Fentanyl Withdrawal Symptoms, Timeline & Detox

Fentanyl, America’s deadliest drug, has made recovery from substance addiction more urgent than ever before. Here are the facts about withdrawal and detox from fentanyl.

Fentanyl Withdrawal Symptoms

Fentanyl, America’s deadliest drug, has made recovery from substance addiction more urgent than ever before. Here are the facts about withdrawal and detox from fentanyl.

Fentanyl Withdrawal Symptoms

Fentanyl withdrawal symptoms in the acute phase (the initial period after stopping the drug) tend to be more physical in nature, while psychological symptoms become more prominent after this phase. Symptoms include:

Physical Withdrawal Symptoms

• Runny nose 
• Watery eyes 
• Yawning 
• Sweating 
• Chills 
• Nausea/vomiting 
• Diarrhea 
• Muscle cramps or spasms 
• Insomnia

Psychological Withdrawal Symptoms

• Dysphoria (a general state of unease/discontent) 
• Anhedonia (inability to experience pleasure) 
• Depression 
• Anxiety 
• Cravings 
• Restlessness

Fentanyl Withdrawal Timeline

Because of fentanyl’s short half-life of 219 minutes, withdrawal symptoms can begin as early as two to four hours after the last use, but they will generally develop within 12 hours.

• 2–12 hours: Withdrawal symptoms begin
• 1–2 days: Peak symptom severity
• 3–5 days: Symptoms will gradually resolve

This can be longer in people who were using the fentanyl patch, which is a slow-release delivery system. In this case, withdrawal symptoms usually start within about 30 hours of removing the patch and can last for around 10 days.

Some people may develop symptoms that last well beyond the acute withdrawal phase. These are known as protracted withdrawal symptoms and may last weeks to months.

How Long Does It Take To Detox From Fentanyl?

It is difficult to predict how long fentanyl withdrawal will last in a particular individual. Typically, withdrawal symptoms taper off and end after 5 to 10 days in most people, depending on the fentanyl dosage form. The fentanyl withdrawal timeline usually follows a general pattern, but there are specific factors that affect each person’s level of withdrawal. These factors include age, gender, general health, liver and kidney health, genetic and biological make-up, concurrent use of other drugs, co-occurring mental health disorders, use of medically assisted detox and previous attempts at detox.

FAQs About Fentanyl Withdrawal

What is fentanyl withdrawal?

Fentanyl, a synthetic opioid, has made recovery from substance addiction more urgent than ever before. Now known as America’s deadliest drug, fentanyl has overtaken heroin and oxycodone as the leading cause of drug overdose deaths. When treating addiction through a fentanyl detox, the body experiences withdrawal as the brain and body react to the shock of the drug’s removal. Because of fentanyl’s ultra-high potency and short half-life, its withdrawal symptoms can be particularly severe. Fear of withdrawal can be a barrier to recovery for many people, but fentanyl withdrawal does not have to be a difficult and frightening experience. Medically assisted fentanyl detox can help people stop their drug use safely and comfortably.

How can I cope with fentanyl withdrawal symptoms?

Fentanyl withdrawal can be profoundly uncomfortable, especially for people who quit “cold turkey” without medical support. There are no shortcuts or easy fentanyl withdrawal remedies that can prevent symptoms when you quit suddenly. However, people who participate in supervised medical detox programs have access to 24/7 medical professionals who can address concerns as they arise and, if appropriate, administer pharmacotherapies to mitigate the severity of withdrawal symptoms. This includes medication-assisted treatment (MAT) with methadone or buprenorphine if medically appropriate. Fentanyl withdrawal is best addressed in a professional rehab setting that includes medical detox. At the very least, someone facing fentanyl detox and withdrawal should seek professional assistance to obtain an appropriate tapering regimen.

How long does fentanyl stay in your system?

The fentanyl half-life varies quite a bit based on the formulation and the route of administration. There are three types of fentanyl: pharmaceutical fentanyl, derivatives of pharmaceutical fentanyl and non-pharmaceutical (illicit) fentanyl, which all have different half-lives. Broadly speaking, intravenously administered pharmaceutical fentanyl has an average half-life of 7 hours, but the range spans from 3 to 12 hours. Transdermal fentanyl patches administer fentanyl through the skin, slowing the metabolic half-life to 20 to 27 hours. Derivatives and illicit fentanyl have shorter half-lives than pharmaceutical fentanyl.

Can I detox from fentanyl at home?

It is strongly suggested that someone with a fentanyl use disorder consult with their doctor or an addiction specialist before they attempt to quit. People who choose to detox without medical supervision should prepare ahead of time. Enlist a trusted friend or family member who can be a cheerleader, errand runner and motivational speaker. Discuss with them why recovery is important and what the short- and long-term goals are. It can be very helpful when struggling to resist relapse to be reminded why they are pursuing sobriety. In addition, make sure the refrigerator is full of healthy food and water. Many people find that a quality multivitamin may help their symptoms.

What is medication-assisted treatment for opioid addiction?

Quitting cold turkey is rarely the most effective approach to overcoming substance use disorders, and fentanyl is no exception. In milder cases of fentanyl dependence, a tapering protocol is a highly effective strategy for managing withdrawal symptoms. In severe cases of dependence, opioid replacement therapy in the form of medication-assisted treatment (MAT) may be more appropriate. 

MAT is a strategy that replaces fentanyl with other opioids that have longer half-lives and do not deliver the euphoria associated with fentanyl abuse. In other words, MAT tricks the brain into believing that it is receiving the drug it has become accustomed to without continuing to reinforce the pleasure associated with fentanyl use. There are several drugs that are valuable MAT options for people recovering from a fentanyl use disorder, including methadone, buprenorphine (Suboxone) and naltrexone.

Professional vs. At-Home Detox

Fentanyl detox treatment can be beneficial in helping someone break free from fentanyl addiction. One medical paper describes fentanyl withdrawal as a mountain of effort where the brain is driven to go around the mountain by relapsing. However, it describes medical detox as a molehill, which the brain does not need to find a way around.

Detoxing at Home

When making the decision to attempt fentanyl detox at home, individuals should do so in conjunction with their physician or an addiction professional. They should also be honest about the extent of their drug use. It is also important to involve loved ones in the process and heed the advice given by medical professionals. 

Detoxing off fentanyl at home may not provide the best recipe for success, as the cravings to relapse and relieve the withdrawal may be overwhelming. As a minimum, people who plan to detox at home should have certain supporting factors in place: 

• A short period of drug use at lower doses
• A stable and supportive home environment
• A safe, drug-free home removed from negative influences such as dealers or people who use drugs
• Not living alone and the people at home being made aware of the detox situation
• A high motivation to recover 

Detox does not in any way constitute treatment for fentanyl addiction. People should make arrangements in advance for some kind of treatment to address the reasons behind the substance use. 

Quitting Cold Turkey

Stopping fentanyl “cold turkey” results in a rapid onset of withdrawal symptoms that are usually severe. The risk of relapse during such a stark withdrawal is high, as the craving to use fentanyl to stop the symptoms can be overwhelming. Going through fentanyl withdrawal cold turkey is not recommended, as it is the most difficult way to stop fentanyl use and is a major driver of relapse. Rather, medically supervised detox uses medications, counseling support and symptom management, making the experience much easier, safer and more likely to result in a successful recovery.

Tapering off Fentanyl

People often overestimate their ability to taper off their opioids and stop drug use on their own. People who wish to avoid withdrawal symptoms by doing an opioid taper should discuss opioid replacement therapy with an addiction professional as part of an overall plan for treatment and recovery. People who use the fentanyl patch also need to taper off the drug, even if they are using it for legitimate purposes by prescription. Although the effects will be delayed, they can suffer significant withdrawal effects if they suddenly stop using their patch. They should discuss how to taper off the fentanyl patch with their prescriber.

Medically Assisted Detox

Medically assisted detox offers much more than the option of using opioid replacement therapy to prevent or reduce withdrawal. It also provides: 

• A safe place to detox away from distractions, temptations and triggers
• Immediate help if any complications arise
• Proper non-opioid management of side effects, such as insomnia, high blood pressure or diarrhea
• The ability to connect with other motivated people who are detoxing
• The ability to connect with counselors and begin working out an individualized plan of success for treatment and long-term recovery
• Access to proper, medically accurate information and facts
• The ability to demonstrate to loved ones that the individual is serious about recovery

Finding a Fentanyl Detox Center

Undergoing medically assisted detox at an accredited facility is the safest and most effective way to rid the body of fentanyl and other substances. This detox also helps them transition smoothly into treatment and recovery. Some factors to consider when selecting a detox program include:

• Location
• Cost
• Effectiveness
• Staff-to-patient ratio

If you or a loved one is addicted to fentanyl, help is available. Addiction is overwhelming, but you don’t need to go through it alone. Our fentanyl recovery experts at The Recovery Village at Baptist Health are available. They can work with you every step of the way as you overcome your addiction. Don’t wait: contact us today to learn more.