at a detox or rehab facility is much easier than detoxing at home. During heroin detox, you’ll receive around-the-clock medical supervision. Nurses will monitor your vital signs to ensure your safety.

You’ll receive adequate nutrition and fluids that may ease some symptoms associated with heroin withdrawal. You may also receive some medications to treat symptoms such as pain, nausea or diarrhea.

When you’re assessed at a heroin treatment facility, you can learn about medication-assisted treatments that may relieve symptoms of heroin withdrawal. Medications such as methadone or Suboxone may be recommended to help you taper off of heroin. These medications are proven to decrease relapse rates when they’re combined with other types of therapy for opioid addiction, according to the Substance Abuse and Mental Health Services Administration.

Heroin withdrawal symptoms are among the most painful withdrawal symptoms caused by drug addiction. But they aren’t insurmountable, and people going through withdrawal don’t have to try to power through the symptoms on their own. Help is available to ease the recovery process and prevent relapse.

AuthorSenior Content Writer, DrugRehab.com Chris Elkins worked as a journalist for three years and was published by multiple newspapers and online publications. Since 2015, he’s written about health-related topics, interviewed addiction experts and authored stories of recovery. Chris has a master’s degree in strategic communication and a graduate certificate in health communication. @ChrisTheCritic9 editor ,

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