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What Happens When You Quit Heroin Cold Turkey?

Dr. Richard Foster, LICDC-CS

Medically reviewed by

Dr. Richard Foster, LICDC-CS

March 19, 2019

Quitting heroin cold turkey on your own can be dangerous and can increase the risk for relapse. Medically-supervised detox programs can provide supervision and support for successfully detoxing from heroin.

Heroin is a powerful and addictive opioid that can rapidly lead to physical dependence. This physical dependence can cause people to experience distressing withdrawal symptoms with stopped or reduced use of the drug.

People who have become addicted to heroin will need to go through some form of detoxification (detox) to remove the drug from their system. Some may attempt to do this at home by suddenly stopping their use of heroin all at once. This is what’s known as quitting ‘cold turkey.’

Stopping heroin cold turkey can lead to severe withdrawal symptoms and increase the risk for certain health consequences. This includes severe emotional distress and complications due to dehydration.

The most effective way to stop using heroin is to enter medical detox where people can be monitored and receive treatment to ease withdrawal symptoms.

Can You Quit Heroin Cold Turkey?

Some people may attempt to detox cold turkey from heroin, but this is not recommended. The physical and psychological symptoms that can occur with suddenly stopped use can also often be too much for a person to handle on their own.

At the same time, tapering heroin doses may also be an inefficient way to detox. As a street drug, heroin is often laced with other substances, and it can be difficult to gauge when and how much to reduce doses.

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If a person is unable to tolerate withdrawal symptoms and does not seek help, they may return to their previous pattern of drug use. Relapse due to severe withdrawal symptoms can be discouraging, and it may make a person feel hopeless about being able to overcome their addiction.

Heroin Withdrawal Symptoms And Timeline

The symptoms experienced during withdrawal can vary from person to person. Symptoms may often resemble those of a bad flu and can vary in severity. The first stage of early withdrawal symptoms may begin between six and 12 hours after last use of the drug.

Physical symptoms of heroin withdrawal may include:

  • muscle aches
  • sweating
  • runny nose
  • diarrhea
  • nausea and vomiting
  • dilated pupils
  • goosebumps
  • stomach pain

Mental and psychological symptoms:

  • depression
  • anxiety
  • agitation
  • insomnia

The most intense stage of the withdrawal process usually begins after the first two to three days of detox. This late withdrawal phase may include symptoms like vomiting, diarrhea, muscle cramping, and a general sense of discomfort. These symptoms may last for up to 10 days.

Most physical symptoms of withdrawal last no longer than 7 to 10 days. However, some psychological symptoms may continue. This can include symptoms of anxiety, depression, or drug cravings, which may last weeks or even months. These lingering symptoms may be treated with individual counseling and medication-assisted treatment (MAT) as needed.

Dangers Of Stopping Heroin Cold Turkey

Withdrawal from heroin is rarely fatal but can pose certain dangers if attempted alone. Without medical supervision, cold turkey detox can increase the risk of physical harm, as well as severe mental and psychological symptoms.

Physical Dangers

One of the most serious concerns during the late stage of withdrawal is dehydration. This can happen if a person is experiencing continued bouts of vomiting and diarrhea. These physical symptoms can place overwhelming stress on the bodies of those who have become dehydrated or malnourished due to their drug use.

In rare cases, repeated vomiting and diarrhea during withdrawal may lead to hypernatremia (elevated sodium levels) or heart failure.

Mental And Psychological Symptoms

The mental and psychological symptoms that can occur during detox may cause high distress. Overwhelming waves of anxiety and depression common during withdrawal can be challenging to face alone. If these symptoms become too much for people to handle, they may return to their drug use if only to relieve withdrawal symptoms.

Self-harm and suicide are also higher risks during opioid withdrawal. People with an opioid use disorder (OUD) are two to five times more likely than the general population to die by suicide.
Attempting to detox cold turkey may make people more vulnerable to suicide or other self-harm behaviors.

These dangers may be most effectively avoided by undergoing medical detox, which provides support to combat and treat these symptoms.

How To Quit Heroin Use

Making the decision to stop using heroin can be difficult, but also beneficial for a more balanced and hopeful future. Attempting to stop heroin alone can increase someone’s risk for relapse, which may result in multiple exhausting attempts to quit. This can be due to the severity of withdrawal symptoms, and may also occur due to a lack of support.

The most effective way to stop using heroin is to enter a facility for medically-supervised detox. Detoxing within an inpatient facility can provide the structure and support most people need when attempting to stop using an addictive drug. Medical detox programs provide 24-hour supervision by medical specialists who can monitor vitals, keep you hydrated, and oversee proper nourishment.

Medication-Assisted Treatment

Certain medications may also be used to treat symptoms of heroin withdrawal.

Medications that are approved by the Food and Drug Administration (FDA) to treat opioid withdrawal include:

Buprenorphine (Subutex): Buprenorphine is a partial opioid agonist that can be used to treat opioid withdrawal. In some cases, it may be able to help shorten the length of detox. While many use it short-term, it may also be used for long-term management of persisting symptoms to maintain sobriety.
Methadone: Methadone is an opioid agonist that can help relieve discomfort during the detox process. It may also help prevent certain withdrawal symptoms or keep them at a milder level.

Naltrexone (Vivitrol): Naltrexone is a non-addictive opioid antagonist that may be used after detox to help prevent relapse. This drug is available in pill form or may be injected once a month for continued sobriety.

Clonidine and some other medications may also be used to treat specific symptoms such as vomiting, nausea, and anxiety. These may be administered by a doctor as needed to relieve physical and psychological discomfort during detox.

Getting Help For Heroin Addiction

Seeking treatment for heroin addiction is the most effective way to stop using heroin for good and continue on a path towards lifelong recovery.

Combining medications and behavioral therapy has shown to be the most effective way to help a person overcome opioid addiction and prevent relapse. These treatments may be offered within an inpatient drug rehab program, or on an outpatient basis.

Inpatient treatment is often recommended to provide professional support and structure in the early stages of sobriety. These programs may also offer group therapy and additional help for co-occurring mental and medical disorders.

For more information on finding a detox program and overcoming heroin addiction, contact one of our treatment specialists today.

National Institute on Drug Abuse - Heroin

National Institutes of Health: MedlinePlus - Opiate and opioid withdrawal

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