Opioid Withdrawal & Detox

Opioids are powerful substances that can reduce the body’s perception of pain. If misused, they can cause a sense of euphoria. They are highly addictive. In 2018, misuse of opioids occurred in approximately 10.3 million people aged 12 or older.
Evidence Based
check icon

What is Opioid Use Disorder? 

Opioid use disorder (OUD) is a medical diagnosis given to those who suffer serious impairment or distress due to a continuous use of opioids. While other definitions like opioid addiction do exist, OUD is more commonly accepted among healthcare professionals. 

OUD diagnosis is based on specific criteria, ranging from unsuccessful attempts to reduce or stop opioid use to social or family problems. Individuals with the disorder may report having trouble meeting obligations at work, school, or home. However, as OUD is an extensive disorder, healthcare specialists assess many more signs and symptoms to provide proper diagnosis and treatment. 

Over 2 million individuals aged 12 and older were diagnosed with an opioid use disorder in the United States, comprising 0.7 percent of the population.

Spoon and needle filled with drugs

What are Opioids?

Opioids come in many different forms:

  • Prescription medications — these drugs are often prescribed to patients to treat pain. Some of the more well-known generic names include morphine, codeine, methadone, oxycodone (oxycontin), hydrocodone, fentanyl, hydromorphone, and buprenorphine.
  • Illegal drugs — heroin is a morphine-derived opioid that provides a feeling of pleasure or euphoria. Its potent chemical make-up can lead to long-term effects, such as depression or anxiety, abscesses, liver and kidney disease, and much more. 
  • Illicit substances — Fentanyl analogs like carfentanil are chemically similar to fentanyl, a prescribed synthetic opioid 50 to 100 times more potent than morphine. Since such analogs can produce a high more easily, they are sometimes mixed with other drugs to lower costs for drug dealers. 

Another way to classify different types of opioids further is through the chemical composition of the drug:

  • Natural — some plants like the opium poppy can produce nitrogen-containing chemical compounds. Examples include morphine or codeine. 
  • Semi-synthetic/manmade — these opioids originate from the lab but with the use of natural opiates. Heroin and oxycodone are two opioids of this kind. 
  • Fully synthetic — this last category of opioids are completely manmade. One of the more common names pertaining to this group is fentanyl. 

How Do Opioids Work?

Opioids are powerful substances that can reduce the body’s perception of pain.

When an individual takes the drug, the opioid binds immediately to specific receptors in the brain, spinal cord, and gastrointestinal tract. This opioid-receptor interaction then triggers a series of bodily signs and symptoms that could include slowing breathing, drowsiness, nausea, and more.  

Similarly, because opioid use produces a sense of euphoria or high, the risk of drug misuse, abuse, and overdose is high. 

In 2018, misuse of opioids occurred in approximately 10.3 million people aged 12 or older. 

Graphic human body showing symptoms.

Symptoms of Opioid Withdrawal

Given that opioids affect the receptors of various nerve cells in the body, the following opioid withdrawal symptoms may occur after stopping use: 

  • Pain in the muscles and bones
  • Trouble sleeping 
  • Diarrhea and Vomiting
  • Cold flashes with goosebumps
  • Uncontrollable leg movements
  • Extremely intense cravings for the drug
  • Agitation
  • Anxiety
  • Muscle aches
  • Runny nose
  • Sweating
  • Yawning 
Graphic of clipboard with checkboxes for timeline.

Timeline of Withdrawal Symptoms

Withdrawal symptoms will lengthen or shorten in time, depending on many factors. Some factors that can influence the withdrawal timeline the most are as follows:

  • The severity of the addiction 
  • Overall health
  • Frequency of opioid use 
  • Type of opioid 

For short-acting opioids like heroin and oxycodone, symptoms may appear within 12 hours and peak within 24 to 48 hours. Symptoms then tend to subside in 3 to 5 days. 

However, for long-acting opioids like methadone, symptoms may arise within 30 hours since the opioid was last taken and not go away until 10 days have passed. 

Graphic of hospital.

Treatment for Opioid Use Disorder

Opioid Detoxification Process

The goal of detoxification is to rid the body of opioids. While detox may be short-lasting from a few days to a couple of weeks, it is the beginning step on a path to recovery and additional treatments. 

Those going through withdrawal may mistakenly believe that their current pain is the same as the original pain that led to the use of opioids. This type of experience during withdrawal is known as the “rebound effect”, in which symptoms that were either absent or controlled due to medication reappear because of a lack thereof. 

Opioid withdrawal is rarely life-threatening; however, it is recommended to consult a healthcare professional to structure the most suitable approach to pain or discomfort management during that period. Sudden discontinuation of the drug or “going cold turkey” could ultimately lead to relapse in opioid use and even an unintentional overdose. 

Types of Opioid Detox Medications 

As detoxification can cause many symptoms and pain, medical specialists may use one of the following prescribed medications to support the withdrawal period:

  • Buprenorphine (Subutex) - this medication helps to shorten the withdrawal timeline. It neutralizes the effects of other opioids, which can reduce cravings and withdrawal symptoms. 
  • Methadone - another type of opioid, this drug helps to prevent other withdrawal symptoms from appearing. It also reduces any cravings arising during detox.

Methadone and buprenorphine DO NOT substitute one addiction for another. Unlike heroin or other opioids that produce an instant rush or high, methadone and buprenorphine have a more gradual effect on the brain. This means that patients can reduce their cravings to use opioids little by little.  

  • Naloxone - administered in various forms, Naloxone is a common drug used to prevent overdose by opioids. It may be prescribed to patients undergoing medication-assisted treatment (MAT) and/or at risk of opioid overdose. 
  • Clonidine - unlike some of the other prescribed medications above, Clonidine does not reduce cravings. It does, however, help to treat high blood pressure, anxiety, sweating, runny nose, and cramping.
  • Naltrexone - available in a pill form or as an injectable, this drug is typically administered 7 to 10 days after opioid discontinuation. It offsets any euphoric or sedative effects that certain opiates like heroin, morphine, or codeine could cause. 

Additional Treatments

For those who suffer from an opioid use disorder, a “one-size-fits-all” treatment does not exist. It can be extremely difficult for many to overcome this problem, many healthcare professionals recommend that detoxification is coupled with additional psychological or support services. 

A more well-known therapeutic approach for OUD is medication-assisted treatment (MAT). This line of strategy aims to combine prescribed medications with behavioral counseling to address the symptoms caused by OUD as well as the underlying factors that may have led to the misuse of opioids. 

According to Substance Abuse and Mental Health Services (SAMHSA), MAT has been proven to provide the following benefits:

  • Lengthen patient survival
  • Raise retention rates
  • Lower illicit opiate use and other criminal activity among those suffering from an OUD
  • Improve an individual’s ability to get and maintain a job
  • Improve birth outcomes among pregnant women who have an OUD 

If you believe that you or a loved one suffers from an opioid use disorder or may be at risk of developing an OUD, please reach out to your nearest healthcare specialist to determine the best therapeutic approach. 

Ready to Make a Change?


“Medication and Counseling Treatment.” SAMHSA.gov, Substance Abuse and Mental Health Services Administration, Apr. 2020, www.samhsa.gov/medication-assisted-treatment/treatment.

“Naloxone.” SAMHSA.gov, Apr. 2020, www.samhsa.gov/medication-assisted-treatment/treatment/naloxone.

National Institute on Drug Abuse. “Heroin Drug Facts.” National Institute on Drug Abuse, 28 May 2020, www.drugabuse.gov/publications/drugfacts/heroin.

National Institute on Drug Abuse. “Fentanyl Drug Facts.” National Institute on Drug Abuse, 28 May 2020, www.drugabuse.gov/publications/drugfacts/fentanyl.

National Institute on Drug Abuse. “More FAQs about Opioids.” National Institute on Drug Abuse, 3 June 2020, www.drugabuse.gov/publications/opioids-facts-parents-need-to-know/more-faqs-about-opioids.

National Institute on Drug Abuse. “Effective Treatments for Opioid Addiction.” National Institute on Drug Abuse, 4 June 2020, www.drugabuse.gov/publications/effective-treatments-opioid-addiction/effective-treatments-opioid-addiction.

“Opiate and Opioid Withdrawal: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, May 2018, medlineplus.gov/ency/article/000949.htm.

“Opioid Use Disorder.” American Psychiatric Association, American Psychiatric Association, Nov. 2018, www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder.

Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/

“The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder - 2020 Focused Update.” American Society of Addiction Medicine, American Society of Addiction Medicine, 2020, www.asam.org/Quality-Science/quality/2020-national-practice-guideline.

calendar icon
Updated on: June 26, 2020
Anthony Armenta
calendar icon
Medically Reviewed: June 10, 2020
AnnaMarie Picture
Annamarie Coy,
addiction group logo

Find Treatment Today

Are you struggling with substance abuse? You aren’t alone. Here are some of the most frequently asked questions about addiction and treatment:
What is the difference between physical dependence and addiction?How effective is addiction treatment?How long is addiction rehab?
Depending on your unique situation, there are many addiction treatment options available. Compare the most effective types of treatment options here:
Inpatient RehabPartial Hospitalization ProgramsOutpatient Rehab
addiction group logo white text green logo
All unique content created by the Addiction Group team is sourced from current scientific research and fact-checked by an addiction counseling expert before publication. However, the information provided by Addiction Group is not a substitute for professional treatment advice. Read more in out About Us.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

© 2020 by TREATMENT PATHWAY, LLC. All right reserved.