What Are the Common Manifestations of Opioid Withdrawal?
Although opioids are prescribed far less often today than they were several years ago, this type of drug is still responsible for many people’s addictions and overdoses today. These highly addictive and often extremely potent drugs, both illicit versions like heroin and street fentanyl and prescribed medications like oxycodone, are widely misused today, destroying thousands of lives every year across the country. It’s important to understand what to expect if you or someone you love is quitting opioids after a long period of heavy use, especially what could happen as you start to experience opioid withdrawal manifestations. This article will cover what to expect, which can help you better understand how to support a family member with addiction or improve your own situation.
Table of contents
» What Are the First Signs of Opioid Withdrawal?
» When Do Opioid Withdrawal Symptoms Reach Their Peak?
» Can Protracted Withdrawal Increase the Risk of Relapse?
» What Timeline Should Someone Expect for Full Recovery From Symptoms?
» Key Takeaways on Opioid Withdrawal Manifestations
» Resources
What Are the First Signs of Opioid Withdrawal?
No matter which drug it is among the list of opioids strongest to weakest, someone who has used this kind of substance for an extended period of time is at risk of experiencing distressing, uncomfortable opioid withdrawal manifestations as their brains and bodies struggle to get used to no longer having the drug anymore. The first signs of opioid withdrawal can include things like:
- Feeling agitated or anxious
- Runny nose
- Teary eyes
- Muscle aches and headaches
- Difficulty falling asleep or staying asleep
- Excessive sweating
- Yawning
These early symptoms can start as soon as just 12 hours after the person last took the opioid, and they’re a sign that their system has become accustomed to having the drug (a condition known as dependency). Opioids work by interacting with specific neurotransmitter receptors in the brain, and the brain actually adapts to having higher amounts of certain chemicals and starts to expect these levels at all times. Once the level begins to drop as the drugs wear off, the person is at risk of experiencing opioid withdrawal.
Later symptoms of opioid withdrawal can include:
- Diarrhea and upset stomach
- Stomach cramps
- Nausea and vomiting
- Dilated pupils
- Hot and cold flashes
- Tremors
- Sneezing
- More sleep problems
- Goosebumps
The other major thing that people will experience during this time is extreme cravings—they will want to retake the drug to feel “normal” or simply feel better. Often, opioid withdrawal symptoms can make the person feel like they’re suffering from a bad flu, and they will usually feel generally unwell, anxious, and out of sorts as their body struggles to adapt to its new reality.
When Do Opioid Withdrawal Symptoms Reach Their Peak?
The severity of opioid withdrawal manifestations can vary significantly from person to person, depending on many different things like how high a dose they’ve been taking, how long they’ve been taking the drugs, and how quickly they tried to reduce their dose or quit the drug entirely.
Unfortunately, even someone who was taking an opioid medication precisely as prescribed by their doctor can be at risk of suffering from opioid withdrawal if they quit suddenly after taking it for a long time. People who only use opioids occasionally or just for a very short time aren’t likely to have withdrawal symptoms, but it can still happen on some occasions.
If you’re wondering why can’t I stop using drugs, in the case of opioids, it’s not as simple as just telling yourself you’re done – opioids are highly addictive, and you could be hooked on them both physically and mentally at that point. If you quit suddenly, such as quitting cold turkey on your own at home, you could start to experience withdrawal symptoms within just a matter of hours.
Typically, withdrawal symptoms will peak about two to three days after the drug was last used, and gradually get better to resolve within about five to seven days. However, this can vary significantly from person to person.
For example, someone who was taking fast-acting opioids like oxycodone or heroin could start to experience withdrawal symptoms just six hours after they last take the drug, while slow-acting opioids like methadone could have delayed withdrawal symptoms that begin more like one to three days after the last use.
This means that, for many people, the peak of opioid withdrawal symptoms will happen around two to three days after quitting the drug. Peak opioid withdrawal can make people experience several different things, including:
- Nausea and vomiting
- Severely disturbed sleep (insomnia or struggling to stay asleep)
- Fatigue
- Upset stomach
- Diarrhea
- Shaking
- Hot and cold flashes
- General sense of unwellness
Can Protracted Withdrawal Increase the Risk of Relapse?
In the grand scheme of things, the length of opioid withdrawal is relatively short—most people will start to experience symptoms in six to 24 hours, suffer the peak of symptoms after two to three days, and generally be done with “acute” withdrawal (meaning the whole experience of withdrawal) after about a week or, at most, two weeks.
If they can take care of themselves during that time, such as seeking medical support, staying hydrated by drinking plenty of water, and resting as much as possible, they can get through this period. They also have to resist the intense cravings they’re likely to experience to use more of the drug.
However, even getting through acute opioid withdrawal doesn’t mean the experience is necessarily over. Many people who are in the beginning stages of opioid addiction recovery are at a high risk of suffering from something known as post-acute withdrawal syndrome, which means they’ll experience symptoms of protracted withdrawal that can last much longer than the peak of acute withdrawal.
PAWS symptoms can include things like:
- Difficulty concentrating or remembering details
- Powerful urges to use the drug or strong cravings to use again
- Feeling irritated, anxious, panicked, or even hostile
- Depression
- Feeling unmotivated and unable to focus
- Severe mood swings
- Extreme fatigue, insomnia, and vivid or intense dreams
- Sensitivity to stress
Even if someone is experiencing mild symptoms of PAWS, it can be highly distressing—especially because PAWS can start weeks or months after they quit the drug. It can make it feel like it’s impossible ever to be better again. However, it’s essential to keep in mind that PAWS, just like acute opioid withdrawal, is a short-lived and temporary phase, and they will start to feel better again soon.
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What Timeline Should Someone Expect for Full Recovery From Symptoms?
Here’s the complete timeline you can expect of opioid withdrawal manifestations:
- Early Acute Onset Symptoms: Six to 12 hours after quitting the drug (this can be more like two to three days after last using the drug if it’s a slow-acting opioid).
- Peak of Withdrawal Symptoms: Two to four days after quitting.
- Getting Through Acute Withdrawal: One to two weeks after quitting.
- Post-Acute Withdrawal Syndrome (PAWS): Typically, PAWS episodes will last for a few days at a time. These are primarily possible in the first weeks to several months after quitting opioids, and are often prompted by stressful events. After a year or two in long-term recovery, PAWS episodes are much less likely.
Key Takeaways on Opioid Withdrawal Manifestations
- Opioids are highly addictive and often quite potent.
- People who suddenly quit taking these drugs after a long period of time are likely to experience different opioid withdrawal manifestations.
- Opioid withdrawal symptoms can include upset stomach, insomnia, mood swings, anxiety, and powerful cravings to use more of the drug.
- Withdrawal symptoms tend to peak after two to three days, and acute withdrawal typically lasts just one to two weeks.
- Post-acute withdrawal syndrome is possible and can cause short episodes of symptoms weeks or even months after quitting the drug.
If you or someone you love is struggling with opioid addiction, WhiteSands Alcohol and Drug Rehab can help. Our experts know all about the many different phases of opioid withdrawal, including post-acute withdrawal episodes, that can make it hard to stay on track toward your recovery. Together, we can help you stay on the path to recovery and overcome cravings, allowing you to enjoy a brighter future. Call us at 877-855-3470 and let’s get started toward your better life without opioids at any of our Florida-based addiction treatment centers.
Resources
- HealthDirect – Opioid Withdrawal Symptoms Key Facts
- MedlinePlus – Opiate and Opioid Withdrawal Causes
- WebMD – Post-Acute Withdrawal Syndrome and Opioids
If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.
About the Author
Jackie has been involved in the substance abuse and addiction treatment sector for over five years and this is something that she is truly eager about. She has a passion for writing and continuously works to create informative pieces that not only educate and inform the public about the disease of addiction but also provide solutions for those who struggle with drug and alcohol abuse.
