Opiate Withdrawal Timeline
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We’re here to tell you what opiate withdrawal is like.
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Withdrawal can be scary
Part of that is because it’s so uncomfortable, but part of it is because of the uncertainty. A lot of people want to quit opiates like heroin or opioids like Oxy or fentanyl, but they are afraid because they don’t know what to expect or how they can make it through. So we want to share a breakdown of what you can expect to experience when you quit opiates, and some strategies that can help.
(Note that we use the word “opiate” throughout this article, but everything here applies just as much to synthetic opioids.)
Before we get into what withdrawal is like, I want to emphasize that you don’t have to quit cold turkey.
For many people, medication-assisted treatment (MAT) like Suboxone (buprenorphine/naloxone) can help them stop misusing opiates so they can get their lives back on track … without going through opiate withdrawal. But if MAT isn’t right for you, or you don’t have access to it, here’s what to expect as you experience opiate withdrawal, and some things that helped for me.
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1-3 days after your last dose:
The first couple days after you last used are the toughest part of detox, physically. We go into it in greater depth on our blog post, “Heroin Detox: The First Three Days Survival Guide.” Withdrawal symptoms during this time can be pretty miserable. They are commonly mistaken for the flu, and people often talk about this as being dopesick. The good news?
Once you get through this part, you’ll be through the roughest patch.
Opiate withdrawal symptoms 1-3 days after your last dose:
- Chills
- Fever
- Body aches
- Diarrhea
- Insomnia
- Muscle pain
- Nausea
- Dilated pupils
Help with your withdrawal symptoms in the first few days:
- Take hot baths or showers.
- Wear soft and loose clothing.
- Take your mind off the pain by distracting yourself with TV shows, movies, or magazines.
- Stay hydrated.
- Use ice packs or hot compresses.
- Write yourself notes (before you get to this point) that will remind you of your goals, and put them in your bathroom and over your bed or couch.
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1-2 weeks after your last dose:
The intensity of physical withdrawal symptoms will begin to lessen about a week after you last used opiates. Remember that you are still in withdrawal, and take it easy on yourself. Don’t expect your body and mind to be magically working at 100%. It will take time. Be gentle and kind to your body and mind.
Opiate withdrawal symptoms 1-2 weeks after your last dose:
- Tiredness
- Sweating
- Body aches
- Anxiety
- Irritability
- Nausea
Help with your withdrawal symptoms in the first few weeks:
- Minimize your commitments (family/work/social) to lessen your stress.
- Avoid your using friends (and dealer)—don’t visit them, block them on your phone, avoid them on social media.
- Change your bedsheets often, as heavy sweating makes them unpleasant.
- Be honest with those you love so they can support you through the emotional anxiety and irritability of opiate withdrawal.
- Dramamine or Antivert can help with nausea, and ibuprofen or self-massage can help with body aches.
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2-4 weeks after your last dose:
The good news? You are moving past the worst physical symptoms of opiate withdrawal.
The bad news? You are moving into the emotional symptoms. Emotional and mental withdrawal symptoms are often overlooked, but just as important as the physical stuff, and can have a major impact on you.
Opiate withdrawal symptoms 2-4 weeks after your last dose:
- Depression
- Anxiety
- Irritability
- Restlessness
- Trouble sleeping
Help with your withdrawal symptoms in the first few weeks:
- Exercise can help with emotional symptoms as soon as you feel physically up to it. You don’t have to start intense workouts. A gentle walk every day can boost your mood.
- Seek out (healthy) things that give you pleasure. Play with a pet, eat foods you enjoy, listen to music that you love.
- Try to sleep at the same time each night and wake up at the same time each morning. Good sleep habits help.
- Get support for your mental symptoms! You can get support from Workit Health, 12-step or other mutual support programs, or counseling. You don’t have to struggle alone, and being isolated can make these symptoms harder to bear.
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A month and beyond after your last dose:
Cravings can linger and can pop up unexpectedly long after your physical withdrawal symptoms have passed. You may also continue to experience other mental effects of opiate addiction, like depression.
Opiate withdrawal symptoms a month and beyond after your last dose:
- Cravings
- Depression
Help with your withdrawal symptoms in the first few weeks:
- Playing the tape through.
- Thinking about your long-term goals.
- Setting a timer and waiting it out.
- Distracting yourself.
- Helping someone else.
- Moving your body (yoga, walking, swimming, dancing).
- Remembering that the craving won’t last forever, and will eventually fade, no matter how intense it feels in the moment.
- Self-care is crucial for brain repair to assist with depression post-opiates.
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Relief from opiate withdrawal, summarized:
- Stay hydrated. Drink plenty of water. If water feels boring, add a splash of lemon or some flavor drops. You can also add in electrolyte drinks like Gatorade or Powerade.
- Eat. This sounds basic, but a lot of us don’t feed our bodies well while using opioids, and withdrawal can affect our appetites. Eat small, comforting meals, and have nutritious snacks (like fruit, yogurt, nuts, and cheese) available. If eating is hard, Ensure or Pediasure can let you drink some nutrition.
- Use heat or cold. A heating pad or ice pack can ease your discomfort and distract from the physical sensations of your withdrawal symptoms. Make sure you follow the directions on ice packs.
- Hydrotherapy. Sounds fancy, but it basically means using water to ease your aches. This could include baths and whirlpools if you have access to them, but even a shower can help.
- Engage your mind. Your brain can be your biggest help or hindrance in getting through withdrawal. Keep it on your side by avoiding dwelling on cravings or negative feelings. Distract yourself with media that interests you, crafts that require concentration, or talking to friends and loved ones.
- Nonsteroidal anti-inflammatory drugs. NSAIDs relieve pain, reduce inflammation, and lower temperature. Popular over-the-counter ones include ibuprofen (Advil, Motrin), aspirin, and naproxen (Aleve). Acetaminophen (Tylenol) is not an NSAID, but can help with aches.
- Pain relieving creams, rubs, and sprays. Topical analgesics are pain relievers that you put on the outside of your skin, and they can help with muscle aches. These include things like Ben-Gay, Aspercream, Icy Hot, and Tiger Balm. Make sure you follow the directions on the packaging.
- Anti-nausea medications. If you’re working with a provider, they may be able to prescribe you a medication to reduce nausea. Over-the-counter options might include Pepto-Bismol, Kaopeptate, or Dramamine.
- Exercise. It sounds counterintuitive to exercise when you’re feeling bad, but it can really help. Going for walks, doing gentle yoga, swimming, and light dancing or martial arts can all be low-impact, low-intensity ways to move your body.
- Sleep. Make sure the bed, couch, or nest where you’re recovering is as comfy as possible, and have clean sheets and blankets ready in case you sweat through the ones you start with. You could also try chamomile tea or warm milk, or melatonin.
- Antidiarrheal medications. Diarrhea and constipation are major sources of discomfort for people who use opioids and during withdrawal. Pepto-Bismol and Kaopectate can help. If you take Immodium, be sure to abide by the directions, because taking too much is dangerous.
Medication-assisted treatment
This article has been focused on getting through the withdrawal, so we didn’t really talk much about the possibility of avoiding withdrawal by beginning medication-assisted treatment (MAT).
But MAT like buprenorphine (you may have heard of Suboxone) or methadone makes it possible for people to get into stable, long-term recovery from opiates without struggling through withdrawal.
If withdrawal seems insurmountable to you (as it does for a lot of us), MAT might be a way forward.
Get help for opioid use and withdrawal symptoms directly through your phone
Your life is worth the effort of getting off opiates
If you’re looking up what happens during opiate withdrawal, you may already be considering a change.
Just thinking about change is the first step towards a different life, and a new life is created by a series of small changes that add up to result in a big one.
You can kick opiates.
It isn’t easy—withdrawal legitimately sucks—but it’s so worth it.
And so are you.
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Citations
1. Shah, M., & Huecker, M.R. Opioid Withdrawal. [Updated 2023 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK526012/
2. A.D.A.M. Medical Encyclopedia [Internet]. Johns Creek (GA): Ebix, Inc., A.D.A.M.; c1997-2020. Nail abnormalities; [updated 2019 Jul 31; reviewed 2022 Apr 30]. Available from: https://medlineplus.gov/ency/article/000949.htm
3. Wesson, D. R., & Ling, W. (2003). The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs, 35(2), 253–9.
4. Case-Lo, C. (2019).Home Remedies to Ease Opiate Withdrawal Symptoms. Healthline. https://www.healthline.com/health/home-remedies-opiate-withdrawal
Thanks, I’m at the 72hour point right now, I could go fix so bad- but knowing this is the peak Makes it a bit more bearable. I honestly don’t want to repeat the last 2 days.
Hi Micky – The 72 hour point is the toughest point to make it through! YOU CAN DO IT. Remember how far you’ve come and think about how you won’t have to feel this way again. You deserve recovery. We all do.
I’ve hit the 72 hour mark and have had very very minimal symptoms. Does this mean I’m in the clear?
Hi there – It does not! Each person is different, and I’m not a medical expert. You might want to look up post acute withdrawal syndrome, which is a fancy name for the longer-term effects of withdrawal.
Hi. I’m currently lying beside my partner, he’s in the 36th hour and is very irritable and unsure now whether he wants to go through with this in fact I know he’s backing out. He’s going cold turkey at home. He was very bad on codeine tablets, he gave up tramadol last year but stayed taking over the counter ones. He hasn’t even reached withdrawal yet he’s been a codeine addict for 25 years. What can I do to help him?
I’m so sorry to hear that he is struggling and I hope that he’s still okay and ready for help. I would recommend trying to find him some sort of professional help, whether that looks like outpatient treatment or just a checkup at a local urgent care or hospital. Nothing you can do will help him as much as a medical team will (the sad truth). However, your love and support (and insistence that he needs treatment) will help him a bunch. It looks like you are in Ireland: as our blog is in the US of A, I’m not too familiar with treatment in Ireland, but here is a website: http://www.drugs.ie/. If he absolutely refuses to get any sort of professional help, try to make him comfortable with hot baths/showers, keep him hydrated, and remind him of long term goals (being healthy and avoiding the negative cycles of drug use he is stuck in). I would also try to find help for yourself, like family recovery support. As a caretaker, you need to remember to take care of yourself. Workit Health has a program called Tribe, which is designed to support the loved ones of those struggling with addiction: https://www.workithealth.com/tribe
I’m on my 10th day, Vicodin free. I will say it’s a bit easier but I’m still super stuffed up, aches haven’t totally subsided, it’s the worst at night. I’ve been sleeping good with sleep aids from my doctor, the cravings and thinking about it 24/7 are awful though. I’m hoping to feel like my old self again soon, I was taking the pills for over 10 years and finally said I had enough.
Congrats, Jason! It will only get easier from here on out. Without the pills, you will be able to feel life again, the good and the bad, so it won’t be a cakewalk, but I hope you find that old self coming back around any day now. The cravings and obsession can be overwhelming in early recovery, but they do lessen with time.
My brother was injecting oxycodone for the past year and been on them total for about 5-7 years. He also stopped Xanax over a month ago all cold turkey. 3 weeks and 2 days clean from oxy. After taking suboxone for the first 3 days of detox, he decided he didn’t want to take that anymore either. He was in a state of drug induced psychosis on the 4th day of his detox and was treated by a facility. He is now coherent but the cravings are day in and day out. His mood changes daily and the blame game has started along with the questioning of how, what, and why it happened. How long do the cravings last? This is devastating to our family it’s ripping us apart and we don’t want to lose him. He has a supportive wife as well as kids. We are very supportive of him but the pain this has caused us is unimaginable. It’s affecting all of us physically, mentally and emotionally. He refused to go to rehab and wanted to do it on his own. He’s eating healthy but has sleep problems and restless leg as well as muscle aches. Any advice would be greatly appreciated.
Hi there Leanna – First off, let me say that I’m sorry for the struggle that you and your family are going through. Cravings will get less strong in time, but I would recommend that your brother try to get under the care of a clinician. Even if he doesn’t want to go on a medication like Suboxone (evidence shows that this helps with long-term recovery from opioid addiction) they can offer him treatment for his other symptoms and evaluate him for any underlying mental health issues that were causing his addiction. The good news is he doesn’t have to go to rehab to get this sort of treatment. Many doctors offer office-based opioid addiction treatment: psychiatrists and other clinicians specialize in helping people like your brother in office settings, outside of rehab (if you are in Michigan or California, Workit Health offers this sort of treatment online after a single in-person visit). A doctor can assist him with medication, and suggest counseling and other options that might help in his recovery. After immediate withdrawal, post-acute withdrawal symptoms (known as PAWS) will have longer effects but should be more mental, rather than physical. Best of luck to your brother.
He basically did what I would refer to as a spin dry. Which is a typical detox in MA. You receive methadone for 5-6 days. They use to start you on 35-40mg and your last dose would be 5mg. You feel great after 2-3 days and for the whole time you are in detox. The problem is when you go home and the methadone starts to come out of your system. At this time, you need the most help. The half-life of methadone is long and it’s a very potent drug. I’m scared to death of it and would never go on methadone maintenance to treat addiction again. Thirteen years later and prison was the only way I got off but now I’m on suboxen which I find is a lot better for me. I am not lethargic and I am a little bit more like my “old self” then I was on methadone. Personally, if you can get off without needing to stay on a medication then definitely go that route. However, after years of struggling with this problem, I have accepted that I maybe on Suboxen for the rest of my life. Methadone and Suboxen kill the cravings along with time. However, once an addict, always an addict or recovering addict. It took me a very long time to accept that I would never be the person I was prior to unknowingly taking heroin in a pill (OC’s). I personally and strongly feel that I would of never became an IV heroin addict if OC’s never came out. The epidemic has been going on for decades and the government could of prevented a lot of this widespread problem if they really wanted it to stop. After OC’s became illegal to manufacture, perk 30’s hit the streets. Then those were stopped and now we have fentynol killing lots of people. People are dying from overdosing and infections in high numbers. America tends to go to the extreme. Nowadays, if you are in pain, you are lucky if you will be given anything to ease your suffering. It’s ridiculous. Doctors did not create this epidemic, some may of had a small contribution to it but they seem to be pointing the blame there. Also, why punish everyone for a small percentage of the population that are addicts. It would be like banning alcohol due to alcoholics dying from liver failure/cirrhosis. If you take something away, something will replace it. Cause and effect. So, now we have people dying in large numbers because of fentynol replacing heroin. They give out Narcaine. That’s says a lot about the danger of fentynol.
Hello Kali I have been on 100 mcg fentynal and between 20 and 60 mg hydro. For many years prescribed.
I cut my patch in half a week ago Monday and removed it completely a week ago today also stopped the hydro when I first cut my patch …I am taking .15 clonadine and gabapentin . I really haven’t had any real withdraws but because of major injuries in the past I am having some pain and discomfort …I did take an 8mg sub on sat. And 2 on Sunday . I felt good until yesterday and today I did this because I don’t want to be dependent on meds forever or at least not that much my accident was in 1994 I have some kratom from a few years back and thought maybe that would ease things a little but I don’t want it to slow down my recovery time.
Hi Jim – Thanks so much for sharing your story, and I hope you’re doing better now. I know that kratom works for some but for others it can cause a separate addiction. I’ve read stories from both sides of the experience, some really rave about it as a miracle drug while some say it’s risky. I’ve never tried it personally. We’re going to publish a post soon about managing chronic pain in recovery, it sounds like you’re dealing with that yourself from past injuries. Much support to you! -Kali
I’ve tapered down from 16MG a day to 1 mg a day do you have and recommendations for vitamins or any suggestions that can help I’ve been having trouble sleeping on 1 mg I’m really nervous I’d like to get threw this easy as possible I changed my diet and I’ve been drinking lots of water preparing
Hi Jay: Many people in recovery find magnesium or melatonin helpful for sleep. Always check with your doctor before adding in a supplement. We also have sleeping tips on our blog here: https://www.workithealth.com/blog/trouble-sleeping-addiction-help Hope these tips help you find some ZZZ’s!
Thank you guys. I love this info. Tried a cream called diclofenact and it worked. I’m doing nite quilt second night trying it. First week over on to the second week. I’m still getting body shakes smh and a nasty cramp on my neck and I’m tossing and turning a lot.
I was on 24mg of Subutex for the last 4 yrs. I tapered down myself since my doctor didnt want me to and suggested I be on it long term. Before that, I got hooked on Norcos for 2 yrs before starting the Subutex. It’s going on 72 hours pretty soon and so far, I have 0 energy and cold chills, rapid sneezing spells and my back muscles are very sore. The worst part so far, is not even having the energy to move. I go from my bed to a recliner.. is the worst part of it really coming to an end soon? This is awful!