How Long Does Withdrawal Last?
The honest answer is: it depends. Withdrawal timelines vary significantly by substance, by how long and how much a person used, and by individual physiology. This guide gives families realistic timelines for each major substance, including the often-overlooked post-acute phase that can persist for months and is one of the leading drivers of relapse.
Medically Reviewed by:
Dr. Darrin Mangiacarne
Chief Medical Officer
At Banyan Treatment Centers, Chief Medical Officer Dr. Darrin Mangiacarne leads our nationwide clinical team with over a decade of addiction medicine experience, helping ensure evidence-based, compassionate care across every level of treatment.
Author / Written by: Banyan Editorial Staff
Medically reviewed by: Dr. Darrin Mangiacarne, CMO
Updated on: June 2026
Family Resources Hub › Substance Use Resources › Withdrawal & Detox › How Long Does Withdrawal Last?
Why Withdrawal Timelines Matter for Families
Families often have one of two misconceptions about withdrawal duration: either they expect it to be over in a few days and are alarmed when their loved one is still struggling weeks later, or they fear it will last forever and use that fear as a reason to delay seeking help. Neither is accurate.
Understanding realistic timelines serves several purposes: it helps families avoid making premature judgments about how their loved one is doing, it prevents families from pulling support too early, and it helps everyone prepare emotionally and practically for a process that is longer than most people expect.
According to SAMHSA, most substance withdrawal follows two distinct phases: acute withdrawal, the intense early phase and post-acute withdrawal syndrome (PAWS), a subtler but longer-lasting phase that affects mood, cognition, and stress tolerance for weeks to months. Both phases require support, though the type of support differs.
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Withdrawal Timelines: Substance by Substance
These timelines represent typical ranges. Individual experience varies based on duration of use, average dose, overall health, and whether any other substances are involved.
Alcohol
- Onset: 6–12 hours after last drink
- Peak severity: 24–72 hours
- Acute phase: 5–7 days
- Dangerous window: Days 1–3 (seizures, DTs)
- PAWS duration: Weeks to months
- Common PAWS symptoms: Sleep disturbance, anxiety, mood instability, cognitive fog
Requires medical supervision
Opioids (Short-Acting: Heroin, Oxycodone)
- Onset: 8–24 hours after last use
- Peak severity: 36–72 hours
- Acute phase: 5–10 days
- Physical symptoms resolve: 1–2 weeks
- PAWS duration: Weeks to several months
- Common PAWS symptoms: Depression, anxiety, insomnia, cravings
Medical supervision strongly recommended
Opioids (Long-Acting: Methadone)
- Onset: 36–48 hours after last dose
- Peak severity: Days 3–5
- Acute phase: 2–3 weeks
- Full resolution: 3–6 weeks or longer
- PAWS duration: Several months
- Note: Significantly longer and more drawn out than short-acting opioids
Medical supervision strongly recommended
Benzodiazepines
- Short-acting (Xanax): Onset 1–2 days
- Long-acting (Valium): Onset 3–7 days
- Peak severity: Days 2–7 (varies by type)
- Acute phase: 2–4 weeks
- PAWS duration: Months to years in heavy users
- Benzo PAWS is among the most prolonged of any substance
Requires medical supervision
Methamphetamine
- Onset: Hours after last use (the "crash" begins)
- Crash phase: Days 1–3 (extreme fatigue, sleep)
- Acute withdrawal: 1–2 weeks
- PAWS duration: Several months to over a year
- Meth PAWS is severe — prolonged anhedonia and depression
- Cognitive recovery: May take 12–18 months or longer
Medical supervision recommended
Cannabis
- Onset: 1–3 days after last use
- Peak severity: Days 2–4
- Acute phase: 1–2 weeks
- Sleep disruption may persist for several weeks
- PAWS: Mild in most cases; more pronounced in heavy daily users
- Overall: Less severe than other substances but real
Medical supervision helpful but less critical
Post-Acute Withdrawal Syndrome (PAWS): What Families Need to Know
PAWS is perhaps the most underappreciated aspect of recovery, and the one that most catches families off guard. When the acute withdrawal phase ends and the person leaves detox, families often expect rapid improvement. In reality, many people in early recovery experience a prolonged period of subtle but significant neurological and psychological symptoms that can last months.
This is not failure. It is the brain's long journey back to equilibrium after sustained chemical disruption. Understanding PAWS as a normal, if frustrating, part of recovery prevents families from interpreting it as a sign their loved one is not committed to recovery, or from withdrawing support at the precise moment it is most needed.
PAWS Symptoms Families Observe
- Emotional volatility — crying or anger seemingly without cause
- Inability to feel joy or enthusiasm for things previously enjoyed
- Difficulty making decisions or thinking clearly
- Fatigue that doesn't improve with sleep
- Sleep disturbances — insomnia, vivid dreams, oversleeping
- Heightened sensitivity to stress — small problems feel overwhelming
- Episodic intense cravings that can appear weeks after stopping
- Flat affect — appearing emotionally numb or disconnected
How Families Can Help During PAWS
- Maintain realistic expectations — improvement takes time
- Minimize unnecessary stress in the shared environment
- Encourage consistent participation in treatment and peer support
- Recognize that bad days are not signs of failure or relapse
- Celebrate small wins — improved sleep, better mood days
- Avoid pressure to "be better faster"
- Continue your own support — Al-Anon, therapy
- If PAWS symptoms are severe, ensure the treatment team knows
What Makes Withdrawal Longer or Shorter?
Duration of Use
The longer someone has been using, particularly for years, the more deeply entrenched the neuroadaptation and the longer recovery takes. Years of heavy use generally correlates with more prolonged PAWS.
Amount Used
Higher doses over time create greater physical dependence. Withdrawal from high doses is typically more intense and longer-lasting than withdrawal from lower doses of the same substance.
Mental Health
Co-occurring depression, anxiety, or trauma often extends and intensifies PAWS. Integrated dual-diagnosis treatment, addressing both addiction and mental health, typically produces better and faster resolution.
Support System
People with strong family support, engagement in treatment, and participation in peer recovery support typically navigate withdrawal and PAWS more successfully than those who attempt recovery in isolation.
Medical Support
Medically supervised detox, appropriate medication management, and ongoing pharmacological support (such as MAT for opioids) significantly reduce withdrawal severity and duration for many substances.
Genetics
Individual neurobiological differences mean two people with the same use history may experience very different withdrawal severity and duration. Genetics plays a significant and often underappreciated role in withdrawal experience.
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