Heroin is one of the main players in the current opioid crisis. In 2017, 15,482 people died due to overdoses that involved heroin. Heroin is inherently dangerous. It’s an extremely addictive drug, and unregulated street heroin can contain any number of contaminants, including potent drugs like fentanyl.
Because of this, any given hit of heroin can lead to dangerous and deadly side effects. To avoid some of the most severe consequences of heroin addiction, it’s important to achieve sobriety as soon as possible.
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To do that, you will likely have to go through withdrawal. Heroin withdrawal is extremely uncomfortable, but it can be treated.
Learn more about heroin withdrawal, the signs and symptoms, and how it can be treated.
What Are Heroin’s Withdrawal Symptoms?
Heroin works by binding to opioid receptors in your brain and throughout your body. These receptors are designed to bind with endorphins, which are your body’s own naturally occurring opioids. When opioid receptors are activated, it helps to manage pain symptoms by blocking pain signals on their way to the brain.
Heroin is much more potent than your natural endorphins, so its effects are more pronounced.
When you become dependent on heroin, your body starts to rely on the drug to maintain normal neurochemistry. If you stop using, you’ll experience a temporary chemical imbalance. Because heroin affects the whole body, withdrawal symptoms can also be felt all over the body.
Heroin withdrawal is often described as causing flu-like symptoms, but many people say it’s like the worst flu they’ve ever experienced. Heroin withdrawal isn’t typically life-threatening, but the symptoms are so uncomfortable, withdrawal is often a significant barrier to treatment. Heroin withdrawal symptoms can include:
- Muscle aches
- Joint aches
- Runny nose
- Excessive tearing
- Abdominal cramping
- Changes in heart rate
- Changes in blood pressure
- Intense drug cravings
What Are the Stages of the Heroin Withdrawal Timeline?
The timeline on which you experience heroin withdrawal symptoms will depend on several factors that may be unique to you.
Your size and weight, the size of your normal dose, how long you’ve been using heroin, whether or not you used other drugs alongside heroin, and the size of the last dose you took can all affect your withdrawal timeline.
Each person is different, and your withdrawal timeline may be unique to you. However, withdrawal tends to happen on a general timeline that may be similar to your experience. Here’s what might happen if you stop using heroin after developing a chemical dependence:
- 12 hours: Heroin has a relatively short half-life, and it may wear off fairly quickly. You’ll most likely experience your first withdrawal symptoms within the first 12 hours after your last dose. Some people may experience symptoms as early as six hours after your last dose. Early symptoms may feel like you’re coming down with the flu-like fatigue, runny nose, and body aches.
- 48 hours: Within the first two days, your symptoms will intensify before they hit their peak strength. At their peak, you may experience nausea, sweating, vomiting, fever, diarrhea, and headache. Your peak will usually happen by 48 hours, but it can happen as early as 24 hours.
- 1 week: After your symptoms peak, your symptoms will start to go away. By the end of the first week, most of your physical symptoms will be gone, but this can sometimes take as long as 10 days. Some psychological symptoms, like depression or anxiety, can last longer.
- Ongoing: Certain psychological symptoms, insomnia, and powerful drug cravings can continue indefinitely and may need additional treatment to address adequately. Addiction treatment can help you learn how to cope with cravings and address mental health issues like depression.
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Why Should I Detox from Heroin?
Opioids like heroin are sometimes grouped in with central nervous system depressants. But heroin isn’t as dangerous during withdrawal as depressants like alcohol and benzodiazepines. Opioids work in the brain differently and have a unique set of withdrawal symptoms.
While the flu-like symptoms can be extremely uncomfortable, they are rarely life-threatening. Still, in rare cases, opioids can cause potentially deadly medical complications. Sweating, vomiting, and diarrhea can potentially lead to dehydration. This has been fatal in the past in situations where prisoners weren’t given proper medical attention.
Heroin withdrawal can also cause heart-related symptoms like changes in your heart rate or blood pressure. People with heart disease or other conditions that may make them vulnerable to these changes might need to go through medical detox where they can be monitored 24 hours a day.
Heroin addiction has been linked to a higher likelihood of contracting infectious diseases like HIV and hepatitis C. These medical conditions can be addressed and treated and monitored in medical detox, and they can continue to be managed through other levels of care.
Other medical needs that are commonly co-occurring with heroin addiction like constipation, vascular issues, abscesses, bacterial infections, and soft tissue infections can be addressed in medical detox.
What Can Help Heroin Withdrawal?
Heroin withdrawal can be treated in a medical detox or hospital detox setting. Detox is the highest level of care in addiction treatment, and it involves 24-hour medically managed care each day.
Not everyone who goes through heroin withdrawal will need medical detox, but it can help to alleviate some symptoms. Medical detox is intended to help people who may experience severe withdrawal symptoms or other medical complications. On-staff medical professionals will help ensure your safety and ease uncomfortable symptoms.
When you first enter addiction treatment, clinicians will use the ASAM criteria to determine the best level of care for your needs. If you are likely to go through severe withdrawal symptoms or if you have high-level needs because of medical conditions and complications, you may need to start with medical detox.
According to the National Institute on Drug Abuse, detox is typically not the end of treatment, especially when it comes to a substance use disorder involving heroin. Medical detox is often an important first step in your recovery progress, but it may take longer addiction treatment to facilitate a lasting change.
What Is the Next Treatment Step?
After medical detox, clinicians will help you find the next level of care that’s appropriate for your needs. If you have high-level medical or psychological needs after detox, you may continue to get 24-hour treatment in an inpatient program or a residential program.
If you can live on your own, but you could still use many hours of support each week, you may go through intensive outpatient treatment or partial hospitalization. If you have made significant progress in recovery, but you could still use some support each week, outpatient treatment might be the level for you.
When you enter an addiction treatment program, clinicians will work with you to find the best level of care for your specific needs.
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National Institute on Drug Abuse. (2019, January 29). Overdose Death Rates. Retrieved from from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
Waldhoer, M., Bartlett, S. E., & Whistler, J. L. (2004). Opioid receptors. Retrieved from from https://www.ncbi.nlm.nih.gov/pubmed/15189164
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
National Institute on Drug Abuse. (2018, June). Why does heroin use create special risk for contracting HIV/AIDS and hepatitis B and C? Retrieved from from https://www.drugabuse.gov/publications/research-reports/heroin/why-are-heroin-users-special-risk-contracting-hivaids-hepatitis-b-c