Why fentanyl withdrawal is agony and how medication can prevent it

Over 2 million Americans have opioid use disorder, according to some estimates. Illicit opioids such as heroin and fentanyl were responsible for over 80,000 U.S. overdose deaths in 2023.

Despite the known risks, these drugs are notoriously hard to stop using — due in large part to how debilitating withdrawal can be.

“People get trapped in this terrible cycle where they don’t feel normal, they can’t function, they feel horribly ill unless they’re finding and using opioids,” explained Sarah Wakeman, medical director for substance use disorder at Mass General Brigham. “People will forgo other basic, primal needs like connection and sex and food just to relieve their withdrawal symptoms. That’s how powerful it is.”

Medications such as methadone and buprenorphine are very effective at treating opioid dependence, but despite sky-high overdose death rate, these treatments are unnecessarily hard to access in the United States, according to experts.

In this video, Wakeman explains how opioids work in the brain and why they cause such nightmarish withdrawal symptoms. She also explains how treating opioid use disorder with approved medications can help people lead normal, productive lives.

“You need to relieve your symptoms,” said Wakeman. “Just like if you were deprived of water, just like if you were deprived of food … we have to be treating withdrawal, we have to be effectively treating people if we want to address opioid use disorder and if we want to address this crisis.”