Opioid Detox and Withdrawal: Understanding Signs and Treatment

Medical Providers:
Dr. Michael Vines, MD
Alex Spritzer, FNP, CARN-AP, PMHNP
Clinical Providers:
Natalie Foster, LPC-S, MS
Last Updated: September 15, 2023

Deciding to stop opioids is one of the most courageous decisions a person can make. But for most people, trying to quit without support is where the attempt ends. Not because of a lack of will, but because withdrawal is a physical process the body wasn’t meant to face alone.

Opioid withdrawal is a physical event: it is the nervous system reacting to the sudden absence of a drug it has come to depend on. Managing it safely requires clinical monitoring, the right medications, and a team that knows what to watch for. That’s what medically supervised opioid detox provides.

This page covers what opioid detox involves, what withdrawal symptoms to expect, how long the process takes, and what treatment at Scottsdale Detox looks like.

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Understanding Opioids

What Are Opioids?

Opioids are a class of drugs that bind to receptors in the brain and nervous system, reducing pain perception and triggering feelings of euphoria and calm. They include both prescription medications and illicit substances.

Prescription opioids include oxycodone (OxyContin), hydrocodone (Vicodin), morphine, fentanyl patches, and codeine. Illicit opioids include heroin and illicitly manufactured fentanyl — the substance behind most of today’s overdose deaths.

With regular use, the brain adapts to opioids. It reduces its own natural painkilling chemicals and recalibrates around the drug’s presence. When opioids are stopped, that adaptation becomes a problem: the body goes into a rebound state called withdrawal.

What Are Opioid Withdrawal Symptoms?

Opioid withdrawal is not dangerous in the way many people fear. However, it is genuinely miserable without support, which is why it so often leads to relapse.

Physical symptoms of opioid withdrawal include:

Nausea, vomiting, and diarrhea
Severe muscle aches and cramps
Sweating, chills, and goosebumps
Runny nose and watery eyes
Elevated heart rate and blood pressure
Restless legs and insomnia

Psychological symptoms include:

Intense drug cravings
Anxiety and agitation
Depression
Difficulty concentrating

Symptoms for short-acting opioids (heroin, oxycodone) begin within 6 to 12 hours of the last dose. Long-acting opioids (methadone) may take 24 to 72 hours to produce withdrawal onset.

Common Signs of Opioid Addiction

If someone has been using opioids regularly and is struggling to stop, they may be dealing with opioid use disorder and not just physical dependence.

Signs include:

Using opioids in higher doses or for longer than intended
Continuing despite clear harm to work, health, or relationships
Spending significant time obtaining or recovering from opioid use
Repeated failed attempts to cut back

If any of this sounds familiar, it doesn't mean recovery is out of reach. Getting help is the turning point. Scottsdale Detox is ready when you are.

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Common Signs of Opioid Addiction

How Long Does Opioid Detox Take?

The timeline depends on which opioid a person was using, how long they used it, and the dose.

In general:

1. Short-Acting Opioids (Heroin, Oxycodone, Hydrocodone)

Hours 6 to 24: Early symptoms include anxiety, restlessness, muscle aches, runny nose
Days 1 to 3: Peak withdrawal includes nausea, vomiting, diarrhea, intense cravings, and insomnia
Days 3 to 7: Symptoms begin to improve; psychological symptoms persist longer
Total acute detox: 5 to 7 days

2. Long-Acting Opioids (Methadone)

Methadone withdrawal has a delayed onset and prolonged course. Symptoms may not appear for 24 to 72 hours after the last dose and can persist for 2 to 4 weeks. Medical detox uses a gradual taper to reduce discomfort.

3. Post-Acute Withdrawal Syndrome (PAWS)

Some patients experience mood disturbances, sleep problems, and cravings for weeks to months after acute detox ends. PAWS is managed through ongoing therapy and, in many cases, medication-assisted treatment.

This is why detox is a beginning, not an endpoint. The team at Scottsdale Detox plans for what comes next from day one.

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Opioids Withdrawal Symptoms

What Is Opioid Detox?

Medical opioid detox uses clinical monitoring and FDA-approved medications to manage withdrawal safely, reduce symptom severity, and prevent complications.

Detox is not a treatment for opioid use disorder on its own. It addresses physical dependence (the biological adaptation to opioids), but does not address the behavioral and psychological patterns that drive continued opioid use. It is the first essential step, followed by an appropriate level of ongoing care.

Can Opioid Withdrawal Be Dangerous?

Opioid withdrawal is rarely fatal in otherwise healthy adults. The real danger is relapse: patients who stop opioids and relapse even after a few days of abstinence face significantly higher overdose risk because tolerance has dropped while cravings have not. Many fatal opioid overdoses happen this way.

Medical detox eliminates this risk by providing clinical support through the withdrawal period and transitioning patients directly into ongoing treatment.

Medications and Treatment for Opioid Withdrawal

Three FDA-approved medication categories are used in medically supervised detox:

Buprenorphine (Suboxone): A partial opioid agonist that reduces withdrawal symptoms and cravings without significant euphoria. Can be used short-term for detox or extended as maintenance therapy.
Methadone: A full opioid agonist dispensed under clinical supervision. Eliminates withdrawal symptoms. Used for both acute detox and long-term maintenance.
Clonidine: Not an opioid, but it works to reduce the autonomic symptoms of withdrawal like sweating, agitation, and elevated blood pressure. Used as an adjunct medication.
Naltrexone: An opioid blocker used after detox is complete to prevent relapse by eliminating any opioid effect.

Frequently Asked Questions: Opioid Detox at Scottsdale Detox

Opioid withdrawal is rarely fatal in otherwise healthy adults. The greater risk is relapse: tolerance drops quickly during abstinence, which significantly increases overdose risk if a person returns to opioid use. Medical detox manages this risk by providing clinical support through the full withdrawal period.

It depends on the opioid. Short-acting opioids like heroin and oxycodone typically resolve within 5 to 7 days. Long-acting opioids like methadone can take 2 to 4 weeks. Some patients experience post-acute withdrawal symptoms for weeks to months after acute detox ends.

The most commonly used FDA-approved medications are buprenorphine (Suboxone), methadone, and clonidine. Naltrexone may be introduced after detox is complete to support relapse prevention.

If you are physically dependent on opioids, medically supervised detox is typically the first step before entering residential or outpatient treatment. Scottsdale Detox is part of The Hope House treatment network, which allows for direct transition into the next level of care.

Most commercial insurance plans cover medical detox for opioid use disorder under federal mental health parity law. Call (480) 646-7660 or use the insurance verification form on the Scottsdale Detox website to confirm your coverage before admission.

Yes. Scottsdale Detox admits patients 24 hours a day, 7 days a week. Every patient receives a full medical and psychiatric evaluation on admission, along with an individualized care plan.

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Medical Detox at Scottsdale Detox

For a lot of people, that first call is the hardest part. The team at Scottsdale Detox is ready for it whenever you are, 24 hours a day, 7 days a week. Every patient receives a full medical and psychiatric evaluation on admission, an individualized care plan, and round-the-clock nursing care throughout withdrawal.

The facility is part of The Hope House treatment network, which includes residential treatment, an intensive outpatient program, and HART Rehab. We aim to provide a full continuum of care so patients transition from detox into ongoing recovery without a gap.

Most commercial insurance plans cover medical detox for opioid use disorder under the federal mental health parity law. To verify your coverage before admission, call (480) 646-7660 or use the insurance verification form on the Scottsdale Detox website.