Understanding Fentanyl Withdrawal Symptoms
What is fentanyl? Is it addictive? What are the notable fentanyl withdrawal symptoms? Find out in this comprehensive article.
What is Fentanyl?
Its potency makes it a very effective anesthetic, but it can also increase the risk of overdose and death when misused.
When is Fentanyl Used?
Fentanyl is used medically to treat or manage patients with severe chronic pain after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. Prescription fentanyl is available in various forms, including patches, tablets, and injectables.
Illegally made fentanyl has been a major contributor to the opioid epidemic in the United States and many other countries. It is often mixed with heroin or cocaine, significantly amplifying its potency and the associated risks.
Many overdoses, some fatal, have resulted from individuals unknowingly using drugs laced with fentanyl. It’s critically important for individuals to be aware of the risks associated with fentanyl and fentanyl withdrawal symptoms.
Common Fentanyl Withdrawal Symptoms
Fentanyl, like other opioids, can lead to physical dependence when used for an extended period. This can even occur when taken as prescribed. If someone who has become dependent on fentanyl stops taking it suddenly or reduces their dose abruptly, they may experience fentanyl withdrawal symptoms.2
The intensity and duration of these symptoms can vary based on factors such as the duration of use, dosage, method of cessation, and individual physiological factors.
Here are common physical and psychological symptoms of fentanyl withdrawal:
Physical Fentanyl Withdrawal Symptoms
Fentanyl can cause various physical side effects and symptoms. Some examples of these symptoms include:3
- Yawning: An increased frequency of yawning is a common early symptom.
- Runny nose and watery eyes: These are early symptoms of withdrawal.
- Sweating and chills: These can alternate and may be accompanied by goosebumps.
- Muscle aches and pain: Muscle stiffness and discomfort are common.
- Restlessness: A person may find it difficult to stay still.
- Dilated pupils: The pupils may appear larger than usual.
- Stomach cramps: Abdominal discomfort or pain can be pronounced.
- Nausea and vomiting: This can make it difficult to keep food or liquids down.
- Diarrhea: Bowel movements may become frequent and watery.
- Increased heart rate and blood pressure: Vital signs may become elevated.
- Tremors: Shaking or trembling can occur.
Psychological Fentanyl Withdrawal Symptoms
Fentanyl withdrawal can also cause a range of psychological symptoms, including:
- Anxiety and agitation: A person may feel increasingly anxious or jittery.
- Depression: Feelings of sadness, hopelessness, or apathy can set in.
- Irritability: Even minor issues might provoke anger or frustration.
- Intense drug cravings: The desire to use fentanyl or other opioids to alleviate withdrawal symptoms can be very strong.
- Sleep disturbances: This includes insomnia or restless sleep.
- Concentration difficulties: It can become challenging to focus or think clearly.
How Fentanyl Withdrawal Symptoms Compare with Withdrawal Symptoms from Other Opioids
Fentanyl is one of the most potent opioids available, which affects the onset, intensity, and duration of its withdrawal symptoms. When comparing fentanyl withdrawal to other opioid withdrawal, several factors come into play.
Fentanyl Potency and Half-Life
Fentanyl is significantly more potent than most other opioids. However, its half-life (the time it takes for half of the drug to be eliminated from the body) is relatively short, especially compared to other opioids. As a result, withdrawal symptoms can onset quickly after the last dose, often within a few hours.
While the onset of fentanyl withdrawal may be rapid due to its shorter half-life, the overall duration of withdrawal might not necessarily be faster than other opioids.
It’s possible for acute withdrawal symptoms to last for a week or more, with post-acute symptoms (like mood disturbances and sleep issues) persisting for weeks or even months.
Comparison with Other Opioids
Withdrawal from fentanyl can be intensely uncomfortable, particularly for individuals who have been using high doses or using it for an extended period. Generally speaking, the withdrawal from more potent opioids like fentanyl can be more severe than from less potent opioids.
However, individual responses can vary widely. Some examples of other opioid withdrawal symptoms include:
- Heroin: Like fentanyl, heroin has a short half-life, and its withdrawal symptoms can quickly onset. The intensity of heroin withdrawal can be severe, but it’s generally comparable to fentanyl withdrawal.
- Morphine: Morphine withdrawal can be intense but somewhat less severe than fentanyl withdrawal. The onset might be slightly more delayed compared to fentanyl.
- Oxycodone and Hydrocodone: Withdrawal from these opioids can be highly uncomfortable, similar to morphine withdrawal. While intense, the withdrawal is typically considered somewhat less severe than fentanyl or heroin withdrawal.
- Methadone: Methadone is a unique opioid due to its long half-life. This means withdrawal symptoms might take longer to onset after the last dose. This can occur within 24-48 hours or even longer. However, once they begin, methadone withdrawal can be prolonged and intense, sometimes considered even more challenging than fentanyl withdrawal due to its duration.
- Buprenorphine (Suboxone): As a partial opioid agonist, buprenorphine is used in opioid maintenance and withdrawal management. Its withdrawal is generally milder than full agonist opioids like fentanyl but can still be uncomfortable and prolonged.
Fentanyl Withdrawal Symptoms Timeline
The timeline for fentanyl withdrawal can vary based on several factors, including the specific formulation of fentanyl (e.g., patch, injectable, or illicit forms), the duration of use, the dosage, individual metabolism, and other personal factors.
Here’s a general outline of the typical timeline for the onset and duration of fentanyl withdrawal:
Early Symptoms
Early symptoms can appear 6 to 12 hours after the last dose. These can begin rapidly after the previous use due to fentanyl’s short half-life, especially if the individual used fast-acting formulations or illicit versions.
Symptoms that may appear during this time include:
- Yawning
- Runny nose
- Increased tearing
- Sweating
- Muscle aches
- Insomnia
Peak Symptoms
Peak symptoms occur 1 to 3 days after the last dose. This is when the symptoms become most pronounced and uncomfortable.
During this period, individuals might experience increased intensity of the early symptoms, plus additional symptoms such as:
- Nausea
- Vomiting
- Diarrhea
- Abdominal cramps
- Goosebumps
- Dilated pupils
- Intense drug cravings
Diminishing Symptoms
These symptoms occur 4 to 10 days after the last dose. Acute symptoms typically diminish during this period but can still be quite uncomfortable.
Physical symptoms like gastrointestinal upset may start to settle down, but cravings and psychological symptoms may persist. These symptoms include agitation, anxiety, depression, and mood swings.
Post-Acute Withdrawal Syndrome (PAWS)
Not everyone will experience PAWS, but for those who do, it can be challenging. These symptoms can last anywhere between a few weeks to months.
Symptoms include:
- Ongoing mood disturbances (like depression and anxiety)
- Sleep disturbances
- Prolonged fatigue
- Decreased ability to experience pleasure
These symptoms can come and go in waves and might last for weeks or months. Intense drug cravings can persist during this time, posing a risk for relapse.
Potential Fentanyl Withdrawal Symptoms Complications
Several potential complications and risks are associated with fentanyl withdrawal. The risks and potential complications should encourage individuals to seek medical supervision when attempting to detox from fentanyl.
Medical professionals can provide guidance, symptom relief, and necessary interventions to ensure the safety and comfort of the individual. Some complications of withdrawal to consider include:
Dehydration
One of the most immediate risks of opioid withdrawal, including fentanyl withdrawal, is dehydration. Excessive sweating, vomiting, and diarrhea can lead to a loss of fluids and electrolytes, resulting in dehydration. Severe dehydration can be dangerous and lead to complications such as kidney failure.
Choking and Aspiration
Individuals may be at risk of choking, especially if they vomit while drowsy or semi-conscious. If an individual vomits and breathes some of it into the lungs, there’s a risk of aspiration, which can lead to pneumonia.
Relapse and Overdose
After a period of abstinence, the body’s tolerance to opioids decreases. If someone relapses and takes a dose similar to what they were accustomed to during active use, there’s a significantly increased risk of overdose. Given the extreme potency of fentanyl, this risk is especially pronounced.
Aggravation of Co-Existing Medical Conditions
Withdrawal can exacerbate other health conditions. For instance, if someone has a heart condition, the stress and increased blood pressure during withdrawal could be harmful.
Mental Health Risks
Acute withdrawal can exacerbate mental health issues such as anxiety, depression, or other mood disorders. In severe cases, an individual might experience suicidal thoughts or behaviors.
Complications from Concurrent Drug Use
If someone is using other drugs in addition to fentanyl, withdrawal can be more complex, and the potential complications can multiply. For example, benzodiazepine withdrawal, if co-occurring with opioid withdrawal, can be life-threatening.
Self-Harm or Accidental Injury
The distress and discomfort of withdrawal and altered mental states can increase the risk of self-harm or accidental injury.
Post-Acute Withdrawal Syndrome (PAWS)
As mentioned earlier, PAWS can follow the acute phase of withdrawal. Symptoms like persistent anxiety, depression, mood swings, sleep disturbances, and fatigue can be disruptive and increase the risk of relapse.
Fentanyl Withdrawal Symptoms Management
Managing and alleviating fentanyl withdrawal symptoms requires a comprehensive approach. This multidisciplinary approach often combines medical interventions, counseling, and supportive care.
Given the challenges and potential complications of fentanyl withdrawal, it’s essential to consult healthcare professionals when considering detox. They can provide guidance, ensure safety, and make the process as comfortable as possible.
Here are some commonly used strategies and medical interventions:
Medication-Assisted Treatment (MAT)
Medications may be used to help with fentanyl withdrawal symptoms. These medications include:
Methadone
Methadone is a long-acting opioid that can replace fentanyl, stabilizing the individual and reducing withdrawal symptoms. Over time, the dose of methadone can be tapered, allowing the individual to come off opioids gradually.
Buprenorphine
Buprenorphine may also be used to manage fentanyl withdrawal symptoms, often combined with naloxone and marketed as Suboxone. This partial opioid agonist can reduce withdrawal symptoms and cravings. Like methadone, it can be tapered over time.
Naltrexone
Naltrexone is an opioid antagonist, unlike methadone and buprenorphine. It’s not used to alleviate withdrawal symptoms, but once a person has detoxed, it can help prevent relapse by blocking the effects of opioids.4
Symptomatic Treatments
These treatments are used to address specific withdrawal symptoms. By prescribing medication, healthcare professionals can help individuals alleviate some fentanyl withdrawal symptoms.
Some medications used in treatment include:
- Clonidine, originally a blood pressure medication, can reduce anxiety, agitation, muscle aches, sweating, and other withdrawal symptoms.
- Anti-diarrheal medications can help manage diarrhea.
- Anti-nausea medications can alleviate nausea and vomiting
- Non-opioid pain relievers like acetaminophen or NSAIDs might be used for muscle aches and pain
- Some over-the-counter or prescription sleep-aid medications might be given to help with insomnia
Hydration and Nutritional Support
With symptoms like vomiting and diarrhea, dehydration and electrolyte imbalances can be concerns. Oral or intravenous fluids might be given to maintain hydration and balance.
Counseling and Behavioral Therapies
Individual or group therapy can offer support and coping strategies during withdrawal. Cognitive-behavioral therapy, contingency management, and motivational enhancement therapy are effective therapeutic approaches for substance use disorders.
Supportive Care
Support is essential during the withdrawal period. This care might include ensuring a comfortable environment, providing relaxation techniques, and having regular check-ins with medical professionals.
Inpatient vs. Outpatient Treatment
The severity of dependence and the individual’s circumstances will determine the best setting for withdrawal management. Here is how these two treatment options differ:
Inpatient Detox
Inpatient detox provides 24/7 medical supervision and immediate intervention if complications arise. This setting can significantly benefit those with severe dependence or coexisting medical or mental health conditions.
Outpatient Detox
Outpatient detox suits individuals with milder dependence or significant supportive resources at home. They regularly visit a clinic or medical facility for check-ups, counseling, and medication.
Long-term Support and Relapse Prevention
Once the acute withdrawal phase is over, ongoing support is crucial to maintain sobriety and prevent relapse. This can include continued counseling, joining support groups like Narcotics Anonymous, and staying on medication-assisted treatments for an extended period.
Fentanyl Detox is Smoother Under Medical Supervision
Tapering off fentanyl (or any opioid) under medical supervision instead of abruptly stopping offers several benefits that can contribute to a smoother withdrawal experience.
Individuals who choose to get professional help with fentanyl withdrawal symptoms may experience the following:
Reduced Intensity of Symptoms
Gradually reducing the dose allows the body to adjust to decreasing levels of the opioid in the system. This reduces the shock to the body from sudden cessation, decreasing the severity of withdrawal symptoms.
Customized and Flexible Tapering Schedule
Medical professionals can develop a tapering schedule tailored to the individual’s needs. If symptoms become too uncomfortable at any point, the rate of tapering can be adjusted.
Monitoring for Complications
Regular medical check-ups ensure potential complications, like dehydration or severe depression, are identified and addressed promptly.
Pharmacological Support
Physicians can prescribe medications to address specific withdrawal symptoms during tapering. This approach can make the process more comfortable. For example, medications can be provided for sleep disturbances, anxiety, or gastrointestinal symptoms.
Psychological and Emotional Support
The process of coming off opioids can be emotionally challenging. Regular consultations with healthcare professionals or counselors provide an avenue for emotional support. This method also helps individuals address fears and concerns and learn coping strategies.
Mitigated Risk of Relapse
A slower, supervised taper reduces the intense drug cravings that can accompany abrupt withdrawal. Additionally, ongoing engagement with healthcare professionals provides a layer of accountability.
Assessment of Coexisting Conditions
Medical supervision ensures that other health issues, be it mental health conditions like anxiety or depression or physical conditions, are also managed concurrently. This holistic approach ensures that the individual is supported on all fronts.
Education and Resources
Medical professionals can educate individuals about the withdrawal process, what to expect, and resources for further support, such as counseling or support groups.
Safe Environment
For those in inpatient settings, tapering off in a controlled environment ensures they’re away from potential triggers or access to opioids, further reducing the risk of relapse.
Long-term Planning
Beyond the acute withdrawal phase, medical professionals can help design a long-term recovery and relapse prevention plan. This can include ongoing therapy, support groups, and, in some cases, long-term medication-assisted treatment.
Support from Loved Ones in Fentanyl Recovery
A supportive network is essential in helping individuals navigate withdrawal challenges and maintain long-term recovery.
It is beneficial for friends, family, and peers to educate themselves about the complexities of addiction. Their understanding can make their support more effective and reduce potential feelings of frustration or impatience.
Additionally, for many individuals, combining the support of loved ones with professional therapy and counseling offers the most comprehensive and effective approach to long-term recovery. Here’s how such a network can significantly impact the recovery journey:
Emotional Support
Withdrawal and recovery can be emotionally taxing. Having loved ones or peers to talk to, vent frustrations, share fears, and celebrate milestones can provide immense relief.
Accountability
Knowing that someone cares and is watching out for one’s well-being can act as a deterrent against relapse. Regular check-ins or knowing they’d let someone down can keep individuals on track.
Practical Help
During acute withdrawal, daily tasks can become challenging. Friends and family can assist with everyday responsibilities like childcare, cooking, or errands.
Understanding and Non-judgment
The stigma attached to addiction can be a significant barrier to seeking help. A supportive network offers a safe space where individuals can be open about their struggles without fear of judgment.
Distraction and Recreation
Engaging in recreational activities or simply spending time with loved ones can be a positive distraction from cravings or drug-seeking behavior.
Real-life Testimonies
Hearing stories of success or setbacks can be educational and motivational in support groups. Knowing others have walked the same path and overcome similar challenges can instill hope.
Early Intervention
If individuals start to show signs of potential relapse, a supportive network can intervene early, encouraging them to seek professional help or adjust their recovery strategies.
Boosted Self-esteem
Positive reinforcement from friends, family, or peers can boost an individual’s self-esteem and confidence. These are critical components in maintaining recovery.
Guidance in Difficult Situations
The journey of recovery can present various challenging scenarios, such as how to handle social settings where drugs are present. Experienced peers or family can guide an individual in these situations.
How Vista Taos can Help
Vista Taos, a renowned New Mexico rehabilitation facility, offers a comprehensive and compassionate approach to individuals struggling with substance addiction, including fentanyl dependency.
Fentanyl withdrawal symptoms can be particularly challenging due to its intense potency and the severe physical and psychological symptoms that accompany its cessation.
How Vista Taos Can Help Individuals With Fentanyl Withdrawal Symptoms
At Vista Taos, participants are provided with medically supervised detoxification to safely navigate the acute withdrawal phase, ensuring that any potential complications are promptly addressed.
We offer various evidence-based treatments to help individuals during their fentanyl withdrawal symptoms. Our facility is designed to foster a sense of comfort and collaboration to encourage long-term recovery.
Personalized Treatment for Sustainable Recovery
Moreover, our multidisciplinary team collaborates to devise individualized treatment plans incorporating therapy, counseling, holistic practices, and post-treatment support.
This holistic approach not only eases the immediate discomfort of fentanyl withdrawal but also equips individuals with the tools and knowledge to embark on a lasting recovery journey.
Take Action Today
Start your journey toward fentanyl recovery today. Contact Vista Taos today to learn more about our comprehensive fentanyl addiction treatment and detox center.
Resources
- https://www.cancer.org/cancer/managing-cancer/side-effects/pain/opioid-pain-medicines-for-cancer-pain.html
- https://nida.nih.gov/publications/drugfacts/fentanyl
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992259/
- https://icjia.illinois.gov/researchhub/articles/an-overview-of-medication-assisted-treatment-for-opioid-use-disorders-for-criminal-justice-involved-individuals
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