What are the Symptoms of Fentanyl Withdrawal?

Fentanyl is a powerful synthetic opioid used mainly for pain management. Unfortunately, it has also become a major contributor to the opioid crisis. ^[1] This is due to its potency and high potential for addiction. Although fentanyl can provide rapid and effective relief, if you stop using it suddenly, it can lead to fentanyl withdrawal. The risk of withdrawal is especially high after prolonged or heavy consumption. 

By understanding fentanyl withdrawal symptoms, you can help anyone, yourself, or a loved one safely get off fentanyl. In this article, you will learn about the symptoms, the risks involved, and all the treatment options that are available to support recovery.

What is Fentanyl Withdrawal?

Fentanyl withdrawal occurs when a person who has been taking fentanyl on a regular basis suddenly stops taking the drug or reduces its dose. As fentanyl strongly affects the opioid receptors in the brain, the body tends to become physically dependent on it. When fentanyl is removed, the body responds with a series of physical and psychological symptoms. This is because it tries to adjust and function without the drug.

Fentanyl withdrawal can vary in severity and duration based on many factors. Some factors that alter withdrawal symptoms include how long a person has used fentanyl, the dosage, and individual physiology. Some people may only experience mild symptoms, while others may go through severe and distressing symptoms.

What Are the Withdrawal Symptoms of Fentanyl?

Fentanyl withdrawal symptoms usually occur within a few hours to one day after taking the last dose. It can then go on to last for several days or even weeks. These symptoms can be divided into two phases, the early or acute phase and late or protracted withdrawal phases [2].

Early Withdrawal Symptoms (within 12-24 hours)

• Muscle aches and pains: Intense cramping and body pain are common, resembling flu symptoms.
• Restlessness and agitation: Many people feel extremely anxious or restless.
• Insomnia: Difficulty falling asleep or staying asleep is common.
• Sweating: Profuse sweating, often cold sweats, occurs.
• Runny nose and watery eyes: Similar to cold or flu symptoms.
• Yawning: Frequent yawning is a classic withdrawal sign.
• Dilated pupils: Pupils may become larger than normal.
• Increased heart rate and blood pressure: The body is in a hyper-aroused state.
• Chills and goosebumps: “Cold turkey” symptoms like shivering and goosebumps are typical.
  

Late Withdrawal Symptoms (after 24 hours, up to weeks)

• Nausea, vomiting, and diarrhea: Gastrointestinal distress is common and often severe.
• Abdominal cramping: Intense stomach pains occur alongside nausea.
• Cravings for fentanyl: A strong urge to use the drug again.
• Depression and mood swings: Emotional symptoms can be intense.
• Fatigue and weakness: Despite insomnia, there is often overwhelming tiredness.
• Difficulty concentrating: Cognitive function may be impaired.
• Increased sensitivity to pain: People may feel heightened pain sensitivity.
  

Can You Die From Fentanyl Withdrawal?

Fentanyl withdrawal can be extremely uncomfortable and dangerous in certain situations. But fortunately, it is rarely fatal on its own. Unlike the withdrawal that occurs when abstaining from alcohol or benzodiazepines, opioid withdrawal does not lead to death in most cases.

However, this does not mean that the risks are negligible. Serious complications can still occur from severe dehydration secondary to vomiting and diarrhea. Other coexisting underlying health conditions may pose serious health threats when present in those going through opioid withdrawal. Furthermore, the distressing symptoms of opioid withdrawal can even push people to relapse and use fentanyl again. This can then lead to overdose, especially if their level of tolerance has decreased.

It is for these reasons that it is strongly recommended that people going through fentanyl withdrawal be under constant medical supervision. This is especially applicable to those with preexisting health problems or long-term fentanyl use.

How to Get Off Fentanyl Without Withdrawal?

Getting off fentanyl without the withdrawal symptoms is quite difficult due to the drug’s potency and physical dependence. However, there are several strategies that can be tried to minimize the withdrawal symptoms and improve comfort during detox.

Medical Detoxification

The first step to safely and effectively getting off fentanyl is by going through medically supervised detox. Under the supervision of healthcare professionals who continuously monitor symptoms and use medications to safeguard during withdrawal, detox can be a smooth process. ^[2] Some medications commonly used during withdrawal are:

• Methadone or buprenorphine: These are opioids that can help ease withdrawal by gradually reducing overstimulation of opioid receptors’ without the high sensation.
• Clonidine: This is a medication that reduces some withdrawal symptoms such as anxiety, sweating, and agitation.
• Anti-nausea and anti-diarrheal drugs: Taking these can help control gastrointestinal symptoms.

Tapering Off

Instead of trying to quit suddenly, or what people call going “cold turkey,” tapering involves a gradual reduction of fentanyl dosage over time. This helps slow the adjustment process of the body and makes withdrawal symptoms milder. A healthcare provider can help you create a tapering schedule that is customized to the needs of each person.

Supportive Care

Apart from medical treatments, supportive care is also equally important. Adequate hydration, nutrition, rest, and emotional support can help further ease withdrawal symptoms.

Behavioral and Psychological Support

Counseling, cognitive-behavioral therapy, and support groups can help manage cravings. The underlying addiction triggers can help improve long-term success.

Why is Fentanyl Withdrawal Different From Other Opioids?

Fentanyl is about 50 to 100 times more potent than morphine. This means it binds very strongly to opioid receptors. Its high potency makes withdrawal more intense and harder to manage than the withdrawal that occurs from other opioids such as heroin or oxycodone. Additionally, the shorter half-life of fentanyl means withdrawal symptoms can start very quickly after the last dose. It can sometimes start within just a few hours.

When Should You Seek Help?

If you or a loved one is going through fentanyl withdrawal, it is extremely important that you seek professional help. Feel free to reach out to Drughelpline.org by calling their helpline for immediate support.

However, there might be signs Signs that immediate medical attention is necessary include:

• Severe dehydration from vomiting or diarrhea
• Rapid heartbeat or chest pain
• Confusion or hallucinations
• Suicidal thoughts or severe depression
• Inability to keep fluids down or severe weakness