Fentanyl Withdrawals

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Arizona is a state through which a large majority of fentanyl enters the United States. This means that there is no shortage of it in our area. Yavapai County is impacted, too. In response to this, fentanyl awareness campaigns have been created to target youth, and most schools carry naloxone and a person to administer it.

More than half of fentanyl overdose deaths in Yavapai County involved fentanyl in 2022. Wolf Creek Recovery sees the effects of fentanyl use in communities firsthand. As individuals in recovery ourselves, we understand what this process involves. We are here not just to provide treatment services to individuals, but to learn and grow with them. Let’s learn more about fentanyl withdrawals, the symptoms involved, and how to make this process as safe and tolerable as possible.

Fentanyl Withdrawals

Fentanyl is a synthetic opioid that is about 100 times more potent than morphine. It is prescribed by doctors to treat severe pain. However, it can also be manufactured and used illicitly. Due to its high potency, it is possible to develop a dependency on fentanyl very quickly. When this happens, you can experience fentanyl withdrawal symptoms when you try to quit or cut back. These symptoms can be so uncomfortable, they make it difficult to stop using the substance.

Fentanyl Withdrawal Timeline

The severity of fentanyl withdrawal symptoms depends on how long fentanyl has been used, in what doses, and how often. Typically, the more severe the dependency, the more intense the withdrawal symptoms. While withdrawal symptoms can be very unpleasant, they do taper off within a few days.

Withdrawal symptoms from fentanyl can happen as soon as six to 12 hours from the last dose. The initial symptoms include muscle aches, excessive sweating, lethargy, insomnia, and drug cravings. These symptoms increase and become more intense around 24 hours, when additional symptoms, such as diarrhea, nausea, and vomiting, can occur.

Acute withdrawal symptoms begin to taper off after three days and then subside after one week. Post-acute symptoms are symptoms that persist beyond acute withdrawal and may include sleep problems, anxiety, and an inability to feel pleasure. These symptoms can last for weeks or months.

Symptoms of Withdrawal

The symptoms of fentanyl withdrawal are similar to other opioids and include:

  • Aches and pains in the muscles and bones
  • Insomnia or sleep problems
  • Increased sensitivity to pain
  • Dysphoria (feeling down)
  • Uncontrollable leg movements
  • Nausea, diarrhea, vomiting
  • Enlarged pupils
  • Goosebumps
  • Chills
  • Sweating
  • Yawning
  • Runny nose
  • Teary eyes
  • Fentanyl cravings

What Factors Affect the Timeline?

There are several factors that affect the fentanyl withdrawal timeline:

  • Amount of fentanyl. How much fentanyl you take impacts the withdrawal timeline. Generally speaking, the higher the dose, the more severe the withdrawal symptoms.
  • Duration of use. If you have used fentanyl for a long time, it can accumulate in the body. This can cause more intense, longer lasting withdrawal symptoms.
  • Type of fentanyl. There are different types of fentanyl: pharmaceutical fentanyl and illicit fentanyl. It can be injected, taken orally by pill or tablet, or spiked onto blotter paper. Fentanyl patches can also be misused.
  • Individual characteristics. Your age, weight, and metabolism can affect the withdrawal timeline. Having an underlying mental or physical condition can also intensify withdrawal symptoms.

fentanyl withdrawals

The Stages of Fentanyl Withdrawal

The body metabolizes opioids quickly, which is why withdrawal symptoms can appear in just a few hours from the last dose. Withdrawal from opioids is a phased process, with the most intense period occurring in the first 24 hours.

First stage:

Withdrawal symptoms occur because of the absence of dopamine, a brain chemical responsible for pleasure, motivation, and learning. When fentanyl is ingested, it attaches to opioid receptors and causes the brain to release massive amounts of dopamine. The brain then quickly learns to rely on fentanyl to produce this chemical and feel good. When you stop taking the substance, there’s no more of it to release dopamine, and the central nervous system goes into overdrive trying to replace the chemicals.

Fentanyl withdrawal symptoms build over the next 48 hours, peaking around day three and then tapering off. The symptoms include:

  • Intense cravings
  • Insomnia
  • Restlessness
  • Muscle cramps
  • Bone pain
  • Agitation
  • Anxiety
  • Diarrhea
  • Runny nose and eyes
  • Sweating

Second stage:

Within three to five days, the brain starts to produce dopamine on its own again. The body slowly adapts to life without fentanyl, which is why some symptoms taper off. Withdrawal symptoms in the second stage include:

  • Goosebumps
  • Chills
  • Abdominal cramping
  • Vomiting

Third stage: 

Many people describe the third stage of the withdrawal process as feeling like a bad case of the flu. There are lingering aches and pains and overall malaise. The body is recovering, but psychological symptoms are common. They tend to kick up during this stage because dopamine is tied to moods and mental health. The symptoms in stage three include:

  • Anxiety
  • Depression
  • Insomnia
  • Overall malaise

Cold Turkey vs. Weaning

Quitting fentanyl cold turkey is not recommended. This is the most uncomfortable way to detox from fentanyl. Even those who have been prescribed fentanyl by their doctors are not advised to stop cold turkey. Suddenly stopping opioids can result in extreme cravings and withdrawal symptoms, making it nearly impossible to quit. No matter how hard you want to quit, the temptation to give in to cravings is extremely high.

Tapering off fentanyl is the recommended approach, but must be done with the direction of a medical professional. The goal is to reduce or eliminate the unbearable side effects of withdrawal and acclimate your body to the absence of fentanyl. Opiate tapers happen at different rates depending on the individual. The two main ways to wean off fentanyl are:

Direct tapering: 

Direct tapering involves slowly decreasing the amount of opioids you take over time. The slowest wean is a reduction of opiate use by two to 10 percent every one or two months for several years. The fastest wean is reducing opiate use by 10-20 percent daily. Anything faster than this can be dangerous.

Substitute tapering: 

Substitute tapering is also known as medication-assisted treatment, and this is what you will find in fentanyl rehab. The three medications approved by the FDA are buprenorphine, methadone, and naloxone, with buprenorphine being the most common. They are used in combination with behavioral therapies. These medications are taken instead of fentanyl and are tapered down over time to reduce cravings and withdrawal symptoms.

Why Fentanyl Withdrawals Occur

Withdrawal symptoms happen when you have a chemical dependency and stop taking the substance. Due to the potency of fentanyl, you can develop a dependency very quickly. The first thing that happens is tolerance, which is when you need increasing amounts to feel its euphoric effects. You may also continue using fentanyl to avoid uncomfortable withdrawal symptoms.

Like other opioids, fentanyl acts as an endorphin imposter, robbing the body of its ability to produce feel-good chemicals on its own. Fentanyl attaches to opioid receptors in the brain, causing them to release massive amounts of dopamine and other chemicals. These are the chemicals that provide the euphoria that gets many people hooked on the drug.

If you’ve been using fentanyl, your brain can become dependent on the drug to produce normal amounts of the chemical. When you quit, the brain lacks normal levels of these chemicals, and the efforts to restore them bring on the symptoms of withdrawal.

Risks of Overdose

A small amount of fentanyl can be deadly. When you take too much fentanyl, it overwhelms the part of the brain responsible for controlling breathing. This results in ineffective breathing that can lead to death if not treated in time. To survive an fentanyl overdose, a person needs naloxone and immediate medical attention.

How is Fentanyl Withdrawal Different From Other Opioids?

Fentanyl withdrawal is similar to withdrawal from other opioids like heroin or prescription painkillers, but it has distinctive aspects due to its potency and pharmacological profile. Because fentanyl is significantly more potent than most other opioids, it can lead to more intense withdrawal symptoms compared to those from less potent opioids like morphine or codeine. People using fentanyl often report a faster onset of symptoms that can start as soon as a few hours from the last dose, whereas longer-acting opioids might not produce symptoms until several days later.

Additionally, fentanyl withdrawal symptoms can be acute but brief compared to other opioids. The total duration of withdrawal might be shorter, but you may experience very intense symptoms that peak rapidly. While many symptoms of fentanyl withdrawal are common to opioid withdrawal in general, the severity and rapid onset can increase the risk of serious complications like severe dehydration or heart strain.

Finally, because of fentanyl’s potency and the severity of withdrawal symptoms, managing fentanyl withdrawal often requires more intensive medical supervision and potentially higher doses of medication-assisted treatments (MAT) like buprenorphine. There is also a greater emphasis on supportive care to manage the intense discomfort and medical risks associated with withdrawal.

Physical Withdrawal Symptoms

The most common physical withdrawal symptoms from fentanyl are:

  • Yawning
  • Sweating
  • Goosebumps
  • Aches and pains
  • Nausea or vomiting
  • Fever
  • Runny nose
  • Watery eyes
  • Uncontrollable leg movements

Mental Withdrawal Symptoms

The most common mental withdrawal symptoms from fentanyl are:

  • Anxiety
  • Depression
  • Dysphoria
  • Intense cravings

Fentanyl Withdrawal Medications

Several medications have been approved to treat opioid withdrawal and help you quit fentanyl. Buprenorphine is the most common.

Buprenorphine helps reduce cravings, shortens the detox process process, and improves withdrawal symptoms. It may also be used for long-term maintenance. Naltrexone works as a reversal agent. It can prevent misuse, as it blocks the effects of opioids if they are taken.

Other medications may be used to manage the symptoms of withdrawal, such as anti-anxiety medications for anxiety, sleep medications for insomnia, and medications for nausea, vomiting, and diarrhea.

wolf creek recovery fentanyl withdrawals

Get Treatment for Fentanyl Withdrawal in Prescott, AZ

Fentanyl detox is the first step in the recovery process. While withdrawal symptoms can be uncomfortable, there are ways to make this process easier and more tolerable. Tapering off opioids makes it possible to manage withdrawal symptoms so that they are not as intense and sudden. Taking the appropriate medications can also help by managing withdrawal symptoms, reducing cravings, and blocking the effects of opioids.

Once you are through the detox period, treatment for fentanyl use disorder begins. This includes therapies such as cognitive behavioral therapy and motivational enhancement therapy. You will also continue taking the appropriate medications to help make your recovery successful. With the right support, it is possible to make a full recovery from fentanyl use disorder. People learn to find happiness and feel good again in their everyday lives.

Wolf Creek Recovery is a rehabilitation center in Prescott, AZ, about 100 miles outside of Phoenix. We are known for our mild year-round climate and pleasant seasons. Our staff takes advantage of this by getting clients outdoors for outdoor therapy, teambuilding, and relaxation. Because our staff is also in recovery, we are truly one big family learning new ways to cope and rebuild our lives. To learn more about our programs, contact us today at 833-732-8202

FAQs About Withdrawals From Fentanyl

Why do fentanyl withdrawals happen?

When your brain becomes dependent on fentanyl, it has come to rely on the substance to produce normal amounts of dopamine. When you quit, the brain lacks normal levels, and the efforts to restore them bring on the symptoms of withdrawal.

What are the common symptoms of fentanyl withdrawal?

Fentanyl withdrawal symptoms include aches and pains, restlessness, trouble sleeping, watery nose and eyes, goosebumps, sweating, yawning, and an increased sensitivity to pain.

What does protracted withdrawal symptoms mean?

Protracted withdrawal symptoms are symptoms that persist after the expected acute withdrawal period. These symptoms typically include insomnia, anxiety, depression, and dysphoria, and can last for months or years.

How long does fentanyl withdrawal last? 

Symptoms from fentanyl withdrawal usually occur within 6 to 12 hours from the last use, peak around one to three days, and then begin to taper off.

Are there medications that can help with fentanyl withdrawal?

Yes, the FDA has approved medications to help with withdrawal. These medications decrease cravings, reduce withdrawal symptoms, and block the effects of opioids. Some can even be used long-term to maintain abstinence.