Addiction Withdrawal Timelines

The Information below comes from the American Addiction Center

The precise duration of withdrawal is influenced by which substance someone used as well as the magnitude of their dependence on the substance. It may take days, weeks, and—in some cases—months to reach complete resolution of all withdrawal symptoms, depending on various factors and individual differences.

A general overview of certain drugs and their characteristic withdrawal timeline is as follows:

• Alcohol: The first signs of alcohol withdrawal may appear within several hours after the last drink and peak over the course of 24-72 hours.5 Delirium tremens usually develops 48-72 hours after heavy drinking stops and usually lasts for 3-4 days but can last up to 8 days.6

• Short-Acting Opioids (such as heroin and certain prescription painkillers): Short-acting opioid withdrawal symptoms generally begin 8-24 hours after last use and last an average of 4-10 days.

• Longer-acting opioids (such as methadone): For methadone and other longer-acting opioids, it may take 2-4 days for withdrawal symptoms to emerge. Withdrawal will likely fade within a period of 10 days.7

• Benzodiazepines (such as Xanax and Valium): Withdrawal from benzos may begin within 1-4 days after the last use, peaking in severity in the first 2 weeks. In some cases, certain symptoms of protracted withdrawal can remain troublesome for months or years without treatment.8

Heroin & Opiate Withdrawal

Heroin belongs to the opioid class of drugs. Opioids work by attaching to and activating opioid receptors throughout the body. Opioid receptor activation is associated with a subsequent release of dopamine in the brain, which serves to reinforce the continued use of opioid drugs for their pleasurable effects.10

Opioids are a widely abused and highly addictive class of drugs. Some degree of opioid dependence may develop after short periods of use, even when taken according to a prescription, in the case of prescription painkillers.

Opioid medications, when used under the supervision of a medical doctor, successfully alleviate physical pain caused by injury, illness, or surgery. Misuse of these drugs can greatly increase the risk of someone becoming physiologically dependent on them.

Symptoms of Withdrawal for Opioids

The acute opioid withdrawal syndrome may include several characteristic symptoms, such as:

• Nervousness or anxiety.

• Trouble sleeping.

• Frequent yawning.

• Nausea.

• Diarrhea.

• Flu-like symptoms.

• Muscle cramps/body aches.

• Runny nose.

• Excessive sweating.

• Hot and cold flashes.

• Goosebumps.

Although withdrawal from heroin and other opioids is rarely associated with life-threatening complications, enduring the sometimes markedly unpleasant symptoms can present unnecessary challenges to recovery. The mere discomfort of withdrawal—which some describe as mimicking a bad case of the flu—can lead to immense physical and psychological distress.11

Left unmanaged, opioid withdrawal can easily drive someone toward immediate relapse, which can derail recovery attempts.

Someone who has developed an addiction to heroin will have withdrawal symptoms once they stop using this illegal substance. They will experience physical and psychological side effects.

Within 6-12 hours:

The most common symptoms will include:

• Sleeplessness

• Nervousness

• Diarrhea

• Dilated pupils

• Feeling anxious

• Muscular aches

• Shaking

• Panic attacks

After 1-5 days:

These withdrawal symptoms will worsen over the next days, peaking on the third day after the last heroin dose and will also likely include:

• Stomach cramps

• Sweating

• Chills

• Nausea and vomiting

6th or 7th day:

This acute withdrawal period will ease up symptoms. Muscle aches and nausea will lessen, but most people will still feel worn out and tired.

For months after acute withdrawal from heroin, PAWS might continue to cause anxiety, depression, sleeplessness, fatigue, and irritability.

Heroin withdrawal can be very physically dangerous and possibly fatal when not performed under medical supervision.

Opioid Painkiller Withdrawal Timelines​

When quitting opioid drugs, there is a detox period during which time the toxins leave the system. This detox period should be done under medical supervision, as the withdrawal effects can be physically and psychologically harmful.

The severity of opioid withdrawal symptoms can depend upon how long the addiction has lasted, how suddenly drug use is stopped, and the dosage that’s been used during that length of time.

Opiates stay in the system for up to 2 days after the last dose but can be seen in urine samples for a few days afterward.

Some of the most common opioid withdrawal symptoms can be expected to stick to the following timelines:

6-30 hours after last dose of an opioid:

This early withdrawal period may cause:

• Muscular aches and pains

• Runny nose

• Sleep issues

• Extreme yawning

• Anxiety

• Increased pulse/heart rate

• Sweating

• Fever

• Increased blood pressure

72 hours-7 days after last opioid dose:

This late withdrawal period may cause:

• Diarrhea

• Nausea

• Vomiting

• Cravings for the drug

• Stomach pain

• Depression

After 1 -2 weeks:

Some people experience post-acute withdrawal symptoms (PAWS) that may last longer than a week:

• Psychological symptoms like depression and anxiety

• Cravings

Severe vomiting and diarrhea during the late withdrawal period can become life-threatening, making medical treatment a very important part of opioid detox.