How Long Does Fentanyl Withdrawal Last?

Fentanyl withdrawal generally lasts several weeks, but the first week of symptoms is the most intense. 

Fentanyl detox is characterized by withdrawal symptoms that are both physical and mental. Without the benefit of Medication for Addiction Treatment (MAT), these symptoms can be very uncomfortable and feel worse than the flu. 

Withdrawal symptoms generally tend to begin within 12 to 30 hours of the last dose, peak within the first couple of days after cessation of fentanyl use, and then slowly taper off over the coming weeks.[1] The first week of symptoms is widely viewed as the hardest. 

With MAT, fentanyl detox is far more comfortable. Even with medication, it is not completely devoid of withdrawal symptoms, but most people are able to function well enough to attend group therapy sessions, go to work, and take care of other aspects of their lives. 

Without medication, fentanyl withdrawal symptoms can feel like a terrible flu, complete with nausea, vomiting, and insomnia. It is virtually impossible to function when in the throes of fentanyl withdrawal without medication and support. 

What Are Common Fentanyl Withdrawal Symptoms? 

Fentanyl is a powerful opioid pain medication that is 50 times stronger than heroin and 100 times stronger than morphine.[2] A white powdery substance, fentanyl is often mixed into batches of street drugs like heroin and cocaine, made into pills that look like Vicodin or OxyContin, or used on its own. 

Though it can be used for medicinal purposes, it is usually only on an inpatient basis under the watchful eye of a medical team and only for a short period of time. 

No matter the reason it is taken, fentanyl is highly physically addictive. Even just a few days of regular use can mean that withdrawal symptoms occur when the person stops taking the drug. These withdrawal symptoms may be more severe due to long-term use, high dosages, underlying medical or mental health disorders, and the use of other substances. 

Not everyone will experience the same withdrawal symptoms or the same intensity of symptoms, but common withdrawal symptoms associated with fentanyl may include the following:[3]

• Muscle and bone pain
• Restlessness and agitation
• Insomnia
• Cold flashes with goosebumps
• Diarrhea
• Nausea and vomiting
• Dilated pupils
• Sweating
• Runny nose and watery eyes
• Cravings for fentanyl 

Withdrawal symptoms typically start within a few hours to a few days after the last dose of fentanyl. They can last for several days to several weeks. Each person’s experience is different, but no one can escape fentanyl withdrawal without discomfort unless the person undergoes treatment, especially MAT.

If you or someone you love is experiencing withdrawal symptoms due to fentanyl detox, it is important to connect with a medical professional who can provide medication to moderate symptoms and avoid potential medical complications, especially if there are underlying, chronic illnesses present. If you attempt detox on your own, relapse is highly likely.

What Are Post-Acute Withdrawal Symptoms & Why Do They Last Longer? 

The acute symptoms of fentanyl withdrawal typically last for up to seven days, with the peak of the symptoms occurring within the first few days. However, some may experience acute symptoms for a longer period of time, which is known as post-acute withdrawal syndrome (PAWS).

PAWS can last for a few weeks to a few months.[4] It can include a range of symptoms like these:

• Anxiety and depression
• Insomnia and sleep disturbances
• Fatigue and lethargy
• Irritability and mood swings
• Difficulty concentrating and memory problems
• Cravings for the drug
• Reduced appetite and gastrointestinal problems
• Sensory disturbances, such as tingling or numbness

The duration and severity of PAWS can vary depending on factors such as the duration and frequency of fentanyl use, the dosage at the time detox begins, and other issues like age and overall health. PAWS can be challenging to manage, which can increase the risk of relapse because taking an opioid will immediately quell the symptoms. 

To manage PAWS, a combination of support and treatment interventions, such as counseling, MAT, and support groups, are recommended. It is important to seek professional help to manage the experience without a potentially deadly relapse, especially if fentanyl withdrawal symptoms are severe, prolonged, or overwhelming to manage alone.

What Factors Impact How Long Fentanyl Withdrawal Lasts?

No two people’s experiences in life, physical health, and even in their relationship to fentanyl will be the same. The characteristics of each of these issues will impact the duration and severity of fentanyl withdrawal symptoms.

These factors and characteristics include the following:

• Duration and frequency of use: The longer and more frequently fentanyl is used, the more likely it will be to experience severe withdrawal symptoms. Chronic use can lead to a more intense and prolonged detox experience.

• Dosage: Taking higher doses of fentanyl will usually result in more intense withdrawal symptoms.

• Method of administration: Stopping use of fentanyl after a habit of injecting the drug can result in a more rapid onset of withdrawal symptoms compared to other methods of administration (e.g., snorting).

• Age and health: Older people or those with underlying medical conditions may experience more severe withdrawal symptoms or require longer periods of recovery compared to younger, healthier individuals.

• Mental health: Pre-existing mental health conditions may translate into a more intense experience with withdrawal symptoms, which may then increase the risk of relapse.

• Withdrawal management: Withdrawal symptoms can be managed through various treatments, such as medications, support groups, counseling, and holistic therapies.

In most cases, the worst of fentanyl withdrawal typically ends within a week, but when post-acute withdrawal syndrome (PAWS) occurs, the symptoms can last for months.[5] PAWS can come with a deeper struggle with mental health symptoms like depression, anxiety, irritability, fatigue, and cravings. 

The good news is the medications like buprenorphine and Suboxone can make these withdrawal symptoms more tolerable and decrease the risk of relapse in the process. 

How Can Medication for Addiction Treatment Help Fentanyl Detox?

MAT can be an effective tool in decreasing the severity of length of detox from fentanyl. One medication commonly used in MAT for opioid detoxification is Suboxone, which contains buprenorphine and naloxone.[6]

Buprenorphine is a partial opioid agonist, which means it can help alleviate withdrawal symptoms and reduce cravings without producing the euphoric effects of fentanyl. Naloxone is an opioid antagonist, which can reverse the effects of fentanyl and other opioids if taken in large enough doses. This “blocking” effect helps to deter misuse. 

Suboxone can help to ease the transition from fentanyl use to abstinence by reducing the intensity of withdrawal symptoms and cravings. By providing a safer and more manageable detoxification process, Suboxone can increase the likelihood of a successful recovery by making the process more comfortable and decreasing the risk of relapse. 

MAT with Suboxone is often used as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to address the underlying causes of OUD and help people in recovery develop coping skills for maintaining sobriety.

It is important to note that MAT with Suboxone should only be used under the guidance of a medical team who can monitor and adjust the dosage as needed. The use of Suboxone in opioid detoxification should be part of a larger treatment plan that addresses the physical, psychological, and social factors of OUD.

Is Medication Right for Me?

If you are living with an active opioid use disorder and the primary drug of misuse is fentanyl, then Medication for Addiction Treatment is highly recommended by most medical professionals. The exact dose needed will vary from person to person based on overall health concerns, goals for recovery, and past experiences with treatment. 

It is recommended that you connect with a treatment professional to map out your course into detox before you begin to experience the withdrawal symptoms. Bicycle Health has a team of professionals on standby to assist you with this process. We are available to discuss your unique circumstances. 

Call Bicycle Health now to begin your journey toward recovery and get the medication that will make your experience simpler, shorter, and more streamlined. This will allow you to dedicate your time to the therapeutic interventions that will help you to build a new life in recovery.