Opioid withdrawal timeline — and why you shouldn't do it alone
Stopping opioids — heroin, oxycodone, codeine, morphine, methadone — after dependence sets in produces a withdrawal syndrome that is famously miserable: often described as the worst flu of your life, combined with crushing anxiety and cravings.1
Unlike alcohol withdrawal, opioid withdrawal is rarely life-threatening on its own. But it is severe enough that most people cannot get through it without help — and the period right after carries its own danger. Here is the timeline, and the safe way through it.
Last reviewed July 6, 2026
The opioid withdrawal timeline
- 6–12 hours
Early withdrawal (short-acting opioids)
After heroin, oxycodone or similar short-acting opioids, symptoms usually begin within 6–12 hours: anxiety, agitation, muscle aches, insomnia, yawning, sweating, and a runny nose and tearing eyes.1 Long-acting opioids like methadone start later — typically 24–48 hours after the last dose.1
anxietymuscle achesinsomniasweating - 36–72 hours
The peak
Symptoms typically peak around 36–72 hours: nausea and vomiting, diarrhea and abdominal cramps, dilated pupils, goosebumps, rapid heartbeat and intense cravings. This is the hardest window — and the point where medical support matters most.1
nauseadiarrheacrampsintense cravings - 5–10 days
Acute symptoms ease
For short-acting opioids, the worst physical symptoms usually subside over about 5–10 days. Methadone withdrawal runs longer and slower, reflecting its long half-life.1
improving - Weeks to months
Turn day one into a streak you can see
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The treatment that actually works
Detox alone — getting through withdrawal — is not treatment for opioid use disorder, and relapse afterward is common. What works is ongoing medication: methadone or buprenorphine relieve withdrawal and cravings, and naltrexone can follow once detox is complete.1 Buprenorphine must be timed carefully by a clinician, because starting it too early can precipitate withdrawal rather than relieve it — one more reason this should be medically supervised.1
SAMHSA lists medications for opioid use disorder alongside counseling and recovery support as the standard treatment options, available through opioid treatment programs and, increasingly, regular medical practices.2
Common questions
How long does opioid withdrawal last?
For short-acting opioids like heroin, symptoms start in 6–12 hours, peak around 36–72 hours, and ease over about 5–10 days. Methadone withdrawal starts later (24–48 hours) and lasts longer. Lingering cravings and low mood can persist for weeks.1
Can you die from opioid withdrawal?
Unlike alcohol withdrawal, opioid withdrawal itself is rarely fatal — but it is severe, and the danger shifts to after: lost tolerance means a relapse dose can cause a fatal overdose. That is why medical supervision and ongoing treatment matter more than white-knuckling detox.12
Count the days once you're stable
Once you're through the acute phase with proper care, Day One helps you protect the streak you fought for. Free on iPhone.
Keep reading
Sources
This guide is educational and is not medical advice. Timelines vary from person to person. If you are quitting heavy alcohol use, or have a medical condition, talk to a doctor before you stop — some withdrawals can be dangerous. In the US you can reach the free, confidential SAMHSA National Helpline at 1-800-662-4357, or call or text 988.