Withdrawal can occur when a person stops or significantly reduces the use of certain substances.3 Heroin is an extremely addictive opioid. Its use can lead to the development of significant physical dependence, and can result in particularly uncomfortable withdrawal symptoms when one stops using after an extended period of time.1, 3 As such, people who try to do heroin detox on their own or through the 'cold turkey' method may struggle to endure the withdrawal symptoms and may fall back into previous heroin use patterns to relieve the uncomfortable symptoms.2 However, effective detox treatment exists to help individuals mitigate challenging heroin withdrawal symptoms as they embark on their addiction recovery efforts.2 Understanding heroin withdrawal, when key symptoms will appear, and how those symptoms can be managed can help one start their journey to recovery. What is Heroin Withdrawal? Heroin withdrawal can occur after one stops using heroin after an extended period of heavy and prolonged use.3 As one continually uses substances like heroin, the body grows increasingly accustomed to the substance, eventually developing marked physical dependence.4 Once dependence develops, the cessation of heroin usage can result in a range of unpleasant withdrawal symptoms.3 The severity of heroin withdrawal symptoms will largely depend on what substance was taken, how long it was taken, the dosages taken, and the frequency of the doses taken.7 While heroin withdrawal is not usually fatal, the withdrawal symptoms can be intense and uncomfortable, and many people may abandon their attempts to detox in order to find relief.5 As such, the Substance Abuse and Mental Health Services Administration (SAMHSA) advises against attempts at managing acute opioid withdrawal without detox medications.7 Heroin Withdrawal Timeline The severity and duration of opioid withdrawal symptoms can vary greatly depending on how long one used heroin, the quantity of heroin used, and the frequency of use. However, there are some general milestones of opioid withdrawal that one can watch out for. Day 1 of Heroin Withdrawal The first day of heroin withdrawal will generally see the appearance of withdrawal symptoms. With relatively short-acting opioids like heroin, withdrawal symptoms may begin to arise within 12 hours after heroin was last used.6, 7 These acute heroin withdrawal symptoms may peak in severity within several before gradually diminishing over the course of about a week, in many cases.3 Some common symptoms of heroin withdrawal may include:1,3 Bone and muscle pain. Muscle spasms, twitching, or tension. Tremors. Abdominal cramps. Nausea, vomiting, diarrhea. Restlessness. Irritability. Hot flashes or cold chills. Fast pulse. Watery eyes. Sweating. Runny nose. Pupil dilatation. Yawning. Goosebumps. Fever. Days 2 to 4 of Heroin Withdrawal Symptoms of heroin withdrawal may continue to worsen over the next few days. While individual experiences may vary from person to person, symptoms commonly peak after 2 to 3 days.6, 7 Days 5 to 7 of Heroin Withdrawal After heroin withdrawal symptoms peak, they may begin to gradually alleviate over a period of 5 to 7 days.3 The Weeks After Heroin Withdrawal While withdrawal symptoms caused by short-acting opioids will generally subside after a week or two, there are circumstances in which heroin withdrawal symptoms may persist for longer periods of time.3 In some people, certain symptoms, such as anxiety and insomnia, may last longer, possibly taking a few weeks to a few months to resolve.3 How Long Does Heroin Withdrawal Last? While there is no set timeline for how long heroin withdrawal may last.3 Generally speaking, symptoms will peak after 5 to 7 days, and begin to subside after that. 3 Certain symptoms may persist for longer. Anxiety, insomnia, and other symptoms like dysphoria and anhedonia (inability to feel pleasure) can linger for a few weeks to a few months after other withdrawal symptoms subside.3 It’s important to be open and honest with your treatment team, as they can adjust doses of withdrawal management medications for heroin withdrawal symptoms depending on their severity and progression. Medications Used in Heroin Detox During heroin detox, certain medications may be prescribed to make the process more comfortable. Two of these medications are opioid receptor agonists, meaning that they attach to and activate opioid receptors in the brain to minimize the opioid withdrawal symptoms that would otherwise be felt when quitting heroin.1, 8 Medications that can be used during detox include: Buprenorphine: This is a long-acting partial opioid agonist that binds tightly to opioid receptors in a way that can displace heroin or other opioids from the same binding site.7 It reduces or eliminates opioid withdrawal symptoms and reduces cravings.1 Buprenorphine may be relatively more accessible (as it may be dispensed through waivered clinicians) and has a lower potential for overdose in misuse than methadone.7 Methadone: As a long-lasting opioid agonist, methadone attaches to and activates opioid receptors while prevents heroin or other opioids from attaching to receptors, in the meantime.7 It can help reduce or eliminate opioid withdrawal symptoms and reduces cravings.1, 7 While generally safe when taken as prescribed, methadone does have the potential for misuse and as such is heavily regulated.7 Methadone use is highly regulated, and may be only be prescribed and dispensed  through certified opioid inpatient treatment programs.7 [vob-aktify-cta title="American Addiction Centers accepts many types of insurance" subtitle="Check your coverage online or text us your questions for more information"] Finding Heroin Detox Treatment If you’re looking for a heroin detox program, there are steps you can take to can take to find a detox facility near you. A good first step would be to reach out to your doctor or a trusted medical professional. They may be able to help you determine your medical needs and may be able to refer you to a nearby treatment center. Another powerful tool is the SAMHSA treatment locator, which allows you to search for heroin detox facilities by zip code. Addiction helplines can be another useful tool. Addiction helplines are 24/7 phone line that provide support for those struggling with addiction. American Addiction Centers (AAC) operates an addiction helpline that can answer questions you may have about heroin detox, help you find nearby detox facilities, and help you verify your insurance. If you’re ready to begin your journey to recovery, contact us today at [phone]. [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Rehab Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Inpatient rehab Outpatient rehab Preparing for rehab Relapse prevention State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] Dangers of detoxing at home The cost of detox [/accordion][accordion title="Other Types of Narcotics"] Codeine Fentanyl Hydrocodone Kadian Lorcet Lortab Methadone Morphine Norco Opiates Opium Oramorph Oxycodone Tramadol [/accordion]   [sources] National Institute on Drug Abuse. (2021, June). Heroin DrugFacts. National Library of Medicine. (Updated 2022, May 15). Opioid withdrawal. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).  National Institute on Drug Abuse. (2022, March 22). What are the long-term effects of heroin use? Centers for Disease Control and Prevention. (2015). Today’s heroin epidemic. Kosten, T.R., Baxter, L.E., (2019) Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. American Journal on Addictions. Volume 28, Issue 2, pages 55–62. Substance Abuse and Mental Health Services Administration (2015). TIP 45: Detoxification and substance abuse treatment. Pages 66–67. Substance Abuse and Mental Health Services Administration. (2022, July.) Medication-Assisted Treatment. National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. Substance Abuse and Mental Health Services Administration. (2021). Medications for Opioid Use Disorder Tip 63. [/sources] ...