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Prescription Opioid Withdrawal Symptoms

Prescription opioid withdrawal is a real possibility for anyone who has used prescription opioids for an extended period.

Prescription opioid withdrawal symptoms can be intense and life-threatening in some situations. However, knowing what to expect and how to manage withdrawals will go a long way in ensuring your safety and recovery.

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What Is Prescription Opioid Withdrawal?

Prescription opioid withdrawal occurs when a person abusing prescription opioids quits the drug, triggering a range of withdrawal symptoms.

While some individuals became addicted to prescription opioids by taking them to get high, others began taking opioids for severe or chronic pain management per their prescribing doctor.

Unfortunately, prescription opioid dependence and addiction are a real possibility—even when these pain medications are taken as directed.

Once a person stops using opioids, their body struggles to cope without the drug, which causes mild or severe withdrawal symptoms. These symptoms often make it difficult to control their use of opioids.

What Causes Prescription Opioid Withdrawal?

When a person takes prescription opioids, the drug binds to and activates opioid receptors found in the brain, spinal cord, and other organs in the body.

Opioids block pain signals sent from the brain to the body, releasing large amounts of dopamine to create a “high” feeling.

Taking prescription opioids longer than recommended can lead to drug abuse and physical dependence. Because of this dependence, stopping opioids makes it difficult for your body to compensate, and withdrawal symptoms begin.

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Common Prescription Opioid Withdrawal Symptoms

Symptoms of prescription opioid withdrawal often get compared to flu-like symptoms.

While these symptoms aren’t life-threatening, they can pose an increased risk if the person has other health conditions or develops acute opioid withdrawal syndrome symptoms.

Common symptoms of opioid withdrawal include:

  • Bone pain
  • Muscle aches and spasms
  • Fever
  • Chills and goosebumps
  • Teeth chattering
  • Hyperalgesia (enhanced pain sensitivity)
  • Insomnia
  • Intense cravings
  • Yawning
  • Watery eyes
  • Runny nose
  • Drooping eyelids and dilated pupils
  • Stomach cramps, nausea, vomiting, diarrhea
  • Elevated heart rate
  • High blood pressure
  • Weakness

Prescription Opioid Withdrawal Timeline

For individuals with opioid use disorder, withdrawal symptoms first appear up to 36 hours after the last use and can continue for up to 14 days or more.

Factors such as opioid type (fast or long-acting), dosage, and tolerance to the drug may affect this timeline.

  • In the first few days, people with severe addiction may experience abdominal cramps, nausea, and sweating.
  • By days 3 to 5, the drug is completely out of the body, but severe symptoms like muscle pain, cramping, excessive sweating, vomiting, and diarrhea can worsen.
  • After a week, most physical withdrawal symptoms will disappear, but the emotional side effects of withdrawal may continue for weeks or longer.

How to Safely Withdraw From Prescription Opioids

Due to the highly addictive nature of these drugs, the safest way to withdraw from prescription opioids is with some level of medical intervention.

Specifically, medical detoxification and withdrawal management under the supervision of healthcare providers is the best way to ensure your safety during prescription opioid withdrawals.

Withdrawing from opioids on your own increases the risk of opioid overdose should you relapse in response to severe withdrawal.

Tapering off Opioids

For patients abusing prescription opioids, tapering off the drug can lead to better success than “cold turkey” discontinuation. Tapering refers to the process of slowly lowering the dose over a set period of time.

Tapering should always be done under the instruction and supervision of a medical clinician. Whether through inpatient or outpatient opioid treatment programs, many patients find getting sober much easier by tapering.

Opioid Medical Detox

Medical detoxification is usually offered as part of a substance abuse treatment program for opioid use disorder. Not only does medical detox ensure complete safety while you stop drug use, but your doctor can prescribe certain medications to lessen withdrawal symptoms.

Your doctor may use both opioid and non-opioid options during medical detox.

Some of these medications work as opioid agonists (e.g., buprenorphine, methadone), which eliminates the effects of any kind of opiates and helps prevent relapse.

Other medications, like Promethazine, can ease certain symptoms of opiate withdrawal.

Common medications used for prescription opioid withdrawal symptoms include:

  • Methadone
  • Buprenorphine
  • Lofexidine
  • Suboxone (Buprenorphine and Naloxone combined)
  • Loperamide
  • Promethazine for nausea/vomiting
  • Ibuprofen
  • Clonidine
  • Benzodiazepines
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Follow-Up Treatment for Prescription Opioid Addiction

Opioid use disorder treatment includes more than just medical detox. Treatment programs often use cognitive behavioral therapy and group therapy to address the mental health aspect of addiction.

In addition, support groups like Narcotics Anonymous (NA) and SMART Recovery can offer peer support through every stage of recovery and help maintain long-term recovery.

For long-term success, medication-assisted treatments like Naltrexone help by blocking the activation of opioid receptors. Many addicts find that just knowing Naltrexone will prevent the high helps with their overall recovery.

Get Help for Prescription Opioid Withdrawal Symptoms

Opioid use disorder can be devastating for the addict and their loved ones. If you or someone you know struggles with prescription opioid abuse, there are treatment options available that can ease you safely and more comfortably off prescription opioids.

By using SAMHSA’s online treatment locator or calling (800) 662-4357, you can find a local treatment center that can help you on your journey to recovery.

Prescription Opioid Withdrawal FAQs

How long does prescription opioid withdrawal last?

The timeline for prescription opioid withdrawal can vary, but symptoms generally appear up to 36 hours after the last use and can continue for up to 14 days or more.

What are the worst symptoms during prescription opioid withdrawal?

From a medical safety standpoint, the worst symptoms of prescription opioid withdrawal include fever, vomiting, and diarrhea. Should these symptoms get out of hand, they can be life-threatening.

Can you die from prescription opioid withdrawal?

Generally speaking, prescription opioid withdrawal isn’t fatal. However, extreme dehydration is a serious concern, as it can lead to elevated blood sodium levels and heart failure if left untreated.

What is the first sign of prescription opioid withdrawal?

The first signs of prescription opioid withdrawal usually include muscle aches, restlessness, anxiety, sweating, watery eyes, and runny nose.

What causes prescription opioid withdrawal?

Because the body and mind can quickly become dependent on prescription opioids, the brain struggles to compensate for the lack of pain relief and dopamine opiates provide. As a result, withdrawal symptoms begin to manifest.

Can I avoid opiate withdrawal symptoms?

Unfortunately, no. Once your body is dependent on prescription opioids, you cannot avoid withdrawal. However, through a medical detox and medication-assisted treatments like buprenorphine and methadone, your withdrawal experience may not be as severe.

Kent S. Hoffman, D.O. is a founder of Addiction HelpReviewed by:Kent S. Hoffman, D.O.

Chief Medical Officer & Co-Founder

  • Fact-Checked
  • Editor

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.

Jessica Miller is the Content Manager of Addiction HelpWritten by:

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

  1. Centers for Disease Control and Prevention. (2022, December 5). Prescription Opioids: The Basics. Centers for Disease Control and Prevention. Retrieved March 15, 2023, from https://www.cdc.gov/rxawareness/information/index.html

  2. FDA. (2021, March 29). Opioid Medications. U.S. Food and Drug Administration. Retrieved March 15, 2023, from https://www.fda.gov/drugs/information-drug-class/opioid-medications

  3. Medications for Opioid Use Disorder. Substance Abuse and Mental Health Services Administration. (2021, July). Retrieved March 15, 2023, from https://store.samhsa.gov/product/TIP-63-Medications-for-Opioid-Use-Disorder-Full-Document/PEP21-02-01-002

  4. Shah, M., & Huecker, M. R. (2022, September 9). Opioid Withdrawal. National Library of Medicine. Retrieved March 15, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK526012/

  5. U.S. Department of Health and Human Services. (2023, January 9). Prescription Opioids DrugFacts. National Institutes on Drug Abuse. Retrieved March 15, 2023, from https://nida.nih.gov/publications/drugfacts/prescription-opioids

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