Opiate withdrawal symptoms can vary, but many people develop anxiety and restlessness. While you may feel awful at first, the most intense withdrawal symptoms will typically resolve within 4-10 days.[4] Medications like methadone and buprenorphine can also help to ease your anxiety and other withdrawal symptoms.
Common opiate withdrawal symptoms include many symptoms that can cause anxiety, such as these:[1, 2, 3]
If left untreated, opiate withdrawal can lead to a relapse to drug use. While you could try to wait out your anxiety, it’s best to get it treated—for your comfort and safety. Talk to your doctor about Medication for Addiction Treatment (MAT) for opioid use disorder.
Somebody who is going through opiate withdrawal may experience a range of mental health symptoms like generalized anxiety and restlessness. Symptoms of opiate withdrawal anxiety include: [9]
Withdrawal-induced anxiety may range from uncomfortable to extremely distressing, depending on the severity of opiate addiction and dependence, previous withdrawal experiences and mental health status.
One manifestation of opiate withdrawal anxiety is panic attacks. Panic attacks differ from generalized anxiety because they come on suddenly and are characterized by intense fear when there is no identifiable trigger or danger. It is an acute episode that may last for a few minutes and then resolve but those few minutes are incredibly distressing.
The symptoms of a panic attack during opiate withdrawal include: [9]
A person going through opioid withdrawal may experience ongoing generalized anxiety with sudden and unpredictable panic attacks, although they won’t necessarily experience these episodes.
People develop anxiety and other withdrawal symptoms within about 8 to 48 hours of their last opioid dose. [4]
Without treatment, your opioid withdrawal symptoms can last between 4 and 20 days, depending on whether you were dependent on a short-acting opioid like heroin and some other prescription painkillers or a long-acting opiate like methadone. [4]
This doesn’t necessarily mean that your anxiety will last for the entire duration of your withdrawal symptoms—it depends on your mental health, proneness to anxiety and panic and other individual factors.
Medical detox involves 24/7 medical supervision, monitoring and care in a hospital setting and includes opioid withdrawal medications, supportive care and mental health support. Medical detox services can help relieve opiate withdrawal symptoms, including anxiety, restlessness and panic attacks. The medications used during medical detox include: [4]
If you have a co-occurring mental health disorder, such as generalized anxiety disorder or panic disorder, your doctor may prescribe you an antidepressant or anti-anxiety medication that doesn’t have the potential for misuse. These may include selective serotonin reuptake inhibitors (SSRIs) like Zoloft or Lexapro.
While medications are helpful for opiate withdrawal, you can also benefit from other therapies and self-care strategies. These are a few of the options your team might try.
Many people experience dehydration during opiate misuse and withdrawal.[5] A lack of fluids can leave you feeling very anxious. Keep yourself hydrated by drinking at least 2-3 liters of water per day. You should also take vitamin C and B supplements. [4]
Yoga has been shown to help reduce stress and anxiety and can be a great way to supplement counseling and medications for OUD. [8]
Most people associate mindfulness with sitting in “meditation,” but this is a misconception. Mindfulness practices are highly variable and can be as simple as even just a few minutes of gentle breathing exercises. Researchers say mindfulness activities could help people stay sober after treatment for a substance use disorder.[6]
Your body needs rest as you heal. Insomnia is a common part of opiate withdrawal, but if you can sleep, you may feel less anxious. [7] Practice good sleep hygiene while in the process of recovery. This involves turning off all screens and electronics before bed. It could also involve doing a sleep meditation or using essential oils.
Once opiate withdrawal resolves, you may find that you are still experiencing anxiety or panic attacks. This could be a sign of an underlying anxiety disorder that you didn’t know you had—and was likely influencing your opiate misuse. In fact, research indicates that people with anxiety and mood disorders are more likely to misuse opioids than people without one of these mental health conditions. [10]
This is why receiving comprehensive and integrated treatment for both opioid use disorder and co-occurring anxiety or mood disorder is so essential. Both conditions affect one another, and long-term recovery may be difficult to obtain if both disorders aren’t treated concurrently.
Untreated co-occurring anxiety disorder could increase the risk of relapse to opiate use. As such, after you go through opiate detox, it’s important to transition into a dual diagnosis treatment program that can provide you with addiction treatment and mental health services.
Dual diagnosis programs can help you obtain long-term recovery from both conditions by offering many services and therapeutic interventions, such as: [9]
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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