Understanding opioid detox and fentanyl withdrawal 

Fentanyl is an extremely powerful synthetic opioid that has been at the center of the opioid epidemic. While doctors prescribe it for severe pain, illicit fentanyl is often mixed into heroin, counterfeit pills, or other drugs without a person’s knowledge. This increases the risk of overdose and makes quitting incredibly difficult. Because fentanyl is up to 100 times stronger than morphine, dependence can develop very quickly, even after short-term or occasional use. 

Fentanyl binds to the brain's opioid receptors, which control pain and reward, causing an intense release of dopamine, leading to euphoria and pain relief. Over time, the brain adapts, requiring fentanyl to feel normal. Individuals need higher or more frequent doses as tolerance grows, leading to dependence, and abruptly stopping results in painful withdrawal symptoms, often unbearable without medical help.

Detox is not the same as rehab, but it is the essential first step. Detox focuses on safely managing withdrawal, restoring balance to the body, and helping individuals stabilize. Rehab, whether residential or outpatient, is where the deeper work happens—therapy, relapse prevention, and long-term recovery planning.

At Cedar Grove Recovery, we offer medically assisted withdrawal management through our fentanyl detox program. This gives clients a safe place to begin healing and prepares them for ongoing care through therapy, group support, and structured treatment.

The first signs of withdrawal can appear quickly, especially if someone has been using fentanyl regularly. These often include anxiety, restlessness, muscle aches, watery eyes, sweating, and trouble sleeping. Many people describe it as having the worst flu, combined with overwhelming cravings.

Within the first few days, withdrawal symptoms reach their peak. Individuals may experience nausea, vomiting, diarrhea, abdominal cramping, high blood pressure, and rapid heart rate. Intense cravings, agitation, and feelings of hopelessness are also common. Without medical care, this stage can feel unbearable, which is why relapse often happens here.

Even after the most painful withdrawal symptoms pass, post-acute withdrawal syndrome (PAWS) can linger for weeks or months. This includes fatigue, ongoing cravings, sleep problems, and mood swings. While these symptoms aren’t usually life-threatening, they can make recovery difficult if not addressed with therapy and ongoing support.

For most people, fentanyl detox lasts between five and seven days, though some symptoms may persist for two weeks or longer. Every individual’s detox timeline is unique and depends on several factors:

• Duration of fentanyl use
• The amount and frequency of use
• Whether fentanyl was combined with other drugs or alcohol
• Overall health and age
• Co-occurring mental health conditions
• Support systems and living environment

When someone detoxes at home, they are often unprepared for the severity of withdrawal. Vomiting and diarrhea can quickly lead to dehydration and dangerous electrolyte imbalances. Cravings may feel impossible to resist, and relapse is likely. Because tolerance drops quickly during detox, relapsing can put someone at higher risk of overdose, even with smaller amounts of fentanyl.

In a professional detox setting like Cedar Grove Recovery, clients are surrounded by 24/7 medical staff who provide care, reassurance, and clinical monitoring. Vital signs are tracked, IV fluids may be used to correct dehydration, and medications can be administered to ease discomfort.

Most importantly, clients are in a safe environment away from triggers, reducing the likelihood of relapse. Our medically assisted withdrawal management program is designed to help clients begin recovery with dignity and compassion.

Methadone is a long-acting opioid that prevents withdrawal symptoms and reduces cravings without producing the same euphoric high. It has been used for decades in opioid treatment programs and can be especially helpful for people with a long history of opioid dependence.

Buprenorphine is a partial opioid agonist, which means it activates opioid receptors enough to ease withdrawal but doesn’t produce the same intense effects as fentanyl. It can be given as Subutex (buprenorphine only) or Suboxone (buprenorphine combined with naloxone). Treatment typically begins with an induction phase, followed by stabilization and maintenance.

Lofexidine, a non-opioid medication, helps relieve withdrawal symptoms like anxiety, agitation, and sweating. Other medications may also be used to manage nausea, insomnia, depression, or muscle aches during detox.

Detox alone does not address the long-term nature of opioid use disorder. Continuing MAT in residential or outpatient programs helps reduce relapse risk and supports lasting recovery. At Cedar Grove Recovery, MAT is integrated with therapy and support services to create a comprehensive plan for healing. The MAT medications that we offer include buprenorphine (Subutex), Naltrexone (Vivitrol), and Suboxone.

Inpatient detox is recommended for individuals who have been using high doses of fentanyl, have struggled with previous detox attempts, or live in environments where relapse risk is high. It's also a good option for those with co-occurring mental health conditions or polysubstance use. Inpatient detox provides round-the-clock monitoring, medical supervision, and emotional support.

Outpatient detox may be appropriate for people with mild-to-moderate withdrawal symptoms, strong family support, and reliable transportation to appointments. It allows individuals to continue meeting responsibilities at home or work while receiving professional care.

Detox is just the first step. Afterward, many clients transition into residential treatment (21–35 days), partial hospitalization programs (PHPs), or intensive outpatient programs (IOPs). Others continue with outpatient MAT and therapy. These programs build on the foundation created during detox, helping clients develop coping skills, identify triggers, and practice relapse prevention strategies.

Many people who struggle with fentanyl addiction also live with untreated mental health conditions such as depression, anxiety, PTSD, or bipolar disorder. If these issues are left unaddressed, they can complicate recovery.

At Cedar Grove Recovery, we provide integrated dual diagnosis care. Each client receives a psychiatric evaluation, medication management if needed, and access to evidence-based therapies. Individual therapy helps clients work through personal challenges, while group therapy builds connection and support. Trauma-informed care and approaches like cognitive-behavioral therapy (CBT) provide tools for long-term healing. By treating both conditions together, clients are better equipped to maintain recovery.

Tolerance drops quickly after detox. If someone relapses and uses the same amount of fentanyl as before, the risk of overdose is significantly higher. Clients and families are educated on this danger from day one.

Cedar Grove Recovery encourages the use of naloxone (Narcan), a life-saving medication that reverses opioid overdoses. We also support harm reduction tools like fentanyl test strips, which can detect fentanyl in other substances.

We help each client develop a personalized safety plan, which includes crisis contacts, access to naloxone, and strategies for seeking support if relapse occurs. Recovery is a journey, and setbacks do not erase progress. Having a plan in place saves lives.

Clients are encouraged to continue MAT as prescribed, attend therapy sessions, and participate in recovery groups such as Narcotics Anonymous (NA) or SMART Recovery. These resources help provide accountability and connection.

For those who need additional structure, sober living homes and case management services provide stability. Alumni programs keep clients connected to the recovery community and offer ongoing encouragement.

During treatment, clients learn coping skills to handle stress, cravings, and emotional triggers. Recognizing relapse warning signs early helps clients reach out for help before a return to use occurs.

When seeking a fentanyl detox program, it’s important to look for:

• Accreditation and licensed staff
• 24/7 nursing and medical oversight
• Evidence-based care, including MAT
• Trauma-informed and holistic supports

At Cedar Grove Recovery, our admissions team helps verify insurance quickly and explain payment options in a confidential and compassionate way. We want clients and families to feel supported as they take this step.

Cedar Grove Recovery is located in Louisville, Kentucky, and provides accessible and supportive detox care. We welcome individuals and families from across the region who are ready to take their first step toward healing.

Detox begins with a thorough assessment, including medical history, lab work, and a review of mental health needs. This helps our team design an individualized detox plan.

Clients receive around-the-clock monitoring, medical care, and comfort medications as needed. Our staff provides encouragement, compassion, and safety during every stage of detox.

From the very beginning, we prepare clients for what comes after detox. This includes discharge planning and warm handoffs to residential treatment, outpatient therapy, or MAT programs, so no one feels lost or alone when leaving detox.

Whether seeking help for yourself or someone you love, Cedar Grove Recovery offers a healing place to begin. We offer medically assisted withdrawal management, therapy, and long-term support. Our team is here to support you at every stage of recovery. You can call us today at 502.317.8031 or contact us online for a confidential consultation, quick insurance verification, and help starting your path to recovery.