Fentanyl Withdrawal: Symptoms, Timeline & Treatment

Last Updated: November 2, 2023

Editorial Policy | Research Policy

Fentanyl withdrawal can be uncomfortable and dangerous, so it’s important to know when to seek help.

Fentanyl withdrawal can be challenging and overwhelming. Withdrawal symptoms can be severe and difficult to manage on your own, increasing your risk of abandoning the attempt at quitting the drug and falling into relapse. If you or a loved one is struggling with fentanyl, it is important to seek help. With assistance, it is possible to overcome a fentanyl addiction and live a fentanyl-free life.

What Is Fentanyl Withdrawal? 

People who use fentanyl over a long time may become physically dependent on the substance, leading to fentanyl withdrawal when they stop. Fentanyl withdrawal symptoms are uncomfortable and sometimes dangerous, so a medical detox is often recommended for a successful recovery.

Other Information on Fentanyl

Fentanyl is a synthetic opioid that’s 50 to 100 times more potent than morphine. It is classified as a Schedule II controlled substance often used to treat severe chronic pain or intense pain right after surgery, but it is also made illegally. Synthetic opioids, like fentanyl, are the most common drugs involved in drug overdose deaths in the United States and kill more than 150 Americans every day.

What Causes Fentanyl Withdrawal?

Opioids like heroin, morphine and fentanyl all work by binding to the brain receptors in the areas that control pain and emotions. When these medications are taken repeatedly, the brain becomes used to them and adapts to reduce sensitivity. This makes it difficult for the person to feel pleasure from anything other than the drug. If they stop taking the drug or even reduce the dose, a person can feel symptoms of withdrawal as the body struggles to adjust to the drug’s absence.

Fentanyl Withdrawal Symptoms

If someone who is addicted to fentanyl suddenly stops taking it, they may experience severe withdrawal symptoms as soon as a few hours after their last dose. Fentanyl withdrawal symptoms include:

Physical Withdrawal Symptoms

  • Muscle aches 
  • Insomnia 
  • Teary eyes
  • Sweating 
  • Runny nose 
  • Yawning 
  • Enlarged pupils
  • Abdominal cramping
  • Goosebumps
  • Nausea and vomiting 
  • Diarrhea

Psychological Withdrawal Symptoms

  • Agitation
  • Anxiety

Fentanyl Withdrawal Timeline

Although a person’s exact fentanyl withdrawal experience can vary, the withdrawal timeline is generally similar

  • Within 12 hours of the last fentanyl dose: Fentanyl withdrawal symptoms are likely to begin, although the symptoms and their intensity can vary.
  • Within 1 to 2 days of the last fentanyl dose: Fentanyl withdrawal symptoms are likely to peak in terms of intensity during this time.
  • Within 3 to 5 days of the last fentanyl dose: Fentanyl withdrawal symptoms slowly start to improve.
  • Within weeks to months of the last fentanyl dose: Prolonged fentanyl withdrawal symptoms can linger for the next few weeks to months. Specifically, anxiety, depression, insomnia and concentration problems may continue during this time.

Fentanyl Withdrawal Duration

Because fentanyl is a short-acting opioid, its withdrawal symptoms do not last as long as symptoms for longer-acting opioids. Generally, fentanyl withdrawal lasts up to five days, although lingering symptoms like anxiety, depression, insomnia and trouble concentration may persist for the next few weeks or months.

Factors Determining the Length and Severity of Fentanyl Withdrawal

Several factors can influence how long and intense a fentanyl withdrawal is, including:

  • Duration of fentanyl use
  • Amount of fentanyl used
  • Underlying medical conditions, including mental health conditions
  • Family history
  • If the person is also addicted to other substances 

How to Safely Withdraw From Fentanyl

Abruptly stopping fentanyl can lead to symptoms of withdrawal. While these are usually mild or moderate, they can also be severe and even lead to death. For the safest way to detox from fentanyl, speak with your doctor, who may recommend a taper or medical detox.

Fentanyl Taper

A fentanyl taper is when the drug’s dose is slowly decreased over time to avoid withdrawal symptoms. There are many considerations to determine if a fentanyl taper is appropriate and how quickly to taper down. Because of this, it is important to speak with a doctor if you are considering a taper. The first step is to determine how much opioid is being used each day, which can help determine whether this option is appropriate.

Fentanyl Detox

Fentanyl is a potent opiate, and detoxing on your own can be uncomfortable and dangerous. Often, medical detox treatment begins with medication to manage symptoms of withdrawal. The entirety of rehab treatment can vary from weeks to months depending on your specific needs.

In addition to medications, behavioral therapies like counseling have been shown to help with fentanyl addiction. This may include cognitive behavioral therapy to help manage triggers and stress or contingency management, which provides positive reinforcement. With your healthcare provider, you will be able to determine the best course of action for your care and treatment goals.

Fentanyl Withdrawal Medications

Medications can help slowly reduce opioid intake or manage symptoms. These medications are often called medication-assisted treatment (MAT). Buprenorphine or methadone works by binding to the opioid receptors in the brain and can help patients wean off of opioids like fentanyl in a safe and controlled way and prevent relapse. 

Naltrexone is another medication sometimes used for this purpose. It works by blocking opioid receptors and stopping fentanyl from working in the brain. Other medications can help treat symptoms of withdrawal, like clonidine for anxiety and agitation or antidiarrheals as needed.

Getting Help for Fentanyl Addiction and Withdrawal

The Recovery Village Cherry Hill at Cooper is located in South Jersey and just 20 minutes away from Philadelphia. Our facility offers many levels of care tailored to your needs, including medical detox, residential services and outpatient programs. We are also proud to offer several amenities that holistically support your recovery, including gyms, yoga and creative outlets.

If you or someone you love is struggling with a fentanyl addiction, The Recovery Village Cherry Hill at Cooper is here to help. Contact us today to speak with a representative and learn more about individualized treatment plans and programs that can work for you.

Common Questions about Fentanyl Withdrawal

Why is fentanyl so addictive?

Like heroin, morphine and other opiates, fentanyl is highly addictive. These medications work by binding to the brain’s opioid receptors responsible for pain and emotion.

If fentanyl is taken consistently or for a long period of time, the brain becomes less sensitive to it, and more is needed to achieve the same effect. This is how tolerance develops. As someone takes more over a longer time, they may become physically dependent, where they experience uncomfortable withdrawal symptoms if they stop.

How long does fentanyl stay in your system?

The half-life, or time it takes for the body to metabolize and eliminate half of one dose, varies widely depending on the formulation of fentanyl. Buccal lozenges, which are administered through the cheek, have the shortest half-life of about 2.6 hours, whereas transdermal patches have the longest, lasting up to 27 hours.

Detection of fentanyl in drug tests can also vary depending on whether the test is detecting fentanyl or its metabolite norfentanyl. In general, fentanyl is detectable for 3 to 12 hours in the blood and its breakdown product norfentanyl for 10 to 12 hours. In the urine, both fentanyl and norfentanyl can be detected for 1 to 3 days. Fentanyl and norfentanyl are not consistently detected in saliva, and as a result, saliva is not the preferred method of detection. A 1.5-inch hair test can detect exposure to fentanyl in the last three months.

Can you die from fentanyl withdrawal?

While it is unlikely for someone to die from fentanyl withdrawal, it is not impossible. This is because diarrhea and vomiting associated with withdrawal can be severe and lead to dehydration and changes in heart rhythm.

Another possible complication is aspiration, where the person vomits and then inhales the vomit into their lungs, causing an infection. For these reasons, it is important to always speak with your healthcare provider if you are considering stopping fentanyl.

What does fentanyl withdrawal feel like?

While fentanyl withdrawal can vary from person to person, withdrawal is very uncomfortable. Muscle aches, mood changes, goosebumps, nausea/vomiting and diarrhea can be difficult for a person to manage over the course of several days. For this reason, some people abandon their withdrawal attempts and go back to fentanyl use. However, with medical assistance, withdrawal symptoms can be managed and eased, setting you up for success in remaining off fentanyl.

Sources

Drugs.com. “Fentanyl Monograph for Professionals.” April 19, 2023. Accessed June 25, 2023.

Centers for Disease Control and Prevention. “Fentanyl Facts.” May 12, 2023. Accessed June 25, 2023.

Gryczynski, Jan, et al. “Hair Drug Testing Results and Self-reported Drug Use among Primary Care Patients with Moderate-risk Illicit Drug Use.” Drug and Alcohol Dependence, May 17, 2014. Accessed June 25, 2023.

ARUP Laboratories. “Drug Plasma Half-Life and Urine Detection Window.” September 2022. Accessed June 25, 2023.

American Society of Addiction Medicine. “National Practice Guideline for the Treatment of Opioid Use Disorder.” December 18, 2019. Accessed June 25, 2023.

Substance Abuse and Mental Health Services Administration. “Protracted Withdrawal.” July 2010. Accessed June 25, 2023.

Nuamah, Joseph K.; Sasangohar, Farzan; Erranguntla, Madhav; & Mehta, Ranjana K. “The past, present and future of opioid withdrawal assessment: a scoping review of scales and technologies.” BMC Medical Informatics and Decision Making, June 18, 2019. Accessed June 25, 2023.

Get your life back

Recovery is possible. Begin your journey today

Call Us Now Admissions Check Insurance

What To Expect

When you call our team, you will speak to a Recovery Advocate who will answer any questions and perform a pre-assessment to determine your eligibility for treatment. If eligible, we will create a treatment plan tailored to your specific needs. If The Recovery Village is not the right fit for you or your loved one, we will help refer you to a facility that is. All calls are 100% free and confidential.

All calls are 100% free and confidential.