Can I quit opioids cold turkey?

When patients with opioid use disorder (OUD) decide they want to make a change, their first thought is often to immediately stop using opioids entirely. That’s an understandable reaction. However, it’s not necessarily the safest or most effective approach. Pursuing evidence-based OUD treatment options, like medications for addiction treatment (MAT), with clinical support is often the better way forward.

What does quitting opioids cold turkey mean?

When someone says they’re “quitting cold turkey,” that’s another way of saying giving something up abruptly and entirely, typically without any outside help. You can quit anything cold turkey, but it’s most often used for drugs like alcohol, nicotine, and opioids.

To quit opioids cold turkey means stopping all opioid use right away. From that point forward, you wouldn’t use any form of opioids, even in small doses. You wouldn’t do any tapering or gradual reductions of your opioid doses.

Risks of quitting opioids cold turkey

The problem with this approach is that abruptly stopping opioid use can lead to severe opioid withdrawal. Long-term opioid use can cause someone to become physically dependent on the drug, meaning the patient’s body begins to depend on it to function properly. If you then take away opioids entirely, the patient may suffer unpleasant or even dangerous withdrawal symptoms that include:

• Anxiety and panic attacks
• Trouble sleeping
• Nausea
• Muscle aches and pains
• Vomiting
• Depression 
• Fevers and chills
• Diarrhea

The question of quitting cold turkey is less about whether you can and more about whether you should. It is possible for someone to stop using opioids this way, but it comes with significant risks.

You should also question how effective quitting opioids is for long-term OUD treatment. If you have already developed a dependence on opioids, the willpower to quit alone will not prevent intense opioid withdrawal symptoms, including craving more opioids. Around 65 to 70% of people diagnosed with OUD in the United States go through relapses¹. Even with the best of intentions, quitting opioids cold turkey may not be the best way to reduce the chances of relapsing in the future.

You can also go into precipitated withdrawal — a rapid, severe onset of opioid withdrawal symptoms — if someone administers an opioid antagonist or partial agonist, like Narcan®, to treat an opioid overdose. If you do use opioids again after quitting cold turkey and require emergency treatment, you can face severe opioid withdrawal symptoms.

How long does opioid withdrawal last?

Opioid withdrawal breaks down into three stages: early, peak, and late withdrawal. Not long after quitting cold turkey, opioid users will go into the first stage of withdrawal.

Early withdrawal

Early withdrawal starts within 24 hours of taking your last opioid dose or significantly decreasing your dose². The early symptoms include:

• Fever and chills
• Runny nose
• Sweating
• Teary eyes
• Nausea
• Muscle aches and pains

The severity of these symptoms will depend on factors like your general health, hydration level, and opioid use history, including how long and how much. You may be able to manage these symptoms with over-the-counter medicine or other support.

Peak withdrawal

Between 24 and 72 hours after your last opioid dose, you’ll enter peak withdrawal. This is the most dangerous part of withdrawal, and symptoms include:

• Diarrhea
• Nausea and vomiting
• Cramps
• Fatigue
• Muscle aches and pains

You may also experience intense opioid cravings during this stage of withdrawal. That’s part of the reason why quitting cold turkey and relying only on willpower can backfire — the cravings may get more severe before they improve. Resisting these cravings while also dealing with other uncomfortable opioid withdrawal symptoms is very difficult.

Late withdrawal

The final stage of withdrawal typically starts about 72 hours after you use opioids and lasts for about another two days before becoming less severe. In this stage, you may experience symptoms like:

• Depression
• Irritability
• Anxiety
• Insomnia

No two experiences with opioid withdrawal are the same, so it’s hard to know exactly what to expect after quitting cold turkey. Depending on the type of opioids you use and other factors, your withdrawal symptoms may last longer than five days or be more intense. Having a care team on your side to help reduce and manage these symptoms can change your experience for the better.

The importance of clinical support for OUD treatment

Part of what makes quitting cold turkey appealing to some patients dealing with OUD is that it’s something you can, in theory, do alone. That way, the patients don’t have to explain their OUD to anyone else or reach out for help. However, clinical support is an invaluable tool in treating OUD.

When you work with clinicians to stop opioid use and begin OUD treatment, you get a team of experienced, supportive professionals to help you through the process. It’s no longer something you have to do alone—but it is entirely confidential. With clinical support, you can also access medications for addiction treatment like Suboxone® (important safety information). Medications like Suboxone have been shown to reduce opioid use and OUD symptoms as well as decrease your risk of a fatal opioid overdose³. They can be an effective part of recovery alongside support from your social circle and clinicians.

Your care team can provide information and support when you need it during OUD treatment. They’ve been with other patients through this process and will help you when you’re struggling. This and the proper medication can make all the difference during your treatment journey.

Taking a different approach to OUD treatment

Everyone who needs it deserves access to personalized, evidence-based OUD treatment. Ophelia is working toward that goal by providing telehealth and medications for opioid use disorder (MOUD). Our private, personal approach helps patients manage their OUD symptoms for long-term success. You can contact your care team day or night, 24/7, from the comfort of your home when you need support. Book a welcome call to learn more and see whether Ophelia is right for you.