Opioid withdrawal is a physically and emotionally taxing process that occurs when someone dependent on opioids reduces or stops use. Understanding the duration of opioid withdrawal is essential for anyone preparing for detox or supporting someone through recovery.
In this article you’ll find out that while the timeline varies depending on several factors, withdrawal generally follows a clear pattern with distinct stages.
The Role of Opioid Type in Withdrawal Duration
The length and intensity of opioid withdrawal are largely determined by the characteristics of the opioid used. Short-acting opioids like heroin or immediate-release oxycodone tend to produce symptoms more quickly after cessation, often within 6 to 12 hours. In contrast, long-acting opioids such as methadone or extended-release formulations delay the onset of symptoms by up to 36 hours or more. However, their effects linger, often extending the duration of withdrawal.
Chronic use and high dosage intensify the body’s physiological dependence, which prolongs the withdrawal timeline. Someone using high doses of opioids for several years can expect a more extended and more severe withdrawal period than someone who used for a few months at lower doses. Tapering strategies, when applied properly, can help reduce the duration and severity of withdrawal.
For individuals seeking structured support, our medically supervised opioid detox in Utah offers a safer, more manageable withdrawal experience with personalized care, symptom relief, and 24/7 medical oversight.
Other Factors Influencing Withdrawal Duration
Individual physiology plays a significant role in how long opioid withdrawal lasts. Metabolism, age, liver and kidney health, and co-occurring disorders like anxiety or depression can alter how the body clears opioids and copes with the absence of the drug. People with multiple detox attempts may also experience longer or more complex withdrawals due to what’s known as “kindling”, a neurological response where each withdrawal becomes progressively worse.
Access to medical supervision can significantly reduce the duration and severity of withdrawal. Medications like buprenorphine and methadone can ease symptoms, while supportive therapy can address psychological stress. These interventions not only shorten the withdrawal period but also improve long-term outcomes.
Typical Timeline of Opioid Withdrawal
Opioid withdrawal is not a single, uniform phase. It unfolds in stages. The acute phase typically begins within hours to a day of the last dose, depending on the type of opioid used. This phase can last from 4 to 10 days and is marked by the most intense symptoms. Once the acute phase ends, a subacute phase follows, during which symptoms start to fade but may still impact daily function.
Beyond this stage is post-acute withdrawal syndrome (PAWS), a lesser-known but critical condition that can persist for weeks or months. While PAWS does not affect everyone, it often delays full recovery if not properly managed.
The total duration of withdrawal, from the acute onset to the resolution of PAWS, can range from a week to several months, depending on individual factors and the level of clinical support.
Early Withdrawal Symptoms and Their Duration
The earliest symptoms of opioid withdrawal often mimic a severe flu. These may include muscle aches, anxiety, excessive sweating, insomnia, and restlessness. For short-acting opioids, this stage typically begins within 6 to 12 hours of last use, and for long-acting opioids, symptoms can take up to 30 hours to appear.
These initial symptoms usually last two to three days. This is when discomfort begins to escalate and marks the start of the acute withdrawal phase. During this period, most individuals report heightened cravings, irritability, and disrupted sleep, all of which set the stage for the next, more intense phase of withdrawal.
Peak Withdrawal Phase: Intensity and Duration
The peak phase occurs between the second and fourth day after stopping opioids. This is typically the most physically demanding part of withdrawal. Common symptoms include vomiting, diarrhea, abdominal cramping, elevated blood pressure, chills, and rapid heartbeat. The psychological toll also deepens, with increased anxiety, agitation, and mood swings.
This phase can last anywhere from 48 to 72 hours, depending on how the body metabolizes opioids and the presence of any complicating medical issues. The peak phase gradually gives way to a milder, but still persistent, group of symptoms as the body adjusts to functioning without opioids.
Subacute Phase and Lingering Symptoms
After the most severe symptoms pass, individuals enter the subacute phase. Though the pain, nausea, and physical distress have usually lessened, lingering symptoms like fatigue, sleep disturbance, and depression remain. This period can last anywhere from 7 to 14 days, during which time mood instability and low energy levels are common.
This stage plays a crucial role in recovery, as it often determines whether a person remains committed to sobriety. Without proper support, lingering symptoms can undermine progress and lead to relapse, even after the most difficult physical symptoms have ended.
Post-Acute Withdrawal Syndrome (PAWS)
Some individuals experience post-acute withdrawal syndrome, which is characterized by waves of psychological symptoms that come and go for weeks or even months. These may include anxiety, depression, lack of motivation, memory problems, and sleep difficulties.
PAWS does not affect everyone, but when it occurs, it can significantly prolong the overall recovery process. This syndrome can last anywhere from several weeks to six months, depending on personal history, mental health conditions, and environmental stressors. The unpredictable nature of PAWS often makes it the most challenging phase of withdrawal.
Final Thoughts from Guidance Detox & Rehab
Opioid withdrawal varies by substance, usage history, and personal health, but patterns exist. While symptoms can last days or weeks, long-term recovery requires more than time.
At Guidance Detox and Rehab, we offer medically supervised detox tailored to each individual’s needs, with 24/7 care and evidence-based support. Our approach is designed to manage symptoms safely and create a foundation for lasting recovery. Withdrawal is challenging, but with the right environment, healing becomes achievable.
