Fentanyl Withdrawal Symptoms, Timeline, & Detox

Kimberly Langdon, M.D.

Medically Reviewed By: Kimberly Langdon, M.D.

on December 10, 2022

Fentanyl is a prescription opioid drug with a strong potential for dependence and addiction. If you try to stop using the drug after long-term use, you can experience uncomfortable withdrawal symptoms that may peak around 2-3 days after the last dose.

Fentanyl is a synthetic opioid drug used to treat breakthrough pain or severe pain that doesn’t go away despite the use of other pain medications. It works by binding to opioid receptors in the brain and changing the way the central nervous system responds to pain.

Despite its medical use, fentanyl is dangerous. The FDA classifies it as a Schedule II controlled substance, and it carries a strong risk of life-threatening opioid overdose. In Ohio in 2020, 81% of overdose deaths involved fentanyl.

When opioid dependence develops after long-term fentanyl abuse, discontinuing the drug can lead to serious opioid withdrawal symptoms.

Fentanyl Withdrawal Symptoms

With an opioid like fentanyl, withdrawal symptoms can be painfully uncomfortable. Without proper medical supervision, there is a strong likelihood of relapse and further drug use. 

Fentanyl withdrawal symptoms can include

  • aches in muscles and bones
  • insomnia
  • increased sensitivity to pain
  • dysphoria
  • uncontrollable leg movements
  • enlarged pupils
  • sweating
  • goosebumps
  • runny nose
  • nausea and vomiting
  • diarrhea
  • opioid cravings
  • irregular heart rate
  • high blood pressure/hypertension

Fentanyl Withdrawal Timeline

How long the withdrawal symptoms last depends on a number of factors including how long you’ve taken the drug, the dose or strength, if you used other substances, and your overall medical history.

However, you can use a general timeline for opioid or opiate withdrawal as a guide to determine if what you’re feeling is a typical withdrawal experience. 

6-12 Hours After Last Dose

The first withdrawal symptoms are likely to show up at this stage. They may be relatively mild and include sweating, runny nose, sleep problems, and muscle aches.

36-72 Hours

This is when withdrawal symptoms will likely be at their worst, and when the risk of fentanyl overdose and relapse is most likely. Symptoms can include vomiting, nausea, diarrhea, stomach cramps, and fever. After this period, withdrawal symptoms are likely to decrease. 

4-7 Days

This is the period when withdrawal symptoms start to subside and you may eel more normal. That being said, some people may continue to feel intense symptoms for a few weeks. 

8+ Days (PAWS)

Several weeks (or even months) after your last fentanyl use, some withdrawal symptoms may continue. This can include increased sensitivity to pain, cravings, depression, sleep issues, and anxiety. 

When symptoms continue for a long period of time, it is known as post-acute withdrawal syndrome (PAWS).

Fentanyl Detoxification

For anyone going through fentanyl withdrawal, there is help available to ensure the process is a lot more comfortable. You can receive detox support at inpatient or outpatient treatment centers or through your healthcare provider. 

Addressing fentanyl withdrawal may consist of medical detox, tapering, or medication-assisted treatment as part of a substance abuse treatment plan

Medical Detox

Medical detox involves being medically supervised while the drug leaves your system. When withdrawal symptoms show up, healthcare professionals can treat your specific symptoms with medication or UV fluids to make the process less intense.


Tapering is also an option for withdrawal management. With tapering, a healthcare provider lowers the dose of fentanyl over a period of weeks or months until the dose is so low that you can stop taking it entirely without the risk of intense withdrawal symptoms.

Additionally, if you have pain, they can provide an alternative medication with a lower potential for substance abuse.

Medication-Assisted Treatment

If you have a substance use disorder involving fentanyl or another opioid, medication-assisted treatment (MAT) may be available. With MAT, methadone, buprenorphine, and naltrexone are available to help reduce symptoms and ease cravings related to opioid addiction and dependence. 

MAT is likely part of a larger fentanyl addiction treatment plan via an inpatient or outpatient treatment program. Treatment services can include mental health counseling, behavioral therapy, group therapy, and wellness activities.

If you or a loved one live with opioid use disorder and are worried about withdrawal, contact Ohio Recovery Center for information on our inpatient treatment options, including medical detox.

  1. National Library of Medicine: MedlinePlus — Fentanyl https://medlineplus.gov/druginfo/meds/a605043.html
  2. National Library of Medicine: MedlinePlus — Opiate and opioid withdrawal https://medlineplus.gov/ency/article/000949.htm
  3. National Library of Medicine: StatPearls — Opioid Withdrawal https://www.ncbi.nlm.nih.gov/books/NBK526012/
  4. Ohio Department of Health — Drug Overdose https://odh.ohio.gov/know-our-programs/violence-injury-prevention-program/drug-overdose/#:~:text=This%20trend%20has%20continued%20through,a%2025%25%20increase%20over%202019.

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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