As a synthetic opioid used to treat chronic severe pain primarily in cancer patients, fentanyl is highly addictive and can easily be abused. It often gets mixed with heroin or cocaine with or without the drug user’s knowledge. Because fentanyl is illicitly manufactured, it also leads to an increasing number of synthetic opioid deaths.

Fentanyl overdose is on the rise, increasing by nearly 57% from 2010 to 2015 according to the  U.S. Centers for Disease Control and Prevention.

While it increases temporary feelings of euphoria, it has been known to cause long term effects on respiratory systems and mood impairment, especially when combined with alcohol and other drugs. Studies have shown irreversible damage to the brain’s white matter due to heroin use that can impair decision-making abilities. Manufactured as a pill, pure powder or powder mixed with other drugs, or a pitch, fentanyl is tasteless and odorless but deadly and intense.

What are Fentanyl Withdrawal Symptoms?

While fentanyl withdrawal symptoms are not usually life-threatening, they can be difficult to manage. Symptoms vary depending on the length of time used, how much was used, an individual’s metabolism, age, gender, weight,  the method of ingesting it and other drugs used simultaneously.

Fentanyl withdrawal symptoms may include:

  • Nausea
  • Vomiting
  • Abdominal cramps and pain
  • Diarrhea
  • Muscle pain
  • Sweating
  • Fevers
  • Increased heart rate
  • Anxiety
  • Restlessness
  • Hallucinations
  • Confusion
  • Insomnia or drowsiness
  • Tremors

Emotional issues can also arise during the withdrawal process which includes mood swings, anxiety, depression, problems with memory or cognition and intense cravings.

What are the Stages of the Fentanyl Withdrawal Timeline?

Fentanyl withdrawal symptoms can vary from individual to individual and usually appear in as little as 12 to 24 hours after the last dose.

Stage 1 or the early stage with initial symptoms: It may take several hours for the body to feel withdrawal after the last dose. However, early stage withdrawal effects may be experienced in as few as three to four hours following dosage and last for two t three days peaking with symptoms such as agitation, muscle aches, insomnia, sweating and runny nose.

Stage 2 with serious symptoms: Fentanyl withdrawal symptoms typically appear within one to two days and subside within a week or two in most cases. This is the stage when the worst physical symptoms start becoming intense. This includes nausea, diarrhea, vomiting, muscle and bone pain, increased tearing and runny nose. By day five, Fentanyl withdrawal symptoms will decrease once the brain relearns how to manage on its own with Fentanyl in its system.

Stage 3 includes post-acute withdrawal symptoms (PAWS) may affect users for months, even years. Physical symptoms generally disappear within a week, but emotional symptoms like depression, anxiety, and cravings can become post-acute.

On average, it takes seven to 10 days for the worst symptoms to pass.

Cravings for Fentanyl can last for years after the last dose, but users can relapse without understanding the emotional and physical stressors.

Why Should I Detox?

Quitting Fentanyl cold turkey is never a good idea without medical intervention. As one of the most powerful opioid drugs that are highly addictive, it’s extremely challenging to stop taking the drug successfully without some kind of professional help.

At-home detox is not recommended. During medical detox, trained health care professionals typically set up an individual tapering off the of the drug schedule, along with medication to manage the side effects of withdrawal.

One of the dangers of relapse is the danger of overdosing on fentanyl. Medical detox can help with the process of identifying psychological and emotional triggers to help one learn how to cope with the addiction.

For a substance abuser to come clean, one needs the support of a medical team of professionals to prevent relapse. The physical aspect of withdrawal is too demanding to undergo alone. Even if one has a strong intention of quitting, medical detox is recommended for fentanyl withdrawal.

When people with fentanyl addiction relapse, they end up overdosing This is where a medical detox can help with the process of identifying emotional triggers so one can learn how to cope with them without addictive substances.

What is the Next Treatment Step?

A successful full recovery starting with medical detox to outpatient rehabilitation is crucial. This implies having in place the support of a professional team in addition to the emotional support of family and friends. The first, most intense and shortest of all stages – medical detox.


During the period of medical detox, a team consisting of doctors, nurses and staff will conduct an intake to determine one’s level of fentanyl addiction and health needs thus jumpstarting the detox process. Detox at Arete Recovery also includes FDA-approved medications to limit withdrawals to prevent relapse.

Drug Rehabilitation

The next step of treating substance abuse will be admittance to an inpatient or residential program. The specialists at Arete Recovery will recommend the right program based on the detoxification process and the severity of one’s case and symptoms. Generally speaking, an inpatient recovery program extends for 45 days and is more suited for a short-term recovery period. In cases where the addiction is more severe, one might be recommended for a residential recovery program, appropriate for a long-term recovery period lasting anywhere from 60-90+ days.

Both of these programs help minimize the number of treatments which can be quite intense. On the other hand, a resident learns important coping mechanisms that can ultimately help with preventing relapse and better equipped for long-term recovery and the transitioning to an outpatient program.


Beyond the walls of the inpatient clinic and residential recovery, is a new, clean world that can be intimidating for the user who is relearning how to navigate life without addiction and drugs for the first time. This is where an intensive outpatient program is designed to provide ongoing counseling as the user navigates life.

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