Footprints to Recovery

Detoxing from Heroin: What Is Withdrawal Like?

Medically Reviewed by David Szarka, MA, LCADC

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In recent years, the opioid epidemic has ravaged America. Almost 70% of the 67,367 overdose deaths in 2018 involved an opioid. While the opioid epidemic has made more people more aware of the perils of drug addiction, treatment continues to remain a problem.

Heroin, an opioid, is one of the most potent drugs in the world. It can be highly addictive, and because of that, many people who use heroin fear the thought of detox and withdrawal. Let’s unpack what you need to know.

Detoxing from Heroin: What Is Withdrawal Like?

What Causes Heroin Withdrawal to Happen?

All opioids can become habit-forming. When you build a tolerance to heroin, you need to take more of it to feel high. Eventually, you can become physically and psychologically dependent on the drug.

Chronic opioid use changes the nerve receptors in your brain. They come to depend on heroin to function. If you stop using heroin or reduce the amount you take, you may experience withdrawal symptoms. The withdrawal symptoms represent your body’s physical response to the absence of heroin.

Heroin Withdrawal Symptoms And Timeline

Heroin withdrawal symptoms can range in severity, but none are pleasant, and the first withdrawal symptoms emerge quickly. Some people experience them just six hours after their last dose. The initial symptoms may feel mild. They include:

  • Heightened anxiety
  • Insomnia
  • Sweating
  • Nausea or vomiting
  • Body aches and muscle spasms
  • Intensified opioid cravings
  • Flu-like symptoms (runny nose, chills)

Those symptoms usually peak between two to four days after the last use of heroin. But within the first three days, most people also experience psychological problems. These often include:

  • Depression
  • Rapid mood swings
  • Anxiety
  • Sleeping problems
  • Irritability
  • Concentration problems
  • Restlessness

Around three days after the last dose, many people face digestive and physiological problems, including:

  • Intense stomach pains
  • Muscle spasms
  • Shivers
  • Hypertension
  • Body aches
  • Vomiting
  • Diarrhea

Typically, the withdrawal symptoms peak between two and three days, but they can last anywhere from one to two weeks. Some people experience symptoms for several weeks or months. This is known as protracted withdrawal.

Is Medical Supervision Necessary During Heroin Withdrawal?

Detoxing from heroin is not inherently life-threatening, but you can experience complications. Therefore, most treatment professionals support medical supervision.

As mentioned, heroin is highly addictive, so the withdrawal symptoms can be extremely intense. To compound the issue, cravings peak during detox. As a result, many people find themselves struggling with chronic relapse. Even if they want to stop using the drug, it can feel impossible.

It’s fairly common to use heroin with other drugs. In some cases, withdrawing from particular substances, like alcohol or benzodiazepines, can be fatal. There is no accurate way to know how your body will react to the detox process. Fortunately, trained detox staff can handle acute medical complications that may arise.

Finally, detox can intensify feelings of depression or anxiety. Some people even experience suicidal ideation. When you detox under medical supervision, you’re doing so under the care of people who know how to handle the mental struggle that sometimes comes along with withdrawal. You will be supported and held accountable for your recovery goals.

What to Expect During Medically Supervised Detox

Medical detox provides 24/7 structured care. The length of detox varies, and it will depend on several factors including:

  • Your medical and mental health history
  • Drugs present in your bloodstream
  • Your history of previous detox episodes
  • Your motivation and desire for change

All detox begins with a thorough assessment, during which you’ll talk about your medical and psychiatric history. You will also meet with a medical doctor. It’s not uncommon to spend the first few days sleeping or resting because detox can be both physically and emotionally uncomfortable. When you do medical detox, you’ll be supported by compassionate staff and other clients seeking recovery.

You may meet with a case manager or therapist. These professionals will teach you the basic concepts of relapse prevention. They’ll also teach you coping skills to manage cravings.

You may also attend clinical groups. Group topics vary, but common ones include:

  • Relapse prevention
  • Self-esteem
  • Spirituality
  • Cognitive behavioral therapy (CBT)
  • Expressive therapy
  • Meditation and mindfulness
  • Healthy relationships

Successful detox includes aftercare referrals. Detox alone isn’t clinical treatment. People who struggle with heroin addiction usually need formal, long-term care. Most people benefit from residential or outpatient programs.

Are There Any Medicines That Can Help with Withdrawal?

Several pharmacological treatments can help with heroin withdrawal. Sometimes finding the right medicine requires a process of trial-and-error.

Methadone – Methadone is an opioid agonist, which means it works on the same receptors as heroin and other opioids. However, it’s been used for over 50 years to treat heroin addiction, and it can be a fantastic treatment option for people who don’t respond well to other methods. That said, methadone is an opioid, so it has the potential for misuse and addiction. You can only receive methadone through a specific treatment program.

Buprenorphine (Subutex) – Buprenorphine is a partial opioid agonist. It reduces drug cravings and can block the high people experience if they take heroin. Suboxone can be taken as an oral tablet or a dissolving strip. If a person injects Suboxone, the naloxone immediately triggers withdrawal symptoms. There is the potential to misuse these substances, so they should only be taken under medical supervision.

Naltrexone (Vivitrol) – Naltrexone is an opioid antagonist. The medication comes in both injectable and tablet forms. It blocks the pleasurable opioid effects, so there’s no potential for dependence. However, to be effective, patients must take naltrexone in a timely manner.

Heroin withdrawal may seem frightening, but the discomfort is short-lived. No matter your circumstances, recovery is possible. You deserve to give yourself another chance for health and happiness! Contact Footprints to Recovery to learn about our medical detox and heroin treatment programs, and get on the road to recovery today.

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Jenna Richer
Medically Reviewed by Jenna Richer, MSW, LCSW
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