Spontaneous Withdrawal – What It Is and How to Manage It


Key Takeaways

  • Spontaneous withdrawal occurs when opioid use is suddenly reduced or stopped.
  • Symptoms include anxiety, nausea, insomnia, muscle aches, and severe cases can cause seizures.
  • Management involves medications, hydration, and mind-body therapies to ease symptoms.
  • Medically supervised withdrawal programs minimize risks and help manage symptoms effectively.

Deciding to stop taking opioids and get sober can be one of the best decisions of your life.

However, you need to be very careful going about your abstinence because it can trigger spontaneous withdrawal.

It’s defined as a condition that occurs in patients who are addicted to a particular substance and suddenly stop taking it or reduce their consumption.

That means whether you lower your drug intake or stop completely, you might experience unpleasant symptoms that could push you to relapse.

Here’s why spontaneous withdrawal happens and how to manage or minimize its effects.

How Does Spontaneous Withdrawal Happen?  

Spontaneous withdrawal happens if you’re suffering from opioid use disorder and try to cut back or quit abruptly.

The unpleasant symptoms you experience are caused by withdrawal, which is the loss of the chemical balance created by the substance in your system.

The severity of spontaneous withdrawal symptoms depends on several factors, such as:

  • How long you’ve been taking the opioids
  • The type of opioid drugs you’ve taken
  • Opioid dosage
  • Your metabolism, which determines how quickly your body processes drugs

Symptoms of Spontaneous Withdrawal

When you first go through spontaneous withdrawal, you might experience symptoms such as the following:

  • Anxiety
  • Irritability
  • Insomnia
  • Fatigue and muscle aches
  • Nausea, vomiting, and diarrhea
  • Sweating, chills, and fever
  • Headaches

However, severe cases of spontaneous withdrawal can regress to serious complications such as seizures, hallucinations, and even death.

Why Does It Happen?

Opioids have different effects, one of which is causing a feeling of relaxation and euphoria by triggering the reward and pleasure centers of the brain.

Whenever you take opioids, your body releases endorphins, the feel-good chemicals, which is why you often find yourself craving them.

However, when you take opioids for too long or take them in larger doses than you should, your body starts to get addicted to the euphoria and constant rush of endorphins.

The opioid receptors in your central nervous system become dependent on opioids to function.

If you stop taking them abruptly or reduce your intake, you can become sick and start experiencing withdrawal symptoms because you can’t function properly without them.

How Long Does It Last?  

How soon and how quickly you might fall into withdrawal depends on the opioids’ duration of action. For example:

  • Short-acting Opioids (Oxycodone, Heroin): You might experience withdrawal within 8-24 hours of your last dose. They’ll usually peak within two days and fade within 4-10 days.
  • Long-acting Opioid Agonists (Methadone): It takes about 12-48 hours for symptoms to start and lasts for 10-20 days.

Even after you’ve safely gone through withdrawal, you might continue to experience a general feeling of unpleasantness or continue to crave opioids on and off for up to six months.

Managing Spontaneous Withdrawal


A wide range of prescription and over-the-counter medications can help you manage your symptoms. Here are a few examples:

  • Loperamide (Imodium): An over-the-counter treatment for diarrhea
  • Methadone and Buprenorphine: Prescription-only medication that can help lower your opioid cravings
  • Lofexidine: A prescription medication that blocks certain hormones that contribute to withdrawal symptoms
  • Clonidine: A prescription medication that can help with gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain.

Naltrexone is another drug that’s often prescribed to reduce opioid cravings, but it doesn’t improve withdrawal symptoms.

Naltrexone can make the symptoms worse at first before you start to see any kind of improvement.

Most of these drugs are prescribed at a clinic, doctor’s office, or rehab facility where you can undergo medically supervised opioid withdrawal.

Stay Hydrated

Sweating, vomiting, and diarrhea are all common symptoms of spontaneous withdrawal that can easily lead to dehydration.

You can also lose precious minerals such as sodium and potassium, leading to electrolyte imbalance.

To rehydrate, drink plenty of fluids, such as fruit juice and water. You can also try sports drinks to replace any lost electrolytes.

Mind-body Therapies

Try doing mind-body therapies such as yoga and meditation to help you relax and ease through withdrawal-associated pain.

Getting a massage can help with muscle aches and spasms, as well.  

Spontaneous Vs. Precipitated Opioid Withdrawal

Unlike spontaneous opioid withdrawal, which happens when you stop taking opioids, precipitated withdrawal is caused by treatment rather than abstinence.

It could happen when you first start taking drugs like:

  • Suboxone
  • Subutex
  • Naltrexone
  • Naloxone

Symptoms of precipitated withdrawal are similar to those of spontaneous withdrawal, but their severity mainly depends on the type of opioids you were on before starting medication-assisted treatment.

However, regardless of which opioid you’ve taken, the one common feature they all have is the fast onset of symptoms.

How Does Precipitated Withdrawal Happen?

When you take an opioid drug like morphine, for example, it circulates the bloodstream until it comes across opioid receptors in your nervous system.

Being an opioid agonist, it then binds to these receptors and starts causing pain relief, euphoria, relaxation, slowed breathing, and other effects.

After taking opioids for a long time or in large quantities, your body starts getting used to the constant effects of these drugs.

If you start taking medication like Naloxone, which is an opioid antagonist, it blocks these receptors, preventing all the effects of opioids.

It’s as if you’ve suddenly removed all traces of opioids from your body instead of gradually weaning off of them.

This causes naloxone-precipitated withdrawal, where the naloxone binds to opioid receptors so powerfully that your body almost immediately goes into severe withdrawal symptoms.

How To Minimize Chances of Withdrawal

The best way to minimize the chances or severity of spontaneous withdrawal is to join an opioid treatment program.

These rehab programs allow you to go through medically supervised withdrawal, where trained professionals monitor you and help manage your symptoms.

They can also determine the best time for you to start taking opioid addiction medication based on your symptoms so you can avoid precipitated withdrawal.

To determine this, doctors often use the COWS (Clinical Opiate Withdrawal Scale).  

Clinical Opiate Withdrawal Scale

COWS is a valuable screening tool that clinicians use to determine the severity of your withdrawal by assigning each symptom a score, typically from 0 to 4 or 5.

The doctor then adds the numbers and uses the final score to determine how far along you are in withdrawal and the level of your opioid use disorder.

Get Help for Opioid Use Disorder Today…

Choosing to quit opioids is the right decision; just make sure you choose the right time and method to do it so you don’t go into withdrawal too soon or in dangerous circumstances.

If you’re uncertain how to do so, book an appointment with Curednation’s telemedicine service, and we’ll guide you through the process.


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