One of the most common fears people have about opioid withdrawal is not knowing what to expect. The discomfort is real, but the timeline is predictable. Understanding it can make the difference between getting through it and giving up.
Short-Acting Opioids (Heroin, Oxycodone, Hydrocodone)
Short-acting opioids have the fastest onset of withdrawal and the shortest acute phase.
- 6–12 hours after last use: Early symptoms begin: yawning, anxiety, restlessness, watery eyes, runny nose
- 24–48 hours: Symptoms peak: muscle aches, severe restlessness, insomnia, nausea, vomiting, diarrhea, sweating, chills, goosebumps
- 72–96 hours: Acute symptoms begin to subside
- Days 5–7: Most people feel substantially better physically
- Weeks to months: Post-Acute Withdrawal Syndrome (PAWS): lingering mood issues, cravings, sleep disturbance
Going through opioid withdrawal right now?
Medication-Assisted Treatment can dramatically reduce the severity of what you’re experiencing. Talk to someone about your options, there is no commitment required.
Long-Acting Opioids (Methadone, Extended-Release Oxycodone)
Long-acting opioids stay in the system longer, which means withdrawal onset is delayed but the duration is extended.
- 24–48 hours after last dose: Symptoms begin (later than short-acting)
- 72–96 hours: Symptoms peak
- 2–3 weeks: Acute phase: significantly longer than short-acting opioids
Fentanyl Withdrawal: Why It’s Different
Fentanyl is significantly more potent and lipophilic than other opioids: it stores in body fat and releases slowly. This means:
- Withdrawal onset may be delayed 12–36 hours
- The acute phase can be more prolonged and unpredictable
- Symptoms may seem to improve and then worsen again as stored fentanyl continues to release
Fentanyl withdrawal is best managed in a medical setting with MAT support.
What Helps During Opioid Withdrawal
Medications that significantly reduce withdrawal discomfort include:
- Buprenorphine (Suboxone): Most effective: reduces cravings and withdrawal symptoms, can be started during early withdrawal
- Methadone: Used in supervised clinic settings, effective for high-dependency cases
- Clonidine: Reduces autonomic symptoms (sweating, elevated blood pressure, heart rate)
- Comfort medications: Anti-diarrheal, anti-nausea, sleep aids
Want to know more about MAT for opioid withdrawal?
The admissions team can explain how medication-assisted treatment works and whether it’s appropriate for your situation. One call, no commitment.
Post-Acute Withdrawal Syndrome (PAWS)
After the acute phase, many people experience a prolonged withdrawal period that can last weeks or months. Symptoms of PAWS include: mood swings, anxiety, difficulty experiencing pleasure, poor sleep, and cravings. PAWS is one of the primary drivers of relapse in early recovery. Knowing it exists, and that it is temporary, is an important part of navigating it.