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Detoxification Guide for Opiates.

Written By Jeff Mahre BA MFA MLIS - January 12th, 2017

Opiates are natural substances derived from opium poppy pods. These natural substances include morphine, codeine and heroin. Opioids are synthetic or man-made substances which act on the same brain receptors as opiates, and are often used as medicine for pain-relief (John Hopkins Medicine, 2018). Colloquially, opiates and opioids are known as “narcotics.” Regardless of whether they are natural or synthetic, they are a highly addictive class of substance. Contact someone who can help you today.

For our guide on heroin, a type of opioid, please click here.

For our guide on suboxone, a drug containing an opioid, please click here.


opiate abuse facts

Withdrawal symptoms  |  Withdrawal timeline  |  Detox |  Back to top

The Centers for Disease Control and Prevention (2018) showed that, in 2017, the number of overdose deaths involving opioids was six times higher than the number of deaths in 1999. Other staggering statistics cited were as follows:

  • 68% of drug overdose deaths in 2017 involved an opioid
  • 130 Americans die every day from an opioid overdose
  • Overdose deaths secondary to heroin has increased from 2010 and now plateaued
  • Overdose deaths secondary to synthetic opioids significantly spiked in 2013 and has continued to rise

As mentioned, natural opiates include morphine, codeine and heroin. Synthetic opioids include fentanyl, pethidine, tramadol and methadone (Fareed et al., 2011).

Opioids have an incredibly high potential for addiction, even if used as appropriately prescribed. The opioid receptors in the brain that these drugs bind to are responsible for pain and pleasure (Fareed et al., 2011). A tolerance is also quickly developed against opioids. This means that most addicts never get that same “first high” again, and forever “chase” that high. Therefore, a terrible cycle ensues that leads to a person taking ever-increasing dosages. These ramped-up doses are often responsible for the high rate of overdoses and deaths.

Intoxication produces the following (Fareed et al., 2011):

  • Feelings of euphoria
  • Relief of anxiety
  • Constipation
  • Numbing of pain
  • Pinpoint pupils
  • Sweating
  • Nausea and vomiting
  • Impairment of memory, concentration and attention

Eventually, feelings of apathy occur as well as decreased bodily movement. It can produce convulsions, decreased breathing and confusion if used in high enough doses. As highlighted by Darke & Hall (2003), large doses can be potentially lethal and accidental overdose is the commonest cause of death in heroin users. This risk increases with the use of other depressant drugs such as alcohol, other opioids or benzodiazepines.

symptoms of opiate withdrawal

Abuse facts  |  Withdrawal timeline  |  Detox |  Back to top

Short-acting opioids, including heroin and fentanyl, can lead to withdrawal very quickly; the patient usually displays symptoms within 8-12 hours after the last dose. Long-acting opioids, such as oxycodone and methadone, cause a peak withdrawal between 5-6 days. The symptoms linger for much longer in long-acting opioids (Fareed et al., 2011).

Withdrawal symptoms can entail (Fareed et al., 2011):

  • Vomiting and nausea
  • Diarrhoea
  • Abdominal pain
  • Muscle aches and cramps
  • Anxiety
  • Irritability
  • Insomnia
  • Sweating
  • Elevated pulse and blood pressure

opiate withdrawal timeline

Abuse facts  |  Withdrawal symptoms  |  Detox |  Back to top

As delineated by Fareed et al. (2011), the timeline depends on whether a short or long-acting opioid was used.

After the last dose of a short-acting opioid (including heroin):

  • Withdrawal symptoms start within 8-12 hours after the last dose
  • If untreated, symptoms peak at 36-72 hours. Exhaustion, apathy and pain (joint pain, muscle pain and abdominal cramps) are usually experienced during this peak
  • Symptoms usually subside substantially by 5 days

For longer-acting opioids:

  • Withdrawal symptoms start within 12-48 hours after the last dose.
  • Withdrawal peaks at 5-6 days
  • Symptoms do not subside for 14-21 days

symptoms of opiate detox

Abuse facts  |  Withdrawal symptoms  |  Withdrawal timeline  |  Back to top

Even though opioid withdrawal itself is not as life-threatening as certain other drug withdrawals, it is highly recommended to carry out detoxification in a treatment centre. What is life-threatening, with regards to opioids, is the propensity to overdose. This can easily occur after a failed attempt at recovering from withdrawal.


The good news, however, is that there is medical treatment available for this drug addiction and withdrawal. That Is because substitute medications can be offered to assist with withdrawal symptoms. This also makes relapse less likely. Please note that using medication to assist with withdrawal symptoms should only be carried out by a professional in a facility. The entire process should be monitored by health care providers that have specific knowledge and expertise in the field of opioid addiction treatment (Kleber, 2007). Give us a call today to find the right centre for you.



Centers for Disease Control and Prevention. (2018). Opioid overdose: understanding the epidemic. Retrieved February 26, 2019, from

Darke, S., & Hall, W. (2003). Heroin overdose: research and evidence-based intervention. Journal of Urban Health80(2), 189-200.

Fareed, A., Stout, S., Casarella, J., Vayalapalli, S., Cox, J., & Drexler, K. (2011). Illicit opioid intoxication: diagnosis and treatment. Substance Abuse5, 17-25

John Hopkins Medicine. (2018). Glossary of Terms. Retrieved February 26,2019, from

Kleber, D. (2007). Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues in Clinical Neuroscience9(4), 455-70.


Chief Editor

Dr. Ashley Murray


Dr Ashley Murray obtained her MBBCh Cum Laude in 2016. She currently practises in the public domain in South Africa. She has an interest in medical writing and has a keen interest in evidence-based medicine.



Jeff Mahre BA MFA MLIS


Jeff holds an MFA in Creative Writing from the University of California-Irvine, and has eleven years of experience teaching Composition on the college level.