How Long Does It Take to Detox from Fentanyl?

Fentanyl is a synthetic opioid contributing to more than half of the drug overdose deaths in the US. Many teens use fentanyl unknowingly, often laced in counterfeit pills, leading to quick addiction and accidental overdose or death. Its potency makes it physically challenging to quit without intervention, complicating the detox process for already vulnerable teens.

Read on to understand how fentanyl affects the adolescent brain and what to expect during the detox process.  

What is Fentanyl and Why Is It So Addictive? 

Fentanyl is one of the strongest illicit substances and synthetic opioids on the black market. It activates specific brain circuits involving the mu-opioid receptors much faster and more intensely than other opioids such as heroin or morphine. When fentanyl binds to these receptors, it causes large surges of dopamine in the brain’s reward system, quickly leading to a cycle of addiction that is hard to end without professional intervention. 

Teens may be more vulnerable to the effects of fentanyl, developing an addiction after just one time use. Studies have shown that the earlier opioid exposure, the greater the risk of long-term changes occurring in adolescence, particularly related to pain sensitivity and drug response [1]. 

Rates of Overdose and Death 

Fentanyl has stolen hundreds of thousands of lives across the US over the past decade, and many of them are teens. Below are a few key statistics to highlight the severity of the fentanyl crisis [2] [3]:

• 500+ fentanyl-related teenage deaths reported annually in the US

• Drug overdose deaths involving fentanyl increased from 32% in 2018 to 76% in 2023, but have since started to plateau and decline

• 9.8% of ER visits among 15 to 14-year-olds were related to nonfatal fentanyl overdoses

• 244,900 emergency service calls for opioid overdoses reported, many involving fentanyl, and many involving teens 

• 1.8 million children under 18 have lost a parent, sibling, or close relative to overdose 

Common Signs of Fentanyl Use 

Fentanyl abuse manifests as physical, behavioral, and psychological symptoms. Many of the signs mimic other substance abuse disorders, such as mood swings, secretive behavior, academic decline, social isolation, and decline in self-care. However, there are some specific signs of fentanyl use in teens. These include [4]:  

• Dilated, contracted pupils that look abnormally small. These are often called “pinpoint pupils” and happen when fentanyl activates the parasympathetic nervous system and muscles that control the iris.  

• Drowsiness and sedation can make it difficult to stay awake during conversations, eating, or performing basic tasks. Fentanyl has strong depressant effects that slow down activity and reaction time in the brain and central nervous system. 

• The fentanyl fold is a physical posture commonly seen in fentanyl or heroin users where the person is bent forward at the waist, appearing unresponsive or unable to move correctly. This position can last minutes to hours and is associated with decreased breathing and poor circulation. It is thought to be caused by muscle rigidity brought on by fentanyl, specifically in the torso area. 

• Signs of overdose include cold or clammy skin, purple or blue lips or fingertips. Gurgling or choking sounds, and total loss of consciousness or lack of response. 

The Importance of Supervised Detox 

While some drugs, such as nicotine or cannabis, can be detoxed from without medical supervision, fentanyl and other opioids often require around-the-clock care. Supervised fentanyl detox ensures that vital signs are monitored, symptoms are managed, and teens are not in a setting filled with temptations.  

Fentanyl Withdrawal Symptoms

The symptoms that arise during fentanyl withdrawal are one of the most challenging parts of the detox process. In a detox or residential program, teens are monitored to ensure safety, and medication can be prescribed to alleviate pain and discomfort. 

• Anxiety and restlessness: Opioid users report feeling like they want to crawl out of their skin during withdrawal. It is a heightened state of anxiety, often creating emotional turmoil and physical symptoms such as headaches and increased heart rate. 

• Muscle and bone pain: Intense aches, muscle cramps, and general soreness occur throughout the body. These symptoms, paired with a runny nose, slight fever, and chills, are why many describe opioid withdrawal as feeling like they have the flu. 

• Insomnia: Many users in fentanyl withdrawal report trouble falling or staying asleep, sometimes for days at a time, without a sleep aid. This can worsen mental health effects that accompany withdrawal, such as anxiety, depression, and paranoia.  

• Gastrointestinal Distress: Nausea, vomiting, and diarrhea are all common symptoms of fentanyl withdrawal. This can increase the risk of dehydration and prolong the length of withdrawal. 

• Cravings and mood swings: Intense cravings and urges to use fentanyl combined with depression, irritability, and mood swings can complicate recovery efforts and increase the risk of relapse. 

Detox Timeline and Factors That Affect Recovery

The detox timeline for fentanyl can vary for each teen, but peak symptoms usually last for a few days to a week. The general detox timeline for fentanyl is as follows: 

1. Onset of Withdrawal Symptoms (6 to 24 hours after last use): Anxiety, runny nose, sweating, muscle aches, irritability.  

2. Peak (Day 1 to 3): Nausea, vomiting, intense body pain, chills, goosebumps, insomnia. 

3. Symptoms Begin to Subside (Days 4 to 10): The intensity of symptoms decreases, but emotional challenges, trouble sleeping, and cravings persist. 

4. Post-Acute Withdrawal Syndrome (PAWS): This can last weeks to months for some teens and is less physically stressful, but often emotionally demanding. Symptoms may persist for months after detox and include anxiety, depression, mood swings, and cravings. 

There are several factors that can impact the length of detox. Not every teen will struggle with PAWS, and some teens may have symptoms that peak and subside within 1-4 days. Some of the factors that impact the fentanyl detox timeline include: 

• Length and frequency of use
• Polydrug use 
• Presence of co-occurring mental health disorder or underlying health condition
• Access to medically supervised detox, evidence-based treatments, and social support prevents relapse risk during the sensitive detox stage when cravings are often most intense 

Long-Term Treatment for Fentanyl Addiction Recovery 

Withdrawal management is an essential first step on the path to recovery from fentanyl. However, sustainable recovery requires a comprehensive treatment approach that combines behavioral therapies, social supports, and medication (if necessary). 

Detox helps “clean out the body” of the presence of drugs and alcohol, but a residential treatment program for teens helps them build coping skills and a social support system that encourages their long-term recovery. Some of the treatment options we provide teens in our residential treatment program to help them recover from fentanyl and prevent relapse include: 

• Evidence-based therapies such as Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and Eye Movement Desensitization and Reprocessing (EMDR)  target underlying thoughts or trauma that drive addiction. These focus on improving teens' self-esteem, communication skills, resilience, and mental strength to avoid temptations. 

• Social and group support play a crucial role at Lotus, helping teens connect with others who have experienced similar struggles and fostering feelings of mutual understanding. 

• Family involvement is encouraged throughout your teen's time in treatment. We offer family therapy, as well as days, events, or activities to involve the family in the recovery process. This has been shown to improve treatment outcomes significantly.

• Medication management can be prescribed as needed by our team of clinical psychiatrists. Although we don’t offer medication-assisted treatment (MAT) as part of formal opioid treatment, we can provide medication to treat symptoms of co-occurring mental health disorders. 

• Creative arts and recreational activities keep teens engaged and connected. Activities such as music, art, and dance can help teens process emotional distress that can be hard to talk about in traditional therapy. Physical fitness and sports can ease cravings for fentanyl and help teens find fun in sobriety. 

Fentanyl Addiction Treatment for Teens in Winter Springs, Florida 

Lotus Behavioral Health is a residential treatment facility for teens located in Florida. Our programs are designed to support teens and their families with the tools they need to recover from substance abuse and co-occurring mental health disorders. 

We offer a blend of comprehensive recovery services such as individual therapy, group therapy, medication management, and skill-building workshops to help teens recover from fentanyl addiction and other opioids.  

Sources

[1] Taylor, J. et al. 2023. Effects of neonatal fentanyl on late adolescent opioid-mediated behavior. Frontiers in Neuroscience. 

[2] 2025. Trends in Suspected Fentanyl-Involved Nonfatal Overdose Emergency Department Visits, by Age Group, Sex, and Race and Ethnicity. CDC. 

[3] Watchel, I. 2024. Over a million US children scarred by drug overdoses. USC Dornsife. 

[4] Ghorab, D. et al. 2024. The impact of chronic fentanyl administration on the cerebral cortex in mice: Molecular and histological effects. Journal of Brain Research Bulletin. 

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