These symptoms are so characteristic of early opioid withdrawal that clinicians use them as part of standardized withdrawal scoring tools like the COWS scale. COWS scale article

Why it happens: These are classic signs of the autonomic nervous system rebound that occurs when opioids are no longer suppressing it — the same category of effect as sweating and chills.

What tends to help: There’s no specific treatment for these symptoms in isolation; they’re generally used as an early indicator that withdrawal has begun and other symptoms will likely follow, rather than something to treat on their own.

Why this matters practically: If you’re planning to start buprenorphine, these symptoms (along with others) are often used to judge whether enough withdrawal has begun to start safely, without triggering precipitated withdrawal. [precipitated withdrawal article]

Medically reviewed by [pending]. Source: SAMHSA TIP 63, COWS scale documentation.