Opiate Withdrawal Timeline

After prolonged usage of opiates, individuals may become physically dependent on the drug. Once physical dependence has occurred, an individual that ceases to use the drug or substantially reduces the dosage may experience physical withdrawal symptoms. Although, opiate withdrawal is non life threatening, it can still be extremely unpleasant and psychologically difficult to cope with. We’re often asked, ” What does the opiate withdrawal timeline look like?” The experience is different for everyone. If you begin experiencing withdrawal symptoms from opiates, it is a good idea to consult with a physician surrounding the best course of treatment for the problem. 

The Opiate Withdrawal Timeline

Here’s a generic outline of what you may experience:

Day 1

  • Headaches
  • Irritation or Anxiety
  • Muscle Aches
  • Loss of Appetite
  • Difficulty Sleeping

Day 2

  • Symptoms Consistent with Day 1
  • Sweating
  • Insomnia
  • Runny Nose

Day 3

  • Symptoms Consistent with Days 1 and 2
  • Nausea
  • Vomiting
  • Diarrhea

Day 4

Day four will normally be the peak of opiate withdrawal symptoms on the timeline for most people.

  • Symptoms Consistent with Days 1, 2, and 3
  • Cramping
  • Fatigue
  • Cold or The Shivers
  • Stomach Pain

Day 5

  • Symptoms Consistent with Days 1-4

Day 6

  • Symptoms Consistent with Days 1-5

Day 7

Day 7 is when the withdrawal will start to subside for most people. Symptoms may include:

  • Fatigue
  • Insomnia
  • Depression
  • Irritability

Long-Term Opiate Withdrawal Timeline

Post-Acute withdrawal syndrome, commonly known as PAWS, can continue for months.

Typically symptoms of opiate withdrawal begin within 24 hours of stopping usage and can last any from 48 to 72 hours. Most individuals report resolution of most symptoms within a week of stopping usage.

Listed below are several of the common side effects associated with opiate withdrawal:

  1. Muscle Aches – Many individuals will experience muscle aches very similar to muscle
    aches experienced when one has the flu.
  2. Anxiety and Restlessness – Once the sedating effect of opiates wears off individual may experience restlessness and increased levels of anxiety.
  3. Excessive Sweating – Individuals going through opiate withdrawals typically experience flushed skin and sweat excessively.
  4. Diarrhea – This symptom typically sets in around 24-48 hours after last use and lasts for a few days.
  5. Abdominal Cramping / Nausea and Vomiting – These symptoms are experienced by a high number of individuals experiencing opiate withdrawals and may last for a few days after withdrawal has begun.
  6. Rapid Heartbeat and High Blood Pressure – After 36-48 hours after ceasing opiate use many individuals experience rapid heart beats accompanied by an increase in blood pressure. Typically these symptoms resolve themselves after a few days.

When To Seek Alternatives To Opiate Treatments For Chronic Pain

Every individual responds to opiate medications differently, especially when treating chronic pain. Some individuals experience substantial pain relief at low doses and are able to keep their doses low for a long period of time. For these individuals long term opiate treatment may be a viable option. However, the majority of individuals develop a tolerance to opiates after prolonged usage and require dosages to be increased to attain the same effect. For these individuals long term opiate treatment may not be the best available option. Studies have shown a direct correlation between increased opiate dosage and increased risk of overdose.

Additionally, increased doses of opiate medications can result in the amplification of negative side effects a user may experience. With these issues in mind. when is it a good idea for an individual treating chronic pain with opiates to consider an alternative method of treatment? The sooner an individual begins exploring alternatives the better. Since opiates in some cases may slow down the recovery process in individuals the quicker one can be transitioned to an alternative the better. Another time to consider a different treatment is when low to moderate doses of medication cease to provide the pain relief they once did. If an individual is constantly increasing their dosage to remain pain free it may be a sign that it is not the ideal form of treatment.

Individuals that do decide to consider alternative methods to treat chronic pain should keep in mind that if opiate use has been occurring for very long they will more than likely experience some form of physical withdrawal. In these instances it is very important that they come off of opiates under the supervision of a physician, ideally one that specializes in pain management. During this process the physician can ensure the patient stays as comfortable as possible and can also help them explore and transition into alternative treatments.

Opiate Withdrawal Timeline: Starting the Process

Choosing to move from pain management centered around opioids to a more holistic option can be difficult. Here are a few ways we have seen patients go about this process:

  1. Cold Turkey: All use of the drug is ceased. This particular method may cause the most severe of withdrawal symptoms, even so much that reuse is very likely in order to decrease the effects of withdrawal. Cutting off supply to the drug so that it is not readily available is a drastic but essential standard for quitting cold turkey.
  2. Tapering: Tapering allows the continued use of the drug at the current dose. Over time, reduction in dose by a certain amount should occur until the dose ultimately arrives at zero.
  3. Therapeutic Treatments: Abstinence based treatments focus on the user abstaining from the drug use altogether and includes options such as Narcotics Anonymous groups and therapeutic communities. Therapy is proven to reduce mental health conditions that are a leading cause of relapse.
  4. Naltrexone: Naltrexone is a relapse prevention drug prescribed to people who have completed detoxification and who want to maintain abstinence from opioids. It works by blocking opioid receptors in the brain which in turn blocks the effects of heroin. This means that if the person taking naltrexone uses heroin, they will not experience any effects from the heroin. Naltrexone’s effectiveness depends on the individual’s dose and their ongoing supervised treatment.
  5. Substitution Treatment: Substitution treatment is also sometimes called “maintenance treatment” and involves substituting prescribed methadone in the place of an illegal opioid. Prescribed opioid medicines taken under medical supervision are safer and can provide a way for people to distance themselves from the daily struggle to obtain an illegal drug. This option means that people can commence treatment without having to go through withdrawal. Treatment can last months to years.

Strategies for Dealing with Opioid Addiction and Getting Through the Opiate Withdrawal Timeline

Years of research have shown that addiction to any drug (illicit or prescribed) is a brain disease that can be treated effectively. Treatment must take into account the type of drug used and the needs of the individual. Successful treatment may need to incorporate several components, including detoxification, counseling, and sometimes the use of addiction medications. Multiple courses of treatment may be needed for the patient to make a full recovery.

Behavioral and Pharmacological Treatment Options for Opioid Withdrawal

The two main categories of drug addiction treatment are behavioral and pharmacological.

Behavioral Treatments

Behavioral treatments help patients stop drug use by teaching them strategies to function without drugs, deal with cravings, avoid drugs and situations that could lead to drug use, and handle a relapse should it occur. When delivered effectively, behavioral treatments, such as individual counseling, group or family counseling, contingency management, and cognitive behavioral therapies, also can help patients improve their personal relationships and their ability to function at work and in the community.

Opioid dependence, which affects more than 2 million American, is a medical diagnosis characterized by an individual’s inability to cease the use of opiates as the result of a physiological or psychological change within their body.

Pharmacological Treatments

Drugs such as morphine, heroin, codeine, oxycodone, and hydrocodone are considered opioids. Some addictions, such as opioid addiction, can be treated with medications. Buprenorphine is a partial opioid agonist (i.e., it has agonist and antagonist properties), which can be prescribed by certified physicians in an office setting. Like methadone, it can reduce cravings and is well tolerated by patients. NIDA is supporting research needed to determine the effectiveness of these medications in treating addiction to opioid pain relievers. These pharmacological treatments counter the effects of the drug on the brain and behavior, and can be used to relieve withdrawal symptoms, help overcome drug cravings, or treat an overdose. Although a behavioral or pharmacological approach alone may be sufficient for treating some patients, research shows that a combined approach may be best.

Plano Pain Clinic Offers Holistic Options

At The Pain Relief Center in Plano, Texas, we offer a variety of treatment options for those who want to avoid opiates or opioid prescriptions. To learn move, visit our Plano Wellness Center for holistic opportunities.


The most critical step on the path to recovery is finding a pain management doctor who can address your pain management needs successfully. The Pain Relief Center and its five specialized institutes are dedicated to meeting any and all of a patient’s needs. Located in the Dallas-Fort Worth area, Dr. Rodriguez and his friendly staff will help you along the path to recovery.


Our new center in Dallas is part of a nationwide development by Pain Relief Centers, geared to providing individualized and comprehensive healing and pain management services with unprecedented levels of compassion, care, and comfort for each patient.