Fentanyl Withdrawal Symptoms, Timeline & Detox

Fentanyl, a synthetic opioid, has made recovery from substance addiction more urgent than ever before. Now known as America’s deadliest drug, fentanyl has overtaken heroin and oxycodone as the leading cause of drug overdose deaths.

When treating addiction to the drug through a fentanyl detox, the body experiences withdrawal as the brain and body react to the shock of the drug’s removal. Because of fentanyl’s ultra-high potency and short half-life, its withdrawal symptoms can be particularly severe.

Fear of withdrawal can be a barrier to recovery for many people, but fentanyl withdrawal does not have to be a difficult and frightening experience. Medically assisted fentanyl detox can help people to stop their drug use safely and comfortably.

Fentanyl withdrawal can be profoundly uncomfortable, especially for people who quit “cold turkey” without medical support. There are no shortcuts or easy fentanyl withdrawal remedies that can prevent symptoms. However, people who participate in supervised medical detox programs have access to 24/7 medical professionals who can address concerns as they arise and, if appropriate, administer pharmacotherapies to mitigate the severity of withdrawal symptoms.

Fentanyl withdrawal is best addressed in a professional rehab setting that includes medical detox. At the very least, someone facing fentanyl detox and withdrawal should seek professional assistance to obtain an appropriate tapering regimen.

The fentanyl half-life varies quite a bit, depending on the formulation and the route of administration. There are three types of fentanyl: Pharmaceutical fentanyl, derivatives of pharmaceutical fentanyl and non-pharmaceutical (illicit) fentanyl, which all have different half-lives.

Broadly speaking, intravenously administered pharmaceutical fentanyl has an average half-life of 7 hours, but the range spans from 3-12 hours. Transdermal fentanyl patches administer fentanyl through the skin, slowing the metabolic half-life to 20-27 hours. Derivatives and illicit fentanyl have shorter half-lives than pharmaceutical fentanyl.

It is difficult to predict how long fentanyl withdrawal will last in a particular individual, but withdrawal symptoms taper off and end after four to 10 days in most people. The fentanyl withdrawal timeline usually follows a general pattern, but there are specific factors that affect each person’s level of withdrawal. These factors include age, gender, general health, liver and kidney health, genetic and biological make-up, concurrent use of other drugs, co-occurring mental health disorders, use of medically assisted detox, and previous attempts at detox.

Fentanyl dependence is a consequence of the brain becoming adapted to its presence. When someone who has become dependent on fentanyl quits abruptly, their brain will attempt to rapidly restore normal functionality. Unfortunately, this is not always a smooth process and, as brain chemistry rapidly changes, the result can include dangerous physical and psychological symptoms like seizures and hallucinations.

For these reasons, quitting abruptly is never recommended for people who have developed a fentanyl dependence. It is strongly suggested that someone with a fentanyl use disorder consult with their doctor or an addiction specialist before they attempt to quit.

People who choose to detox without medical supervision should prepare ahead of time. Enlist a trusted friend or family member who can be a cheerleader, errand runner, and motivational speaker. Discuss with them why recovery is important and what the short and long-term goals are. It can be very helpful if someone struggling to resist relapse is reminded of why they are pursuing sobriety. In addition, make sure the refrigerator is full of healthy food and water. Many people find that a quality multivitamin may help their symptoms.

Quitting cold turkey is rarely the most effective approach to overcoming substance use disorders and fentanyl is no exception. In milder cases of fentanyl dependence, a tapering protocol is a highly effective strategy for managing withdrawal symptoms, but in severe cases of dependence, opioid replacement therapy in the form of medication-assisted treatment (MAT) may be more appropriate.

MAT is a strategy that replaces fentanyl with other opioids that have longer half-lives and that do not deliver the euphoria that is associated with fentanyl abuse. The goal of MAT is to provide the brain with a substance that can mimic the chemical effects of fentanyl in the brain without delivering the sense of euphoria that perpetuates addiction. In other words, MAT tricks the brain into believing that it is receiving the drug it has become accustomed to without continuing to reinforce the pleasure that is associated with fentanyl use.

There are several drugs that are valuable MAT options for people recovering from a fentanyl use disorder, including methadone, buprenorphine, Suboxone and naltrexone.