Fentanyl Withdrawal & Detox

Last Updated: May 30, 2023

Editorial Policy | Research Policy

The opioid epidemic affects people throughout the state of Washington. Fentanyl overdoses increased by 70 percent in Washington during the first half of 2018 and overall opioid overdose death rates increased by 77 percent.

Fortunately, people who want to overcome fentanyl addiction can get the treatment they need. The Recovery Village Ridgefield offers medically supervised fentanyl detox as well as residential, partial hospitalization and outpatient programs. These integrated programs can address co-occurring mental health conditions and the medical complications of fentanyl withdrawal.

Fentanyl Withdrawal

The way fentanyl use changes the brain over time causes people to experience psychological and physical fentanyl withdrawal symptoms when they stop taking the substance. When people repeatedly use fentanyl, opioid receptors in the brain respond less strongly to it, requiring people to take more fentanyl to achieve the same effect. Some people start using fentanyl after another, less potent opiate stops working for them.

As people become dependent on fentanyl, some regions of the brain become more active and others become less active. Withdrawal symptoms occur in part due to increased amounts of noradrenaline in the brain, which impacts the digestive, cardiovascular and central nervous systems. Signs of fentanyl withdrawal include flu-like physical symptoms and psychological symptoms including heightened anxiety and paranoia. In extreme cases, people can even experience hallucinations and other psychotic symptoms during fentanyl withdrawal.

Fentanyl Withdrawal Symptoms

Fentanyl withdrawal symptoms reflect a combination of understimulated opioid receptors and excess noradrenaline. Fentanyl detox symptoms can include the following:

  • Anxiety
  • Tremors
  • Sweating
  • Insomnia
  • Diarrhea
  • Runny nose
  • Watery eyes
  • Muscle spasms
  • Fever and chills
  • Stomach cramps
  • Nausea and vomiting
  • Yawning and sneezing
  • Restlessness and agitation
  • Muscle soreness and stiffness

Early withdrawal or detox symptoms usually peak in a week and fully dissipate within a month. Learning about the fentanyl detox timeline can help people navigate the detox process and know what to expect as their recovery progresses.

Fentanyl Detox Timeline

There are three main phases in the fentanyl withdrawal timeline:

  1. Acute
  2. Residual
  3. Post-acute

When it comes to fentanyl withdrawal symptoms, duration of each phase and symptom can vary significantly from person to person. Most people experience acute withdrawal symptoms in the first week, but not everyone experiences post-acute withdrawal symptoms.

  • The acute phase of fentanyl detox typically starts 12 to 24 hours from the time a person last used fentanyl and lasts for about five days. Early withdrawal symptoms can be subtle, like mental or physical unease and restlessness. From the third to the fifth days of detox, acute symptoms peak. This time is when people typically experience the worst flu-like symptoms of fentanyl withdrawal, which include chills, fever, muscle aches, diarrhea and muscle pain.
  • The residual phase of fentanyl withdrawal starts at the end of the first week of detox and usually lasts for one to two weeks. Physical withdrawal symptoms typically improve during this period, though some can persist, including nausea and muscle pain. Psychological symptoms, like depressed mood and anxiety, usually dominate the residual withdrawal phase. Some people experience more severe symptoms like paranoia, panic attacks and suicidal thoughts. It is essential for people to receive adequate social support and mental health care during this phase of detox.
  • For many people, most or all withdrawal symptoms stop by the end of the third week. However, some people experience post-acute withdrawal symptoms that can last for weeks or even months. People who have used fentanyl in large amounts over long periods or people with underlying medical, neurological or mental health conditions are at increased risk for post-acute withdrawal syndrome (PAWS).

Long-term changes to brain chemistry result in PAWS symptoms which persist as the brain recovers its previous level of functioning. In the recovery community, many people say that the first 90 days of recovery are the hardest and are when people need the most support. Formal research supports that time frame and shows that the brain’s reward system returns to normal functioning after two to three months of abstinence from opioid use.

Some people experience symptoms of PAWS for as long as one to two years. However, other factors can affect how long PAWS lasts. Having the right support makes a difference. Recovery from addiction can inspire people to confront other things in their lives that need to change, which can increase stress levels and affect how people feel about themselves. Receiving peer support and counseling can help people process their feelings and fears and cope with them.

Symptoms of anxiety and depression don’t always indicate PAWS. Co-occurring mental health disorders are common for people with substance use disorders and require additional support and treatment to address. Fortunately, just as people can recover from addiction, they can also recover from psychiatric conditions.

Finding a Fentanyl Detox Treatment Center in Washington & Oregon

The potency of fentanyl can make the early withdrawal period especially intense. Early withdrawal is not only uncomfortable, but it can also be dangerous to try to detox without professional help. Fortunately, there are multiple sources for fentanyl detox treatment in Washington and Oregon.

The Recovery Village Ridgefield Detox Center

5114 NE 94th Ave Vancouver, WA 98662 (877) 800-0264

Some individuals start their recovery journey in the emergency room. Most hospitals in Washington and Oregon can help patients get through the acute withdrawal phase safely. However, people who leave a hospital or other medical detox facility are at risk of resuming opioid use if they don’t have ongoing support. People experience the best outcomes when they follow admission to medically-supervised detox with inpatient or outpatient treatment.

At The Recovery Village Ridgefield, people can receive detox and treatment in the same facility with support from the same clinical team. If you are looking for a fentanyl detox and treatment center in the state of Washington, please contact The Recovery Village Ridgefield to learn more and get help finding the right program to facilitate your recovery from fentanyl addiction.


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    Blethen, Ryan. “Huge Rise in Overdose Deaths, in Washington State and the Nation, from Fentanyl, Which Can Kill Even in Tiny Doses.” The Seattle Times. Published December 5, 2018. Retrieved February 16, 2019.

    University of Washington Alcohol and Drug Abuse Institute. “Opioid Trends Across Washington State.” Updated October 9, 2018. Retrieved February 16, 2019.

    Kosten, Thomas R., and George, Tony P. “The Neurobiology of Opioid Dependence: Implications for Treatment.” National Institute on Drug Abuse Science and Practice Perspectives, 1(1): 13-20. Published July 2002. Retrieved February 16, 2019.

    Wolters Kluwer Health: Lippincott Williams and Wilkins. “People with Opioid Dependence in Recovery Show ‘Re-Regulation’ of Reward Systems.” ScienceDaily. Published December 9, 2014.  Retrieved February 16, 2019.