Opiate Withdrawal Timeline

What is the Timeline for Opiate Withdrawal?

When you’re addicted to opiates like heroin, OxyContin, morphine, or Vicodin, it can be tough to stop taking the drugs due to the sometimes daunting withdrawal symptoms. If you’ve tried to stop on your own and you haven’t been able to, rest assured that it is possible to get free. Treatment is available and is most successful when it is done at a treatment center.

When it comes to the opiate detox and withdrawal process, you may have some questions regarding the timeline of withdrawal symptoms. Today, let’s take a look at what may occur as you move forward with the intent to stop using opiates once and for all.##The beginning stage

The first thing that will occur as you move toward abstinence in a treatment program is that you will be given a comprehensive assessment and evaluation. This information will then be used to help you create a customized treatment plan for treatment and after treatment. Meeting with professionals to discuss the addiction openly will serve as a catalyst for change. If you continue to hide the addiction from others, you’re likely to stay addicted.

The Withdrawal Stage

Within a day or two of your last opiate, you’ll start to feel some withdrawal symptoms. The intensity will depend on what type of opiate you’ve been using, how long, and how much. Due to the severity of some symptoms, medical monitoring is recommended as you go through the detox period. Professionals state that the worst of the withdrawal symptoms will occur within the first 3 days of detoxing. As your body rids itself of the toxins associated with the drugs, you will be able to relax and feel secure at a detox or rehab center, knowing that the professionals know what to do in order to assist you. You may be given medications to help manage your symptoms as well, which will help tremendously. Psychological help

While you’re detoxing, it is helpful to visit with a substance abuse counselor to discuss addiction and any other issues that you may have. You may even have the opportunity to attend 12 Step groups while you are in treatment. Once you’ve completed treatment, you may want to continue with such long-term in order to continue to facilitate your recovery.

Follow up

Opiate detox usually lasts about a week and then you’ll be feeling much better. You may still need to contend with some physical and mental cravings, so be sure that you have a follow-up treatment plan in place before leaving. You may decide to get a counselor, attend 12 Step groups, or an alumni support group. Opiate Withdrawal Timeline

General Opiate Withdrawal Timeline

Day 1 and 2: Withdrawal symptoms will begin to occur within 12 hours after you’ve had your last opiate. Many report the first symptoms being muscle and body aches, which can be quite painful and frightening. Sweating may occur as well. Other symptoms include nausea, diarrhea, sleep difficulties, and no appetite. You may also experience some anxiety these first couple of days, feel jittery, irritable, and confused.

Days 3, 4, and 5: When you hit these days, you will have been through the worst of it. You may still have some achiness and feel a bit tired, but you’ll feel a bit better. You’ll have a better appetite and may be able to sleep better. Some common withdrawal symptoms during this time are stomach cramping, getting goosebumps, nausea, and vomiting. Day 6 and on: You may still feel a bit queasy at times, but the worst is over. You’ll have more clarity and your appetite should resume. You may still contend with mental cravings, but the physical cravings should be gone.

Opiate Withdrawal Timeline Specifics

The opiate withdrawal timeline is as follows:

*Opiate withdrawal may persist for three days with short-acting opiates, and up to two weeks with long-acting opiates (methadone).

*Signs and symptoms of opiate withdrawal will begin 6 to 12 hours after the last dose for short-acting opiates and 24 to 48 hours after cessation of long-acting agents (methadone). Opiate withdrawal typically begins a couple of hours after stopping use the drug. However, drugs that block opioid receptors ("opioid antagonists") can rapidly induce withdrawal.

Examples of opioid antagonists include naloxone. Nalaxone is commonly used to reverse respiratory depression (impaired breathing) caused by opiates. This can be a life-saving measure in emergency situations when a patient has overdosed.

The following figure compares 10-day and 21-day methadone detoxification.

opiate-withdrawal-timeline

How To Read The Table of Opiate Half-Lives (Below)

The table below is a list of half-lives for common opiates. The half-life is the amount of time it takes for half of the drug to be cleared from your system. So, after one-half 50% of the drug will remain, after two half-lives 25% will remain, and so on.

Drugs with longer half-lives (e.g., methadone, 27 hours) are associated with a longer withdrawal period.

Half-Life of Common Opiates

Opioid Class Half-Life (hours)
Morphine Natural 1.9h +/- 0.5
Codeine Natural 2.9h +/- 0.7
Hydromorphone Semi-synthetic 2.4h +/- 0.6
Oxycodone Semi-synthetic 2.6h
Hydrocodone Semi-synthetic 4.24h +/- 0.99
Meperidine Synthetic 3.2h +/- 0.8
Methadone Synthetic 27h +/- 12
Propoxyphene Synthetic _
Tramadol Synthetic 5.5h (4.5-7.5)
Fentanyl Synthetic 3.7h +/- 0.4
Tramadol Synthetic 5.5h (4.5-7.5)

Signs and Symptoms of Opiate Withdrawal

Opiate withdrawal is associated with the following complaints:

  • Nausea and vomiting
  • Abdominal cramping and diarrhea
  • Dysphoria (depressed mood) and agitation
  • Rhinorrhea (the nasal cavity fills with mucus)
  • Lacrimation (flow of tears)
  • Myalgias (muscle pain) and arthralgias (joint pain)

The severity of these symptoms will depend on the patient's tolerance to opiates and the continued presence of the opiate in the body (which depends on the half-life of the drug).

Example:

A patient accustomed to 200 mg/day of methadone was administered 2 mg of naloxone intravenously. This patient would experience much more severe withdrawal symptoms compared to someone taking 10mg per day who stopped abruptly.