Fentanyl Withdrawal: Symptoms, Timeline, & Treatment

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Fentanyl is a deadly synthetic opioid that is highly addictive, and can have dangerous withdrawal symptoms. Fentanyl withdrawal and detox is similar to withdrawal from other opioids, with Fentanyl withdrawal symptoms including nausea, vomiting, chills, rapid heart rate, and body pain (keep reading for more details). 

This guide explores the following issues:

  • How long does fentanyl withdrawal last?
  • What are the side effects of fentanyl withdrawal?
  • Can you die from fentanyl withdrawal?
  • What are the most common signs of fentanyl withdrawal?
  • What medication is best for withdrawal?


If you want to discover how to get through fentanyl withdrawal as comfortably and safely as possible, read on.

a woman looks out at a sunset to represent fentanyl withdrawal symptoms.

Fentanyl Withdrawal

Fentanyl use carries a range of risks, including tolerance, dependence, abuse, and addiction. Developing a tolerance to fentanyl can occur rapidly and means that you will need to take higher doses or more frequent doses to achieve the same effects.

Once physical dependence sets in, individuals may experience fentanyl withdrawal symptoms when the drug is no longer in their system. These symptoms can start within 12 hours of the last dose and last for up to a week.

Fentanyl addiction, or opioid use disorder, is a chronic and relapsing condition characterized by compulsive drug-seeking and drug-taking behaviors despite negative consequences. Obtaining and using the substance can become the primary focus of life for someone with a fentanyl addiction.

The most effective treatment for fentanyl addiction will depend on the severity of the opioid use disorder. Treatment options for fentanyl addiction, withdrawal, and detox are similar to those for other opioid use disorders and will vary based on individual needs and circumstances.

Symptoms of Fentanyl Withdrawal

Using opioids long-term, even as prescribed, can quickly trigger the development of tolerance, meaning that you will need to increase the amount or frequency of your fentanyl doses to achieve the same effects. Prolonged opioid abuse can also lead to changes in nerve receptors in the brain, causing dependence and withdrawal symptoms when opioids are not present.

Withdrawal symptoms of fentanyl (similar to most opioid withdrawal symptoms)include:

  • Vomiting
  • Nausea
  • Diarrhea
  • Anxiety
  • Insomnia
  • Elevated blood pressure
  • Raised body temperature
  • Chills
  • Sweating
  • Racing heart
  • Muscle pain
  • Bone pain

While opioids are not typically associated with psychosis, some individuals may experience hallucinations, delusions, or other psychotic symptoms during withdrawal from fentanyl.

To minimize unpleasant fentanyl withdrawal side effects and prevent the occurrence of psychotic symptoms, it is essential to seek medical assistance and consider medically supervised detox when withdrawing from fentanyl. This approach can provide the necessary support and care to manage withdrawal symptoms effectively and reduce the risk of complications as you detox from fentanyl.

How long does it take to detox from fentanyl, then?

A man looks out a car window to represent the symptoms of fentanyl withdrawal and opioid withdrawal treatment.

Fentanyl Withdrawal Timeline

How long fentanyl withdrawals last will depend on the scope and duration of fentanyl abuse. The onset of withdrawal symptoms usually occurs between 8 to 36 hours after the last dose. However, this can vary based on the dosage and frequency of use.

Fentanyl is a short-acting opioid associated with withdrawal symptoms that present from 8 to 24 hours after the last dose. On the other hand, long-acting opioids like oxycodone extended-release tablets may take longer for withdrawal symptoms to appear, usually from 24 to 48 hours after the last dose.

The timeline for fentanyl withdrawal normally follows this pattern:

  • Day 1: During the first day of fentanyl withdrawal, you may experience symptoms such as powerful cravings, anger, aggression, irritability, muscular aches and pains, headaches, disrupted sleep patterns, and loss of appetite.
  • Day 2: The second day of fentanyl detox is characterized by the continuation of the above symptoms, along with additional negative effects such as insomnia, excessive sweating, runny nose, upset stomach, and panic attacks.
  • Day 3: Withdrawal symptoms will typically peak on the third day of detox. Nausea, vomiting, and diarrhea are the most pressing symptoms during this acute phase of opioid withdrawal, and they are likely to persist throughout the day.
  • Day 4: As the most acute phase of fentanyl withdrawal subsides, lingering symptoms may include fatigue, GI disturbances, cramps, shivering, and enlarged pupils.
  • Day 7: After a week of fentanyl detox, most withdrawal symptoms should start to subside. Having said that, it may take longer for sleep patterns to normalize, and fatigue and depression may persist.

In some cases, individuals may experience PAWS (post-acute withdrawal syndrome), where symptoms can persist for several months after discontinuing the use of fentanyl. Common symptoms of PAWS include depressed mood, strong cravings for opioids, fatigue, disrupted sleep patterns, and irritability. Seeking medical assistance and a medically supervised detox can help manage the symptoms of fentanyl withdrawal.

Fentanyl Withdrawal Symptoms Treatment

The objective of fentanyl detox is to safely eliminate toxic substances and metabolites from the body. This typically requires undergoing detoxification at a licensed medical detox or substance abuse treatment center, either as a standalone service or as a preliminary step to residential rehab. In either case, 24-hour medical attention and mental health care are available to monitor and manage any complications associated with fentanyl withdrawal.

During detox, various medications may be prescribed to alleviate the more severe symptoms of opioid withdrawal, as well as reduce cravings for fentanyl. These medications can help minimize the discomfort and suffering that accompanies the withdrawal process.

Fentanyl Addiction Treatment

After completing fentanyl detox, it is crucial to continue receiving addiction treatment to maintain long-term recovery. Fentanyl addiction treatment typically involves a combination of MAT (medication-assisted treatment) and behavioral therapies.

MAT uses medications like methadone, buprenorphine, and naltrexone to reduce withdrawal symptoms, prevent relapse, and ease cravings. These medications work by binding to the same mu-opioid receptors in the brain as fentanyl but in a safer and more controlled way. MAT can be highly effective in treating fentanyl addiction and is often used as part of a comprehensive treatment plan. MAT is most effective when combined with behavioral interventions.

Behavioral therapies like CBT (cognitive-behavioral therapy) and DBT (dialectical behavior therapy), are also integral components of fentanyl addiction treatment. These therapies help individuals understand their addictive behaviors, develop coping strategies, and manage cravings and triggers. They also provide a safe space to process any underlying emotional issues that may be contributing to the addiction.

In addition to medication and therapy, support groups like NA (Narcotics Anonymous) can be highly beneficial for individuals in recovery from fentanyl addiction. These groups provide a supportive community of peers who understand the challenges of addiction and offer guidance, encouragement, and accountability.

Keep in mind that addiction is a chronic and relapsing condition, and that recovery is an ongoing process that may not always be linear. Continuing to engage with addiction treatment and support after detox is critical for long-term success in overcoming fentanyl addiction.

Get Treatment for Opioid Addiction at Ohio Recovery Centers

At Ohio Recovery Centers, we specialize in treating opioid addiction through outpatient programs. If you need help with substance use detox, we can connect you with licensed medical detox centers in Cincinnati, OH.

Once you complete drug detox treatment, we offer several opioid addiction treatment programs for your transition, including PHPs, IOPs, and dual diagnosis treatment programs. Our team of medical professionals and addiction specialists uses science-based treatments like MAT, behavioral therapies, and counseling alongside holistic interventions to provide comprehensive care.

Our Cincinnati rehab also includes a robust aftercare component to increase your chances of sustained recovery without relapse. Whether you need help with opioid addiction or alcoholism, we are here to support you from detox to discharge and beyond. Call 513-757-5000 now for immediate assistance with supervised drug or alcohol detox in Ohio.

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