Heroin Withdrawal

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What Is Heroin Withdrawal?

Once a person becomes physically dependent on heroin, withdrawing from the drug becomes a difficult and very uncomfortable process. The safest way to detox is under medical supervision, which can help prevent relapse and overdose.

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Heroin Withdrawal Symptoms

Heroin withdrawal has many physical and emotional symptoms, including: 3,4

  • Nausea.
  • Vomiting.
  • Muscle aches.
  • Abdominal cramps.
  • Goose bumps.
  • Insomnia.
  • Increased tearing.
  • Sweating.
  • Runny nose.
  • Irritability.
  • Anxiety.

These symptoms will vary depending on:

  • How long the person was taking the drug.
  • How much he or she used.
  • Whether the person was combining heroin with other drugs.
  • Age.
  • Individual physiology.
  • The user’s mental health.

Find Heroin Withdrawal Treatment

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Many people who detox alone or go “cold turkey” relapse due to the severity of the withdrawal symptoms. For example, insomnia may sound annoying, but many people in heroin detox describe being unable to sleep for days.

Risks of Withdrawal

Although physical withdrawal is typically not medically dangerous,4 the symptoms can be difficult for a person to manage without medical assistance. A heroin user who is in withdrawal and relapses is also at risk of overdose due to lowered tolerance. 4 In addition, heroin withdrawal can result in medical complications, such as dehydration,4 or the emergence of mental health disorders that were previously suppressed by heroin.


Withdrawal Timeline

  • Physical symptoms will begin to occur 6 to 24 hours after the last use of the drug.3,4
  • The symptoms are at their most severe during the 2nd to 4th day after the last use of the drug. 3
  • Most people’s physical symptoms subside after a week. 3

Cravings, depression, anxiety, and sleep problems can continue for weeks or even months after a person quits using heroin. 3 The cravings can make it hard for many to stay clean after the physical withdrawal symptoms have waned.2


Causes of Withdrawal

Man with heroin withdrawal symptoms vomiting

Heroin can be snorted, smoked, or injected. It acts upon the reward centers of the brain and causes feelings of euphoria and pain relief. 1 Some users find these effects pleasurable and begin to take heroin routinely.

Over time, the user builds a tolerance to the drug and requires more heroin to achieve the desired effects. This continued and increased use can lead to physical dependence.

When a person who is physically dependent on heroin stops using it, they will usually experience withdrawal symptoms.1


Treatment for Withdrawal

Locate a Detox Center

If you need help with heroin withdrawal, call 1-888-319-2606

Who Answers? to find a treatment center for detox and addiction.

  • Detox programs: Heroin detox programs can last from 24 hours to a few days and provide medical oversight, as well as the management of some of the more severe withdrawal symptoms. Detox is only designed to provide the initial steps to recovery. A user should enter a recovery program after detox to prevent relapse and maintain sobriety.
  • Inpatient rehab treatment: Many people who are recovering from heroin addiction stay in an inpatient treatment program after detox. Some of these rehabilitation programs are housed along with a detox program, but other inpatient programs accept people after they have completed detox elsewhere. Inpatient treatment can last from a few days to a few weeks. It provides a structured 24/7 setting with medical oversight, as well as supportive counseling and relapse prevention techniques. Inpatient treatment may be necessary when a person has had several failed attempts at outpatient rehab treatment or has a very unsupportive home environment. In addition, people with underlying psychological issues or major medical issues often require inpatient treatment.
  • Partial hospitalization: Partial hospitalization programs, sometimes called day treatment programs, can range from a couple of hours per week to up to several hours per day, and as often as 7 days per week. These programs may provide detox for people who are experiencing less severe withdrawal symptoms. Partial programs provide structure, ongoing counseling, medical evaluations and oversight, and often are built around either a 12-step or other support group format. However, a person in partial treatment spends the night in his or her own home and may continue to work.

Medications for Heroin Withdrawal

Common medications include buprenorphine, methadone, and clonidine.


Medications can help reduce cravings and prevent relapse during detox. These medications should be combined with behavioral therapy to be most effective.

Some common medications are:

  • Buprenorphine (which is also combined with naloxone and marketed as Suboxone), is a partial opioid agonist, and it does not cause the high or dangerous side effects of heroin. It can be given during the withdrawal phase or on an ongoing basis to maintain recovery from heroin use. 2, 3,1
  • Methadone has been used since the 1960s to treat addiction. It is only available at certain programs that are certified to treat heroin addiction with the use of methadone. It is a so-called opioid agonist, which means that it acts upon the opioid receptors in the brain in a similar way to heroin, but is slower-acting. 2
  • Naltrexone is called an opioid antagonist, which means it blocks the effect of heroin on the opioid receptors of the brain. When a person takes any form of opioid while on naltrexone, the medication does not allow the heroin or other opioid to affect the brain. It is not addictive and does not cause physical dependence. However, compliance with this drug is low.2

Clonidine is sometimes used in detox programs to help alleviate some of the symptoms of withdrawal from heroin, such as anxiety, cramps, and agitation.4


Find a Detox Center

If you or your loved one is suffering from heroin addiction, finding the right detox center is critical. Numerous inpatient and outpatient programs are available to treat heroin withdrawal, and they can vary in terms of cost and accessibility.

Call 1-888-319-2606 Who Answers? to speak with a treatment referral specialist, who can help you choose the right program based on your insurance and particular situation.

Sources

[1]. National Institute on Drug Abuse (2014). Drug Facts: Heroin.

[2]. National Institute on Drug Abuse (2014). Heroin: What are the treatments for heroin addiction?

[3]. National Drug Strategy. Australian Government (2014). Guidelines for the management of heroin withdrawal.

[4]. National institutes of Health (2016). Medline plus: Opiate and opioid withdrawal.

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You are never too old to improve your health and quality of life!

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