Fentanyl Withdrawal

Part of the Complete Guide to Understanding Addiction
Learn more about withdrawal
Learn more about Fentanyl

Shlomo Hoffman
Medically Reviewed by
Dr. Jefferey A. Berman MD, DFASAM
Last Updated
March 22, 2023

Part of the complete guide to understanding addiction

Table of Contents
  1. Fentanyl Withdrawal
  2. Fentanyl Background
  3. Fentanyl Side Effects
  4. Fentanyl Withdrawal Symptoms
  5. Fentanyl Withdrawal Timeline
  6. Tapering off from Fentanyl Addiction
  7. Taper Schedule
  8. Drugs that Help with Withdrawal
  9. Fentanyl Patch Withdrawal
  10. Can Someone Die from Fentanyl Withdrawal
  11. Inpatient Treatment for Fentanyl
  12. Outpatient Treatment
  13. Therapy for Fentanyl Addiction
  14. Counseling Modalities
  15. Sources

Fentanyl Withdrawal

Fentanyl withdrawal is a serious medical condition that can occur when someone is recovering from fentanyl addiction. Fentanyl withdrawal should never be purposely attempted without the supervision of a trained addiction specialist.

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Fentanyl Background

Fentanyl was first created in 1960 by a pharmaceutical company to be used as an anesthetic. It is classified as a synthetic opioid similar to morphine but is 50-100 times more powerful. It can be administered in different forms such as a patch, nasal spray, lozenges and a shot. It is used to treat patients with severe pain through boosting dopamine levels in the brain and causing a euphoric “high’’. Synthetic opioids, including Fentanyl are now the most reported substances found in drug overdoses in the USA and is a factor in more than half of overdose deaths [1]. The opioid epidemic itself is responsible for more than 136 deaths a day in America. Drug related overdoses exceeded deaths by homicides by 306% and has continued to rise.
The affordable street cost of fentanyl aids the raging opioid epidemic.

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Fentanyl Side Effects

Fentanyl suppresses the central nervous system which turns off the sensation of pain. The body gets used to this new “normal” and becomes reliant on fentanyl to feel balanced. While taking the drug a person will experience physical and mental side effects.

Side effects include.

  • Lowered body temperature
  • Depressed heart rate, blood pressure and respiration rate
  • Feeling relaxed, drowsy and mellow
  • Constipation
  • Unconsciousness
  • Sedation
  • Extreme happiness

Heavy or prolonged use of fentanyl can lead to opioid dependence, and if stopped a person will experience symptoms of withdrawal.

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Fentanyl Withdrawal Symptoms

To begin the process of recovery from fentanyl addiction, the substance must first be removed from the body completely through the process of detoxification. To learn the answer to the question how long does fentanyl stay in your system, read our online resource on this topic.

While detoxing, symptoms of withdrawal appear, and can be severe.

As per the US NIH [2], fentanyl withdrawal symptoms include.

  • Muscle and bone pain
  • Sleep problems
  •  Diarrhea and vomiting,
  • Cold flashes with goose bumps
  • Uncontrollable leg movements
  • Severe cravings
  • Restlessness
  • Sweating

Emotional withdrawal symptoms can include:

  • anxiety
  • irritability
  • depression

These symptoms can be extremely uncomfortable which is why it is important to have the proper support in place while detoxing and to taper off the drug slowly.

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Fentanyl Withdrawal Timeline

There are three stages to withdrawal.

  1. The first stage sets in 6-24 hours from last dose. Common symptoms at this stage can be, anxiety, muscle pain, insomnia, sweating and a runny nose.
  2. Symptoms typically peak on day three and last until day 5 when the body adjusts to the lack of fentanyl. The second stage can include symptoms of diarrhea, nausea and vomiting.
  3.  Post physical symptoms which usually appear after a week, when the emotional symptoms start and can affect a person for a few months. These symptoms include cravings, depression, and anxiety.  

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Tapering off from Fentanyl Addiction

Tapering is the process of gradually taking smaller doses of a drug until your body can fully stop taking it. This process is used to prevent withdrawal symptoms from being unmanageable. It also prevents the body from being shocked from stopping cold turkey. It should be done with the help of doctor or professional for optimal results.  If choosing to do it outpatient it should be done with the oversight of a doctor, psychiatrist or pain management specialist. It can also be done inpatient at a detox center or a drug rehabilitation center.  

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Taper Schedule

A doctor or professional will set a schedule for tapering off the drug based on the individual and the form of fentanyl that was used. Factors such as age, sex, length of addiction and whether other substances are present are taken into consideration as well. A common method of tapering is to replace Fentanyl with a slow acting opioid drug until it can be fully stopped. Another tapering method is to use lower doses of fentanyl until it can be completely stopped.

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Drugs that Help with Withdrawal

There are medications that are approved by the FDA to help with withdrawal symptoms. 

  • Methadone and Buprenorphine are opioid replacement drugs approved by the FDA to aid in withdrawal. These slower acting opioids work through keeping cravings and physical symptoms to a minimum until the individual is fully tapered off opioids.
  • Naltrexone is an approved drug that blocks the physical symptoms of withdrawal but can only be used a week after the last opioid dose.
  • Sedatives can be administered to help with symptoms as well.

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Fentanyl Patch Withdrawal

A fentanyl patch releases the drug through the skin continuously for a 72-hour period. When the patch is removed it can take about a day for the Fentanyl to be fully processed in the body. Once removed, it remains active for about 17 hours in the body which causes withdrawal to likely begin about a day after removal. The patch also raises tolerance and therefore withdrawal symptoms can be worse than other forms of Fentanyl. The method for detoxing from a patch will differ from other forms as a result.

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Can Someone Die from Fentanyl Withdrawal

Withdrawal is a challenging process but rarely leads to death. Some of the major risks involved can be.

  • Dehydration from the vomiting and diarrhea symptoms.
  • Aspiration from inhaling vomit into the airway accidentally or chocking on vomit.
  • Depression, which can lead to suicidal thoughts and behaviors.
  • Insomnia which can cause relapse.
  • Cravings can trigger relapse, which increases the risk of overdose in an even smaller quantity since the body is no longer tolerant of the drug.

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Inpatient Treatment for Fentanyl

Being in an inpatient facility can help a patient manage the withdrawal symptoms while receiving support for quitting a Fentanyl addiction. A facility will provide medical oversight, counseling, and evaluations to help a person recover. For patients recovering from multi drug abuse it is especially important that they receive the proper treatment since complications can occur. Inpatient treatment will help with the short-term physical symptoms of withdrawal as well as address the long-term psychological impact. Removing a patient from their environment while in treatment, can also ease the healing process for them.

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Outpatient Treatment

For patients that can manage their symptoms at home there are outpatient treatment centers that provide services such as medication-assisted therapy, counseling and a community for recovery. This is an option for patients that require a lower level of care and still want to maintain their routine.

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Therapy for Fentanyl Addiction

Therapy can aid in recovery from fentanyl addiction and help a patient through withdrawal symptoms. The right therapy will be individually determined per person and depends on backgrounds, needs and circumstances.

Some commonly used therapies are.

  • Individual counseling
  • Group therapy
  • Medication management
  • Case management
  • Skills training
  • Mindfulness Intervention
  • Peer Support

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Counseling Modalities

Counseling can provide patients with tools and healthy life skills and is used in treating addiction alongside medications.

Some common forms of therapy that have been found helpful are,

  • Cognitive behavior therapy, this therapy is used the modify a patient’s behavior, manage stress and expectations of drug use
  • Contingency management, is a voucher-based system which rewards patients based on negative test results which allows them to earn items for healthy living
  • Motivational interviewing, addresses a patient’s resistance to change

Addiction is a lifelong battle, however with proper support and therapy recovery is possible. The right treatment can lead a patient on a path of physical and mental wellbeing and give them a renewed freedom in sober living. Reach out to Avenues Recovery today if you need help with a fentanyl addiction or fentanyl withdrawal.

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[1] drugabusestatistics.org

[2] www.drugabuse.gov

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