Opioid Withdrawal Symptom Timeline

Being “dope sick” is no walk in the park. Even the initial signs of opioid withdrawal symptoms can cause a person so much emotional distress that they relapse on opiates to avoid experiencing these withdrawal symptoms.  These symptoms are flu like in nature and can cause a person to feel miserable.

Two types of opioids that cause withdrawal symptoms:

  1. Short Acting Prescription Opioids
  2. Long Acting Prescription Opioids

Typically, the opioid withdrawal timeline will start 8 to 24 hours after last opioid use and range between 4 and 10 days.  For some people, the opiate withdrawal timeline will be shorter, while for others, it can last longer. One thing is for sure, preparing yourself psychologically to be uncomfortable and reminding yourself that it will end in a few days is a good way to approach it.  Also, knowing that you have probably gotten through alot worse in your life is important. And of course, always seek professional advice/consultation by a trained alcohol and drug counselor/doctor before going through opioid withdrawal on your own.

Opioid Withdrawal Syndrome

Short-Acting Opioids such as heroin, hydrocodone and codeine will have the onset of opioid withdrawal symptoms between 8 to 24 hours after last use and the symptoms can last 4 to 10 days.

Long-Acting Opioids such as methadone, morphine and oxycodone controlled release will see the onset of opioid withdrawal symptoms 12 to 48 hours after last use and the symptoms can last between 10 to 20 days.

Whether using short-acting or long-acting opioids, opioid withdrawal symptoms are essentially the same. The only real differences between long and short-acting opioid withdrawal syndrome is the time of onset and length of withdrawal symptoms.

Typical Opioid Withdrawal Symptoms

  • Nausea and vomiting
  • Headaches
  • Anxiety
  • Difficulties sleeping
  • Hot and cold flushes
  • Perspiration
  • Muscle aches and pains
  • Runny eyes and nose
  • Diarrhea
  • Stomach Aches
  • Fatigue
  • Depression and Irritability
  • Drug Cravings

Four Key Factors Affecting the Opiate Withdrawal Timeline

  1. The amount of opiates in your system at the time of detoxification.  The more in your system, the longer it will take to leave your system.
  2. The length and severity of the dependence on opiates.  Longer periods of using at high amounts can potentially influence the severity of withdrawal symptoms.
  3. Your  general state of physical and mental health. If you have complicating medical conditions that are untreated (diabetes, heart problems, etc.), opioid withdrawal symptoms may be more severe and can create medical complications.  If you struggle with anxiety or depression symptoms, opioid withdrawal might be harder psychologically to get through.
  4. Your choice of medical detoxification or withdrawing on your own can have a huge impact on treating the symptoms of opioid withdrawal effectively.

Follow-up Care Considerations

It should be noted that acute opioid withdrawal can be followed by a withdrawal phase that lasts for up to six months and is characterized by a general feeling of reduced well-being and strong cravings for opioids. These cravings can often lead to opioid relapses. To reduce the risk of relapse, patients should be engaged in active and supportive programs of recovery and addiction counseling. People who repeatedly relapse following withdrawal management are likely to benefit from medication assisted treatment utilizing methadone maintenance treatment or other opioid substitution treatment in the form of suboxone or naltrexone.

All opioid dependent people who have withdrawn from opioids should be advised that they are at increased risk of overdose due to reduced opioid tolerance. Should they use opioids, they must use a smaller amount than usual to reduce the risk of overdose.

Just remember that opioid withdrawal symptoms are temporary and that you can do this!  With the right kind of professional and family support you can begin your new life drug free!


Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva: World Health Organization (2009). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK310652/

About Ted Izydor - LPC, CSAC, ICS, MINT 62 Articles
Ted Izydor holds both a Master of Counseling Psychology and Master of Business Administration. With a distinguished 20-year clinical therapy background as a mental health and addiction counselor, Ted offers techniques, strategies and approaches that produce changes. As the founder of Full Potential Coaching and Consulting of Wisconsin, he devotes himself to sharing this knowledge and insight to people seeking more fulfilling, happier and healthier lives.

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