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Fentanyl is a manmade opioid painkiller prescribed to treat sudden episodes of pain. This may include post-surgery pain management and ongoing cancer care. Healthcare providers may prescribe fentanyl under the brand names Actiq, Sublimaze, Lazanda, and Abstral. While the drug is similar to morphine, it is much stronger (around 50 to 100 times). Fentanyl works by easing pain receptors and producing dopamine that regulates and improves mood. Long-term use of fentanyl may result in opioid dependency, leading to intense withdrawal symptoms. Some illegal supplies of fentanyl may differ from what you would get at a pharmacy, resulting in overdose and more severe withdrawal symptoms.

The National Institute of Drug Abuse identifies fentanyl use as a possible epidemic1 due to the drug’s potency and the fact it is added to other drugs without the user’s knowledge. It is highly addictive, and medical reports state that up to 10% of patients who switch from morphine to fentanyl, experience some form of withdrawal. We will provide a deeper look into fentanyl withdrawal symptoms and timelines as well as how a comprehensive detox program can help someone cope and recover from their symptoms.

How Long Does Fentanyl Withdrawal Last?

Medical staff can detect fentanyl in urine 24 to 72 hours after the last dose. Blood test results can track the drug 5 to 48 hours after use, while hair tests may show traces of the drug up to three months after the last dose. As with other opioids, the length of fentanyl withdrawal varies depending on a range of lifestyle factors. Users may feel symptoms as soon as 2 to 4 hours after the last use. In cases of fentanyl patches (a slow-release administration), users may experience symptoms 24 to 36 hours after their last dose. Fentanyl is an opioid with a 219-minute half-life2, and users may experience the worst symptoms in the first few days of withdrawal. Usually, the symptoms improve in the following weeks with the right healthcare support and professional counseling. But some people may continue to experience milder withdrawal symptoms for a month or longer. The withdrawal period usually depends on the individual’s genetics, underlying health conditions, and severity of addiction (length and amount of daily use). Specialized healthcare providers will conduct a physical examination and request a medical history to create the right recovery plan.Typically, fentanyl withdrawal symptoms last from around 4 to 20 days. The process, widely known as PAWS (post-acute withdrawal syndrome), applies to all types of opioid withdrawal. While medical support can help get rid of physical symptoms within a month, psychological challenges tend to last longer. So, it is important to seek professional help to deal with episodes of anxiety, cravings, and depression. Specialized professionals can also provide guided coping techniques to help avoid the triggers and situations that cause a return to drug use.

Identifying the Most Common Fentanyl Withdrawal Symptoms

Like other opioid withdrawal syndromes, the severity of fentanyl’s effects differs vastly among users based on their health and dosage. Fentanyl withdrawal symptoms usually involve physical and psychological effects. These may include:

  • Anxiety
  • Nausea
  • Trouble sleeping
  • Vomiting
  • Fever
  • Heavy sweating
  • Runny nose
  • General irritability
  • Chills and goosebumps
  • Muscle or joint aches
  • Dilated pupils
  • Dizziness
  • Sleepiness
  • Increased breathing rate
  • Abdominal cramps

People also undergo different symptoms during each phase of fentanyl withdrawal. There are three main stages of withdrawal: early, peak, and long-term effects.

Early Symptoms (2 to 4 Hours After Last Dose)

The earliest symptoms of fentanyl withdrawal involve slight bodily discomforts, such as constant yawning, aches, and chills. Physical symptoms may come with feelings of anxiety, restlessness, and an intense craving for drug use.

Peak Symptoms (24 to 36 Hours After Last Dose)

Peak symptoms may last up to about a week after the last dose. Symptoms may include an increase of earlier withdrawal effects. Individuals may also experience additional symptoms that require medical care and attention, such as fever and vomiting.

Long-Term Fentanyl Withdrawal Symptoms

These symptoms might appear weeks after medical detox and occasionally recur. So, it is important to seek continuous withdrawal management to prevent relapses. Former fentanyl users may also face the challenge of disruptive thoughts and cravings. Long-term symptoms may include:

  • An inability to experience pleasure/depressive disorders
  • Pink cloud syndrome — carefree thoughts that might place someone in physical harm (for example, reckless driving)
  • Volatile mood disorders
  • Outbursts of anger and self-harm
  • Increased sensitivity to pain
  • Trouble sleeping

The symptoms of fentanyl withdrawal are usually not life-threatening. But it is important to watch fluid levels closely to avoid dehydration from diarrhea and vomiting. When left untreated, the rapid loss of fluids may lead to sodium buildups that cause heart failure. In such cases, patients may require intravenous (IV) therapies and other medical support to replenish lost metabolites. A medically supervised treatment center can help prevent the complications of fluid loss.

Medically Detoxing From Fentanyl

A combination of careful withdrawal management and medical detox can greatly reduce the effects of fentanyl withdrawal. Medical detox often serves as the first stage of treatment, offering many benefits, including:

  • Reducing the pain and discomfort brought on by withdrawal
  • Enabling healthcare professionals to identify other complications/underlying medical issues
  • Planning long-term recovery plans for opioid use disorders
  • Reducing relapse risks
  • Removing the physical dependence on opioid products

Those seeking recovery may choose to undergo medical detox in a residential, in-patient, or outpatient program. The choice of setting might depend on a person’s current living environment and the severity of withdrawal symptoms. Medical detox eliminates the residual fentanyl within the body, which removes its toxic effects. By doing so, the body returns to pre-fentanyl function. Studies have shown a higher completion rate for residential programs compared to outpatient options. But the relapse risks remain similar for both settings. Some points of consideration include:

  • Complications that involve other existing medical conditions
  • An individual’s commitment to positive change
  • The current living and recovery environment (factors that might cause drug use)
  • High intoxication levels needing round-the-clock management and close-by medical care
  • Underlying psychological conditions that might trigger a relapse

Medications Used in Fentanyl Treatment

Since going “cold turkey” can cause serious withdrawal symptoms, some people may choose to wean off fentanyl gradually. The process requires close medical supervision as it involves drugs like Buprenorphine/Naltrexone, which may lead to further addictions. Healthcare experts would then reduce the daily dose of these alternate drugs to help the body slowly decrease its dependencies. Weaning processes differ among individuals depending on their health, co-occurring disorders, and the severity of fentanyl use.Qualified practitioners will work closely with each person to create the most suitable weaning program based on their background and requirements.Healthcare providers may prescribe various medications to treat symptoms caused by fentanyl withdrawal. These may include muscle relaxants and anti-depressants. The FDA has officially recognized three drugs suitable for opioid withdrawal management programs. These include:Buprenorphine/Naltrexone: A powerful drug used in pain relief. Buprenorphine/Naltrexone provides a slower effect compared to other mainstream options such as morphine. Additionally, Buprenorphine/Naltrexone may reduce the hallucinogenic effects of other drugs such as hydrocodone and codeine. Buprenorphine/Naltrexone acts as an opioid replacement for fentanyl withdrawal, functioning as a mild substitute that supports recovery. But many healthcare providers may avoid Buprenorphine/Naltrexone due to its high potential for misuse. Buprenorphine: A drug treatment option widely used in opioid withdrawal management. As the drug is a partial opioid agonist, it creates an improved safety profile that reduces overdose risks. Similar to Buprenorphine/Naltrexone, buprenorphine acts as an opioid replacement to help the body return to pre-fentanyl function. Lofexidine hydrochloride: A drug that reduces the effects of opioid withdrawal symptoms. Lofexidine relieves common fentanyl symptoms such as insomnia, stomach discomforts, and joint/muscle aches.

Treatment for Fentanyl Misuse

Medical detox is most effective during the initial stages of fentanyl withdrawal management. But those in recovery must undergo complete treatment for lasting positive outcomes. Medical detox should be the first step in the recovery process, where continuous treatment reduces relapse risks. You can reach out to the dedicated professionals at Windward Way Recovery to discover the most suitable detox option. In addition, our experts recommend ongoing counseling, therapy, maintenance medicine, and self-help support groups to maintain the most effective recovery plan. It is essential to seek the most suitable fentanyl withdrawal management arrangement according to your specific needs. Treatment options include:

  • Outpatient treatment with routine nonresidential follow-ups at a treatment center
  • Residential inpatient treatment that offers round-the-clock care by trained healthcare staff

Factors to Consider for Fentanyl Withdrawal Treatment

While outpatient treatment provides people with the freedom to recover without disrupting their lifestyles, it brings a set of considerations. It is important to consider the overwhelming symptoms at the beginning of withdrawal. While some symptoms are manageable, others such as vomiting and diarrhea require professional supervision. Some questions to consider include:

  • Is there a responsible adult at home to oversee my outpatient recovery?
  • Are there influences (for example, hidden stashes) in my home environment that might trigger a relapse?
  • Am I physically fit or have reliable help to travel back and forth from a treatment center?
  • Do I have the social support and skills to cope with temptations in the recovery process?
  • Am I prepared to face the overwhelming emotional and psychological changes that might clash with my sobriety goals?

In most cases, fentanyl withdrawal requires medically supported detox alongside emotional support. Partial hospitalization and inpatient treatments provide the medical support necessary to overcome withdrawal symptoms and therapeutic options for long-term aftercare. For example, cognitive behavioral therapy can help reduce the stress and emotional effects of withdrawal to prevent relapse.While some people may prefer outpatient treatment, professional support can greatly improve recovery outcomes. It is possible to reach out to loved ones during the recovery process. In some instances, family therapy plays a huge part in the journey, offering those in recovery the moral support they need to move forward.

Windward Way Recovery — The Guided Path to Wellness

At Windward Way Recovery, we are committed to providing comprehensive and compassionate care throughout withdrawal management. We understand that many factors are surrounding the recovery outcome for fentanyl withdrawal. As such, we offer a combination of partial hospitalization and intensive outpatient treatment for leading treatment center outcomes. We customize the most suitable programs according to your withdrawal experience. Every Windward Way Recovery professional offers the highest standards in fulfilling immediate recovery needs while prioritizing underlying mental health considerations. Windward Way Recovery provides an evidence-based approach to addiction recovery for fentanyl withdrawal and various other addictions. Our dedicated team will ensure you or your loved one receives the best care and medical support every step of the journey toward wellness. Call or contact us at (855) 491-7694 to reach a Windward Way Recovery representative today.

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