Withdrawal from High-Dose Fentanyl (10mg/day)

They call it "dope sick," but that feels like a euphemism. At this dosage—where my tolerance is strong enough to kill five regular people—the withdrawal isn't just sickness; it is a physiological exorcism. My brain has stopped producing its own endorphins entirely, relying solely on that 10mg synthetic flood. When the flood stops, the drought is immediate and violent.

Here is the itemized descent, hour by hour.

Phase 1: The Anticipatory Dread (Hours 6–12)

The Noradrenergic Storm Begins

The first sign isn't pain; it’s a vibrating anxiety in my chest. My locus coeruleus—the part of the brain responsible for the fight-or-flight response—has been suppressed by the fentanyl for so long that it compensates by working overdrive. Now that the brakes are off, it is dumping noradrenaline into my system.

  • Lacrimation and Rhinorrhea: It starts subtly. My eyes won't stop watering (lacrimation), and my nose is running constantly (rhinorrhea). It mimics a severe allergy attack, but I know better.

  • The Yawn: I am yawning every 30 seconds. It’s not a tired yawn; it’s a deep, painful stretching of the jaw that makes my eyes water more. It feels like my body is trying to suck in oxygen it can't process.

  • Psychological State: The "Fear" sets in. It is a primal, chemically induced panic. I am hyper-aware of the clock. Every minute feels like an hour.

Phase 2: The Physical Assault (Hours 12–24)

Piloerection and Thermodysregulation

The medical term is piloerection, but on the street, it's "cold turkey." My skin looks like plucked poultry. The temperature regulation in my hypothalamus is malfunctioning.

  • Hot/Cold Cycling: One minute I am drenched in sweat, soaking through my clothes. The next, a draft hits me, and it feels like liquid nitrogen. I am shivering violently under three blankets, yet my skin is clammy and cold to the touch.

  • Hyperalgesia (Heightened Pain Sensitivity): My opioid receptors are screaming. Without the fentanyl to dampen signals, normal sensations translate as pain. The fabric of my t-shirt hurts my skin. My joints—knees, elbows, lower back—begin to throb with a deep, rusted ache, as if the marrow is expanding inside the bone.

  • Restless Leg Syndrome (Akathisia): This is the torture. I cannot be still. My legs possess a frantic, electric energy that forces me to kick and thrash. I pace the room until I collapse, then thrash on the bed until I have to pace again. There is no comfort, only constant motion.

Phase 3: The Peak (Hours 24–72)

Gastrointestinal Distress and Autonomic Hyperactivity

This is where the dignity vanishes. The opioids had paralyzed my gut; now, the rebound effect causes the smooth muscles in my intestines to spasm violently.

  • Emesis and Diarrhea: I am vomiting bile because my stomach is empty, yet the dry heaving continues. Simultaneously, I have explosive diarrhea. The risk of dehydration and electrolyte imbalance here is real. I am losing fluids faster than I can keep them down.

  • Tachycardia and Hypertension: My heart is hammering against my ribs—110, 120 beats per minute. My blood pressure is spiking. I can hear the blood rushing in my ears.

  • Insomnia and Delirium: I haven't slept in 48 hours. The exhaustion is total, but the noradrenaline won't let me shut down. I enter a twilight state of lucid misery. I start hallucinating shadows in the corner of the room. The smell of my own sweat—acrid and chemical—makes me gag.

  • The Kicking: The muscle spasms are now full-body. My back arches involuntarily. I am literally "kicking the habit."

Phase 4: The Plateau (Day 4–5)

The Gray Zone

The acute vomiting slows, but the malaise is bone-deep.

  • Anhedonia: This is the psychiatric crash. My dopamine levels are nonexistent. The world is entirely gray. I feel a crushing depression, a certainty that I will never feel "okay" again. This is often the point of relapse, not because of the pain, but because of the absolute void of emotion.

  • Nutritional Deficit: I am weak, shaking like a leaf. I try to eat a cracker, but it tastes like cardboard. My body is depleted of magnesium and potassium, making the muscle cramps linger.

Summary of Experience

It feels like having a severe flu, a panic attack, and being beaten with a bat, all simultaneously. It is a biological debt being collected with aggressive interest. The 10mg that used to make me feel normal has dug a hole so deep that climbing out feels impossible.

If you are looking for information on how to manage these symptoms or seeking help for addiction, would you like me to provide resources for medical detox centers or addiction support hotlines?