Manifest Recovery Centers (866) 359-9052
18663 Ventura Blvd, Suite 300 Tarzana CA 91356
10100 Santa Monica Blvd Los Angeles CA 90067
Call (800)376-8402 for any question or concern

Blog Post

Opiate Withdrawal Timeline and Symptoms
Addiction Treatment Drug Addiction

Opiate Withdrawal Timeline and Symptoms

Opiate Withdrawal Timeline and Symptoms


In the last few decades, society changed the way it responded to and treated pain. This finally caught up to us in the form of the opiate epidemic, which now sweeps across the country. Between 1991 and 2013, the number of prescription opiates written annually increased from 76 million prescriptions per year to 207 million prescriptions per year. Ironically, this increase in demand for pills whose whole purpose were to stop the pain, only wound up creating more pain as a result, leading to the deaths of more than 50,000 Americans in 2016.

Recently, opiates claimed the ignominious title of the primary killer of people under the age of thirty-five. If the trend of previous years is any indicator, this epidemic will only worsen unless drastic measures are taken. These drugs are just far too potent and habit forming to be taken regularly, especially for mild to moderate pain. For this reason, we as a country need to discuss the grave consequences of opiate abuse.

If opiate abuse is something that you or someone you care for struggles with, it is critical you address it immediately. While no one denies that the road towards recovery can be fraught with challenges, the consequences of ignoring the problem grow exponentially worse as time passes, increasing the likelihood of serious damage occurring. To that end, we will discuss the opiate withdrawal timeline and symptoms so that you are mentally prepared to face that which lies ahead.


What Are Opiates


The central nervous system (CNS), which consists of the brain, cardiovascular, and respiratory systems, contains various opioid receptors. Opiates attach to these receptors and send signals to the rest of the brain, “Causing the opioid effect,” which causes the following:

  • Antidepressant effects
  • General calming effects
  • Prevents pain
  • Slows breathing

These drugs target the reward system of the brain, saturating it with dopamine, the neurotransmitter responsible for regulating:

  • Cognition
  • Emotion
  • Motivation
  • Movement
  • Pleasure

The brain’s reward system evolved so that a person would repeat life-sustaining tasks like eating, exercising, and intercourse, by linking those activities with a rewarding feeling of pleasure. When activated, the brain makes a note of what is happening and starts ingraining that action. With opiate abuse, the artificial overstimulation of this system that rewards our natural behaviors produces those euphoric effects and teaches the brain to repeat that deed.

Over time opiates can impact the chemistry of the brain in two distinct ways:

  1. Alters how the brain responds to pain stimuli
  2. Produces an overstimulation in the brain, upsetting the communication between the brain and the pleasure center

Regular opiate use can eventually rewire the brain and transform into psychological and physical dependence.


Types of Opiates


There are a variety of medicines and street drugs that fall under the opiate chemical makeup umbrella. Such drugs include:

  • Codeine
  • Dilaudid (Hydromorphone)
  • Fentanyl (Duragesic)
  • Heroin
  • Hydrocodone
  • Hydrocodone/Paracetamol (Vicodin)
  • Oxycodone
  • Meperidine (Pethidine)
  • Morphine


The Effects of Opiates


Opiates can be taken orally or suppository, snorted, smoked or injected. Once they enter the brain, they create a euphoric high and produce short-term feelings of:

  • Drowsiness
  • Hypothermia
  • Nausea
  • Pain relief
  • Relaxation
  • Sedation
  • Slowed breathing
  • Slowed mental capabilities

In the long-term, regular opiate can damage and restructure the brain, causing:

  • Addiction
  • Impact rational decision-making
  • Impaired mental acuity
  • Increased tolerance
  • Organ failure
  • Physical dependence


Opiate Withdrawal


As an opiate user’s tolerance and physical dependence increases, their body will gradually adapt and make that state its new normal. As a result, when the substance is no longer in the system, withdrawal symptoms will inevitably occur.  

The symptoms of opiate withdrawal can vary from mild to severe and are contingent upon the level of dependence on opiates. This dependency can be a result of several factors including:

Biological factors

  • Dosage amount
  • Family history
  • Level of dependence
  • Past trauma
  • The existence of co-occurring mental health disorders
  • The length of time taking that specific opiate
  • The type of opiate
  • The way the opiate was administered


Opiate Withdrawal Symptoms


Symptoms of withdrawal can be broken up into two separate categories, early onset withdrawal symptoms, and late opiate withdrawal symptoms.

Early Withdrawal Symptoms

Early withdrawal symptoms can kick in within 6-12 hours for short-acting opiates, and 30+ hours for longer-acting opiates. Such symptoms include:

  • Aches
  • Agitation
  • Anxiety
  • Excessive yawning
  • Fever
  • Hypertension
  • Insomnia
  • Itchiness
  • Pounding heart
  • Runny nose
  • Sweats
  • Tearing up

Late Withdrawal Symptoms

Late withdrawal symptoms can include:

  • Cramps
  • Cravings
  • Dehydration
  • Depression
  • Diarrhea
  • Extreme sweating
  • Goosebumps
  • Nausea
  • Vomiting

Because of the factors discussed above, the opiate withdrawal process has a vague timeline that is not identical for any one person. For this reason, it is crucial that a person who desires to get clean performs the opiate detox under medical supervision at an inpatient treatment center.


The Opiate Withdrawal Timeline


The brunt of withdrawals takes place during the stabilization period of the detoxification process. The goal of medical professionals during this time is to help their client safely kick their physical dependence to opiates. This involves monitoring heart rate, hydration, breathing, and other key vitals, as well as possibly giving the client less powerful drugs to ease the uncomfortable symptoms (what is known as tapering).

Opiate Withdrawal Timeline – 6-12 Hours In

In the initial period of detoxification from opiates, the client will start to feel the early symptoms of withdrawal. These feeling will magnify as more time passes since the last dose of opiate. The body knows something is wrong which leads to disturbed feelings of anxiety, anger, irritation, and unease. Even though they are not yet at their peak, these symptoms can be so uncomfortable that those who try and detox outside of medical supervision may give up at this stage in order to allay these unpleasant symptoms.

Opiate Withdrawal Timeline – 12-24 Hours

As the client enters their second day of opiate withdrawals, withdrawal symptoms will likely be taking their full effect, leading to weakness, confusion, and extreme discomfort. One Reddit user addicted to Oxycodone and Dilaudid described the feelings of withdrawal like this:

So imagine having the worst flu you have ever had times thirty. You feel completely miserable. You are sweating constantly, and you are cold. You have a runny nose and sneeze constantly. You experience extreme nausea and/or diarrhea. You are in constant pain all over your body. You can try to sleep but, you get restless legs, and they are twitching at random moments. You also have the worst depression you could ever imagine. Plus, the whole time you know what would fix it, so you are constantly obsessing about it. The thought of that drug never leaves your mind.

At times these symptoms may feel unbearable, especially since the body is as weak as it has ever been. Many of these symptoms lead to dehydration, which in turn can lead to cramps, muscle spasms, and possible death in extreme cases. This is a primary reason why medical supervision and a solid support system are so essential for a safe and successful detox.

Opiate Withdrawal Timeline – 24-48 Hours

Depending on the severity of dependence, a client’s symptoms of withdrawal from opiates may be peaking or starting to abate. Moods and emotions will likely be out of whack due to a constant pendulum of feelings such as anxiety, intense cravings, and depression.

Heroin Detox Timeline – 48 – 128 Hours

Opiate users who make it this far will likely notice that symptoms become more manageable and infrequent. As time continues and physical dependence wanes, the symptoms become decreasingly less potent. For the first time in days, a client will likely be able to finally work up an appetite and actually recover some strength thanks to a meal and some sound sleep.  


Only once a client is free from the clutches of physical dependence on opiates can they truly begin preparing to conquer their substance abuse issues. Now that their body and mind is relatively clear, they can start studying and deciphering the motivations and triggers at the heart of their addiction. They can set their mind to learning from medical professionals and other substance abusers, gaining invaluable tools for fighting opiate addiction.

This learning process will typically begin at an inpatient facility which will last somewhere from one to three months. Once a client graduates this program, they are sent away from the temporary shelter of an addiction treatment center back to their old lives. Because this return to the real world can come with a host of temptations, triggers, and stressors, clients are encouraged to find a recovery program so that they can share their struggles and their journey with others.




If you or someone you care for struggles with opiate abuse, it is essential you seek addiction treatment right away. Manifest Recovery Center specializes in helping people who struggle with opiate abuse find freedom from opiate addiction. If you have any questions or concerns, pick up the phone and give us a call.


The National Alliance of Advocates for Buprenorphine Treatment – “Opiates/Opioids,”

Reddit – “Explain to me like I’m five – What does Heroin withdrawal feel like,”

Psychamedics Corporation – “Opioids”