Opioid Withdrawal: Physical and Emotional Symptoms to Expect

Opioid withdrawal is one of the most challenging aspects of recovery, but understanding what to expect can help you prepare mentally and physically for the journey ahead. While withdrawal symptoms are uncomfortable, they’re temporary—and with proper medical support, you can navigate this phase safely and more comfortably.

At Healing Pines Recovery, we’ve supported hundreds of men through opioid withdrawal in our Colorado facility, providing medical supervision and compassionate care throughout the detox process. This guide explains the physical and emotional symptoms you may experience, the typical timeline, and how professional treatment can help.

Understanding Opioid Withdrawal

Opioid withdrawal occurs when someone who has developed physical dependence on opioids suddenly reduces or stops their use. Whether the opioid is prescription pain medication like oxycodone or illicit drugs like heroin or fentanyl, the withdrawal process follows a similar pattern—though severity and duration vary based on several factors.

According to the National Institute on Drug Abuse (NIDA), over 2.5 million American adults had an opioid use disorder in 2023, and many will face withdrawal when attempting to stop use.

Why Withdrawal Happens

Opioids work by binding to receptors in the brain and body, reducing pain signals and creating feelings of euphoria. With regular use, your brain adapts to the constant presence of opioids by reducing its natural production of feel-good chemicals and adjusting receptor sensitivity. When opioid use stops, your body needs time to rebalance—resulting in withdrawal symptoms.

The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that physical dependence develops because opioids fundamentally change brain chemistry, making medical support crucial during the withdrawal process.

Factors That Influence Withdrawal Severity

Not everyone experiences opioid withdrawal the same way. Several factors affect symptom severity:

• Type of opioid used: Short-acting opioids like heroin produce faster but shorter withdrawal periods, while long-acting opioids like methadone create delayed but prolonged symptoms
• Duration of use: Longer periods of opioid use typically result in more intense withdrawal
• Dosage: Higher doses generally lead to more severe symptoms
• Method of use: Intravenous use often creates stronger dependence than oral use
• Individual physiology: Metabolism, overall health, and genetics all play a role
• Polysubstance use: Using multiple substances complicates the withdrawal picture

Research from the Centers for Disease Control and Prevention (CDC) shows that understanding these factors helps medical professionals tailor withdrawal management to individual needs.

The Physical Symptoms of Opioid Withdrawal

Physical symptoms of opioid withdrawal are often compared to a severe flu—but that comparison doesn’t capture the full experience. Here’s what you might encounter:

Early Symptoms (6-12 Hours After Last Use)

The first symptoms typically appear within 6-12 hours for short-acting opioids or 24-48 hours for long-acting opioids:

• Anxiety and restlessness
• Increased tearing and runny nose
• Excessive yawning
• Sweating
• Muscle aches
• Difficulty sleeping

These early symptoms signal that your body is beginning to adjust to the absence of opioids. At Healing Pines Recovery’s detox program, medical staff monitor these initial symptoms closely and can intervene with medications to ease discomfort.

Peak Symptoms (1-3 Days After Last Use)

Symptoms intensify during the peak phase, which usually occurs 1-3 days after your last dose:

• Severe muscle and bone pain
• Nausea and vomiting
• Diarrhea
• Abdominal cramping
• Dilated pupils
• Rapid heartbeat
• High blood pressure
• Chills and goosebumps (“cold turkey”)
• Intense sweating
• Tremors

According to the American Society of Addiction Medicine (ASAM), these physical symptoms, while extremely uncomfortable, are not typically life-threatening in otherwise healthy adults. However, complications can arise, which is why medical supervision is strongly recommended—especially for individuals with underlying health conditions.

Lingering Physical Symptoms

Some physical symptoms may persist for weeks:

• Fatigue and low energy
• Difficulty sleeping
• Increased sensitivity to pain
• Gastrointestinal issues

Understanding post-acute withdrawal syndrome helps you prepare for the longer recovery journey ahead.

The Emotional and Psychological Symptoms

While physical symptoms often get the most attention, the emotional and psychological aspects of opioid withdrawal are equally challenging—and sometimes longer-lasting.

Acute Psychological Symptoms

During the first week of withdrawal, you may experience:

• Severe anxiety: Intense worry, panic attacks, and a sense of impending doom
• Depression: Profound sadness, hopelessness, and loss of interest in activities
• Irritability and agitation: Mood swings, anger, and emotional sensitivity
• Difficulty concentrating: Mental fog and inability to focus
• Drug cravings: Powerful urges to use opioids again

The National Alliance on Mental Illness (NAMI) emphasizes that these psychological symptoms often stem from underlying mental health conditions that require specialized treatment.

Post-Acute Withdrawal Syndrome (PAWS)

For many people, psychological symptoms continue well beyond the acute withdrawal phase. This is known as post-acute withdrawal syndrome (PAWS) and can include:

• Ongoing depression and anxiety
• Difficulty experiencing pleasure (anhedonia)
• Memory and concentration problems
• Sleep disturbances
• Emotional numbness or mood swings
• Continued drug cravings

PAWS symptoms can come and go for months—sometimes up to two years. This is why residential treatment that addresses both the physical and psychological aspects of recovery is so important. Our comprehensive dual diagnosis approach ensures co-occurring mental health conditions receive proper treatment alongside opioid addiction.

The Opioid Withdrawal Timeline

While everyone’s experience differs, opioid withdrawal typically follows this general timeline:

Hours 6-12: Onset

• First symptoms appear
• Anxiety and restlessness begin
• Physical discomfort starts

Days 1-3: Peak

• Symptoms reach maximum intensity
• Physical symptoms are most severe
• Strong cravings emerge
• Psychological distress is high

Days 4-7: Decline

• Physical symptoms begin to improve
• Energy starts returning
• Appetite may return
• Sleep quality gradually improves

Weeks 2-4: Stabilization

• Most acute physical symptoms resolve
• Psychological symptoms may persist
• Sleep patterns normalize
• Energy levels improve

Months 1-6+: Post-Acute Phase

• PAWS symptoms may emerge or continue
• Cravings can still occur
• Mood regulation challenges persist
• Gradual improvement continues

The Cleveland Clinic provides additional details on the withdrawal timeline and what to expect at each stage.

Why Medical Detox Matters

Given the intensity of opioid withdrawal, attempting to detox alone—”cold turkey”—is not recommended. Here’s why medical detox at a facility like Healing Pines Recovery makes a significant difference:

Medical Monitoring

Healthcare professionals monitor your vital signs, hydration status, and overall condition around the clock, intervening immediately if complications arise. Our men’s-only residential treatment provides a supportive environment specifically designed for male recovery needs.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment can significantly reduce withdrawal symptoms. According to SAMHSA’s guidelines on MAT, common medications include:

• Buprenorphine: Reduces cravings and withdrawal symptoms without producing euphoria
• Methadone: Eases withdrawal symptoms and reduces cravings
• Clonidine: Helps with anxiety, sweating, and muscle aches
• Antiemetics: Reduce nausea and vomiting
• Sleep aids: Help restore normal sleep patterns

Research from NIDA demonstrates that MAT significantly improves long-term recovery outcomes.

Nutritional Support

Proper nutrition and hydration are crucial during detox. Medical facilities ensure you receive adequate nutrients and fluids even when nausea makes eating difficult. Our holistic therapy approach includes nutritional counseling to support your body’s healing.

Psychological Support

Mental health professionals help you manage anxiety, depression, and cravings through therapy and supportive interventions from day one. We utilize evidence-based approaches including Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) to address the psychological aspects of withdrawal.

Safe Environment

A supervised medical setting eliminates access to opioids during your most vulnerable moments, dramatically increasing your chances of completing detox successfully. Our boutique facility in Colorado provides privacy and comfort during this vulnerable time.

After Detox: The Importance of Continued Treatment

Completing detox is a crucial first step, but it’s just the beginning of recovery. According to the National Institute on Drug Abuse, research shows that individuals who transition from detox to residential treatment have significantly higher long-term success rates than those who detox alone.

Why Residential Treatment Follows Detox

At Healing Pines Recovery, our residential inpatient program addresses the underlying factors that contributed to opioid use:

• Trauma processing: Many men turn to opioids to cope with unresolved trauma. Our EMDR therapy helps process traumatic experiences safely.
• Mental health treatment: Dual diagnosis care addresses co-occurring conditions like anxiety, depression, or PTSD
• Coping skill development: Learn healthy ways to manage pain, stress, and difficult emotions without substances
• Relapse prevention: Identify triggers and develop strategies to maintain sobriety
• Peer support: Connect with other men facing similar challenges in our small group structure

The Colorado Advantage

Our location in Elizabeth, Colorado, offers unique benefits for opioid recovery:

• Mountain setting: Natural surroundings that promote healing and reflection through nature
• Outdoor experiential therapy: Physical activity in nature that aids mental health recovery
• Small group structure: Personalized attention in our boutique facility
• Evidence-based care: Combining proven therapies like CBT and DBT with holistic approaches

Preparing for Opioid Withdrawal

If you’re considering stopping opioid use, here’s how to prepare:

1. Seek Professional Help

Don’t attempt to detox alone. The CDC emphasizes the importance of medical supervision during opioid withdrawal. Contact Healing Pines Recovery at 720-575-2621 to discuss medically supervised detox options.

2. Clear Your Schedule

Plan for at least one week where you have no obligations. Professional detox programs typically last 5-10 days. Learn more about what to expect during detox.

3. Arrange Support

Let trusted friends or family members know you’re entering treatment so they can provide emotional support. Understanding how family can support recovery is crucial for long-term success.

4. Understand Your Insurance

Most insurance plans cover opioid detox and treatment. Our admissions team can verify your coverage and explain your options.

5. Be Honest About Your Use

Accurate information about what substances you’ve been using, how much, and for how long helps medical staff provide the most effective treatment. If you’re using prescription opioids, heroin, or fentanyl, be specific about your usage patterns.

What Comes After: Building a Life in Recovery

Recovery from opioid addiction extends far beyond managing withdrawal symptoms. At Healing Pines Recovery, we help men build comprehensive recovery plans that address:

• Physical health: Restoring wellness through nutrition, exercise, and medical care
• Mental health: Processing trauma, managing co-occurring conditions, and developing emotional resilience
• Relationships: Repairing damaged relationships and building healthy connections
• Purpose: Discovering meaning and direction in sobriety
• Community: Connecting with support networks for long-term accountability

The Mayo Clinic emphasizes that comprehensive treatment addressing all these areas provides the best outcomes for long-term recovery.

Frequently Asked Questions About Opioid Withdrawal

Can opioid withdrawal be life-threatening?

For otherwise healthy adults, opioid withdrawal is rarely life-threatening. However, according to Johns Hopkins Medicine, complications like severe dehydration, heart problems, or mental health crises can occur, which is why medical supervision is recommended—especially for individuals with underlying health conditions or those using multiple substances. Learn more about safely detoxing from substance use.

How long does opioid withdrawal last?

Acute physical symptoms typically last 5-10 days, with peak symptoms occurring around days 1-3. However, psychological symptoms and PAWS can persist for months. The exact timeline depends on the type of opioid used, duration of use, and individual factors. Read more about post-acute withdrawal syndrome.

Is medication-assisted treatment (MAT) just replacing one drug with another?

No. According to SAMHSA’s research on MAT, MAT medications are prescribed at therapeutic doses, don’t produce euphoria, and are gradually tapered under medical supervision. They allow your brain chemistry to stabilize while you work on the psychological and behavioral aspects of recovery—significantly improving long-term outcomes. Learn more about how we use medication-assisted treatment.

Can I detox at home?

While some people attempt home detox, it’s not recommended for opioid withdrawal due to the intensity of symptoms, risk of relapse, and potential complications. The American Addiction Centers strongly advises against “cold turkey” attempts. Medical detox provides monitoring, medications to ease symptoms, and immediate intervention if problems arise.

Will I experience withdrawal if I’ve only been using opioids for a short time?

Physical dependence can develop within days to weeks of regular opioid use. According to Harvard Health, even short-term prescription use can result in withdrawal symptoms when stopping, though they’re typically less severe than withdrawal after long-term use.

What if I relapse after detox?

Relapse is common in addiction recovery—it’s not a failure, but a signal that additional support is needed. If relapse occurs, reach out for help immediately. The CDC warns that your tolerance has likely decreased during abstinence, making you more vulnerable to overdose if you use the same amount you previously used. Learn more about how to overcome relapse.

How do I know if I need detox before rehab?

If you’re experiencing physical dependence on opioids—meaning you have withdrawal symptoms when you don’t use—you likely need medical detox. Read our guide on whether you need detox before rehab to help you decide.

Take the First Step Toward Recovery

Opioid withdrawal is challenging, but you don’t have to face it alone. At Healing Pines Recovery, our medical team provides comprehensive detox services in a supportive, men-only environment in the Colorado mountains.

From the moment you arrive, we focus on your comfort, safety, and successful transition to residential treatment. Our small group structure ensures personalized attention, and our evidence-based approach addresses both the physical and psychological aspects of opioid addiction.