When someone is going through opioid withdrawal, you may hear people refer to this syndrome as dope sick, the slang or colloquial term for it, often referenced in pop culture.
While dope sickness is not typically life-threatening, the symptoms can be extremely distressing and painful. This may cause people to return to opioid misuse in order to alleviate the symptoms and feel better. Medication for Addiction Treatment (MAT) is one of the best ways to alleviate dope sickness, prevent complications, and ensure comfort and safety when quitting opioids like fentanyl, oxycodone, hydrocodone, and heroin.
Dope sick is slang for opioid withdrawal, which occurs after a person has become dependent on opioids and then suddenly stops taking them. Dope sickness happens because the brain and body has adapted to the presence of opioids and now needs them to function properly.
Opioid withdrawal isn’t typically deadly, although it can be extremely uncomfortable. It is often what triggers relapse once a person attempts to stop misusing opioids. The discomfort of withdrawal is so intense that the person simply uses opioids again to make it go away.
When a person uses opioids, the drugs attach to specialized receptors in the brain called mu-opioid receptors.[1] Those receptors are turned on and produce analgesic and euphoric effects.
Over time, the body becomes used to having these receptors permanently “on” because of the constant presence of opioids. When a person stops taking opioids suddenly, all of those receptors are turned off, causing a reverse reaction of withdrawal (or dope sickness).
Opioid withdrawal symptoms, also called dope sick symptoms, can include the following:[2]
Opioid withdrawal is often described as flu-like. While it isn’t generally hazardous (though some symptoms like dehydration can be dangerous), it may be so uncomfortable or unpleasant that it needs medical treatment.
This may involve medical detox in a hospital or inpatient detox setting, which involves 24-hour care, withdrawal medications, and supportive treatment. The most common medications for opioid withdrawal are methadone, buprenorphine, and Suboxone (a combination of buprenorphine/naloxone) although you already have to be feeling dope sick when you start taking buprenorphine or Suboxone.
The timeline for dope sickness depends on the type of opioid most commonly used as well as the dosage, duration of use, and method of administration (e.g. snorting or injecting).[3]
For short-acting opioids like heroin and immediate-release prescription painkillers, withdrawal generally begins within 6-12 hours after last use. Dope sick symptoms peak within one to three days, and they generally dissipate after about a week.[8]
Time After Last UseExperience6-12 hoursDope sick symptoms emerge1-3 daysSymptoms peak in severity5-7 daysSymptoms gradually resolve
For long-acting opioids like methadone or extended-release prescription opioids, dope sickness may take 2-4 days to appear and about 10-20 days to resolve. [8]
Time Since Last UseExperience2-4 daysDope sick symptoms emerge5-8 daysSymptoms peak in intensity10-20 daysSymptoms dissipate and resolve
In the case of both short-acting and long-acting opioids, once acute withdrawal resolves, many people experience lingering symptoms known as post-acute withdrawal symptoms or protracted withdrawal. These symptoms may include: [8]
Because these symptoms can last for weeks, months, or even years, it’s especially important to have ongoing support in the form of therapy, treatment programs, or support groups.
The best way to prevent dope sickness is to seek out medical detox services. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends a 24-hour detox setting for those withdrawing from opioids due to how severe and painful these symptoms often are. Medical detox settings may include:
Within a medical detox program, you’ll receive many interventions to help manage your dope sickness while keeping you safe and comfortable. These interventions may include:[4],[6]
There are several FDA-approved medications to treat dope sickness.[4]
The two primary MAT options that prevent and manage opioid withdrawal symptoms are methadone and buprenorphine. Both of these medications mitigate symptoms, reduce cravings, and help prevent complications.
Suboxone is a combination of buprenorphine and naloxone, an opioid antagonist that deters misuse. Suboxone is considered the gold standard medication for opioid use disorder (OUD).[5]
Some individuals may choose to go through withdrawal without medications, but this is generally not recommended by experts since it makes relapse much more likely.
If you’re not sure how to access MAT, a good first step is to use SAMHSA’s National Helpline or a similar resource to find out more about your options and the treatment resources in your area.[7] The helpline, available at 1-800-662-4357, is a free, confidential resource. You can call it to get referrals to local treatment facilities, support groups and community-based organizations.
You can also speak to your primary care doctor directly, or reach out to us at Bicycle Health for more information about how to access Suboxone therapy.
Remember that medication on its own is not enough. Therapy is recommended to address underlying issues that contributed to OUD.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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