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Fentanyl Withdrawal and Detox

Like other addictive substances, fentanyl alters the chemistry of the brain and reinforces the need to regularly take the drug. This can lead to taking escalating doses, dependence and in some people, addiction. Drug withdrawal from fentanyl, like other opioids, can lead to nightmarish symptoms. Withdrawal is associated with several of the body’s long-suppressed systems being suddenly deprived of the drug they became dependent on. In extreme cases, if fentanyl has been taking for an excessively long period of time or in large doses, withdrawal can result in hallucinations and seizures.1,2

Fentanyl Withdrawal Symptoms

  • Night sweats
  • Hot flashes
  • Chills
  • Fever
  • Uncontrollable trembling
  • Nausea and vomiting
  • Loss of appetite
  • Stomachache
  • Diarrhea
  • Constipation
  • Headache
  • Powerful drug craving
  • Muscle cramping
  • Sleeplessness
  • Rapid breathing
  • Increased heart rate1,2

Mental Fentanyl Withdrawal Symptoms

  • Confusion
  • Irritability
  • Altered reality
  • Apathy
  • Depression
  • Agitation
  • Anxiety
  • Nightmares
  • Inability to focus and concentrate1,2

Fentanyl Withdrawal Timeline

Withdrawal typically starts six to 36 hours after the last dose of fentanyl was taken. After the first 24 hours, symptoms usually persist for another two to three days, with an excruciating peak hitting around the 48-hour mark. After reaching a peak, the symptoms gradually start to dissipate, although recurrence of symptoms can persist for as long as six months. Individuals who are withdrawing on their own often take more fentanyl because the symptoms are so distressing. Relapsing at this point not only deepens addiction, but can also lead to a fatal overdose.1,3 The duration of withdrawal is dependent on the following factors:

  • Duration of drug use
  • The average dosage
  • Last intake dosage
  • Individual medical history
  • General tolerance level for pain and pain medication (e.g. how much medication has to be taken before an effect is felt)1,3

Fentanyl Detox Treatment

Residential detox is the safest venue for undergoing the complex process of fentanyl detox. During this highly structured period of detox, a client works closely with an addiction specialist to manage withdrawal symptoms. Drugs such as buprenorphine or Suboxone (a combination of buprenorphine and naloxone) are administered with around-the-clock medical monitoring. The latter is a lifesaving drug used on its own to reverse opioid overdoses. However, more is needed with fentanyl than heroin due to the drug’s potency, and it is does not always work. These drugs also have inherent risks of dependence, further reinforcing the importance of medically supervised pharmacological treatment.3,4

During detox, the dosage of buprenorphine or Suboxone is sequentially reduced over a predetermined amount of time to mitigate the extreme discomfort associated with opiate withdrawal. Clonidine, a medication prescribed for hypertension, has shown some success in the management of troubling opioid withdrawal effects such as anxiety and flu-like symptoms (e.g. sweating, aches and sweating).4,5 After detox, psychotherapy sessions help clients address the underlying causes of addiction, an essential component of recovery. Rehab often includes a wide array of behavioral and alternative therapies to help clients deal with everyday stressors and learn healthier coping mechanisms. Among these are skills training, family therapy, 12-step programs, acupuncture, yoga, equestrian therapy and more.4

  1. Fentanyl Withdrawal. Dual Diagnosis website. http://www.dualdiagnosis.org/fentanyl-risks/withdrawal/ Accessed February 11, 2017.
  2. Fentanyl – Withdrawal Symptoms and Detoxification Process. Detox From Opiates.Net website. http://www.detoxfromopiates.net/fentanyl-withdrawal-symptoms-detoxification-process/ Published May 11, 2016. Accessed February 11, 2017.
  3. When does fentanyl withdrawal start? Addiction Blog website. http://prescription-drug.addictionblog.org/when-does-fentanyl-withdrawal-start/ Published April 7, 2016. Accessed February 11, 2017.
  4. The Effects of Fentanyl Use. Drug Abuse website. http://drugabuse.com/library/the-effects-of-fentanyl-use/#fentanyl-treatment Accessed February 11, 2017.
  5. Suboxone Withdrawal. Drug Abuse website. http://drugabuse.com/library/suboxone-detox-withdrawal/ Accessed February 11, 2017.
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