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Heroin Withdrawal Symptoms and Timeline

Read on to learn more about specific heroin withdrawal symptoms, as well as the heroin withdrawal timeline and medications used to treat withdrawals.

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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

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 .