Stages of Opiate Withdrawal: What To Expect From Beginning To End

In this article, I’m going to provide you with detailed and helpful information about the Stages of Opiate Withdrawal. The first time I went through opiate withdrawal was a nightmare.

I was scared because I had no idea how long the Stages of Opiate Withdrawal would last.

The physical symptoms were bad, but the psychological terror I was experiencing was almost unbearable. Furthermore, the symptoms were getting more intense as time went on!

Since then I have gone through opiate withdrawal several times, learning more and more about how to ease symptoms along the way.

I finally got clean a little over six years ago, and I’ve since made it my Life’s Purpose and Mission to help people recover from opiate addiction.

For this Blog post, I’m going to paint you a picture of what my first withdrawal was like. Next, I will cover the various symptoms you will likely experience, how long they could last, and how severe they could be. Finally, I will teach you about the top 20 things that can either ease your symptoms or completely stop withdrawal.

So fasten your seatbelt as we begin to explore the many aspects of the Stages of Opiate Withdrawal.

Stages of Opiate Withdrawal: My First Experience

It seemed harmless and innocent when I started taking prescription painkillers for recreational use. For years I was able to get high a few times per month, and I never became addicted or suffered any negative consequences. Then one day I found myself completely out of pills after I had been using every day for a few months.

I woke up in the morning, walked to work and had a cup of coffee, and then it started.

I was on the first day of the Stages of Opiate Withdrawal and I didn’t even know it.

Right after I got to work I puked up my coffee. A few minutes later…I had a panic attack that was so intense my boss took one look at me and told me I could go home!

I had never even heard of opiate withdrawal, so of course, I didn’t know that’s what was happening to me. I literally just thought it was a massive panic attack.

The next few days kept getting worse, not better, so I was really scared and didn’t know what to do. I ended up staying home from work for the next four days because I was too sick and terrified to leave my house.

Finally, my dealer told me I was going through the Stages of Opiate Withdrawal, so I went online and learned everything I could about it.

That was over eight years ago, and I’ve now been off opiates for over six years.

During that time I became a Substance Counselor and then left the profession to become an Opiate Recovery Coach. I teach people how to get off opioid drugs without getting sick, and how to feel amazing and happy without using opioids ever again.

The first part of getting through withdrawal is knowing what you’re up against. And thus, knowing what to expect during the Stages of Opiate Withdrawal will mentally prepare you for the formidable obstacle ahead of you.

And to really prepare you in the best way possible, I believe it will help to give you a basic overview of the science of opiate withdrawal…so that’s where we’ll begin.

How Opiates Work in the Body

Opiates are drugs that are derived from the opium poppy plant. Opioids are synthetic or natural drugs that do not originate from the opium poppy plant, however, they still bind to the same opioid receptors in the brain and body that opiates bind to, resulting in the same types of effects.

Despite all of the associated negative aspects (addiction, overdose, crime, etc.), prescription opiates still have a positive intent. They are commonly prescribed for the treatment of moderate to severe pain.

These drugs, along with heroin, attach to specific proteins called opioid receptors, which are located on nerve cells in the brain, spinal cord, GI tract, and other organs.

Once these drugs attach to the opioid receptors, their effects come on, which include, but are not limited to:

 

As human beings, we already have an endogenous painkilling system that is capable of producing pain relief, sedation, and euphoria.

This natural pain relief system is activated when we exercise, eat certain foods (e.g. dark chocolate and chili peppers), or perform other activities.

For example, imagine a man who has just run five miles along the beach.

As a result of this intense physical exertion, his body naturally produces its own opioid chemicals, known as endorphins and enkephalins, thus reducing pain, and promoting euphoria naturally (“runners high”).

Tolerance and Dependence

We already produce natural opioid chemicals (endorphins/enkephalins) in the precise amounts our bodies were designed to handle. The problem arises when an individual has been using an opioid drug for a period of time.

After prolonged use of opioid drugs, the production of endogenous opioids is inhibited, which accounts in part for the withdrawal syndrome that results from the immediate cessation of the drug.

The continuous use of opioids overrides our natural ability to produce endorphins and enkephalins.

The brain comes to rely on the drugs to create these neurotransmitters.

When a person stops using the opioid drug, the brain doesn’t start creating these endogenous opioids right away. It short-circuits, leading to withdrawal symptoms, and deteriorating psychological function.

Whether an individual is abusing opioids or even taking them as prescribed by a physician, the continued use quickly leads to tolerance. Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a decrease of the drug’s effects over time.

If an individual continues using opioids after a tolerance has been established, they will eventually develop a physiological dependence.

Dependence develops when the neurons (pictured below) adapt to the repeated drug exposure and only function normally in the presence of the drug.

The Opiate Withdrawal Syndrome

When a dependent individual abruptly stops taking opioids (leading opioid-blood concentration to fall below the required level), the now opioid-tolerant central nervous system (CNS) goes haywire. With no inhibitive stimulation to satisfy receptors, the pathways of the CNS fire signals strenuously, performing at a level much higher than pre-dependence levels.

Now the locus coeruleus responds by triggering the autonomic fight or flight response. What results is known as the opioid withdrawal syndrome, and it’s one of the most horrific experiences an individual could even go through.

Acute Opiate Withdrawal Symptoms

Now that you have a good overview of how the whole process starts, we can now review the physical, mental, and emotional opiate withdrawal symptoms that result from the abrupt cessation of opioid drugs.

Please note that these opiate withdrawal symptoms can also result from lowering your dosage too quickly on an opiate taper. Tapering is lowering your dosage systemically over a predetermined time frame, which significantly reduces the shock to your body that a cold-turkey detox creates.

Physical opiate withdrawal symptoms include:

 

Mental/Emotional opiate withdrawal symptoms include:

 

As you can see, there are plenty of unpleasant opiate withdrawal symptoms that can afflict you while lowering your dosage too fast, or coming off opioids cold-turkey. The really awful aspect of opiate withdrawal is that you get hit with a ton of different physical and psychological opiate withdrawal symptoms.

If it were just one or the other, it wouldn’t be near as horrific of an experience.

But alas this isn’t the case.

Opiate withdrawal symptoms are both physical and psychological, and most of the time these symptoms are very severe.

Acute Stage of Opiate Withdrawal: What to Expect

How long do opiate withdrawal symptoms last? That depends on a number of factors. The main element which determines when your opiate withdrawal symptoms will start, when they will peak, and when they will finally subside, is the type of opioid drug you’ve been taking.

For instance, if you’ve been using short-acting opiates like oxycodone, hydrocodone, codeine, heroin, or other short-acting opiates, the opiate withdrawal symptoms typically begin around the 12-hour mark.

So 12 hours after your last dose of a short-acting opiate, the mild opiate withdrawal symptoms will begin to arise.

The duration and magnitude of the Stages of Opiate Withdrawal depend on the following criteria:

 

Note: Everyone’s situation is unique, so it’s hard to determine exactly what your opiate withdrawal experience will be like. The following outline of the opiate withdrawal timeline is based on the most common experience people have. Your withdrawal may be shorter or longer, more severe or less severe, depending on your unique situation.

Stages of Opiate Withdrawal: Day 1

If you’ve been using opiates that have a short half-life, your opiate withdrawal timeline should start approximately twelve hours after your last dose. Some examples of opiates that have a short half-life are heroin, oxycodone, hydrocodone, and morphine.

The first day of opiate withdrawal is usually the easiest (though still very unpleasant).

Some common symptoms people experience are:

 

Stages of Opiate Withdrawal: Day 2

These withdrawal symptoms usually start to get worse on Day 2. The anxiety is amplified, and it’s usually impossible to get any sleep whatsoever at this point.

You can experience hot and cold flashes, sweating, extreme diarrhea, vomiting, and a level of fatigue so extreme that you feel like you’re completely out of batteries.

Stages of Opiate Withdrawal: Days 3-4

These two days are typically the worst. It’s known as the “Peak Stage.” This is where your opiate withdrawal symptoms are peaking in severity, and most people would do just about anything to make it all go away.

Five minutes seems like an hour, and it’s truly a living hell. I wouldn’t wish this horrific experience on my worst enemy.

Stages of Opiate Withdrawal: Day 5 and Beyond

On Day 5 the acute stage is ending or nearing its end, and the symptoms typically decrease considerably. The anxiety typically goes down as does the severity of other symptoms, and the lingering symptoms that persist the most are exhaustion and anhedonia (inability to feel pleasure).

If you’ve been taking long-acting opiates such as Morphine Extended-Release, or long-acting opioids such as methadone, Suboxone, Subutex, Probuphine, or Zubsolv, the acute withdrawal starts much later than the 12-hour mark.

Due to the long-acting and long half-life effect of these drugs, you’ll typically start to experience acute opiate withdrawal symptoms around 30 hours after your last dose. If you haven’t tapered off these drugs, but are going through a cold-turkey detox, the acute withdrawal phase might last a lot longer than 4 days.

The acute opiate withdrawal symptoms might last up to 7 days or even longer.

I’ve had several clients at the methadone clinic I used to work at tell me they went to jail and had to come off methadone cold-turkey with no medicine to help.

Many of them stated they went through acute opioid withdrawal for a month or longer.

Stages of Opiate Withdrawal – PAWS Overview

Many opiate users have successfully managed to get past the acute Stages of Opiate Withdrawal, only to realize that the struggle was far from being over. Though the symptoms, duration, and severity vary, an estimated 90% of all opiate abusers experience Post-Acute Withdrawal Syndrome (PAWS) to some degree after the acute withdrawal is over.

To accurately and simply define PAWS, let’s break down the meaning of each individual word:

 

Simply put, PAWS is a group of symptoms that occur after an individual has gone through the serious withdrawal stage induced by the discontinuation of drugs.

In his popular book, Staying Sober: A Guide for Relapse Prevention, Terence Gorski states the following:

“Post-acute withdrawal is a group of symptoms of addictive disease that occur as a result of abstinence from addictive chemicals. In the alcoholic/addict these symptoms appear seven to fourteen days into abstinence, after stabilization from the acute withdrawal. Post-acute withdrawal is a bio/psycho/social syndrome. It results from a combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.”

PAWS Stage of Opiate Withdrawal: Duration

PAWS can last anywhere from a few weeks to several years. In fact, there is even a possibility that opiate PAWS can continue for the rest of an individual’s life after quitting opiates. Unfortunately, there is really no way to determine how long it will last.

Luckily, things like supplementation, nutrition, and exercise can help you reduce the severity and timeline of PAWS opiate withdrawal symptoms. Click here to check out my holistic PAWS treatment plan that will help you get better FAST.

PAWS Stage of Opiate Withdrawal: Symptoms

There is a wide range of symptoms an individual might experience from PAWS. Post-acute opiate withdrawal symptoms will vary from person to person. Post-acute opiate withdrawal symptoms will also vary in severity from person to person.

Some common post-acute opiate withdrawal symptoms include:

 

I strongly believe that the last two symptoms (“pleasure deafness” and fatigue) are the #1 reason why most individuals going through PAWS relapse within the first 90 days of getting sober.

Going weeks to months without feeling any pleasure in life, and on top of that having no energy or motivation, is in my opinion more detrimental to recovery than any of the other post-acute withdrawal symptoms.

Stages of Opiate Withdrawal – Top 20 Things That Can Help

Since you’ve made it this far in the article, I know you’re serious about using the best remedies for reducing symptoms while moving along the Stages of Opiate Withdrawal timeline.

I aim to deliver on my promise.

Thus, without further ado, here are the Top 20 things that can help, with clickable links so you can learn more by checking out articles entirely dedicated to each remedy.

In order from the most helpful first, here are the Top 20 remedies alleviating symptoms of withdrawal:

1. Methadone
2. Buprenorphine
3. Kratom
4. Ibogaine
5. Gabapentin
6. Lyrica
7. Mega-Dose Vitamin C
8. Clonidine
9. Klonopin
10. Xanax
11. Valium
12. Ativan
13. Librium
14. Loperamide
15. DXM
16. Baclofen
17. Tramadol
18. Cannabis
19. Exercise
20. Phenibut

Along with these, no matter which remedies you end up using, make sure you also take this Opiate Recovery Supplement.

You’ll need the nutrients in this formula to help your brain begin restoring healthy levels of dopamine, endorphins, serotonin, and GABA, which are the most important neurotransmitters for mood and behavior.

This supplement can lead to the following benefits:

 

Stages of Opiate Withdrawal: Conclusion

I hope you’ve gained tremendous insight and value from this Blog post on the Stages of Opiate Withdrawal and the Top 20 Things That Can Help.

I didn’t provide overviews on the Top 20 remedies for opiate withdrawal symptoms because this article is over 2,000 words long (which is long enough!), and I’ve already written separate articles for each remedy, which have detailed information, including how to use each remedy for opiate withdrawal.

Now you have everything you need to know about the Stages of Opiate Withdrawal and what to use to feel better fast.

And if you liked this article, then you’ll absolutely love The Ultimate Opiate Recovery System, which goes much deeper into opiate withdrawal and recovery methods.

Click here now to check it out.

Stages of Opiate Withdrawal Comments?

If you have any comments or questions on the Stages of Opiate Withdrawal, please post them in the comment box below.

Please review this post!