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Opioid Withdrawal | Timeline, Symptoms, Detox

Opioid drugs are some of the most physically and mentally addictive substances in the world. Because of this, it can be easy to develop an opioid addiction or substance use disorder. Opioids may be prescription or illicit (illegal) drugs. If someone becomes addicted, the addiction can result in great stress to both the person struggling with it and to their loved ones, causing significant physical, mental, emotional and financial challenges. Someone may want to stop using opioids but find the process difficult because of uncomfortable opioid withdrawal symptoms. Following a professional opioid withdrawal, a treatment plan can help make the recovery process more successful.   

How Opioids Affect the Brain

Believe it or not, opioids can actually change how the brain works. What makes opioids so powerful? The drugs stimulate a reward process in the brain; chemicals in the drugs attach to special proteins, or receptors, on certain brain cells. When this connection happens, a biochemical reaction occurs that causes a pleasure response in the body.

This pleasurable response usually happens as a result of important life activities like eating and sex. Using opioids without the need to treat significant pain still activates this reward system, but it causes the body to begin to develop a craving, or addiction to the drug to feel the pleasure response. As this usage for pleasure, or a “high,” continues, the brain adjusts and develops a tolerance to the drug. Soon, the brain requires more of the drug to feel the same high. At this point, the brain has become dependent on the drug.

What You Can Expect From Opioid Withdrawal

Opioid withdrawal causes uncomfortable but not life-threatening, symptoms. These symptoms usually begin about 12 hours after last using heroin and within about 30 hours of last using methadone. Opioid withdrawal symptoms range in severity depending on several biological factors.

Early symptoms:

  • Agitation
  • Anxiety
  • Body aches
  • Increased tear production
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goosebumps
  • Nausea
  • Vomiting

Opioid Withdrawal Timeline

Opioid withdrawal symptoms usually begin within six to 30 hours after the last use, with the worst of the symptoms occurring at about 72 hours after the last time you take the drug. The first week of opioid withdrawal is typically the worst. Symptoms can last up to about a month and may even continue for a few months after you stop using.

During the first few hours of opioid withdrawal, you may experience symptoms such as:

  • Anxiety or agitation
  • Muscle pain 
  • Aching body
  • Fatigue
  • Insomnia
  • Sweating

Over the next few days of the withdrawal process, you may encounter more symptoms, including:

  • Chills
  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach pain

You may continue to experience some symptoms for a month or longer. Opioid withdrawal symptoms that may linger often include anxiety, depression, fatigue, and insomnia. 

What Are the Opioid Withdrawal Treatment Steps?

While it’s possible to detox and go through the opioid withdrawal process at home, it can be very difficult to do it alone. Having the emotional support of family and friends is helpful, yet often getting professional help is key to managing the withdrawal process successfully. Professional treatment usually includes three levels: detox, residential and outpatient services. The typical full continuum of care follows these basic steps:


The initial stage of withdrawal treatment is known as detox. The goal of this stage is medical stabilization. The medical team, which includes doctors, nurses, and support staff, will give you a complete medical assessment to determine not only your level of addiction but also your overall health and any additional medical needs you may have. A detox plan will be created for you. Then, under the care of your medical team, you will begin the detox process. Detoxing includes a combination of detox drugs, such as buprenorphine, and emotional support as you begin to enter addiction therapy.

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After completing detox, which focuses on eliminating the physical need for the drug, the next stage is to continue treatment in an inpatient, or residential facility. During this stage, you’ll live full-time at the residential treatment center while undergoing a rigorous, structured treatment program at least five days a week. The program will address your emotional and mental health needs. Important aspects of this stage of treatment include learning positive life skills and coping mechanisms in addition to techniques to help prevent relapse so that you will be better prepared for long-term recovery. 

Intensive Outpatient

Following the completion of inpatient treatment, you may transition into an intensive outpatient program. This part of the program provides key counseling and treatment services you may need as you return home. The emphasis at this stage is on continuing to hone life and coping skills and relapse prevention education so that you can develop a healthy routine and enjoy your day-to-day life.


After completing the treatment program, you will have the opportunity to join other treatment center graduates for weekly support groups and social events. While recovery is a lifelong process, these opportunities that an alumni group provides can help you develop new friendships and social support to help better position you for long-term success.

If You’re Struggling with Opioid Addiction, We Can Help

If you’re seeking help to overcome an opioid addiction, contact our admissions specialists here at Ocean Breeze Recovery for free and confidential help. They’re here to listen to your concerns and walk you through the process so that you know what to expect from our evidence-based services. You will feel prepared to make an informed decision about your withdrawal recovery.

Our specialists can also check with your private health insurance to see if your treatment costs will be fully covered. You don’t have to do this alone. Call us today at 844-554-9279 and let us help you get started on your journey back to a healthy, fulfilling life.


verywellmind. (2020, March 23) Why an Opiate's Impact on the Brain Can Cause Addiction. How Opiates Affect the Brain. Cherry, K. Retrieved from

Addiction Science Clinical Practice. (2002 July) The Neurobiology of Opioid Dependence: Implications for Treatment. Kosten, T. M.D., George, T. M.D. Retrieved from

U.S. National Library of Medicine. (2018, May 5) MedlinePlus. Opiate and opioid withdrawal. Berger, F. MD Retrieved from

healthline. (2020, July 21) Opiate Withdrawal: What It Is and How to Cope with It. Overall timeframe. Cherney, K. Retrieved from

Diaogues in Clinical Neuroscience. (2007 December) Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Kleber, H. MD Retrieved from

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