Fentanyl and Opioid Detox – What to Expect and How to Prepare

When someone stops using opioids, they will experience unpleasant and uncomfortable withdrawal symptoms.

In this article, you will learn about the symptoms of opioid withdrawal, the typical duration and how to manage the symptoms as well as the various treatment options.

Definition of Fentanyl and Opioids

Opioids include both prescription painkillers like morphine and illegal substances like heroin. Doctors may prescribe opioids to treat severe pain. Even when used as prescribed, use can lead to dependence. 

Opioids are extremely addictive due to their effects on the reward center of the brain. Endorphins—the neurotransmitters in the brain that make us feel good—produce a great sense of well-being and reduce pain.

When the effects of the drug wear off and the user feels an overwhelming urge to use again, abuse and addiction begin.

Types of Opioids:

• Morphine
• Heroin
• Opium
• Fentanyl
• Codeine
• Hydrocodone
• Hydromorphone
• Oxycodone
• Oxymorphone
• Meperidine
• Methadone

Fentanyl is a synthetic opioid that can be fifty to one hundred times more potent than morphine and heroin. In the United States, it is the leading cause of overdoses and fatalities. 

Fentanyl comes in two different forms (both are synthetic):

1. prescription (pharmaceutical) fentanyl
2. fentanyl produced illegally

Fentanyl can be prescribed by doctors to treat and manage severe pain. It is sold under the names Actiq, Duragesic, and Sublimaze.

The illegally used form of fentanyl is linked to a high number of the overdoses and deaths and is manufactured in labs and sold as powder, blotter paper, eye drops, nasal sprays and pills.

Fentanyl is now being mixed with cocaine, heroin, MDMSA and methamphetamine by many drug dealers. This makes it cheaper for the dealers and has a major impact on the number of accidental overdose cases.

People with mental health issues, personality and substance use disorders have a predisposition for addiction and increased risk of using un-prescribed prescription medications.

Overview of Detox Symptoms

Fentanyl withdrawal symptoms can be extremely uncomfortable, making it hard to quit on your own.  Detox should be under the supervision of a doctor and for the best success, at a licensed treatment center.

They will help you manage your withdrawal symptoms as safely as possible. To learn more about detox settings and what is best for you or your loved one, please contact Luxe Recovery today. 

While the detox symptoms may be very uncomfortable, they are not typically life-threatening. In some cases, complications do arise from pre-existing health conditions or complications from IV drug use.

People who detox at home or without medical supervision are at risk of dehydration from excessive diarrhea and vomiting. Be careful and always seek professional help.

It is important to note that there is an increased risk of overdose and death for people who use after a period of abstinence. 

What to Expect During Detox

Withdrawal from some opioids will last longer than others, it depends on the type of drug used, duration and dose. 

• Heroin withdrawal symptoms appear 8-12 hours after the last use, peak within 1-3 days and last for up to a week. 
• Short-acting opioids, like morphine, oxycodone, hydrocodone and fentanyl will lead to withdrawal symptoms 8-24 hours after the last use and can last up to 10 days.
• Long-acting opioids, like methadone, morphine, oxycodone, hydrocodone and fentanyl will lead to withdrawal symptoms up to 36 hours after last use and can last more than 2 weeks.

Withdrawal depends on the following factors:

• history of drug use
• physical and mental health status
• genetic and biological factors
• if detox medications are used

When you stop taking fentanyl or any other opioid, the withdrawal process begins quickly. The first signs of withdrawal can appear anywhere from 12 to 30 hours after your last dose.

Due to the opioid’s effects on dopamine and neurotransmitters, which are responsible for how the brain experiences pleasure, people going through withdrawal frequently experience symptoms that can resemble depression. This may last longer than many of the other withdrawal side effects.

It is important to seek help such as counseling and peer support groups to help with the effects on one’s mental health.

Withdrawal symptoms include:

• a strong urge to use the drug
• irritability, mood changes
• nausea, vomiting, cramps, diarrhea
• chills, goosebumps, sweating
• muscle cramps, bone pain
• weakness, excessive yawning
• restlessness, difficulty sleeping, excessive yawning

Cold Turkey

Quitting cold turkey is not something that is recommended. There is a high risk of relapse due to the severe physical symptoms and how hard it is to fight the urge to use.

Medically supervised detox, medications, counseling and support are easier and safer and result in higher rates of successful recoveries. 

Opioid Withdrawal Deaths

Despite how dangerous opioids and fentanyl are, the detox is much safer than alcohol or benzo detox.

Death during detox is usually because of extreme dehydration caused from excessive vomiting and diarrhea which lead to dangerously high levels of sodium in the blood – this is called hypernatremiaand causes heart failure. 

Remember, these deaths can be prevented by seeking medical supervision in a detox facility. You should never attempt to detox alone.  

Opioid and Fentanyl Addiction Treatment

It’s important to note that detox from opioids and being prescribed a medication to help treat opioid use disorder may only be the first step on the path to recovery.

While, for many people, medically supervised detox can lead to long-term recovery, detoxification alone is usually not enough to maintain lasting recovery. People are encouraged to seek counseling and there are various options out there to suit individual needs.  

Each person who needs opioid detox and treatment for an opioid use disorder will have a different treatment plan, depending on their needs.

Opioid Detox Medications

To reduce the withdrawal symptoms, these medications can be used. 

1. Methadone – relieves pain, reduces cravings and withdrawal symptoms. This was the detox drug of choice prior to 2000. The issue with methadone is the high potential for misuse, abuse and addiction.  
   
2. Buprenorphine (Suboxone, Subutex) – these medications reduce pain and cravings and can prevent uncomfortable withdrawal symptoms while increasing one’s sense of wellbeing. Buprenorphine was introduced in 2002 and is preferred due to the lower potential for abuse.
   
3. Naltrexone – this medication blocks the effects of the drugs and does not provide any type of high or pleasurable feeling. 
   
   

These detox medications are effective as they block the effects of opioids in the brain and reduce withdrawal symptoms and cravings. They are successful in helping one to maintain abstinence from other drugs and reduces risk of overdose and death.

Other medications can be used to provide relief such as Clonidine for anxiety or Loperamide for diarrhea.

Most people experience opioid withdrawal for a few days, but for others it may take several weeks. Your opioid withdrawal timeline will vary based on many different factors, including the type of opioids you have been using, whether or not you used other drugs in addition to opioids, and how long you’ve been using opioids.

Medication-Assisted Treatment (MAT)

The first step in treating substance abuse is the person admitting that they have a problem and having the motivation to quit using drugs. 

Sometimes people need to be admitted to a detox facility to manage the withdrawal symptoms. This can be done as an outpatient or inpatient. 

MAT should always be used in combination with talk therapies, individual counseling and group therapies. This provides a whole-patient approach and leads to better recovery success rates. 

Inpatient Treatment

Residential / inpatient treatment programs provide medical and emotional support within a safe environment away from one’s regular environment.

This is the best option for people to detox safely and get the most out of treatment. It sets you up on the road to recovery.

There are a number of therapies available that can help throughout the detox and recovery process. These include:

1. Cognitive behavioral therapy (CBT): aims to help people change thought patterns and behaviors
2. Motivational enhancement therapy (MET): aims to help people stay motivated during recovery
3. Group counseling: peer supported therapy has great success rates for people with addictions

Aftercare for Opioid Use Disorder

After detox or inpatient treatment, it is crucial to have a robust aftercare or continuing care plan in place.

This will provide structure and help with maintaining abstinence and long-term recovery. People who detox and do not engage in aftercare will struggle and usually end up relapsing and so the cycle continues. 

Continuing Care Plans

There is no particular length of time one needs to engage in aftercare programs, but it is proven that the longer one stays connected, the better the outcomes.

• aim to help create relapse prevention strategies by building on the skills and tools learned during detox and inpatient treatment but at one’s home environment where life’s triggers can lead to relapse
• help people stay connected through peer support groups, therapists, sponsors, friends in recovery who are a good influence throughout the recovery process 
• offer ongoing support for people with co-occurring mental health issues who may need medication monitoring or specific interventions
• help one reach goals for recovery and boost self-esteem which have a positive impact on personal relationships and professional life

Get Help

At Luxe Recovery, you will have the opportunity to speak with a caring knowledgeable admissions staff to discuss treatment options including detox, counseling options and aftercare. If you or a loved one are struggling with addiction, please reach out today.