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6 - 12 Hours After Last Dose: Withdrawal Begins Onset of initial symptoms can include: Anxiety Muscle aches Increased tearing Insomnia Runny nose Excessive sweating Frequent yawning 24 - 48 Hours After Last Dose: Peak of Early Withdrawal Intensification of early symptoms and possible appearance of additional symptoms, such as: Agitation Diarrhea Heart palpitations High blood pressure Fever 72 Hours After Last Dose: Peak of Acute Withdrawal Typically, symptoms reach their peak in intensity and discomfort and can include: Nausea and vomiting Abdominal cramping Dilated pupils Goosebumps Blurred vision Rapid heartbeat 1 Week After Last Dose: Symptoms Begin to Subside At this time there is typically a gradual reduction in the intensity of physical symptoms, while psychological symptoms may persist or become more pronounced, including: Anxiety Depression Irritability Cravings for opioids 1 - 2 Weeks After Last Dose: Decrease in Physical Symptoms Most physical symptoms significantly diminish, while ongoing psychological and emotional challenges and the potential for continued cravings remain