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Heroin Withdrawal & Detox: Causes, Timeline & Symptoms

Last Updated: December 7, 2023

Editorial Policy | Research Policy

Heroin withdrawal is uncomfortable, but you can successfully overcome symptoms with medical help.

If you or a loved one is addicted to heroin, quitting the drug can seem scary due to the possibility of experiencing heroin withdrawal. Although heroin withdrawal can be uncomfortable, it does not need to be a stumbling block. Medical assistance can help you ease through heroin withdrawal, paving your path toward recovery.

Causes of Heroin Withdrawal

When you take an opioid like heroin regularly, your brain becomes used to its presence. This phenomenon, called tolerance, means you need to take progressively larger amounts of the drug to achieve the same effects. 

After you are used to taking a high dose of heroin, your body can become dependent on it, expecting the drug’s presence daily. Stopping heroin can wreak havoc on your brain chemistry. Specifically, an area of your brainstem called the locus coeruleus releases excessive amounts of norepinephrine during withdrawal, which leads to unpleasant withdrawal symptoms. 

Fortunately, heroin withdrawal is temporary, and withdrawal symptoms resolve with time. 

Heroin Withdrawal Timeline: How Long Does Heroin Withdrawal Last?

Although everyone’s withdrawal timeline is different, heroin withdrawal often follows a predictable pattern. Symptoms can occur at any time during withdrawal, typically starting soon after the drug is stopped and then worsening before resolving. In general, you should expect the following time frame:

  • Withdrawal symptoms begin: Generally, heroin withdrawal symptoms start within 12 hours of the last drug dose. These symptoms vary from person to person and occur as the drug begins to leave your system.
  • Withdrawal symptoms worsen: Heroin withdrawal symptoms reach their peak severity 24–48 hours after the last drug dose. At this time, heroin has left your system, and your brain is struggling to adjust to suddenly being without a drug on which it came to rely.
  • Withdrawal symptoms resolve: Typically, heroin withdrawal symptoms improve three to five days after the last drug dose. At this time, your body has started to re-adjust to being without the drug. However, some symptoms like anxiety, depression and sleep problems may persist for several weeks to months after the last heroin dose. Nonetheless, these symptoms will resolve with time and continued sobriety.

Heroin Withdrawal Symptoms

Heroin withdrawal symptoms may vary from person to person. Not everyone will experience all withdrawal symptoms, and symptom severity can vary. Typical heroin withdrawal symptoms include:

  • Muscle aches 
  • Trouble sleeping
  • Runny eyes 
  • Runny nose
  • Sweating
  • Goosebumps
  • Yawning
  • Enlarged pupils
  • Abdominal cramps
  • Diarrhea
  • Nausea and vomiting
  • Agitation 
  • Anxiety

Withdrawal symptoms can be challenging to overcome on your own and, in severe cases, can lead to strong cravings and relapse. Fortunately, heroin withdrawal symptoms can be managed with medical assistance and medication-assisted treatment (MAT), improving your chances of recovery.

Heroin Withdrawal Management

Sometimes, people want to try to quit heroin on their own. This can include trying to quit the drug cold turkey. Attempting to stop heroin on your own without help can lead to severe withdrawal symptoms that increase your risk of relapse. For this reason, home detox should be avoided when possible.

Quitting Heroin Cold Turkey

People sometimes try a rip-the-Band-Aid-off approach to overcoming a heroin addiction. This means they quit the drug cold turkey, suddenly stopping heroin. Because their brain is often dependent on the drug, withdrawal symptoms occur and can be overwhelming. For this reason, experts do not recommend a cold turkey approach to quitting heroin.

Detoxing From Heroin at Home

When someone decides to detox from heroin at home, it is important they prepare for the challenges they will face when stopping heroin without medical assistance. Some factors to consider before attempting a cold turkey withdrawal include:

  • Having a loved one monitor withdrawal symptoms and seek help if necessary
  • Mental preparation for a surge of withdrawal symptoms as the drug leaves the body
  • Adequate food and hydration to help keep your strength during withdrawal

Because it is so difficult to manage withdrawal symptoms successfully at home, experts recommend seeking medical help for heroin withdrawal.

Medication-Assisted Treatment (MAT) for Heroin Withdrawal

Experts recommend MAT for heroin withdrawal to help ease symptoms and set the stage for a successful recovery. In MAT, medications are used alongside other interventions like therapy to increase your chances of remission from heroin addiction. First-line MAT medications for heroin withdrawal include methadone and buprenorphine-based products. Methadone and buprenorphine are long-acting opioids that block the effects of heroin and can reduce cravings, helping to keep you sober.

Methadone is an oral medication that has been one of the gold-standard treatments for opioid addiction for decades. The drug is dispensed from special outpatient methadone clinics that require you to obtain the drug in person on a daily or near-daily basis.

Buprenorphine is a medication that is also considered a gold standard choice for opioid addiction. The drug is available in multiple dosage forms, including oral film, tablet and a long-acting injection. When taken orally, unlike methadone, buprenorphine can be dispensed from any outpatient pharmacy. The Recovery Village Atlanta offers buprenorphine for MAT as medically appropriate.

Other medications may also be used as adjunctive treatments if needed. These can vary and include acetaminophen for pain and loperamide for diarrhea.

Deciding on Where to Detox in Georgia

There are many factors to consider when deciding where to undergo heroin detox. Choosing an experienced medical detox facility with caring staff is extremely important. The Recovery Village Atlanta is staffed with compassionate experts in heroin recovery. We offer 14 medical detox beds and a full continuum of care to support your recovery after medical detox is complete. Following medical detox, The Recovery Village Atlanta offers residential treatment options, including a partial hospitalization program to help you stay heroin-free. Don’t wait: contact us today to learn how we can help.

Sources

American Society of Addiction Medicine. “National Practice Guideline for the Treatment of Opioid Use Disorder.” December 18, 2019. Accessed October 22, 2023.

Substance Abuse and Mental Health Services Administration. “Protracted Withdrawal.” July 2010. Accessed October 22, 2023.

World Health Organization. “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.” 2009. Accessed October 22, 2023.

Kosten, Thomas R.; George, Tony P. “The Neurobiology of Opioid Dependence: Implications for Treatment.” Addiction Science and Clinical Practice, July 2002. Accessed October 22, 2023.

U.S. Department of Justice, Drug Enforcement Administration. “Drugs of Abuse.” December 2022. Accessed October 22, 2023.