Last updated · How we write and source our guides
Step 1
Different substances, different risks
Opioid withdrawal is often intensely uncomfortable and can increase overdose risk after tolerance falls. Benzodiazepine withdrawal can be medically dangerous. Stimulant withdrawal may involve severe fatigue, depression, or suicidal thoughts.
- Share all substance and medication use honestly
- Ask about medication options
- Plan for treatment after withdrawal
- Keep naloxone available when opioid exposure is possible
Step 2
Detox is a first step
Withdrawal management alone is not the same as ongoing addiction treatment. Before admission, ask how the provider supports a transition into continued care.
Step 3
Opioid withdrawal
According to MedlinePlus, early opioid withdrawal symptoms include agitation, anxiety, muscle aches, tearing, a runny nose, sweating, yawning, and trouble sleeping. Later symptoms include stomach cramps, diarrhea, goosebumps, nausea, and vomiting. Symptoms usually start within about 12 hours of last heroin use and within about 30 hours of last methadone exposure.
These symptoms are very uncomfortable but usually not life-threatening by themselves. The greater danger is that tolerance falls during withdrawal, so returning to a previous dose can cause a fatal overdose. Fentanyl in the drug supply raises this risk further.
Step 4
Medications for opioid use disorder
The FDA has approved buprenorphine, methadone, and naltrexone for treating opioid use disorder. A qualified clinician decides whether one is appropriate. Ask any detox program whether it can start or continue these medications, or connect you with a provider who can.
Step 5
Kratom and 7-OH products
7-hydroxymitragynine (7-OH) is a compound related to kratom that is sold in concentrated products. Addiction professionals have raised concerns about its opioid-like effects, withdrawal risk, and easy availability in New York stores. People who use these products regularly may develop withdrawal symptoms that overlap with opioid withdrawal. Share this use with any provider so they can plan safely.
Step 6
Sedatives and stimulants
If you take benzodiazepines or other sedatives regularly, talk with a clinician before stopping or cutting back. Withdrawal from stimulants can bring exhaustion and low mood. If you or someone you know has thoughts of suicide, call or text 988 right away.
Step 7
Naloxone saves lives
Naloxone can reverse an opioid overdose. Ask a pharmacist or a local program how to get it. Call 911 if you suspect an overdose, even after giving naloxone.
How withdrawal concerns differ by substance (general education, not medical advice)
| Substance type | Main safety concern |
|---|---|
| Opioids (heroin, fentanyl, pain pills) | Severe discomfort; high overdose risk if use restarts after tolerance drops |
| Kratom and 7-OH products | Opioid-like withdrawal; tell providers about all product use |
| Benzodiazepines and other sedatives | Talk with a clinician before stopping or reducing |
| Stimulants (cocaine, methamphetamine) | Exhaustion and low mood; call or text 988 for thoughts of suicide |
Questions to ask a drug detox program
- Can you start or continue buprenorphine or methadone?
- How do you support people withdrawing from kratom or 7-OH products?
- Do you send people home with naloxone?
- What continuing care do you arrange after detox?
Related guides
Continue reading: understand alcohol withdrawal warning signs · plan continuing care after detox · prepare coverage and payment questions
Sources and further reading
- Opiate and opioid withdrawal (MedlinePlus, U.S. National Library of Medicine)
- Information about medications for opioid use disorder (FDA)
- About overdose prevention (CDC)
- What Is 7-OH? The Emerging Opioid Threat Addiction Professionals Need to Understand in 2026 (ISSUP)
- 7-OH Withdrawal: Symptoms, Timeline, and Treatment (ISSUP)
- 7-Hydroxymitragynine (7-OH) and Kratom Withdrawal (ISSUP)
Links are provided for education and do not imply endorsement of this site. Medical information should be reviewed with a qualified professional. See all authoritative sources.