How to Ease Withdrawal Insomnia During Recovery

The Three Stages Of Opiate Withdrawal

How to Ease Withdrawal Insomnia During Recovery

Opioids are a class of drugs including heroin, synthetic opioids, and prescription painkillers. Opiates specifically are opioids naturally derived from the poppy plant. These drugs are often used to treat pain and slow down the central nervous system.

Some common examples of opiates and opioids include:

  • oxycodone (Oxycontin or Percocet)
  • morphine
  • codeine
  • Hydrocodone (Vicodin)
  • methadone
  • heroin
  • fentanyl

While opioids are effective in treating pain, they are habit-forming and can quickly lead to dependence. In the United States, an estimated 1.6 million people had an opioid use disorder in 2019.1

Opiate Withdrawal Symptoms

Because long-term misuse of opioids can lead to tolerance and dependence, when someone stops using these drugs, their body and brain struggle to adjust. The result is often a series of uncomfortable symptoms known as opioid withdrawal that can last several days or longer.

Some common opiate and opioid withdrawal symptoms include:

  • aches and pain
  • sweating or chills
  • nausea
  • vomiting or diarrhea
  • insomnia
  • mood swings
  • anxiety

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How Long Does Opiate Withdrawal Last?

The opioid withdrawal timeline and the symptoms vary from person to person as well as from opioid to opioid.

Most people on short-acting opioids codeine, hydromorphone, oxycodone, and morphine will begin experiencing the first signs of opiate withdrawal within 8 to 24 hours after they last took the drug.

These symptoms will peak after a one to three days and then start to fade after about a week when acute opiate withdrawal ends.2,3

In contrast, long-acting opioids extended-release and controlled-release tablets of these drugs have a slightly different opioid withdrawal timeline with symptoms beginning as late as 36 hours after the last dose, peaking on day 3 and 4, and going away closer to the 2-week mark. In both case, psychological symptoms may persist for weeks or months later. 3

Opiate Withdrawal Timeline

Although everyone is unique, there are some distinct stages of opioid withdrawal the symptoms themselves and  their intensity. The stages of opiate withdrawal include early withdrawal, peak period, late acute withdrawal, and post-acute withdrawal.

Stage 1: Early Withdrawal

Short-Acting Opioids: Starting within 8-24 hours

Long-Acting Opioids: Starting after 36 hours

While the opiate withdrawal timeline varies, the first stage of opiate withdrawal typically begin within 8 to 24 hours after the last use for short-acting opiates or closer to 36 hours for long-acting prescription opiates.

Early opiate withdrawal symptoms generally include:

  • a runny nose
  • tearing up
  • excessive sweating
  • chills
  • goosebumps
  • muscle and joint pain
  • stomach cramps
  • anxiety
  • insomnia

Stage 2: Peak Period

Short-Acting Opioids: Days 1-3

Long-Acting Opioids: Days 3-4

During this stage, symptoms from early opiate withdrawal tend to grow in intensity over the next several hours and new symptoms also arise. After one to three days for short-acting opioids and three to four days for long-acting opioids, the severity of these symptoms usually hits their peak.

Symptoms during this stage of opiate withdrawal tend to be both physical and psychological. At this point, the person may feel flu- as well as emotionally distressed. It is important for people to maintain adequate levels of hydration and nutrition as well as have emotional support.

Peak opiate withdrawal symptoms include:

  • rapid breathing
  • racing heart
  • nausea and vomiting
  • diarrhea
  • fever
  • depression
  • mood swings
  • intense drug cravings

Stage 3: Late Acute Withdrawal

Short-Acting Opioids: Ends around days 7-10 

Long-Acting Opioids: End after up to 2 weeks

In the last stage of acute opiate withdrawal, physical symptoms will begin to wane, so a medical detox will near its end. On the other hand, some psychological symptoms may linger or new ones may even arise.

Symptoms of late acute opioid withdrawal include:

  • drug cravings
  • irritability
  • anxiety
  • restlessness
  • depression
  • insomnia

Post-Acute Withdrawal Syndrome

Lasts weeks to months later

Post-acute withdrawal syndrome is the part of the timeline for quitting opiates where the physical symptoms tend to all be gone, but psychological symptoms remain or come and gone. Because these symptoms may last weeks or even months, additional opioid addiction treatment is often needed after detox to help the person maintain their abstinence from opiate use.

Post-acute withdrawal symptoms may include:

  • sleep problems or disturbances
  • anxiety or panic
  • depression
  • mood swings
  • irritability
  • increased sensitivity to stress

Factors Impacting the Opiate Withdrawal Timeline

The exact opiate withdrawal timeline can vary widely because its length as well as the symptoms depend on several variables.

Some factors that can impact the opiate withdrawal timeline include:

  • type of opioid
  • route of administration
  • severity of addiction
  • tolerance
  • regular dosage
  • polysubstance abuse
  • previous opioid use
  • state of mental health
  • overall health
  • medical history
  • care during detox

Medications To Assist In Opiate Withdrawal

Even in more mild cases, the opiate withdrawal timeline can be an incredibly uncomfortable and trying time for someone. While many people tend to be wary of the idea of using other drugs during the detox process, doctors may prescribe or recommend medications as needed to provide a safer and more beneficial experience for the patient.

In particular, medication-assisted therapy (MAT) uses certain FDA-approved medications buprenorphine, methadone, and naltrexone to help ease psychological cravings, reduce withdrawal symptoms, and block the euphoric effects of opioid use.

Getting Help

While these medications can make opiate withdrawal more manageable, detox is only the first step.  Additional treatment is often necessary to address the emotional and psychological aspects of addiction. Our residential addiction treatment in Texas provides a safe and comfortable environment for patients to overcome these lingering symptoms and build a foundation for lasting recovery.

At Vertava Health Texas, formerly The Treehouse, we want to be here for you and your loved ones. To learn more about our programs, contact us today.


What To Do If Your Loved One is Experiencing a Withdrawal

How to Ease Withdrawal Insomnia During Recovery

Did you know that the relapse rate for individuals struggling with substance use disorders is relatively high? The rate is estimated to be between 40 percent and 60 percent.

A few factors influence the severity of withdrawal:

  • Level of dependency 
  • Length of time abusing the substance
  • Type of substance abused
  • Method of abuse (e.g., snorting, smoking, injecting, or swallowing)
  • Amount used each time
  • Family history and genetic makeup
  • Medical and mental health factors

Learn more about withdrawal and how you can help your loved one below. 


Substance withdrawal is the development of a substance-specific maladaptive behavioral change. Typically, your loved one experiences uncomfortable physiological and cognitive consequences, which results in a reduction in, heavy and prolonged substance use. 

A withdrawal occurs due to the brain's production of neurotransmitters being suppressed from addictive substances. Drugs, including alcohol, are depressants. This means the substances reduce the functionality and nervous activity within the brain. When the substance is stopped being in use, the mind rebounds by producing a surge of adrenaline which causes withdrawal symptoms.

Every drug is different, and every person is different. So each experience with withdrawal is personalized to the individual choosing to use the substance. There are, however, general signs and symptoms you can use to tell if a withdrawal is what your loved one is experiencing. 

Alcohol Withdrawal Symptoms:

  • Anxiety
  • Clammy skin
  • Dilated pupils
  • Fatigue
  • Insomnia
  • Irritability
  • Mood swings
  • Seizures
  • High fevers
  • Confusion 

Marijuana Withdrawal Symptoms:

  • Changes in appetite
  • Decreased sex drive
  • Digestion problems
  • Dizziness
  • Insomnia
  • Mood swings
  • Nausea
  • Weight loss 

Cocaine Withdrawal Symptoms:

  • Memory loss
  • Fatigue
  • Mood swings
  • Sleep problems
  • Social isolation
  • Increased appetite
  • Paranoia
  • Nightmares
  • Seizures
  • Ecstasy Withdrawal Symptoms
  • Aches and pains
  • Exhaustion
  • Agitation
  • Hallucinations
  • Anxiety and depression 

Opioid Withdrawal Symptoms:

  • Agitation 
  • Anxiety
  • Watery eyes
  • Muscle aches
  • Sweating
  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Nausea 
  • Vomiting 
  • Dehydration
  • Lung infection 
  • Intense urges to use again 

These symptoms are the most common among adults and typically are seen prevalent within eight hours of the last use and can occur days later.

Certain addiction substances can cause death during withdrawal while others are safe to withdraw from despite the unpleasantness of the symptoms.

Because an individual can not be sure if their withdrawal will be dangerous or safe, it is recommended to consult with a medical professional. 


Withdrawal symptoms are the physical and psychological effects of detoxification, which can occur after stopping drug or alcohol use. 

Not seeking treatment for substance abuse withdrawal can be dangerous to your loved one, as the withdrawal effects can be harrowing. Over the years, many individuals have tried managing their substance withdrawal at home, and some have not survived. Treatment and support should immediately be sought out if your loved one decides to stop using substances and gets sober. 

Supervised detoxification may prevent potentially life-­threatening complications that might appear if the patient were left untreated. 

3 Stages of Detox

According to the Substance Abuse and Mental Health Services Administration, detox comprises three steps:

  1. Evaluation — Assesses the presence of substances through urine, breath, or blood testing, current mental health state, existing medical issues and the appropriate strategy for the next steps. 
  2. Stabilization — Consumes the majority of treatment; acclimates your loved one to the detox process and provides medical and psychological services to treat symptoms if required.
  3. Build a willingness for further treatment — By itself, detox does not constitute thorough addiction treatment. As withdrawal symptoms resolve, staff will begin promoting additional treatment options to increase the chances of sustained recovery following your loved one's detox program. Detox is an appropriate initial step of treatment for those who experience mild to severe reactions to withdrawal. 

For those who have developed a substance dependency for alcohol, hypnotic, sedative drugs or opioids, medically-assisted detox is recommended. People with negative experiences of withdrawal, mental or physical health issues and limited support at home will also ly benefit from medically-assisted detox. 

When the drug use stops, dependent individuals often experience a host of mental and physical health symptoms that are uncomfortable and potentially dangerous.

Stopping the use of substances leads to adverse effects which range from being uncomfortable to fatal. For other drugs associated with a less dangerous or difficult withdrawal syndrome, detox might not require close medical management.

Providence Recovery, an addiction treatment center, offers Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP) for our clients. Professionals will need to evaluate each person individually to determine the best treatment option for them.

However, our IOP and PHP are ideal for those who have been through residential treatment or detox.

People who gain value from our programs are those want to continue their treatment or those who cannot commit to long-term residential treatment and have the motivation and transportation to attend the treatment.

Although Providence Recovery does not explicitly offer detoxification services, we can recommend a detox facility catered to your loved one's specific needs. 

At-Home Withdrawal 

Home-based withdrawal involves your loved one going through withdrawal while living in their own home. Experiencing withdrawal at home is possible, but not recommended.

Disadvantages of experiencing withdrawal symptoms at home include:

  • Lack of powerful medications
  • Lack of professional support
  • Severe withdrawal symptoms that weren’t accounted for
  • Surrounded by potential triggers 

If your loved one completes a successful detox at home, they could experience anxiety about not using drugs or drinking alcohol and getting their life back on track. This has the potential to play an integral part in relapse prevention. You can provide support by recommending the following services: 

  • Alcohol and drug support services
  • Seeking a medical professional 
  • Individual or group counseling
  • Outpatient programs
  • Outreach support
  • Self-help and peer support groups
  • Residential rehabilitation
  • Health and medical services
  • Dietician or nutritionist
  • Welfare services
  • Accommodation services
  • Income support services
  • Advocacy services
  • Legal services
  • Employment, education and training services


Withdrawal symptoms are known to linger for a few weeks. Medical assistance during detox is vital in the recovery process. Providence Recovery can connect your loved one to a:

  • Detox facility
  • Personalized treatment plan
  • Monitoring services
  • Medically-Assisted Treatment (MAT)
  • And most of all, an encouraging and supportive community 

Before, during and after your loved one’s detox in a supervised facility, you can still support them with these helpful tips;

  • Provide emotional support during tough times. You’ll want to verbally encourage your loved one with positive reinforcement that their journey to sobriety is courageous and to make it known they have your support. 
  • Reduce or avoid visitation from people who use drugs. Anyone who may cause stress will make the withdrawal process more difficult for your loved one. 
  • Minimize or remove any obstacles and challenges. Your loved one is mentally and physically going through a lot of change. Fighting cravings, career responsibilities, financial management and family obligations can add up and get to be too much to handle. With your loving support and guidance to help take the load off, it can make their recovery process easier. 
  • Challenging any illogical thoughts during withdrawal is an essential function of a support person. Your loved one could experience adverse symptoms, or question if the withdrawal were a realistic idea. Encourage them to read through their list of reasons and goals for going through withdrawal. 
  • It could also be helpful to view negative symptoms in a positive light, such as viewing them as signs their body is getting rid of toxins.
  • Encourage proper nutrition. Healthy and well-balanced eating reduces mood swings and provides other benefits. Poor dietary habits contribute to increased cravings and the risk of relapse. It is also good to encourage your loved one to drink lots of fluids. The recommended daily intake consists of eight glasses of a variety of non-alcoholic drinks. 
  • Maintain a productive schedule. Do things watching TV or movies, take walks or short car rides, read magazines, etc. 
  • Find healthy ways to cope with stress. Help your loved one manage stress by using basic techniques such as talking, exercise, or massage.

What else can you do to help your loved one?

  • Speak with a medical professional
  • Compile a list of positive goals related to giving up the drug use
  • Develop a plan for potential setbacks


Providence Recovery can provide treatment for your loved one after their withdrawal period: 

Tips from the Providence Recovery staff to prevent relapse for your loved one's continued sobriety:

  • Involving them in a treatment program can significantly reduce relapse rates.
  • Improving their overall quality of life through a holistic treatment approach. At Providence Recovery, we treat our patients as a whole, body and mind.
  • Maintaining a balanced, healthy lifestyle with a nutritious diet and physical activity. Alcohol and drugs deplete the body of essential nutrients.
  • Improving sleep quality, minimizing insomnia and fatigue. These are some side effects of addiction and withdrawal symptoms, and not getting enough sleep can potentially lead to a relapse.
  • Practicing mindfulness by participating in yoga, meditation, acupuncture, or massage therapy.
  • Attending all therapy and counseling sessions.
  • Participating in a support group.
  • Avoiding triggers, such as people, places, or things associated with previous drug or substance abuse.
  • Finding a new hobby painting, writing, learning an instrument, etc.
  • Asking for help when needed.

Let Providence Recovery help your loved one get back to a life they want. 


Using Ambien (Zolpidem) For Opioid Withdrawal

How to Ease Withdrawal Insomnia During Recovery

Opioid abuse is a widespread issue in the United States that too often leads to deadly consequences. According to the Centers for Disease Control and Prevention (CDC), an average of 130 people per day dies from a fatal opioid overdose.

The need for effective opioid abuse and addiction treatment has become a critical public health issue and initiative for struggling individuals across the country. The most effective treatment currently used for opioid dependence is medication-assisted treatment (MAT). This treatment combines the use of medicines to treat symptoms of opioid withdrawal with behavioral counseling.

One of the medications that have been used to treat symptoms of opioid withdrawal is zolpidem, also known as Ambien. This can help alleviate the uncomfortable yet common experience of insomnia during opioid detox.

Despite Ambien’s effectiveness for sleep, there are also some risks to using it for opioid withdrawal. One of these risks is Ambien’s own potential for abuse and dependence, especially in people with a previous history of prescription drug abuse.

Why Is Ambien Used For Opioid Dependence?

Ambien (zolpidem) is a sedative-hypnotic that can effectively treat sleep difficulties when used for no more than a few weeks. Insomnia, which refers to trouble falling or staying asleep, is one of the most common symptoms experienced during opioid withdrawal. It is also considered one of the most uncomfortable.

By acting on certain GABA receptors in the brain, Ambien can slow brain activity in a short amount of time, helping people fall and stay asleep for at least seven to eight hours. For people experiencing insomnia during opioid withdrawal, this effect can come as a significant relief.

When first brought onto the drug market, Ambien was considered safer than benzodiazepines, another type of sedative, due to its lower risk for addiction. This is not a consistent finding, however.

Several studies on the abuse potential of Ambien and similar non-benzodiazepine sedatives have demonstrated a high risk for drug dependence with chronic use.

This poses some risk for people who are undergoing withdrawal or recovering from the abuse of other prescription drugs.

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What Are The Risks Of Using Ambien For Opioid Withdrawal?

Although Ambien can be an effective sleep aid for short-term use, its use within a treatment plan for opioid withdrawal carries some risks. The primary risk is Ambien’s potential for abuse and dependence, which is greater in people with a previous history of substance abuse.

People may also experience negative side effects from taking Ambien, or suffer a negative reaction from mixing Ambien with other withdrawal medicines.

Risk For Ambien Dependence And Abuse

People with a previous history of substance abuse or mental health struggles are at increased risk for abusing other substances. Ambien is a medication that can produce effects that are similar to opioids, which may pose a challenge to people working to overcome their problem.

People can also develop a tolerance to Ambien within as little as a couple weeks. For people with chronic insomnia either as a result of opioid withdrawal or other causes, this can leave a person feeling as if they have no other option but to increase their dose.

Ambien is not considered safe for long-term use. The longer a person continues to use Ambien, the more ly they are to develop a physical dependence, and potentially, a psychological addiction to its effects.

Risk For Polysubstance Abuse

In recent years, there have been higher recorded rates of people mixing benzodiazepines or prescription sleep aids such as Ambien with opioids to achieve stronger effects. To address this, the FDA issued a report in 2016 warning doctors about prescribing opioids with these other drugs at once.

Although they are often mixed to experience more intense euphoria or relaxation, this can also be dangerous, leading to quicker overdose and greater risk for death.

Side Effects Of Ambien

Ambien is a powerful sleep aid with a long list of potential side effects. These side effects have the ability to complicate the withdrawal process or may otherwise create greater discomfort.

Potential side effects of Ambien include:

  • daytime drowsiness
  • mental grogginess
  • memory problems
  • dizziness
  • headache
  • unsteady walking
  • nausea
  • constipation or diarrhea
  • unusual dreams
  • bizarre behavior, including sleepwalking

Negative Interaction With Other Opioid Dependence Drugs

Buprenorphine (Suboxone/Subutex) is a common medication used to ease uncomfortable withdrawal symptoms. It can also shorten the length of withdrawal. As a result of its depressant effects, Ambien can interact negatively with buprenorphine. Mixing the two can cause severe side effects, including respiratory depression, coma, and even death.

Recommended medications for effectively treating sleeping problems during opioid withdrawal include moderate doses of Benadryl (diphenhydramine), Vistaril (hydroxyzine), or Desyrel (trazodone). Un Ambien, these are less ly to have a severe, negative interaction with buprenorphine.

What Other Medications Can Be Used For Opioid Withdrawal?

Ambien or any other sedative alone isn’t capable of providing comprehensive relief for all symptoms of opioid withdrawal. Several other withdrawal symptoms, including anxiety and drug cravings, may require other treatments to be effectively managed.

In 2018, a drug called lofexidine (Lucemyra) became the first FDA-approved drug to treat opioid withdrawal symptoms, with the recommendation that it not be used for more than 14 days. Lofexidine is not a comprehensive treatment by itself, however, and should be used in conjunction with other treatments.

Other medications that may be used to ease symptoms of opioid withdrawal include:

  • clonidine: to ease symptoms of anxiety, agitation, runny nose, cramps, sweating and muscle aches
  • buprenorphine: partial opioid agonist to treat withdrawal symptoms and drug cravings, and shorten the length of the withdrawal process
  • methadone: a long-acting opioid to ease withdrawal for people with severe dependence; it is also used for people who are pregnant undergoing methadone maintenance treatment
  • other medications: to treat nausea, diarrhea, or insomnia

The most effective way for people to receive adequate support during opioid withdrawal is to enter a medical detox program.

Medical detox is a medically-supervised detox service that offers 24-hour supervision and medical support for drug and alcohol withdrawal.

Within this setting, patients can be monitored for health concerns, receive fluids for hydration, and receive medicines to ease symptom-related discomfort.

Find Help For Opioid Withdrawal Today

Finding the medical support necessary to undergo withdrawal and avoid relapse can be an essential first step on the road to addiction recovery.

If you are struggling with opioid dependence, Vertava Health can help. Our treatment specialists are available 24/7 to offer confidential support in finding opioid detox and treatment options that meet your needs.

Call us today at 615-208-2941 to find safe and effective opioid detox and treatment options for you or a loved one struggling with addiction.


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