Key Takeaways
- Opioid withdrawal symptoms typically begin 8-24 hours after the last dose and peak within 36-72 hours.
- While opioid withdrawal is rarely life-threatening, it is extremely uncomfortable and is one of the main reasons people continue using.
- Common symptoms include muscle aches, nausea, vomiting, diarrhea, sweating, anxiety, insomnia, and intense cravings.
- Medication-assisted treatment (MAT) with buprenorphine or methadone can dramatically reduce withdrawal severity.
- The acute withdrawal phase lasts 5-10 days for most opioids, but post-acute symptoms can persist for weeks to months.
- Fear of withdrawal is one of the biggest barriers to seeking treatment — knowing what to expect can reduce that fear.
Understanding Opioid Withdrawal
Opioid withdrawal occurs when someone who has developed physical dependence on opioids reduces or stops use. The body has adapted to the presence of the drug, and its sudden absence throws multiple body systems out of balance.
Opioid Withdrawal Timeline
Short-acting opioids (heroin, oxycodone, hydrocodone):
- 8-12 hours: Early symptoms begin (anxiety, muscle aches, yawning, sweating)
- 36-72 hours: Peak intensity (nausea, vomiting, diarrhea, severe cramping)
- 5-7 days: Acute symptoms begin resolving
- 1-6 months: Post-acute withdrawal (PAWS) — insomnia, mood swings, cravings
Long-acting opioids (methadone, extended-release formulations):
- 24-48 hours: Symptoms begin
- 72-96 hours: Peak intensity
- 10-14 days: Acute phase
- Months: Protracted withdrawal possible
What Withdrawal Feels Like
Opioid withdrawal is often described as an extreme flu combined with intense anxiety:
Physical symptoms:
- Severe muscle aches and bone pain
- Profuse sweating and chills ("hot and cold flashes")
- Nausea, vomiting, and stomach cramps
- Diarrhea (often severe)
- Runny nose and watering eyes
- Goosebumps ("cold turkey" origin)
- Yawning and fatigue
- Dilated pupils
- Rapid heart rate and elevated blood pressure
Psychological symptoms:
- Extreme anxiety and restlessness
- Insomnia (often severe)
- Intense drug cravings
- Irritability and agitation
- Depression and hopelessness
- Difficulty concentrating
How MAT Helps Withdrawal
Medication-assisted treatment dramatically reduces withdrawal severity:
- Buprenorphine (Suboxone): Partially activates opioid receptors, relieving withdrawal and cravings without producing a high
- Methadone: Fully activates opioid receptors, preventing withdrawal entirely when dosed correctly
- Clonidine: Reduces anxiety, sweating, muscle aches, and runny nose
- Other comfort medications: Anti-nausea, anti-diarrheal, sleep aids, and muscle relaxants
With proper medical support, withdrawal transitions from a terrifying barrier to a manageable medical process.
If you or a loved one is facing these challenges, learn more about specialized opioid addiction treatment near you available at Trailhead Treatment Center in Salem, NH.
Trailhead Treatment Center provides MAT programs using Suboxone and other medications to support lasting recovery and wellness.
Conclusion
Opioid withdrawal is uncomfortable but manageable with proper medical support. Fear of withdrawal should not prevent you from seeking treatment — modern medical approaches can dramatically reduce suffering. Trailhead Treatment Center offers MAT and comprehensive support for opioid use disorder.