Thursday June 29th 2017

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When does fentanyl withdrawal start?

Withdrawal from fentanyl (and other opiates) can begin in the first 24 hours following cessation of use. However, onset will depend on a number of individual factors that are based on your use patterns.

More here on fentanyl withdrawal duration, with a section at the end for your questions. In fact, we try to answer all legitimate questions personally!

Fentanyl basics and definition

Fentanyl is a strong opiate pain reliever, that produces the same effect as (but is much stronger than) heroin or morphine. It is typically prescribed or administered by medical professions to relieve pain following a surgery, or in situations of severe chronic pain.

The DEA has categorized fentanyl as a Schedule II drug, meaning it has some medicinal value but is dangerous in terms of its high abuse potential. Further, a version of this drug known as acetyl Fentanyl is now being identified in drug labs across the country, which is just as addictive but is not approved for medical use. Fentanyl is also known as:

  • Apache
  • Cash
  • China girl
  • China white
  • Dance fever
  • Friend
  • Goodfella
  • Jackpot
  • Murder 8
  • Tango
  • TNT

Fentanyl works on opiate receptors in the brain

Fentanyl works by attaching itself to the opiate receptors in the brain. This increases the amount of dopamine in the brain, causing the user to feel “high”. However, it also has an effect on the parts of the brain responsible for some autonomic functions such as breathing, and too high of a  dose can cause the user to stop breathing.

With continued use, the body gradually adjusts for and expects regular delivery of the drug. This is known as physical dependence. When the body stops getting the drug, it is left unprepared for “normal” functioning, causing some very unpleasant withdrawal symptoms.

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NOTE HERE: Fentanyl dependence is different than addiction. While fentanyl’s addictive qualities are well documented, not everyone who uses this medication will become addicted to it. In fact, if you are taking fentanyl as prescribed, dependence is expected and can be treated via tapering protocols.

What are Fentanyl’s withdrawal symptoms?

Fentanyl produces withdrawal symptoms similar to any other opiate drug, including heroin, morphine, or prescription painkillers. The intensity of the withdrawal will depend on how long the Fentanyl has been used for, and what the dosage was, but symptoms they tend to be incredibly uncomfortable for the user. Fentanyl withdrawal will usually produce:

  • anxiety
  • chills
  • extreme nausea
  • gastrointestinal cramping
  • insomnia
  • irritability
  • muscle and bone discomfort or pain
  • restlessness
  • sweating

When does Fentanyl Withdrawal Begin?

Withdrawal from fentanyl (and other opiates) can begin in the first 24 hours following cessation of use. Onset will depend on a number of factors, such as:

  1. Frequency of use
  2. Severity of physical dependence and
  3. The overall health of the user

After the first 24 hours, symptoms usually persist for another 2-3 days, and then taper off. However, recurrence of symptoms can persist for as long as six months.

Can Fentanyl withdrawal be fatal?

Withdrawal from fentanyl is usually not fatal in and of itself, but it does come with some fairly severe complications that could potentially be life-threatening. For example, suicidal thoughts are not uncommon with opiate withdrawal, and should be closely monitored. Further, a large danger comes with possible relapse.

After several days of not taking an opiate which you are physically dependent on, your body begins the process of returning to normal. If someone who has been attempting to detox goes back out and relapses, there is considerable risk of overdose, as the body is not physically prepared for the amount of a drug the addict is accustomed to using.

How can I withdraw safely and comfortably from Fentanyl?

Opiate withdrawal should always be done under medical supervision. Going through fentanyl detox at a hospital or detox facility will not only minimize dangers from health complications, but will allow the process to be as comfortable as possible. Symptoms will be monitored and both psychological and pharmacological treatments are available during withdrawal.

For example, there are several medications available that allow you to taper off fentanyl (or other opiates), such as buprenorphine, methadone, or naltrexone. These drugs should only be used, however, for tapering off with a plan agreed upon by you and your doctor, as they can cause physical dependence and withdrawal symptoms themselves.

Detoxing at home is always an option, but you may decide that inpatient addiction treatment, whether a simple detox or a 30+ day program, is the best option for you. Either way, you should consult with your doctor or another medical professional, to ensure that whatever route you decide on, you are not subjecting yourself to unnecessary risk or discomfort.

Fentanyl withdrawal questions

Do you still have questions about a safe withdrawal or the duration of fentanyl withdrawal? Please leave us your questions below. We’ll do our best to respond to you personally and promptly!

Reference Sources: Psych Central: Opioid dependence and withdrawal
Healthline: Opiate withdrawal symptoms
National Institute on Drug Abuse

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11 Responses to “When does fentanyl withdrawal start?
8:09 am May 10th, 2016

I desperately want to detox from fentanyl and transition to subutex, can this be done without painful withdrawal symptoms? I plan on checking into a rehab center tomorrow. Thank you, any response is welcomed. I was put on 100 mcg fentanyl patches 4 yrs ago and it has become a nightmare

Lydia @ Addiction Blog
5:41 pm May 11th, 2016

Hi Sandra. You may call the helpline you see on our site to get in touch with a trusted treatment consultant who can help you make the right decision. Moreover, you may search treatment facility on SAMHSA’s treatment locator:

12:55 pm August 25th, 2016

I got on the patch in early June. Late June I was upped to 50mcg. Currently I’m weaning off and I have on a 25mcg pain management says to us my 2cg patches from early Jine. I have 3. Then go down to the 12.5 mcg for 15 days. I FEEL VERY SICK. but, I’ve felt this way for 2 weeks already. I need some help.

3:01 am February 9th, 2017

My husband was put on 25 mcg fentanyl February 2016( while in another state for 3 months) due to severe cancer pain in his back. April 2016 his pain was relieved successfully by radiation; September 2016 he reduced his dosage to 12 mcg with his local doc’s approval. His goal was to go off the fentanyl, so it will be available to him in the future when he has a NEED for pain reduction. After being on fentanyl for a year, within 3 days of discontinuation, he had severe headaches & increased blood pressure (195/101). It was recommended he go to the local ER, which we did. They determined we should double his blood pressure meds, and recommended he see his primary doc ASAP, which happened within the week. His BP reduced to 145/95. Still high. Headaches persist. Due to only one kidney, he uses acetaminophen. Current dosage is 2 extra strength at 10 a.m., 1 at 2 p.m., another 2 at 11 p.m. with NOMINAL relief . Can we (assume?) this is due to withdrawal? How long can we anticipate this to continue? ER doc did a full blood workup, and can’t find any reason for what’s happening. His primary doc has no experience with fentanyl.

9:04 am March 7th, 2017

I had a pretty invasive surgery two years ago to remove a tumor from the roof of my mouth Basically, they removed my pallet on the right side along with all my upper jaw, teeth and sinus tissue on that side as well. I am grateful to say, that after all that and 7 weeks of radiation treatments, I am still cancer free today (two years later last week)!

Since then I have been on very high dosage of pain meds. 150mcg Fentanyl patch along with 10mg oxycodone for break through pain. After a year and a half, I knew it was time to get off the pain meds as it was severely affecting my cognitive function. I struggle at my job as a manufacturing supply chain/production manager, as my role is for a large part, solving problems “on the fly” and relying on my previously sharp memory to recall a lot of detailed information about our complicated processes used to manufacture aircraft engine parts.

Following my doctors recommendation, I tapered off 25mcg at a time, with a month in between step downs to give my body time to adjust. Each time, the first 2-3 days were rough (headache, body ache, nausea), but then things returned to somewhat “normal”.

10 days ago, I finally went completely off the patches. The first few days were about the same as before, but since then I have been suffering from severe joint pain, mostly in my shoulders, back & hips. It is not too severe during the day as long as I keep moving, but as soon as I lay down to sleep, it quickly becomes impossible for me to get comfortable. I toss/turn all night. I have not slept more than 2 hours straight in 10 days now, and it doesn’t seem to be getting any better. I have tried taking Advil and Tylenol, but the have no affect. I have tried hot showers and heating pads, also with little/no improvement. I have started “sleeping” on the couch to prevent keeping my wife up all night as well. I am desperate here, and haven’t gotten any help for my doctor, other than”hang in there, it will get better with time”.

How long will this last? Is there anything I can do to help with the aching?

8:23 am March 15th, 2017

I have been on fentynal over 10yrs on 75mcg like to try and get off its getting harder to find pain Dr’s cause I am on disability from rare blood disorder which causes bone pain, highest was 100mcg can I taper off to 25mcg how without Dr help, can’t afford treatment program please give help to taper off!

Lydia @ Addiction Blog
10:28 pm March 20th, 2017

Hi Geneva. I suggest to speak with your doctor to help you plan a tapering schedule based on your needs.

6:24 pm April 3rd, 2017

I’ve been on this fentanyl 25 n 12 mg since 2008 I had over 10 or more serious surgeries I even had which I almost die from a rip esophagus which I ended in hospital for 6 weeks then infection in my stomach but I can keep going on n on. I didn’t want these pills patches but now I’m having the worst time in my life getting off I am a 62 year old woman .

Lydia @ Addiction Blog
12:46 pm April 4th, 2017

Hi MrBig1028. Withdrawal symptoms are different from person to person, and they also vary in length. It’s a hard process, and you must stay strong.

1:06 pm April 11th, 2017

i have been using heroin for a 3 days first day i did 4 bags. second day i did 5 bags but this time it was much stronger i asked the person i got it from they told me he cut it with fentanyla. so im looking it up now because it much stronger and i dont want to get withdrawals. this is day 3 now and i did 5 bags today. this was my last day i dont want to get withdrawals but at the same time i dont know if my body is addicted to it now because or the strength of the product this time. total i did 13 bags or heroin 10 or witch was laced with fentanyla within 3 days. my question is will i get withdrawals from the 3 days i have been using. Also i only sniff it i dont not use needles. please let me know if anyone can answer the question for me thank you for your time.

2:37 pm April 19th, 2017

Hi Michael. You might just feel some withdrawal symptoms due to your use. Of course, they will not be nowhere as severe as those experienced by regular or long-term users. But, you can expect the discomfort to subside rather quickly.

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About Heather King, PhD

Heather King, Ph.D., completed her graduate studies in preclinical substance abuse research in July of 2015. She has authored several peer-reviewed publications in scientific journals on the effects of drug abuse on the brain and behavior, and has personal experience in addiction and recovery. She currently works at Serenity Acres, a drug and alcohol treatment center outside of Annapolis, MD.

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