Fentanyl Withdrawal Timeline

Fentanyl is a dangerous opioid that has been linked with the majority of overdose deaths in recent years. While many of those deaths were due to unintentional ingestion of fentanyl, some people do use fentanyl recreationally. When someone decides to enter recovery, they must first complete a fentanyl detox and withdrawal. Read on to learn about the fentanyl withdrawal timeline, and the next steps in recovery.

Learn About Fentanyl

Fentanyl is a synthetic opioid with a Schedule II controlled substance rating for being highly addictive and prone to abuse. It is available as lozenges, nasal sprays, lingual strips, and dermal patches. Fentanyl is about 100 times more potent than morphine.

Fentanyl is sold under the brand names of Duragesic, Actiq, and Sublimaze. Fentanyl is used in surgery and hospice settings to provide powerful pain relief.

In recent years, analogs, or fentanyl copies, have been produced and widely distributed on the street. This has resulted in countless overdose deaths in people, many of whom were not aware they were ingesting the deadly opioid. 

Why is Fentanyl Abuse So Risky?

There are several reasons why fentanyl use is highly risky. This powerful impact the drug has on the respiratory system is the most obvious risk, but there are others:

  • Adverse health effects. Fentanyl abuse has been shown to cause seizures, heart arrhythmias, and symptoms of psychosis.
  • Dangerous analogs. Foreign labs are producing fentanyl copies and provide no quality control or oversight of the ingredients used.
  • Fentanyl addiction. Fentanyl is highly addictive, so continued use often leads to addiction.
  • Overdose. A tiny amount of fentanyl can cause respiratory failure. Signs of fentanyl overdose include:
  • Difficulty breathing, slowed respiratory function
  • Bluish tint on lips and fingernails
  • Extreme grogginess or fatigue
  • Choking or gurgling sounds
  • Pinpoint pupils
  • Cognitive impairment
  • Loss of physical coordination, limpness, inability to walk
  • Confusion
  • Dizziness
  • Coma
  • Death

Signs of Fentanyl Abuse and Addiction

As with other opioid abuse and addiction, fentanyl provides a sense of euphoria, pain relief, and deep relaxation. This is only temporary, though, which results in a drop in dopamine when the fentanyl wears off. Because the brain has registered the pleasant effects in its reward system, it prompts the person to seek out the drug again.

Physical signs of fentanyl abuse include:

  • Pinpoint pupils
  • Drowsiness or trouble staying awake
  • Slurred speech
  • Muscle weakness or loss of coordination
  • Trouble keeping eyes open
  • Shallow breathing
  • Trouble paying attention
  • Constipation

With extended use, fentanyl addiction takes hold because the brain is used to the flood of dopamine produced. 

Signs of fentanyl addiction include:

  • Using more fentanyl as tolerance increases
  • Attempts to cut back or quit fentanyl fail
  • Fentanyl cravings
  • Continue to take fentanyl despite the adverse impact it has on relationships, career, health or mental health
  • Devoting much time to obtaining, using, and recovering from fentanyl
  • Choosing fentanyl over spending time with friends and family
  • Displaying withdrawal symptoms

Medical Fentanyl Detox and Withdrawal

If a person is physically dependent on fentanyl and wants to quit the drug they will need to have medical support. This is because of the highly unpleasant withdrawal symptoms that surface when the drug is withheld. If someone attempts to quit fentanyl cold turkey, they will likely relapse right back to using the drug during withdrawal.

Under the supervision of a medically trained detox team, the person entering recovery will be eased off the opioid slowly. The tapering process allows the brain to slowly acclimate to lower and lower doses over a period of time. The detox team also provides medications that provide relief from the withdrawal symptoms as they emerge. With these supports in place, the chances of completing the detox are greatly enhanced.

What is the Fentanyl Detox Timeline?

The fentanyl withdrawal timeline follows a fairly predictable pattern that involves three stages. Symptoms are more severe based on how long the person used fentanyl, how frequently they used it, and the dosing. Remember that the symptoms can be relieved by the medications and mental health support provided by the detox team.

The fentanyl withdrawal timeline includes:

Stage 1:  Withdrawal symptoms commence 6-24 hours after the last fentanyl dose. This first phase lasts 1-3 days and features muscle and joint aches, agitation, runny nose, insomnia, yawning, and sweating.

Stage 2: The withdrawal symptoms reach a peak during the second stage, which lasts 3-5 days. The symptoms include nausea, diarrhea, vomiting, bone pain, runny nose, chills, fever, agitation, anxiety, and depression.

Stage 3: During the third stage of the fentanyl withdrawal timeline the symptoms begin to subside. Some symptoms, such as cravings, depression, and anxiety may linger longer. 

The Next Step: Fentanyl Addiction Treatment

Fentanyl recovery involves a menu of daily therapies, classes, and group work. All of these actions will help guide you toward gaining control over the fentanyl addiction.

Therapy teaches new ways of framing thoughts and shows how to adopt new behavior responses. Multi-pronged treatment includes these elements:

  • Individual therapy sessions. In these private therapy sessions you learn new thought/behavior patterns through evidence-based therapies like CBT. 
  • Group therapy sessions. Under the guidance of a therapist, group members share their experiences and feelings and offer support to each other.
  • Family group. The family is an important source of support, but may also be a source of dysfunction. Family group work can help members improve functioning and setting boundaries. 
  • Medication management. Medication can be a useful tool during early recovery and help prevent relapse.
  • Holistic activities. To reduce stress while in rehab, and to gain self-care skills for recovery, you will engage in holistic therapies. These include meditation, cupping therapy, massage, and yoga.
  • Recreational and nutritional counseling. To restore health in recovery, you will receive nutritional therapy and engage in physical exercise. 

Now that you are aware of the fentanyl withdrawal timeline and the treatment that follows, please reach out for support today.

Pacific Bay Recovery Fentanyl Detox and Addiction Treatment


Pacific Bay Recovery is a residential addiction treatment program that offers help for someone with a fentanyl addiction. To learn about our comprehensive program, please reach out to our team today at (619) 350-8220.
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