Heroin is a highly addictive and very dangerous drug. It is an opiate-based drug that provides a euphoric feeling that users crave over and over. The typical way someone uses heroin is via injection. However, it can also be inhaled, smoked, or snorted. Once used, the rush of euphoric feelings will be quick and typically last a few hours.

Today, heroin is considered one of the most accessible drugs to young people, and heroin addiction has become an epidemic in the United States.

What are Heroin Withdrawal Symptoms?

Once addicted to heroin, withdrawal will usually begin within six to 12 hours after the last dose. Because heroin is an opioid, it also has similar effects to painkillers. However, heroin leaves the body quicker than any other opioid, and therefore, allows withdrawals to occur faster. When thinking about heroin withdrawal, it has been compared to having a very bad case of the flu.

Common symptoms typical of heroin withdrawal are:

  • Diarrhea
  • Stomach cramps
  • Nausea and vomiting
  • Sweating
  • Muscle aches
  • Agitation
  • Anxiety
  • Dilated pupils

Stages of Heroin Withdrawal Timeline

The pace in which one gets through the detox process can vary from person to person depending on various factors such as:

  • The amount of heroin used
  • The frequency of use
  • Length of time addicted to heroin
  • Overall health condition
  • Support system
  • Polydrug use
  • Level of tolerance
  • Dietary habits

Generally, heavy users of heroin may experience a longer detox process, experiencing harsher symptoms.

A general heroin withdrawal timeline looks like the following:

Days 1-2: You will begin to feel pain or more specifically, muscle aches. These aches will progress over a day or so. During this period, you will also deal with other symptoms such as insomnia, diarrhea, convulsions, anxiety, and panic attacks.

Days 3-5: At this point, heroin withdrawal will reach its peak. The symptoms at this stage may include nausea and vomiting, stomach cramps, sweating, and shivers.

Days 6-7: Symptoms of withdrawal will start to wear off during this period. This will also mark the end of what is known as acute withdrawal. Your body will mostly feel normal again, but you may feel a bit more tired than usual.

Day 8 and Beyond: After the weeklong period, recovering users will still experience withdrawal symptoms, but they usually do on an inconsistent basis for a few months. Neurological changes may trigger the symptoms. However, other symptoms can last weeks or months. These include but are not limited to depression, anxiety, fatigue, irritability, and insomnia.

Heroin Withdrawal Medications

Opiate replacement therapies manage symptoms such as cravings and withdrawal by using long-acting opioid medications. The medications function in a way that heroin would in your brain, except it is done in a controlled environment and does not cause intoxication. As time moves on, the drugs can be slowly weaned off through a tapering process until the client is deemed opioid-free.

There are only two opioids with FDA approval to treat heroin withdrawal—methadone and buprenorphine. Buprenorphine is considered to have more favorable side effects than methadone, and one type of buprenorphine products that detox facilities use is Suboxone, which also contains naloxone. Naloxone blocks opioid receptors, which prevents it from being abused.

Other medications are used during heroin withdrawal to treat specific symptoms. Sedatives such as benzodiazepines and the medication clonidine are used for a reduction in withdrawal symptoms.

Nearly half of those with addiction struggle with a co-occurring disorder, such as depression or anxiety. It is important to be aware and treat the underlying mental health disorders as it will allow for the best success rates long-term. To do so, an individual must consider medical detoxification as a means to get a proper diagnosis.

Heroin Withdrawal Deaths

Withdrawal from heroin is less dangerous than alcohol, but in some instances can be fatal. When fatalities occur as a result of heroin withdrawal, it is commonly linked to excessive diarrhea and vomiting, which can rapidly dehydrate the body and cause high sodium levels to accumulate in the blood causing the heart to fail. These outcomes are more likely to occur when people stop heroin on their own, which can be prevented by medical detox.

Heroin Withdrawal Cold Turkey

The cold turkey method of stopping heroin will bring about a rapid onset of withdrawal symptoms that are difficult to endure. The risk increases exponentially of experiencing a setback during withdrawal as symptoms can be overwhelming. When someone tries to taper their heroin use alone, they are rarely successful.

Not only is this dangerous, but physicians and addiction specialists alike strongly advise against it. It is not the right way to address the addiction, and medically supervised detox that provides medications, support, and symptom management will simplify the process, which ends with a more successful result.

Why Should I Detox?

Some people will claim that quitting heroin cold turkey is a good idea. On the contrary, it is typically not the safest way to detox from the drug. The reason is that you will subject yourself to long-term withdrawal symptoms long after your last dose of heroin. At the same time, attempting to quit cold turkey can be dangerous to your health.

Complications from heroin withdrawal can kill someone if no medical supervision is present. People who experience withdrawal can become severely dehydrated. Or, if they end up vomiting, they could end up choking on their stomach contents and die by way of asphyxiation.

It is important that you detox from heroin with the help of medical professionals. Not only will you be able to save yourself from relapse, but it will save your life. Doctors in inpatient programs will monitor your psychological progress as you continue to go through withdrawals, especially the psychological symptoms such as depression and anxiety. Unfortunately, those attempting to recover at home alone are more prone to relapse.

What is the Next Treatment Step?

Now that you know quitting cold turkey is not an option, you still have the option to detox under the care of addiction specialists. Taking the first step to beating heroin addiction begins by deciding to go through with detox treatment. Once you have made the decision, you can begin to find out which options are best for you. The typical options available are inpatient, outpatient, and an intensive outpatient program (or IOP).

Here is a brief breakdown of what each of them requires.

Inpatient Treatment

This treatment is highly recommended for those who are getting over an addiction that has existed for a long time. This type of treatment is also for those whose addiction has reached severe levels.

Man discussing addiction with his doctor

For an inpatient treatment option, you will receive around-the-clock care from medical professionals. They will make sure your detox from heroin will be as safe and quick as possible. At the same time, you will receive psychological treatment if you’re dealing with psychological withdrawal symptoms such as depression and anxiety. You will still have a support system of counselors, doctors, therapists, and your peers pulling for your complete recovery.

Outpatient Treatment

For those who are looking for lower costs and schedule flexibility, the outpatient option likely will be best. These are reserved for those with less than severe, but still serious addictions. For outpatient care, you’ll attend an outpatient clinic for sessions throughout the week. The number of sessions varies from person to person, but they usually are between three and seven per week.

Outpatient offers much of the same types of treatment as inpatient facilities. However, participation programs do vary between facilities. Some will require daily participation, while others will require only a few hours a week. The major downside to outpatient care is not being able to leave home to solely focus on your recovery in a safe, structured environment.

Intensive Outpatient Program (IOP)

An IOP program is recommended for those who do not need a medically supervised detox. This is an outpatient program that will require daily participation while you can still live at home. The number of hours you’ll attend at IOP is more than you would if you went to outpatient treatment, usually more than 12.

In most of these settings, you will meet with a therapist regularly and attend a group counseling session. Groups tend to consist of 10 people or less. Because of daily participation, you will be able to get access to any help you may need in times of trouble. As you progress in your detox, your participation periods will become infrequent.

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