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Fentanyl Withdrawal Timeline

Detox From Fentanyl, Managing Withdrawal Symptoms, Addiction Treatment & Inpatient Detox

What is Fentanyl?

Fentanyl addiction is a serious condition that affects more Americans than one would think. Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States. According to the National Institute on Drug Abuse, in 2017, 59.8 percent of opioid-related deaths involved fentanyl compared to 14.3 percent in 2010.

Fentanyl is a powerful synthetic opioid similar to morphine but is 50 to 100 times more potent. It is a prescription drug that is also made and used illegally. Like morphine, it is a medicine typically used to treat patients with severe pain, especially after surgery. 

It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. Tolerance occurs when you need a higher and/or more frequent amount of a drug to get the desired effects. In its prescription form, fentanyl is known by such names as Actiq®, Duragesic®, and Sublimaze®.

When prescribed by a doctor, fentanyl can be given as a shot, a patch on a person’s skin, or as lozenges sucked like cough drops.

The illegally used fentanyl associated with recent overdoses is made in labs. This synthetic fentanyl is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into pills that look like other prescription opioids.

Some drug dealers mix fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl, making it a cheaper option. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive. They might be taking stronger opioids than their bodies are used to and can be more likely to overdose.

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Withdrawals From Fentanyl

What is Fentanyl?
Fentanyl addiction is a serious condition that affects more Americans than one would think.

As sudden discontinuation of the drug may induce fentanyl withdrawal, individuals may instead choose to slowly taper off the drug. Tapering is the slow removal of fentanyl over a set period, and it is also called weaning off the drug. This must be performed under the direction and watchful eye of a medical professional who can set up a tapering schedule that may be able to keep fentanyl withdrawal symptoms from manifesting by keeping some of the opioid drugs in the system. By slowly removing the drug and not stopping “cold turkey,” Fentanyl withdrawal may be managed.

To taper off fentanyl, a person may be first switched to another opioid, such as long-acting morphine or methadone, as reported in the Tapering and Discontinuation of Opioids published by the U.S. Department of Defense (DoD) and the Department of Veterans Affairs (VA). After a person is switched over, these opioids are reduced by about 20-50 percent each day until the dosage reaches 30 mg/day for methadone or 45 mg/day for morphine. At this point, the dosage can be reduced by 15 mg every 2-5 days for morphine and by 5 mg every 3-5 days down to 10 mg/day. It can then be reduced by 2.5 mg every 3-5 days down to 0 for methadone.

Tapering may not be the same for everyone, and different schedules may need to be adopted. Several factors may require the schedule to be modified, such as:

  • Level of dependence on fentanyl: The more significant the dependence, the slower the taper may need to be.
  • Addiction to or abuse of fentanyl: Someone using fentanyl for nonmedical purposes or who suffers from compulsive drug-using behaviors may benefit best from a residential detox program where substance abuse and addiction are addressed in tandem with withdrawal.
  • Co-occurring disorders: Someone suffering from a medical or mental health disorder may take medications that must be properly managed during a tapering schedule.
  • Length of time taking fentanyl: Typically, the longer someone takes an opioid like fentanyl, the slower the taper may need to be to manage withdrawal.
  • Abuse of other drugs or alcohol: Other mind-altering substances can interact with fentanyl and may increase dependence on both substances and/or create a cross-tolerance that may need to be managed differently.

A doctor, substance abuse professional, or another medical professional can help people to set up an individualized tapering schedule to wean off fentanyl safely while minimizing withdrawal symptoms.

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How Long Does it Take to Withdraw From Fentanyl?

Fentanyl withdrawal usually begins within 12-30 hours of the last dose of the drug, the National Library of Medicine (NLM) reports. Fentanyl, in patch form, is an extended-release medication with effects that may continue to increase for the first 12-24 hours of wearing it, lasting up to 72 hours total, according to the labeling information provided by the U.S. Food and Drug Administration (FDA) for Duragesic. With a half-life of around 17 hours after removal of the patch, withdrawal likely begins around a day or so after taking it off.

Fentanyl Withdrawal Timeline

In a medical fentanyl detox facility, your withdrawal symptoms can be treated real-time and your treatment adjusted accordingly. They can also provide emergency medical intervention if necessary. You’ll be able to employ their expertise in managing and reducing withdrawal symptoms. The pain and discomfort of fentanyl detox will remain, but it’s more manageable thanks to the medical team and the treatment they’ll be prescribing.

They’ll also create a treatment plan that addresses your fentanyl use, medical history, and physical and mental condition. The treatments that medical Fentanyl detox facilities provide are holistic and can involve programs and activities like counseling, meditation, group therapy, and yoga.

fentanyl withdrawal timeline
Fentanyl withdrawal usually begins within 12-30 hours of the last dose of the drug.

While fentanyl addiction is common, every individual is different and can benefit from a medically assisted treatment plan that considers their different needs. This sets you up for better, safer, and more long-term recovery than if you were to do it alone.

People also undergo different symptoms during each phase of the fentanyl withdrawal timeline. There are three main stages of withdrawal: early, peak, and long-term effects.

Early Symptoms (2 to 4 Hours After Last Dose)

The earliest symptoms of fentanyl withdrawal involve slight bodily discomforts, such as constant yawning, aches, and chills. Physical symptoms may come with feelings of anxiety, restlessness, and an intense craving for drug use.

Peak Symptoms (24 to 36 Hours After Last Dose)

Peak symptoms may last up to about a week after the last dose. Symptoms may include an increase in earlier withdrawal effects. Individuals may also experience additional symptoms that require medical care and attention, such as fever and vomiting.

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What Are the Withdrawal Symptoms of Fentanyl?

The FDA reports the following as potential side effects of the opioid withdrawal syndrome that occurs when Duragesic (fentanyl) leaves the bloodstream:

  • Yawning
  • Sweating
  • Restlessness
  • Tearing up
  • Runny nose
  • Chills
  • Backache
  • Stomach cramps
  • Pain in joints and/or muscles
  • Body hair standing on end, or bristling
  • Muscle weakness
  • Nausea and/or vomiting
  • Anorexia
  • Diarrhea
  • Elevated heart rate
  • Hypertension
  • Increased respiratory rate
  • Insomnia
  • Anxiety
  • Pupil dilation

Fentanyl withdrawal syndrome likely peaks in the first few days and levels off within a week or so.

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Detox From Fentanyl

The method of removing fentanyl from the body safely is called detox, which is the removal of toxic substances from the bloodstream.

This process is usually performed in a specialized substance abuse treatment center. Fentanyl detox can be part of either an outpatient or an inpatient program, depending on the specific needs of the individual. Typically, residential fentanyl detox is called medical fentanyl detox, as it includes medical and mental health support provided by highly trained professionals around the clock. Vital signs are monitored to ensure each individual’s safety, and medications are also often used to manage physical and emotional withdrawal symptoms. Residential fentanyl detox is usually recommended for fentanyl withdrawal as it is such a powerful opioid.

To begin a safe fentanyl detox, consult with a medical professional, preferably one with addiction treatment or withdrawal management experience. This specialist can provide a thorough assessment of your status and risks. In determining an appropriate treatment plan for you, they may ask you questions about:

fentanyl withdrawal timeline
Fentanyl detox can be part of either an outpatient or an inpatient program, depending on the specific needs of the individual.
  • The type or types of substances you use regularly and whether you are currently intoxicated.
  • The frequency, dose, and duration of your use.
  • Any preexisting and concurrent mental health symptoms.
  • Your physical health/medical history.
  • Previous withdrawal and detox attempts.
  • The support that you have at home.

Your answers to these questions will help determine an appropriate care level. In very limited instances, natural (or “cold turkey”) fentanyl detox may be an option for a healthy person with no significant physical dependence or with a history of use of a substance not typically associated with dangerous withdrawal symptoms (e.g., hallucinogens, some inhalants).

Fentanyl Detox Treatment

Fentanyl addiction is a condition that can cause major health problems such as an overdose. We Level Up rehab treatment & detox center can provide you, or someone you love, the tools to recover from this with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition and give you clarity about issues like the fentanyl withdrawal symptoms. Our specialists know what you are going through. Please know that each call is private and confidential.

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