If you think fentanyl detox is just like any other opioid withdrawal, think again. Fentanyl is no joke; and the withdrawals from it are serious. If you’re wanting to end the cycle of fentanyl addiction, we applaud you. We want you to have all the information and support you need, which is why we put together this guide on all things fentanyl detox.
Most opioids, like heroin or oxycodone, have a half-life (the time it takes for substance to decrease by half in the body) that makes withdrawal fairly predictable. Because of this predictability, users can accurately gauge when withdrawal symptoms will start and generally know how long they’ll last. This allows for a pretty clearcut detox plan.
Fentanyl isn’t like most opioids though. The pharmacokinetics of fentanyl make judging how, when, and the severity of detox difficult. The way it lingers in the body, how the drug was used, and the duration of use all can affect the withdrawal timeline. Plus, most people who use opioids don’t even know they’re ingesting fentanyl since it’s often mixed into other street drugs. This unpredictability makes withdrawal tricky and sometimes more prolonged than expected.
There’s an old idea floating around that opioid detox, while severely uncomfortable, is not life threatening. Let’s be perfectly clear - quitting fentanyl without the aid of a medical detox program is dangerous and life-threatening.
Withdrawal symptoms can range from agonizing to deadly, and dehydration, extreme cravings, or complications like respiratory distress and heart failure can put a person at serious risk. Detoxing off fentanyl alone is extremely dangerous.
While withdrawal is different for everyone, here’s a general timeline of what to expect when detoxing from fentanyl:
Because of fentanyl’s short half-life, the first wave of symptoms usually start within 6 to 12 hours after the last dose. Less than that if the use is chronic and heavy.
The onset feels like the beginning of the flu—muscle aches, sweating, chills, runny nose, and watery eyes. Soon anxiety and an incurable feeling of restlessness set in. Your body knows that more fentanyl will stop these feelings and an overwhelming craving for the drug starts in response.
Between 24 hours and 72 hours is where most people relapse. This is when withdrawal symptoms hit their peak and people break. On top of the flu symptoms, deep bone aches begin and sleep is impossible. While the body is trying to flush out all the fentanyl, most people experience intense nausea, vomiting, and diarrhea. This is when dehydration and organ failure can become an issue.
Shaking, cold sweats, and a deep sense of hopelessness creep in. Heart rate and blood pressure can spike, making this a dangerous time for those with underlying health conditions.
Psychologically, depression, panic attacks, and severe agitation are common. Cravings are at their strongest and without proper detox care, most people won’t make it through this part sober.
Generally speaking, by day 4, you’re starting to come down the other side. Detox isn’t over by any means though. Sleep disturbances, mood swings, and extreme fatigue stick around. Many people describe feeling mentally foggy or emotionally drained. At this point, dehydration and malnutrition from days of vomiting and diarrhea may need to be addressed, and getting proper nutrition becomes critical.
This is also when post-acute withdrawal syndrome (PAWS) can start. PAWS is more mental than physical and includes lingering issues like depression, anxiety, and feeling off that can last for weeks or months. The brain is literally re-wiring itself and trying to heal.
Going into the second week of detox, the body has largely adjusted to life without fentanyl, but the brain is still catching up. Mental and emotional symptoms remain. Many people report experiencing lingering cravings, sleep issues, and mood fluctuations.
This is why medical detox at a residential addiction treatment program is essential. It takes 2 weeks to begin the healing process. After detox, transitioning into a structured treatment program to start on the real work of recovery is the best way to achieve long-term sobriety.
If you’re thinking about quitting fentanyl, don’t do it alone. Detoxing in a professional, supportive environment and then moving into an inpatient treatment program is your best bet. Ready to start? Help is just a call away.