Opioid Withdrawal Symptoms: What Are They And How Long Do They Last?

Opioid medications can be helpful for people experiencing moderate to severe pain. But they have serious risks, such as misuse and overdose, so they’re only prescribed when other pain medications don’t work. Additionally, stopping opioids or switching to a lower dose can lead to opioid withdrawal symptoms.

If you take opioids, it can be helpful to know what opioid withdrawal symptoms look like and how long withdrawal can last.

What is opioid withdrawal?

Opioid withdrawal refers to symptoms that can occur when you stop taking, or reduce the dose, of an opioid. Opioid withdrawal symptoms happen because your body becomes used to having opioids in your system, and relies on them to function normally.

Opioid withdrawal can happen to anyone who stops taking opioids. It’s especially likely if you stop your opioid cold turkey after taking it for more than a few days or weeks. It can also happen if your dose is lowered too quickly. That’s why you should talk to your prescriber before changing your opioid dose or stopping it. They can help you develop a plan to lower your dose over time.

In other cases, experiencing opioid withdrawal is a sign of opioid use disorder (OUD). But along with withdrawal, other symptoms must be present to diagnose OUD. Examples include having cravings for opioids, using opioids despite negative consequences, and using opioids in situations that are dangerous (such as while you’re driving).

What are opioid withdrawal symptoms?

Opioid withdrawal can cause a wide variety of symptoms that affect both the body and the mind.

EXPERT PICKS: WHAT TO READ NEXT

• Opioid side effects: Opioid withdrawal is one possible opioid side effect. But there are many more, including physical dependence, misuse, and overdose. 

• Non-opioid painkillers: Here’s a list of non-opioid medication options that may be good options for treating long-term chronic pain. 

• Medication for opioid use disorder (MOUD): Buprenorphine-containing medications and methadone are first-choice medications for OUD. They can also help with opioid withdrawal symptoms.

Physical symptoms may include:

• Tearing up more than usual

• Blurry vision or trouble focusing 

• Runny nose

• Increased yawning

• Shortness of breath

• Nausea or vomiting

• Stomach cramps

• Diarrhea

• Increased sweating

• Heart palpitations

• Goosebumps or hairs standing up on the arms

• Shakiness or muscle twitching

• Muscle, joint, or bone aches

Mood-related symptoms may include:

• Feeling restless, irritable, or anxious

• Lack of emotion

• Cravings for opioids

• Tiredness or trouble sleeping (insomnia)

• Emotional pain, including depression

Opioid withdrawal symptom timeline

The timing of opioid withdrawal symptoms depends on the type of opioid you were taking and how much you were taking.

Short-acting opioids typically work quickly and last a shorter amount of time in the body. Long-acting opioids can take longer to start working, but their effects can last for days. 

Short-acting opioids also tend to produce quicker and more intense withdrawal symptoms than long-acting opioids. Examples of short-acting opioid medications include immediate-release (IR) morphine, IR oxycodone (Roxicodone), and hydrocodone / acetaminophen. Examples of long-acting opioid medications include extended-release (ER) hydrocodone (Hysingla ER), ER oxycodone (Oxycontin, Xtampza ER), and ER morphine (MS Contin).

In most cases, opioid withdrawal symptoms aren’t life-threatening. But withdrawal is uncomfortable and puts stress on your body. Below, we’ll focus on a typical opioid withdrawal timeline for someone who has opioid use disorder or uses large amounts of opioids. Symptoms often occur in two phases.

Phase One

The first phase of opioid withdrawal is called the acute phase. It occurs right after stopping an opioid and can last several weeks. The chart below covers some general information about the acute phase of opioid withdrawal. It gives you an idea of when opioid withdrawal symptoms first start, peak (feel the most intense), and end.

When going through withdrawal, you’ll likely feel physical symptoms first. These can include muscle pain, stomach cramps, and increased sweating. They can also include diarrhea, a runny nose, and yawning. But you may also experience psychological symptoms like agitation, anxiety, and opioid cravings. 

After a few days, you may feel like your heart is beating rapidly, and your blood pressure may increase. This might cause you to feel dizzy or give you headaches. You might also have nausea, vomiting, and diarrhea. This can lead to weight loss and loss of appetite. 

Phase Two

The second phase of opioid withdrawal lasts longer than the first. How long it lasts varies from person to person, but it can last several weeks or months. In this stage of opioid withdrawal, you may experience more psychological symptoms. These can include long-lasting opioid cravings, depression, anxiety, and loss of motivation. During this phase, the focus of you and your care team is often using medications and therapy to avoid returning to opioid use. We’ll talk more about this later on.

What should you do if you’re experiencing opioid withdrawal?

If you’re experiencing withdrawal symptoms, you may need medical care so you can be monitored by a trained medical staff. And, if necessary, they can get you started on the appropriate medications. For less severe symptoms, you may be able to be seen in an office setting. But for more severe withdrawal, you may need care in a hospital or a dedicated substance use facility.

As mentioned, opioid withdrawal symptoms aren’t usually life-threatening. But for some people — including older adults and those with certain medical conditions — the stress on your body can lead to health complications. For example, spikes in blood pressure may be more dangerous for someone with existing high blood pressure or heart disease.

Below, we’ll cover options for managing opioid withdrawal, and treating OUD itself.

What medications treat opioid withdrawal and OUD?

A number of medications can help ease your withdrawal symptoms and make you more comfortable. There are also medications that treat OUD itself.

Medications for opioid withdrawal symptoms

Several medications can help treat withdrawal symptoms, including:

• Acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), for pain and headaches

• Antihistamines, such as cetirizine (Zyrtec) or diphenhydramine (Benadryl) for runny nose and watery eyes

• Anti-nausea medications, such as ondansetron (Zofran) or promethazine (Promethegan) for nausea and vomiting

• Sleep medications, such as trazodone for trouble sleeping (off-label use)

• Anti-diarrheal medications, such as loperamide (Imodium A-D) for diarrhea

• Alpha agonists, such as clonidine (Nexlicon-XR, Catapres-TSS) and Lucemyra (lofexidine) for anxiety, chills, and body aches (using clonidine in this way is an off-label use)

• Gabapentinoids, such as gabapentin (Neurontin) for mood changes, muscle tension (off-label use)

Medications for OUD

The gold-standard approach for treating OUD is a combination of medications and therapy. This treatment method is called “medications for opioid use disorder (MOUD).” Medications used as part of MOUD include:

• Buprenorphine injection (Sublocade, Brixadi)

• Buprenorphine tablets

• Buprenorphine / naloxone film (Suboxone) and tablets (Zubsolv) 

• Methadone liquid, tablets, and dissolvable products (Methadose)

• Naltrexone tablets and injection (Vivitrol)

Methadone and buprenorphine-containing medications are first-choice options for OUD. They can also help minimize opioid withdrawal, since they are opioids themselves. But you may have to wait up to a day after your last opioid dose to start Suboxone. Taking it too quickly can actually cause or worsen withdrawal symptoms.

Naltrexone injection may be another treatment option for some people. But it’s not a first-choice medication in most cases. Oral naltrexone isn’t usually recommended as part of MOUD, even though it's FDA approved for this reason.

Medications for OUD can keep you away from opioids, improve quality of life, and minimize your risk of opioid overdose.

What are non-medication options for opioid withdrawal symptoms?

Some steps you can take that may ease your withdrawal symptoms include:

• Staying hydrated: Increased sweating and diarrhea can lead to fluid loss. Staying hydrated can help prevent this.

• Eating nourishing foods: If you’re having vomiting or diarrhea, consider following a BRAT diet. This bland, starchy diet can help with nausea, vomiting, and diarrhea. Otherwise, focus on foods that give you energy. Examples include fruits, whole grains, and leafy vegetables. 

• Moving your body: Getting some exercise can help improve withdrawal symptoms like moodiness, insomnia, and pain.

• Trying other treatment options, such as acupuncture: Acupuncture is a traditional Chinese treatment approach for various health conditions. It uses hair-thin needles to stimulate sensations at specific spots on the body. For some people, acupuncture provides pain relief. And it may be recommended alongside traditional treatment for OUD or to lessen opioid withdrawal symptoms. Though more research is needed to know how effective acupuncture is in these situations, it’s considered safe for most people. So talk to your healthcare team if you’re interested in trying it.

Where can you get help for OUD?

Your primary care provider is a good person to contact (if you have one). They can discuss treatment options and which medication is best for you. They may be able to prescribe a buprenorphine product for you. Or they can refer you to an addiction specialist who can help.

Additional places you can reach out to for help include:

• Your health insurance plan: They can provide a list of covered providers and OUD treatment facilities.

• The Substance Abuse and Mental Health Services Administration (SAMHSA): For free and confidential information, anyone can call the SAMHSA helpline at 1-800-662-HELP (4357). It’s available 24/7 every day of the year. 

• SAMHSA’s online treatment services locator: Find local private and public treatment facilities here by entering your address, city, or zip code. You can also use SAMHSA’s Opioid Treatment Program Directory or their Buprenorphine Treatment Practitioner Locator.

• Community-based organizations: Many areas have local support groups to help people and families living with OUD. One international organization that hosts meetings worldwide is called Narcotics Anonymous (NA).

Resources to learn more about OUD are also available from the National Harm Reduction Coalition and the CDC.

Why trust our experts?

Written by:

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP, has over a decade of experience as a pharmacist, professor, and researcher. She was a full-time clinical professor in the pharmacy practice department at D’Youville School of Pharmacy before subsequently joining the faculty of the pharmacy practice department at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Jonathan Avery, MD

Jonathan Avery, MD, is the current vice chair of addiction psychiatry and an associate professor of clinical psychiatry at Weill Cornell Medical College and New York-Presbyterian Hospital.

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