Heroin Withdrawal

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.

Heroin Withdrawal Symptoms

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

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

These symptoms can 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.

Many people who detox alone or try to go “cold turkey” relapse because of severe withdrawal symptoms. For example, insomnia may affect people in heroin detox causing them to lose sleep for days.¹

Risks of Heroin Withdrawal

Although physical withdrawal is typically not medically dangerous, the symptoms can be difficult for a person to manage without medical assistance.⁴ 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, or the emergence of mental health challenges that were previously suppressed by heroin.⁴

Withdrawal Timeline

• • Physical symptoms will begin to occur 8 to 24 hours after the last use of the drug.^3,4
  • The duration of symptoms can last between 4 and 10 days.³

Cravings, depression, anxiety, and sleep problems can continue for weeks or even months after a person quits using heroin.³ These heroin cravings can make it hard for some people to stay sober, even after the physical withdrawal symptoms have lessened.²

Causes of Withdrawal

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 a person can build a tolerance to heroin and requires more of the drug 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

Withdrawal management as an important part of the detox and recovery process as it can help make the process easier and more comfortable. Heroin detox, withdrawal management, and treatment can occur in a variety of settings, such as inpatient or outpatient facilities depending on the needs of the individual.

• • • 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: Some people who are recovering from heroin addiction may stay in an inpatient treatment program after detox. Inpatient rehab programs may include a detox program, but other inpatient programs accept people after they have completed detox elsewhere. Inpatient treatment can last from a few days to weeks or months depending on the level of care a person needs.⁵ 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 co-occurring mental health disorders or medical conditions may require the support that heroin inpatient treatment provides.
    • 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.⁶

Medications for Heroin Withdrawal

There are a number of FDA-approved medications to support a person during heroin withdrawal, including those that help reduce cravings and help ease withdrawal symptoms.⁷ These medications include buprenorphine, methadone, and clonidine.
Medications can help reduce cravings and prevent relapse during detox. Combined with behavioral therapy, using medication in treatment for heroin withdrawal can be effective at treating heroin addiction.

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 elevated or potentially dangerous side effects of heroin.⁷ It can be given during the heroin withdrawal phase or an ongoing basis to maintain recovery from heroin use.²
    • 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, 7}
    • 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.^{2, 7}
    • 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 Heroin Detox Center

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

Call to speak with an American Addiction Centers’ caring admissions navigator who can help you find a heroin addiction treatment program based on your individual needs. You can also learn how to pay for rehabilitation. To see how treatment costs can be covered, use the free form below.