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Opiates & Opiate Abuse

Opioids are a class of drugs including heroin, synthetic opioids, and prescription painkillers. Opiates specifically are opioids naturally derived from the poppy plant. These drugs are often used to treat pain and slow down the central nervous system.

Some common examples of opiates and opioids include:

  • oxycodone (Oxycontin or Percocet)
  • morphine
  • codeine
  • Hydrocodone (Vicodin)
  • methadone
  • heroin
  • fentanyl

While opioids are effective in treating pain, they are habit-forming and can quickly lead to dependence. In the United States, an estimated 1.6 million people had an opioid use disorder in 2019.1

 

Opiate Withdrawal Symptoms

Because long-term misuse of opioids can lead to tolerance and dependence, when someone stops using these drugs, their body and brain struggle to adjust. The result is often a series of uncomfortable symptoms known as opioid withdrawal that can last several days or longer.

Some common opiate and opioid withdrawal symptoms include:

  • aches and pain
  • sweating or chills
  • nausea
  • vomiting or diarrhea
  • insomnia
  • mood swings
  • anxiety

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How Long Does Opiate Withdrawal Last?

The opioid withdrawal timeline and the symptoms vary from person to person as well as from opioid to opioid. Most people on short-acting opioids like codeine, hydromorphone, oxycodone, and morphine will begin experiencing the first signs of opiate withdrawal within 8 to 24 hours after they last took the drug. These symptoms will peak after a one to three days and then start to fade after about a week when acute opiate withdrawal ends.2,3

In contrast, long-acting opioids like extended-release and controlled-release tablets of these drugs have a slightly different opioid withdrawal timeline with symptoms beginning as late as 36 hours after the last dose, peaking on day 3 and 4, and going away closer to the 2-week mark. In both case, psychological symptoms may persist for weeks or months later. 3

 

Opiate Withdrawal Timeline

Although everyone is unique, there are some distinct stages of opioid withdrawal based on the symptoms themselves and  their intensity. The stages of opiate withdrawal include early withdrawal, peak period, late acute withdrawal, and post-acute withdrawal.

Stage 1: Early Withdrawal

Short-Acting Opioids: Starting within 8-24 hours

Long-Acting Opioids: Starting after 36 hours

While the opiate withdrawal timeline varies, the first stage of opiate withdrawal typically begin within 8 to 24 hours after the last use for short-acting opiates or closer to 36 hours for long-acting prescription opiates.

Early opiate withdrawal symptoms generally include:

  • a runny nose
  • tearing up
  • excessive sweating
  • chills
  • goosebumps
  • muscle and joint pain
  • stomach cramps
  • anxiety
  • insomnia

Stage 2: Peak Period

Short-Acting Opioids: Days 1-3

Long-Acting Opioids: Days 3-4

During this stage, symptoms from early opiate withdrawal tend to grow in intensity over the next several hours and new symptoms also arise. After one to three days for short-acting opioids and three to four days for long-acting opioids, the severity of these symptoms usually hits their peak.

Symptoms during this stage of opiate withdrawal tend to be both physical and psychological. At this point, the person may feel flu-like as well as emotionally distressed. It is important for people to maintain adequate levels of hydration and nutrition as well as have emotional support.

Peak opiate withdrawal symptoms include:

  • rapid breathing
  • racing heart
  • nausea and vomiting
  • diarrhea
  • fever
  • depression
  • mood swings
  • intense drug cravings

Stage 3: Late Acute Withdrawal

Short-Acting Opioids: Ends around days 7-10 

Long-Acting Opioids: End after up to 2 weeks

In the last stage of acute opiate withdrawal, physical symptoms will begin to wane, so a medical detox will near its end. On the other hand, some psychological symptoms may linger or new ones may even arise.

Symptoms of late acute opioid withdrawal include:

  • drug cravings
  • irritability
  • anxiety
  • restlessness
  • depression
  • insomnia

Post-Acute Withdrawal Syndrome

Lasts weeks to months later

Post-acute withdrawal syndrome is the part of the timeline for quitting opiates where the physical symptoms tend to all be gone, but psychological symptoms remain or come and gone. Because these symptoms may last weeks or even months, additional opioid addiction treatment is often needed after detox to help the person maintain their abstinence from opiate use.

Post-acute withdrawal symptoms may include:

  • sleep problems or disturbances
  • anxiety or panic
  • depression
  • mood swings
  • irritability
  • increased sensitivity to stress

 

Factors Impacting the Opiate Withdrawal Timeline

The exact opiate withdrawal timeline can vary widely because its length as well as the symptoms depend on several variables.

Some factors that can impact the opiate withdrawal timeline include:

  • type of opioid
  • route of administration
  • severity of addiction
  • tolerance
  • regular dosage
  • polysubstance abuse
  • previous opioid use
  • state of mental health
  • overall health
  • medical history
  • care during detox

 

Medications To Assist In Opiate Withdrawal

Even in more mild cases, the opiate withdrawal timeline can be an incredibly uncomfortable and trying time for someone. While many people tend to be wary of the idea of using other drugs during the detox process, doctors may prescribe or recommend medications as needed to provide a safer and more beneficial experience for the patient.

In particular, medication-assisted therapy (MAT) uses certain FDA-approved medications like buprenorphine, methadone, and naltrexone to help ease psychological cravings, reduce withdrawal symptoms, and block the euphoric effects of opioid use.

 

Getting Help

While these medications can make opiate withdrawal more manageable, detox is only the first step.  Additional treatment is often necessary to address the emotional and psychological aspects of addiction. Our residential addiction treatment in Texas provides a safe and comfortable environment for patients to overcome these lingering symptoms and build a foundation for lasting recovery.

At Vertava Health Texas, formerly The Treehouse, we want to be here for you and your loved ones. To learn more about our programs, contact us today.