Fentanyl Withdrawal Symptoms, Duration, & Risks

When a person who is physiologically dependent on fentanyl abruptly reduces or stops taking the drug, they can experience withdrawal symptoms.¹ Fentanyl withdrawal can be extremely uncomfortable and is one reason a person may find it difficult to stop using fentanyl.¹

This page will help you learn more about fentanyl withdrawal, including the associated symptoms and timeline, and how to get help for fentanyl misuse or addiction if you or a loved one are struggling.

What Happens During Fentanyl Withdrawal?

Chronic fentanyl use, whether prescription or illicit, can lead to the development of significant opioid tolerance and physiological dependence.^{1, 2} Tolerance refers to a physiological state in which the body adjusts to a specific dose of a substance and a higher dose is needed to feel the effects.^{1, 2} Dependence refers to a physiological adaptation in which the body becomes used to the presence of a substance so that when a person abruptly cuts back or stops taking it, withdrawal symptoms emerge.^{1, 2}

A person can develop some degree of substance tolerance and dependence without being addicted, for example, through a therapeutic opioid regimen.¹ However, in a situation of compulsive opioid misuse, the presence of tolerance and the dependence-associated phenomenon of withdrawal also meet two of the eleven diagnostic criteria for an opioid use disorder (OUD).³

While some pharmaceutical fentanyl is diverted for non-medical misuse, illicitly manufactured fentanyl has become an increasingly prevalent concern.  These illicit sources of fentanyl are now commonly found in the U.S. illegal drug supply—even more commonly than heroin.² In the past, many people were exposed to fentanyl unknowingly through adulteration of street drugs. However, studies show that many people now knowingly use fentanyl and prefer it to other illicit opioids, such as heroin.⁴

Compared to heroin, fentanyl is more potent and can lead to greater opioid tolerance.⁵ This means that people who use fentanyl may need to use it or other opioids relatively more frequently and in larger doses to avoid experiencing withdrawal.⁵ This could ultimately lead to an increased willingness to engage in risky behaviors to obtain additional drugs to essentially self-manage the increasingly troublesome withdrawal issue.⁵

Fentanyl Withdrawal Symptoms

All opioids produce similar withdrawal symptoms.⁶ The symptoms a person experiences and the severity of those symptoms depend on several factors, such as the specific opioid a person has been using and how long they have been using it.⁶

Fentanyl withdrawal symptoms can include:¹

• Bone and muscle pain.
• Trouble sleeping.
• Diarrhea.
• Vomiting.
• Cold flashes.
• Goosebumps.
• Uncontrollable leg movements.
• Severe cravings.

How Long Does Fentanyl Withdrawal Last?

Withdrawal from short-acting opioids, such as fentanyl, can begin as early as a few hours after a person last uses the drug.³ However, the onset, duration, and severity of withdrawal can vary from person to person and may influenced by several factors including:⁶

• The duration of use.
• The daily dose.
• The interval between use.

Genetic, physiological, and psychological factors can also influence the severity of withdrawal.⁶

Short-acting opioids are often associated with withdrawal symptom onset within 8 and 24 hours after the last use, with symptoms lasting between 4 and 10 days before they resolve.⁷ Following acute opioid withdrawal, some people experience a more protracted withdrawal syndrome that may last for up to several months and may include symptoms such as persistently decreased well-being and strong opioid cravings.⁷ Engaging with an ongoing treatment program can provide people with skills to reduce the risk of relapse during this time.⁷

Is Fentanyl Withdrawal Dangerous?

Opioid withdrawal, including fentanyl withdrawal, can be extremely uncomfortable but is not typically dangerous, and life-threatening complications are rare.⁶ In some cases, opioid withdrawal can worsen preexisting medical conditions, such as underlying cardiac illness. A person may experience diarrhea and vomiting during opioid withdrawal, which can lead to dehydration or electrolyte imbalances that may require medical attention.⁶

While opioid withdrawal is not typically dangerous, using fentanyl or other opioids after withdrawal may make a person more susceptible to overdose due to a decrease in tolerance levels.^{2, 7}

How to Safely Stop Using Fentanyl

Fentanyl withdrawal can be extremely uncomfortable, presenting challenges to opioid use disorder recovery efforts, especially if left unproperly managed.⁶ Medical detox services can provide medical supervision and support to help patients withdraw from fentanyl and other substances as comfortably and safely as possible.⁶

During medical detox, patients may receive FDA-approved medications to help manage or mitigate withdrawal symptoms. Medications for opioid use disorder (MOUD), including fentanyl use disorder, are effective and safe and may include:^{1, 6}

• Methadone: A long-acting opioid agonist used to manage withdrawal symptoms and reduce cravings. Following the detox period, it can also be used in long-term maintenance therapy.
• Buprenorphine: A partial opioid agonist medication that can reduce withdrawal symptoms and cravings.
• Lofexidine: A non-opioid medication that can help manage certain types of opioid withdrawal symptoms.
• Clonidine: In the same class of drug as lofexidine, clonidine is also a non-opioid medication that has long been used to reduce withdrawal symptoms.

While medical detox can help reduce the discomfort of withdrawal, it is not a substitute for more comprehensive recovery efforts. Following medical detox with ongoing care, such as participating in an inpatient or outpatient treatment program, can help to better address the underlying causes of addiction and improve treatment outcomes.⁸

While in an inpatient or outpatient treatment program, patients may participate in different behavioral therapies, such as cognitive behavioral therapy (CBT), contingency management (CM), and motivational interviewing (MI), to help change their attitudes and behaviors related to substance use.¹ Behavioral therapies have proven effective, especially when used in conjunction with medications.¹

If you’re ready to find treatment for fentanyl misuse or addiction, American Addiction Centers (AAC) can help. With facilities across the country, AAC offers various levels of evidence-based care to suit your needs. Contact us by  24/7, or verify your insurance now and reach out for more information later. Our admissions navigators are here to answer your questions, discuss treatment options, and help you begin the admissions process once you’re ready.