Opioid Withdrawal and Diarrhea: 8 Things That Can Help

When your body is used to opioids and then the drugs suddenly leave your system, the change can feel brutal. One unexpected challenge you may not have anticipated is the sudden stomach trouble that comes with opioid withdrawal. For many people, diarrhea is just one of many troublesome withdrawal symptoms. As if you don’t have enough to deal with already, it can leave you feeling drained and uncomfortable, making it even harder to get through the day.

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This isn’t just a small side effect — it’s a major part of recovery that affects people with opioid use disorder. The good news is that there are simple and safe ways to manage diarrhea during withdrawal. In this article, we’ll break down why it happens, explain how long you can expect it to last, and describe eight strategies to bring relief.

Why Does Opioid Withdrawal Cause Diarrhea?

Did you know that opioids don’t just affect the brain? They also act on opioid receptors — the proteins that opioid drugs act on — in the gut. While someone is using opioids, such as hydrocodone, oxycodone, or codeine, food moves through the intestines more slowly. That’s why as many as 40 percent to 80 percent of people using opioids for chronic (long-term) pain deal with constipation.

When opioid use stops, the gut goes into overdrive. Food and liquid pass through too quickly, which leads to cramping and diarrhea. This sudden change is one of the classic symptoms of opioid withdrawal.

The speed and severity can vary depending on the type of opioid and whether it is short-acting or long-acting. For example, fentanyl or heroin can cause a fast, intense withdrawal. Meanwhile, methadone and buprenorphine often trigger a slower, drawn-out process.

How Long Does It Last?

Diarrhea during opioid withdrawal doesn’t last forever, but it can feel never-ending while it’s happening. For short-acting drugs, such as oxycodone or heroin, diarrhea often starts within half a day and eases after four to five days. For longer-acting drugs, withdrawal symptoms, including diarrhea, may last for about a week or more. Some people may notice stomach issues that linger during early recovery, especially after heavy or chronic opioid use.

The good news is that there are safe and effective ways to find relief. Here are eight tips for managing diarrhea during opioid withdrawal.

1. Stay Hydrated

Diarrhea during opioid withdrawal causes the body to lose water and electrolytes (salts) quickly. Drinking plain water helps, but it’s not enough on its own. Juices, rehydration solutions, sports drinks that contain electrolytes, and clear broths are good choices. Sipping small amounts is safer than gulping it all at once, which may cause more stomach upset. If drinking even small amounts of fluids upsets your stomach, you may need to ask your healthcare team about intravenous (IV) fluids.

2. Eat Gentle, Bland Foods

What you eat can make diarrhea better or worse. During opioid withdrawal, choose gentle foods that are easy to digest. Specialists recommend the BRAT diet as a temporary approach: Eat bananas, rice, applesauce, and toast. Oatmeal, plain crackers, boiled potatoes, or skinless baked chicken are also safe choices. These foods can help calm the stomach and replace lost nutrients.

It’s best to avoid foods that can upset your gut, such as:

• Fried or fatty meals
• Spicy dishes
• Dairy
• Citrus fruits

• Alcohol, coffee, or other caffeinated drinks

3. Try Over-the-Counter Medications

A few over-the-counter (OTC) products can help with diarrhea during opioid withdrawal. Bismuth subsalicylate can calm the stomach, reduce fluid loss, and ease cramping. Some people also benefit from probiotics, which help restore healthy bacteria in the gut.

You may have heard of loperamide, another OTC medication that can help relieve diarrhea. However, it’s typically not recommended for people with opioid dependence because it acts on opioid receptors. At very high doses, some people misuse it to ease withdrawal or cravings, which can be dangerous and even cause heart problems. Always talk with a doctor or pharmacist before adding any new medications to your treatment plan.

4. Ask Your Doctor About Prescribed Medications

Some prescription medicines can ease diarrhea and other withdrawal symptoms. Two common options are clonidine and lofexidine. These drugs lower blood pressure, reduce sweating, calm anxiety, and may lessen stomach upset. They may have other negative side effects, so be sure to check with your doctor.

Your doctor may also prescribe mirtazapine. This drug is an antidepressant that can reduce anxiety, improve sleep, and sometimes help with stomach problems during opioid withdrawal. It may be especially helpful if you’re experiencing mental health problems such as depression, anxiety, or insomnia.

5. Use Heat for Cramping

Placing a heating pad, hot water bottle, or warm towel on your belly can relax tense muscles and reduce pain. A warm bath can also be soothing and restorative, which can help ease anxiety and stomach problems. While heat won’t stop diarrhea, it can make the discomfort easier to manage while your body goes through opioid detoxification or withdrawal.

6. Rest and Try To Reduce Your Stress

Opioid withdrawal puts your body under a lot of pressure. Muscle tension, anxiety, and lack of sleep can all make withdrawal symptoms worse. Taking time to rest helps your body heal. Even short naps or lying down in a quiet room can give your system a break. Gentle practices such as deep breathing, stretching, or meditation may also help calm your nerves and your digestive system.

7. Avoid Certain Medications

It’s important to know that not all medicines are safe or helpful when you’re dealing with diarrhea during opioid withdrawal. For example, some antibiotics can upset the stomach and lead to more diarrhea. Certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), may also cause digestive side effects. Even common pain medicines like aspirin or ibuprofen can irritate the stomach lining if used too often.

Always talk with your doctor or a trusted healthcare professional before making any changes to your treatment plan. If you have concerns about gut-related side effects of the medications you’re currently taking, they can discuss those concerns with you and make adjustments as needed.

8. Seek Professional Support When Needed

Diarrhea is a common and usually non-life-threatening withdrawal symptom, but sometimes it can be a sign of a bigger problem. If you have severe pain, blood in your stool, or signs of dehydration, call your healthcare provider right away, because these may be warning signs of a potentially serious gastrointestinal condition like stomach bleeding or another medical problem. Diarrhea can also cause complications such as dehydration.

Common signs of dehydration include:

• Thirst
• Dry mouth or cough
• High heart rate and low blood pressure
• Loss of appetite
• Sugar cravings
• Dizziness or lightheadedness
• Dark-colored urine

Professional support is also important for recovery as a whole. Your healthcare team is there to guide you through withdrawal management every step of the way. They can offer safe treatment options and connect you with inpatient or outpatient programs that provide both medical care and emotional support.

When To See a Doctor

Diarrhea during opioid withdrawal should usually resolve within a week. However, if it continues beyond that without improving, it’s a good idea to contact a healthcare provider. Long-lasting diarrhea can lead to serious side effects such as electrolyte imbalances that can affect your brain, heart, lungs, and kidneys. If you’re losing weight, feeling weak, or unable to keep food down, don’t hesitate to reach out for extra support. Your doctor can help rule out other potential health problems that could be contributing to your symptoms and adjust your withdrawal management plan so that you can recover safely.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.

What strategies have helped you deal with diarrhea from opioid withdrawal? Let others know in the comments below.