Opiate Detox Stages of Withdrawal

When patients commit themselves to opiate detox, they start a process that will test their resolve. But, after ridding themselves of months or years of narcotic dependence, they will feel the new dawn of freedom sobriety offers.

After just a few days of opiate use, the human body develops a tolerance for the drug. This is not only true with illicit street drugs like heroin. Prescription painkillers such as morphine, codeine, fentanyl and oxycodone can trigger tolerance in people who take them under the expert care of a physician. Even patients who aren’t addicted to opiates will probably feel some withdrawal symptoms when they cease to use them.

Tolerance brings about structural changes in the brains of narcotics users. During detoxification, the mind must again rewire itself, but this time to function in the absence of the opiate. It’s a hard adjustment. Each person has a different experience. Nevertheless, it often helps patients to break down opiate detox into a project with three stages. Three smaller victories are more accessible than one large one.

First Stage: Acute Withdrawal

Shortly after walking through the door of the drug detox center, the staff makes the patient comfortable and gathers an essential medical and drug abuse history. Depending on the opiates he or she used, the symptoms of withdrawal will start to kick in after a few hours. For roughly 24 to 48 hours the dominant symptoms include:

  • Cravings for the narcotic
  • Anxiety
  • Abdominal cramps
  • Sweating
  • Fever
  • Vomiting
  • Insomnia
  • Diarrhea
  • Decreased appetite
  • Achy joints

This is the enormous inner struggle of the body purging itself and the brain coping with the radical adjustment. For people who have lived with heroin addiction, the symptoms are particularly acute. Physicians may prescribe a partial opioid agonist such as Suboxone—a mixture of the two drugs buprenorphine and naloxone—to curtail some of these side effects.

Second Stage of Opiate Detox

The next two weeks are generally less acute but still challenging. Depression is the dominant emotion during stage two, and cravings continue to be strong. Patients often experience:

  • Goosebumps
  • Chills
  • Abdominal cramps
  • Nausea
  • Vomiting
  • Diarrhea

Staff at the drug detox center observes patients during this time because they risk becoming dehydrated if they vomit the liquids they drink. They also help patients make sure they’re eating enough to sustain their physical and emotional strength.

Third Stage: The Psychological Stage

For most patients, starting stage three represents a significant ebb in the physical manifestations of withdrawal. Patients will spend the next few weeks or month building the emotional and psychological framework they’ll need to function without narcotics. Patients have to relearn their sleep cycle. People who depended on opiates to relieve their pain will have to learn new strategies for managing their suffering. Patients who achieved, euphoria, escape and excitement from using heroin spend their third stage time learning how to handle the void left when they no longer abuse.

People who’ve progressed this far in their opiate detox benefit from group therapy and individual counseling. Behavioral treatments for opiate addiction include cognitive-behavioral therapy and contingency management preparation. Cognitive-behavioral therapy helps to modify the patient’s drug-use expectations and behaviors. It also helps manage triggers and stress. Contingency management provides motivational incentives, such as vouchers or small cash rewards for positive actions such as staying drug-free. These behavioral treatment approaches are exceptionally successful when used along with medication.


Seeking Help For (required)
SelfLoved One

Select Insurance (required)