The Three Stages of Opiate Withdrawal

Opiates are highly addictive painkillers commonly abused through both prescription and illicit use. Opiates are naturally-occurring compounds found in the opium poppy and include morphine, codeine, and thebaine.

“Opioids” is the more common term now used for all natural and semi-synthetic (e.g., Oxycontin and heroin) and fully-synthetic (e.g., Fentanyl) drugs that work on opioid receptors in the brain. For the purposes of this article, the terms “opiate” and “opioid” may be used interchangeably.

Due to the addictive quality of opiates, the use of these drugs may lead to tolerance, dependence, and withdrawal. Tolerance develops as a result of the brain’s propensity to reduce the effects of certain substances in response to repeated exposure. Increased tolerance often compels people to use a substance more frequently and in higher amounts, an action that can rapidly lead to dependence.

Dependence is a condition that occurs over time as the brain adjusts to the presence of a substance and eventually becomes unable to function without it. When a person then tries to discontinue use, they encounter highly unpleasant withdrawal symptoms while the brain and body attempt to re-establish equilibrium.

Opiate withdrawal occurs in three stages. A person who has developed a dependence on opiates may start to encounter withdrawal symptoms within 6-12 hours after their last dose.

How Long Does Opiate Withdrawal Last?

Some symptoms of opiate withdrawal may onset within hours after the last dose, and others may occur later in the withdrawal process and continue for a week or more. Psychological symptoms, such as anxiety, depression, and cravings, may persist for weeks or even months after discontinuing use.

Medical detox generally lasts between 5-6 days, depending on the severity of withdrawal symptoms. During this time, a person detoxing from opiates will encounter three different stages of withdrawal. These stages are distinguishable based on the types of symptoms experienced, their severity and how long they are expected to persist.

Timeline for Stages of Opiate Withdrawal

The exact timeline for opiate withdrawal varies between individuals depending on the drug used, method of administration (e.g., oral ingestion, injecting, snorting, or smoking), how long the drug was used and how much of it. Other factors, such as a history of trauma, co-occurring mental health disorders, biological and environmental factors, and whether or not a person receives medical care during detox, can also influence the length and intensity of symptoms a person experiences during opiate withdrawal.

The general timeline for opiate withdrawal can be divided up into three stages: early, peak period, and late withdrawal.

Three Stages of Opiate Withdrawal

Stage 1: Early Withdrawal (6-30 hours)

The first stage of withdrawal typically begins within 6-12 hours after cessation of use for short-acting opiates such as heroin, and within 30 hours for long-acting prescription opiates such as oxycodone.

Those who are undergoing the early stage of withdrawal will begin to encounter a set of uncomfortable physical and psychological symptoms. Symptoms that manifest during this time can generally be expected to worsen over the next 24-48 hours.

Early withdrawal symptoms may include the following:

  • Bone and muscle pain
  • Insomnia
  • Sweats
  • Loss of appetite
  • Rapid heart rate
  • Runny nose
  • Watery eyes
  • Increased blood pressure
  • Anxiety
  • Fever

Stage 2: Peak Period (72 hours)

Peak withdrawal symptoms may be expected to onset about 72 hours after the last use of the drug. It is within this stage that symptoms are at their most severe, reach their peak, and can persist for up to five days after they begin.

Many of the symptoms experienced during this period are flu-like and can result in dehydration and a loss of appetite. For a person to keep their strength during this time, it is essential to maintain satisfactory levels of hydration and nutrition. Solid foods and some fluids may be difficult to consume, and therefore those undergoing withdrawal should drink plenty of water and eat softer foods or take liquid nutritional supplements.

Late withdrawal symptoms may include the following:

  • Stomach cramps
  • Diarrhea
  • Nausea
  • Vomiting
  • Depression
  • Goosebumps
  • Chills
  • Intense drug cravings

Stage 3: Late Withdrawal (72+ Hours)

It is in this final stage of opiate withdrawal that physical symptoms and some of the more severe psychological symptoms will begin to subside. But instead of being in the clear, the person undergoing withdrawal and those supporting him or her will need to be cautious and watch for persisting symptoms. The first few days following the general cessation of symptoms still require monitoring and gentle and patient care.

Opiate abuse and addiction can be complicated and may be associated with psychological or emotional needs that make maintaining addiction recovery more challenging beyond the intense initial stages of withdrawal. While the flu-like symptoms, aches and pains, and other physical effects of withdrawal will have likely subsided by this point, drug cravings and persisting feelings of restlessness, anxiety, depression, and insomnia may still linger.

The length of time a person experiences these persisting symptoms can vary between individuals. While detox is the first step need to overcome opiate addiction, additional care is usually required to help the person sustain abstinence from drug use.

There are multiple treatment options that may be beneficial following detox, including psychotherapy, counseling, medication-assisted therapy (MAT), and group support as recommended based on the unique needs of the individual. If you are investigating which treatment options may be most appropriate or necessary following detox, coordination with a trained addiction treatment specialist may be indispensable to determine what course of treatment will be best for you or your loved one.

Medications for Opiate Withdrawal

Many people are suspicious of the idea of using other prescription drugs to help treat the symptoms of opiate withdrawal. However, experts have found that medication-assisted therapy (MAT) can prove beneficial for many people undergoing opiate detox.

In fact, rather than serving as a total replacement for an opiate or opioid drug, certain FDA-approved medications, such as buprenorphine, naltrexone, and Suboxone, can be used to ease psychological cravings and withdrawal symptoms commonly encountered by those with a dependence on opioids.

Health providers may prescribe medications as necessary to provide a safer and more beneficial experience that will support a person as they endure the stages of detox. Additional treatment may also be needed to address the emotional aspects of the addiction, including co-occurring disorders such as anxiety or depression.

Getting Help for Opiate Withdrawal And Addiction

Willingness and motivation to take the first steps toward quitting opiates is one of the most significant points of progress in recovery, and, fortunately, it is not an endeavor that has to be undertaken alone. Withdrawing from addictive substances such as opiates can be a stressful and even potentially dangerous process.

Whether you or a loved one are struggling with opiate addiction, there is help available Recovery by the Sea employs trained and compassionate staff who offer resources and tools vital to recovery. We are dedicated to helping people in desperate need of treatment to achieve abstinence and develop skills that will help them maintain long-term sobriety and wellness.

Contact our specialists today to discuss opiate addiction treatment options. Discover how we help people free themselves from the clutches of addiction and learn how to foster healthy and fulfilling lives!

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