Fentanyl Withdrawal

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

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 chronic severe pain or severe pain right after surgery, but is also made illegally. Synthetic opioids, like fentanyl, are the most common drugs involved in drug overdose deaths in the United States. In 2017, 59.8% of opioid-related deaths involved fentanyl compared to 14.3% in 2010. 

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.

Table of Contents

Is Fentanyl 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 they take 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 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 3–12 hours in the blood, and norfentanyl for 10–12 hours. In the urine, both fentanyl and norfentanyl can be detected for 3–10 days. Fentanyl and norfentanyl are not consistently detected in saliva and as a result, saliva is not the preferred method of detection. Hair follicle tests can detect exposure to fentanyl in the last three months.

What Causes Fentanyl Withdrawal?

Opioids like heroin, morphine and fentanyl all work by binding to the receptors in the brain in the areas that control pain and emotions. When these medications are taken repeatedly, the brain becomes used to it and adapts to reduce sensitivity. This makes it difficult for the person to feel pleasure from anything other than the drug. If the drug is taken away, or even if the dose is reduced, a person can feel symptoms of withdrawal.

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

  • Muscle and bone pain 
  • Trouble sleeping
  • Diarrhea and vomiting
  • Cold flashes with goosebumps
  • Uncontrollable leg movements
  • Severe cravings 

Fentanyl Withdrawal Timeline

Symptoms of fentanyl withdrawal typically occur within 12 hours. The formulation of fentanyl can determine how long withdrawal lasts, but that time period is usually 4–20 days. There are two phases of opiate withdrawal: Early and late.

Early symptoms of withdrawal include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late symptoms of withdrawal include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goosebumps
  • Nausea
  • Vomiting

Factors Determining the Length and Severity of Fentanyl Withdrawal

Fentanyl is highly potent and, as a result, is very addictive. Several factors can influence the length and severity of fentanyl withdrawal, including:

  • Duration of fentanyl use
  • Amount of fentanyl used
  • Age 
  • Impaired liver function
  • High body fat percentage
  • Other drugs or medications

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.

How to Safely Withdraw From Fentanyl 

Abruptly stopping fentanyl can lead to symptoms of withdrawal. While these are usually mild or moderate, they can 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 

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 medicines to manage symptoms of withdrawal, and 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 health care 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 work by binding to the opioid receptors in the brain and can help to effectively wean off of opioids like fentanyl in a safe and controlled way. Naltrexone is another medication that is sometimes used for this purpose, and 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

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.

Get Help

If you or someone you love is facing an alcohol use disorder, The Recovery Village Cherry Hill at Cooper can help. We offer medical detox and comprehensive rehab programs that are tailored to suit your needs.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.