Substance guides

Opioid withdrawal symptoms: A complete guide

Published November 28, 2025 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Opioid withdrawal symptoms are consistent across all opioids but timeline varies based on the specific drug's half-life.

Symptoms

Muscle aches and pain. Restlessness and insomnia. Diarrhea, nausea, vomiting. Abdominal cramping. Dilated pupils. Sweating and chills. Runny nose and tearing. Yawning. Anxiety and irritability. Rapid heartbeat. Goosebumps. Intense cravings.

Short-acting opioids (heroin, oxycodone, hydrocodone)

Onset: 8-12 hours. Peak: 36-72 hours. Duration: 5-7 days.

Long-acting opioids (methadone, extended-release formulations)

Onset: 24-36 hours. Peak: days 3-5. Duration: 2-3 weeks.

Fentanyl

Onset unpredictable due to fat storage. May begin, improve, then return as stored fentanyl releases. Complicates Suboxone induction timing.

Treatment

MAT (buprenorphine or methadone) eliminates withdrawal and should be the default approach. Comfort medication protocol (clonidine, anti-nausea, anti-diarrheal, sleep aids) for non-MAT approach.

Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC

Frequently asked questions

How bad is opioid withdrawal?

Intensely uncomfortable but rarely life-threatening. Often compared to severe flu. Medical treatment with MAT eliminates withdrawal almost entirely.

How long do opioid withdrawal symptoms last?

Short-acting opioids: 5-7 days. Long-acting: 2-3 weeks. Post-acute symptoms may persist months.

What is the best medication for opioid withdrawal?

Buprenorphine (Suboxone) or methadone eliminate withdrawal and reduce overdose death by 50%. They are the gold standard.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.