opiate withdrawal

Opiate Withdrawal Timeline

Getting through opiate withdrawal. There are a million thoughts that go with these four words. Most of them are so racked with irrational thoughts and fear, a person in active opiate addiction finds them too difficult to face.

Being at that crossroad, that point where you desperately want to stop but feel helplessly locked in the bondage of addiction is a kind of a living hell. The thought that “we will never have to go through this again” once we get through it is often all we have to give us hope.

If you or someone you love is facing opiate withdrawal, it helps to know exactly what you will go through. Whether it’s  heroin withdrawal or prescription pain medication that you’ve obtained legally, here’s what you need to know:

Opiate Withdrawal Timeline

Common opiates include: Heroin,methadone, suboxone, buprenorphine, oxycodone (OxyContin and Percocet), hydrocodone (Vicodin), morphine, codeine, clonidine, and dilaudid.

During opiate withdrawal, you’ll experience the most withdrawal symptoms within the first six days. Once you decide to quit, you’ll need to decide whether medical detox or at-home cold-turkey is your choice. For medical detox, there are a couple of different options. We recommend inpatient detox because you’ll be monitored during the entire process and you’ll have encouragement, group meetings and professional staff to help you through the process.

You could also choose what is called ambulatory detox. It’s also medical, which means you’ll be placed on a prescription to help wean your body off of the opiates while keeping the worst of withdrawal symptoms at bay, but you won’t stay the night at the facility.

The third option is at-home cold turkey detox, which we don’t recommend, but it’s important to be aware of the withdrawal symptoms.

Opiate Withdrawal Onset

How long do you have until you begin to feel the effects of opiate withdrawal?

The onset of opiate withdrawal depends on the drug involved. It is generally connected to the half-life of the drug, so drugs that have a longer half-life (methadone, for example) will take more time than heroin, which has a much shorter half-life.

The half-life of methadone ranges from 15-60 hours, so withdrawal symptoms can be expected to present themselves within 24-48 hours of last use. Heroin withdrawal symptoms, on the other hand, can be felt anywhere from 6-18 hours after last exposure.


Day 1-3

Withdrawal symptoms will begin about six to eight hours after last use. High anxiety going into this time frame is normal. You’ll experience extremely strong urges to use. These cravings should be expected. In active addiction, impulse control is often lacking, so this period of time is going to be the most difficult.

During this time, you may also experience:

  • Profuse sweating
  • Agitation
  • Muscle aches
  • Diarrhea
  • Crawling skin
  • Medium to extreme anxiety
  • Insomnia
  • Loss of appetite
  • Nauseausness
  • An almost unexplainable sense of disease / spiritually bankrupt
  • Lack of peace


Day 3-4

Whether you’re inside the house or outside, wear warm and comfortable, loose fitting clothing. This will help keep you somewhat comfortable when you get the chills. It will also help with skin sensitivity. Cold chills, shivering, tremors and shaking are part of the day 3-4 journey. This usually accompanies a fever.

A tub of warm water can be helpful for muscle aches and chills.

Other opiate withdrawal symptoms you might experience during this time frame include:

  • Loss of appetite
  • Runny nose
  • Watery eyes
  • Fever
  • Sleeplessness
  • Nausea and vomiting
  • Depression
  • Tremers
  • Muscle aches

Day 5-7

Depending on how much you’ve used, you should experience some relief from opiate withdrawal symptoms by day five.  Most will be gone by day seven, though you may still experience mild nausea and anxiety. To help you get through this grueling week, put a calendar on the wall and mark off the days as they go by.

Medical Detox and Opiate Withdrawal

If you’ve been a heavy user of opiates, withdrawal may be dangerous for you to try cold turkey. Not because opiate withdrawal is considered deadly, but because the chance of relapse is high during this first week and inpatient detox is equipped to deal with these feelings. Medical detox also reduces the physical symptoms of withdrawal, as well as anxiety, so between the support and the reduced symptoms, this is our recommendation.

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