Opioid Detoxification: What to Expect

Detoxification from opioids involves removing opioids from the body and managing withdrawal symptoms. It is the first step toward recovery from opioid use disorder (OUD). Knowing what to expect during this process can make it easier to prepare and stay committed to recovering.¹

What is opioid detoxification?

Detoxification, or detox, is the process or period of time when a person stops using an opioid they have become physically dependent on. When your body suddenly stops receiving a substance it depends on, such as opioids, you can have withdrawal symptoms.^1-3

Withdrawal symptoms can be very uncomfortable. Sometimes they can be dangerous. This is why opioid detox is often done under medical supervision.^2,3

Why is detox important?

Detox is a necessary step for recovery from OUD. It clears the body of opioids and helps reduce cravings. It gives people a chance to focus on their health and recovery.^1,2

The goals of medical detox are to:²

• Clear the body of its dependence on opioids
• Lessen the intensity of withdrawal symptoms
• Connect people with the right support services they need to continue treatment
• Prevent relapse

Detox alone is not a complete treatment for OUD. It is only one aspect of a long-term treatment process that should involve medicines for OUD, counseling, and support services.^1-3

What are opioid withdrawal symptoms?

When someone stops using opioids, the body needs time to adjust. This causes withdrawal symptoms. Withdrawal symptoms usually start within 12 hours after the last dose of a short-acting opioid. For long-acting opioids, symptoms may start within 30 hours.^1,3

Common withdrawal symptoms include:^1,3

• Anxiety
• Restlessness
• Stomach cramps or diarrhea
• Nausea or vomiting
• Muscle aches
• Sweating and chills
• Difficulty sleeping

These symptoms usually peak within a few days and begin to improve after about 1 week. But some people experience milder symptoms for weeks or even months. This is called post-acute withdrawal syndrome (PAWS for short).⁴

How is detox done?

Detox can be done in different settings, such as a hospital, clinic, or at home with medical guidance. The choice depends on the severity of the addiction and the person’s health.^2,3

Medically supervised detox

In a medically supervised detox, healthcare professionals monitor the person closely. This is safest for people with severe OUD or other coexisting health conditions.^2,3

Medicines may be used to ease withdrawal symptoms and reduce cravings. Common medicines used during the detox process include:^1-3

• Methadone helps lessen the intensity of withdrawal symptoms and can shorten detox. It is also used for long-term maintenance treatment for OUD.
• Buprenorphine can shorten the length of detox. Like methadone, it is also used for long-term maintenance treatment for OUD.
• Clonidine helps relieve withdrawal symptoms such as nausea and vomiting, muscle aches, sweating, and stomach cramping.
• Naltrexone helps prevent relapse. Note that a person must not have opioids in their system when taking naltrexone.

Outpatient detox

In outpatient detox, people visit a clinic or doctor regularly. They receive medicines and support but do not stay overnight. This option works well for those with mild to moderate OUD and a strong support system at home.^2,3

At-home detox

Some people choose to detox at home with guidance from a doctor. This method is less expensive but can be riskier without medical supervision. It is strongly recommended to have a support person there to help you if you choose to detox at home.^2,3

How to prepare for detox

Being prepared can make the detoxification process smoother. Here are some things you can do to prepare yourself or your loved one before detoxing:^1-4

• Talk to a doctor or healthcare professional – They can assess your health and recommend the best detox plan for you.
• Have a support plan – Having family, friends, or other support people available during a detox is critical. Support groups can also help during this time.
• Prepare for discomfort – Understand that withdrawal symptoms are temporary. While they are anything but pleasant, remind yourself that they will pass.
• Take care of your body – Stay hydrated and eat a balanced diet. This can help support your body as it adjusts to being without opioids.

If you feel overwhelmed or unsafe at any point during the detox process, seek medical help. Signs you may need immediate medical care are:^1,3

• Severe vomiting or diarrhea
• Inability to keep liquids down, resulting in severe dehydration
• Intense anxiety or depression
• Thoughts of self-harm

What happens after a detox?

Detox is only the first step. To stay in recovery, additional treatment is necessary. This includes:^1-3

• Medications for opioid use disorder (MOUD)
• Counseling or therapy
• Support groups
• Complementary and integrative medicine
• Lifestyle changes

When to get help

Detoxing from opioids is a serious matter. Opioids are addictive and quitting can be extremely difficult. But you do not have to go through it alone. Reach out to healthcare providers and support networks to help you on your path to recovery.