Fentanyl withdrawal symptoms & timeline

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Updated December 3, 2024

Authored By:

Joe Gilmore

Edited By

Amy Leifeste

Medically Reviewed By

Javier Rodriguez-Winter

Authored By:

Joe Gilmore

Edited By

Amy Leifeste

Medically Reviewed By

Javier Rodriguez-Winter

A man looks out a window looking concerned to represent how long does prednisone stay in system

Fentanyl withdrawal symptoms & timeline

Fentanyl withdrawal symptoms arise when a person dependent on synthetic opioids, like fentanyl, either stops using the drug or significantly reduces their dosage. The symptoms of fentanyl withdrawal can manifest on a spectrum, varying from mild to severe.

In this blog, we will cover:

  • Identifying fentanyl withdrawal signs and symptoms
  • How long does fentanyl withdrawal last?
  • How to get treatment for the withdrawal symptoms of fentanyl

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Fentanyl Withdrawal Signs

Recognizing the early signs of fentanyl withdrawal is essential for promptly addressing the difficult detox process and ensuring effective treatment. By being aware of these signs, individuals and their loved ones can take proactive steps toward seeking appropriate support. Here are some early indicators that may suggest the onset of fentanyl withdrawal:

  • Severe cravings: A growing desire for fentanyl and a persistent urge to use the drug may become more prominent at the beginning of the withdrawal timeline.
  • Mood fluctuations: Noticeable shifts in mood – increased irritability, restlessness, or anxiety, for instance – may arise as the body begins to adjust to the absence of fentanyl.
  • Physical discomfort: Individuals may experience mild physical symptoms, including muscle aches, headaches, and gastrointestinal disturbances, as their body starts to readjust without the drug.
  • Insomnia or disrupted sleep patterns: Difficulty falling asleep or experiencing restless nights can be an early indication of withdrawing from fentanyl.
  • Excessive yawning: Frequent and uncontrollable yawning can manifest as one of the early physical side effects of fentanyl withdrawal.

These withdrawal effects may intensify over time, underscoring the importance of timely intervention and treatment. If you or a loved one is experiencing fentanyl withdrawal, reach out to healthcare professionals or fentanyl addiction treatment centers for guidance and assistance in navigating this challenging process.

Fentanyl withdrawal symptoms occur due to the body’s adaptation to the presence of fentanyl, a potent opioid. When someone uses fentanyl regularly or in large amounts, their body becomes dependent on the drug to function normally. With continued use, the body adjusts its chemical balance and develops a tolerance to fentanyl, meaning that higher doses are required to deliver the same effects. When fentanyl use is abruptly stopped or significantly reduced, the body goes through a period of adjustment, leading the user to experience withdrawal symptoms.

Fentanyl affects the central nervous system, especially the MOR ( mu-opioid receptors), which play a central role in governing pain relief, pleasure, and reward [1]. When fentanyl is consistently present, these receptors become desensitized, and the body relies on drug use to maintain normal functioning. When fentanyl is suddenly removed, the MOR becomes unoccupied, triggering a cascade of physiological and psychological changes.

The withdrawal symptoms that emerge are the body’s response to the absence of the drug. They can range from mild discomfort to acute symptoms, depending on factors such as the individual’s level of physiological dependence, duration of drug abuse, and overall health.

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Fentanyl Withdrawal Symptoms

Fentanyl withdrawal involves a range of physical symptoms that can vary in intensity and pose certain risks to individuals. Some of the physical symptoms experienced during withdrawal include:

  • Sweating: Profuse sweating, often accompanied by cold or hot flashes, is a common withdrawal symptom.
  • Chills: Individuals may experience sudden cold sensations, shivering, and chills as their body adjusts to the absence of fentanyl.
  • Muscle pains or spasms: Uncontrollable leg movements, muscular and joint discomfort, and muscle spasms can be prevalent during the withdrawal process.
  • Runny nose and teary eyes: Nasal congestion, excessive nasal discharge, and tearing of the eyes are frequently reported.
  • Excessive yawning: Uncontrollable yawning is a typical physical response during withdrawal.
  • Stomach pain and upset: Gastrointestinal distress, including stomach pain, nausea, vomiting, and diarrhea, is common during opioid withdrawal symptoms.
  • Issues with sleeping, breathing, and rapid heart rate: Insomnia, difficulty breathing, and an accelerated heart rate are physical manifestations of withdrawal.
  • Hypertension: This symptom of an increase in blood pressure requires close monitoring during the detoxification process.
  • Exhaustion: Feelings of extreme fatigue and overall exhaustion are frequently experienced.

In addition to these physical symptoms, those undergoing fentanyl withdrawal may also encounter various emotional issues, including:

  • Mood swings: Emotional instability, characterized by rapid and intense shifts in mood, is a common occurrence during the opioid withdrawal process.
  • Anxiety: Feelings of restlessness, unease, and heightened anxiety.
  • Depression: Some individuals may experience feelings of sadness, hopelessness, and a general lack of interest or pleasure during the detox phase of recovery.
  • Problems with memory or cognition: Difficulties with concentration, memory, and overall cognitive functioning may hinder emotional stability.

While fentanyl withdrawal is typically not life-threatening [2], it can be highly uncomfortable, and the severity of symptoms depends on various factors. Complications may arise during the withdrawal process, especially if attempted without medical supervision. Severe dehydration, electrolyte imbalances, and the risk of heart failure can occur if vomiting and diarrhea are left untreated. Additionally, there is an increased risk of overdose during an opioid withdrawal timeline for individuals who resume use after a period of abstinence due to reduced opioid tolerance.

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Fentanyl Withdrawal Timeline

While not everyone will experience the same withdrawal timeline, the following outlines a likely timeline for most fentanyl users:

Fentanyl Withdrawal: Day 1

Fentanyl, like codeine and heroin, are all short acting opioids [3]. Like all drugs in this classification, withdrawal symptoms normally appear within 8-36 hours after the last dose. In contrast, withdrawal symptoms from extended-release oxycodone and other long-acting opioids typically begin 24 to 48 hours after the last dose.

During the initial day of fentanyl withdrawal, you might experience the following early symptoms:

  • Appetite loss
  • Disrupted sleep patterns
  • Headaches
  • Muscular pains
  • Muscular aches
  • Irritability
  • Aggression
  • Anger
  • Intense cravings for fentanyl

Fentanyl Withdrawal: Day 2

During the second day, the above symptoms will persist. You may also experience the following adverse effects:

  • Panic attacks
  • Upset stomach
  • Runny nose
  • Excessive sweating
  • Insomnia

Fentanyl Withdrawal: Day 3

Most symptoms will peak on the third day of detoxification. The most challenging symptoms during this acute phase of opioid withdrawal include:

  • Vomiting
  • Nausea
  • Diarrhea

Fentanyl Withdrawal: Day 4

With the most acute phase of withdrawal complete, these symptoms may linger:

  • Enlarged pupils
  • Shivering
  • Cramps
  • Gastrointestinal disturbances
  • Fatigue

Fentanyl Withdrawal: Day 5-6

At this point, symptoms typically begin to peak before subsiding around day 7:

  • Fatigue
  • Body aches and bone pain
  • Stomach issues
  • Chills
  • Psychological symptoms (anxiety, depression, cravings, etc.)

Fentanyl Withdrawal: Day 7

All withdrawal symptoms should dissipate after a week or so. Sleep patterns may take time to normalize.

Many people report experiencing ongoing fatigue and intermittent episodes of depression during the early phase of recovery from addiction.

PAWS (post-acute withdrawal syndrome) involves symptoms that persist for months after quitting fentanyl. The most common of these effects of PAWS include:

  • Irritability
  • Disrupted sleep patterns
  • Fatigue
  • Powerful cravings for fentanyl
  • Depressed mood

Since every case of addiction is different, a thorough drug evaluation is essential to determine the appropriate length of detoxification needed. Taking this precaution can significantly reduce the risk of overdose.

It’s important to note that while physical symptoms of this withdrawal timeline typically only last up to a week, cravings can persist long after. For the best chance at long-term recovery, seek support from a professional recovery center.

If you or someone you know is experiencing fentanyl withdrawal, you should seek professional medical help to ensure a safe and effective recovery.

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Fentanyl Withdrawal Treatment

Finding safe and effective methods to manage withdrawal symptoms and control cravings can help streamline the recovery process from fentanyl addiction.

Medical professionals can prescribe addiction medicine that not only alleviates withdrawal symptoms but also provides long-term support in maintaining abstinence from prescription and illicit opioids. These medications have been proven effective in fentanyl detox protocol:

  • Methadone: As an opioid agonist, methadone acts on the same receptors in the brain as fentanyl. That said, it does not trigger the intense high associated with fentanyl. When taken as prescribed, methadone helps block cravings and alleviate withdrawal symptoms, supporting individuals in their journey toward recovery.
  • Buprenorphine: As a partial opioid agonist, buprenorphine binds to the same receptors as fentanyl, but its activation is only partial. This property allows it to ease withdrawal symptoms and cravings, helping individuals navigate the challenges of opioid withdrawal more comfortably.

In addition to opioid medications, a non-opioid treatment called lofexidine hydrochloride received FDA approval in 2018. Lofexidine can play a valuable role in reducing the severity of fentanyl withdrawal effects, providing individuals with support as they work towards discontinuing fentanyl use.

By incorporating these medications into a comprehensive treatment plan, individuals can experience significant relief from withdrawal symptoms and cravings, enabling them to focus on their recovery journey. It is essential to consult with healthcare professionals to determine the most appropriate medication options based on your needs and circumstances.

FAQs

How long does fentanyl withdrawal last?

The duration of withdrawal can vary, but it typically lasts for about one to two weeks. However, the exact duration and intensity of withdrawal symptoms can depend on factors such as usage patterns, dosage, and overall health.

Can you die from fentanyl withdrawal?

While withdrawal itself is not normally fatal, it can be a challenging and uncomfortable process. There are nevertheless risks associated with abruptly stopping fentanyl use, such as seizures, dehydration, mental health issues, and other medical concerns. You should seek professional medical supervision when withdrawing from fentanyl to minimize potential dangers.

How long does it take to detox from fentanyl?

The duration of fentanyl detox varies with the level of opioid dependence and individual health factors, but it typically takes 5 to 10 days for the acute withdrawal symptoms to subside. However, some symptoms may persist for weeks or months in a longer-term process known as post-acute withdrawal syndrome (PAWS).

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Get Help for Fentanyl Withdrawals & Addiction at Gratitude Lodge

At Gratitude Lodge in Southern California, we can help you combat fentanyl addiction at our pet-friendly rehab centers dedicated to whole-body recovery located in Newport Beach and Long Beach, CA.

Our fentanyl detox program offers medical supervision to ensure the safest and most comfortable withdrawal process. When your system is purged of addictive substances, you can transition directly into one of the following Gratitude Lodge treatment programs for opioid use disorder and substance use disorder:

  • 30-day inpatient program
  • IOP (intensive outpatient program)
  • Dual diagnosis treatment program

Our addiction treatment programs include behavioral therapies such as:

To move from active addiction into support sustained recovery, place your trust in Gratitude Lodge. Call admissions at 844-576-0144

Sources

[1] https://nida.nih.gov/publications/drugfacts/fentanyl

[2] https://withdrawal.net/narcotic/fentanyl/

[3] https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2788654

Want to learn more?

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Jenni Bussi

Jenni Busse MS, LPCC

Jenni Busse MS, LPSS is the Clinical Director at Gratitude Lodge. Jenni oversees the clinical program and the clinical team at Gratitude Lodge as a whole. Jenni has worked in treatment for almost 14 years. Her background as a licensed therapist and her passion for helping others intersected with addiction recovery when she started working primarily in detox residential treatment.
Joe Gilmore

Joseph Gilmore

Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.

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