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Heroin Withdrawal And Detoxification

Dr. Richard Foster, LICDC-CS

Medically reviewed by

Dr. Richard Foster, LICDC-CS

April 8, 2019

Heroin withdrawal symptoms may only last about a week but can be severe and extremely uncomfortable. For this reason, heroin withdrawal should be carefully treated with a medically supervised detoxification.

Tapering the level of opioids in the body is important in managing withdrawal symptoms. This can be done with the aid of medication, monitoring of vital signs, and round-the-clock care.

After you complete detoxification, a minimum of a thirty-day stay at an inpatient rehab center is highly recommended. Treatment may take place in the same facility as the detox program or a standalone residential treatment center. For many people addicted to heroin, professional detoxification is a necessary first step to complete before embarking on the rest of the healing journey.

What Happens During Heroin Withdrawal?

When you’ve abused heroin for a prolonged period of time, you’ll likely experience some physical symptoms when you abruptly stop taking the drug. Heroin addiction causes a physical dependence, which means your body begins to rely on the drug and produces adverse symptoms when you stop taking it. In addition to physical dependence, heroin is extremely mentally addictive, making abstinence even more difficult to achieve.

Withdrawal from heroin can begin as early as a few hours after your last use, and may last a few days, up to a week, or even a few weeks or more, depending on the duration of abuse. Heroin withdrawal symptoms include:

  • Cravings for the drug
  • Cold flashes with goose bumps
  • Bone and muscle pain
  • Nausea, vomiting, and diarrhea
  • Insomnia
  • Restlessness
  • Tremors
  • Extreme sweating
  • Agitation and nervousness
  • Depression
  • Muscle spasms
  • Abdominal pain

Peak heroin withdrawal symptoms occur between 24-48 hours after last use, but some may experience symptoms for months, according to the National Institute On Drug Abuse (NIDA). That’s why it’s so important to find help in detoxification. While withdrawal symptoms can be extremely uncomfortable,  it is important to note that withdrawal from heroin alone is never life-threatening.

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What Causes Heroin Withdrawal?

Heroin is a physically addictive drug, which means it can cause dependence. When you become dependent on heroin, your body comes to rely on the feelings produced by the drug in order to function. As a result, you experience physical symptoms when not taking it.

Not all drugs will cause dependence. In fact, some drugs are only mentally addicting, meaning you can become addicted to them but the dependence is in your mind. However, those drugs that are physically addicting tend to cause both mental and physical addiction, and heroin is one of them.

When you take heroin, an opioid, it binds to opioid receptors in your brain, producing feelings of calm, well-being, and euphoria, among others. The first few minutes after you take it, this rush of feelings gives you overwhelming joy, followed by an intense, prolonged “high.” For this reason, heroin is one of the drugs that can foster addiction with just one use.

After repeated uses, you can become physically dependent. Though you don’t have to be dependent on heroin to be addicted, once you’ve formed a dependence it’s very hard to quit without help due to the harrowing withdrawal phase.

Luckily, there are now many forms of treatment that can help ease withdrawal, making it manageable. If you can get through withdrawal, you’ve made it past one of the most difficult hurdles in addiction recovery. After that, your biggest focus will be on getting well.

What Factors Affect Heroin Withdrawal?

It’s important to recognize that heroin withdrawal will not be the same set of symptoms for everyone. Each person will experience heroin withdrawal symptoms, and heroin addiction, differently according to a number of factors.

Some things that affect the severity and duration of withdrawal include how long heroin was abused, how often, how much was taken at a time, and the way it was abused (method of administration).

Heroin affects your brain and body in various ways. It stimulates heart rate and blood pressure, and affects your breathing and regulation of body temperature. Heroin also affects your response to pain and perception of pleasure. When you become addicted and take heroin, your body gets a rush of pleasurable feelings. Withdrawal is what happens when you no longer have access to those feelings once you’ve become dependent on them.

So, the severity and duration of withdrawal symptoms will be affected by how much you rely on heroin (degree of dependence). Withdrawal is also affected by how much your brain chemistry has changed during abuse of the drug. For example, if you have only been abusing heroin for a short time, you may experience only mild symptoms, like chills and nausea.

For those who have been abusing heroin for months or even years, the symptoms can be worse and may worsen with time, such as depression, insomnia, and fatigue.

How Can Heroin Withdrawal Become Dangerous?

Heroin withdrawal itself is not life-threatening, but some of the long-term symptoms caused by it can be. For example, withdrawal can cause depression. Left untreated, depression can result in suicidal thoughts, self-harm, and more.

Additionally, if heroin is abused with other drugs (polydrug abuse) such as benzodiazepines (xanax, ativan, etc) or alcohol, a medical detoxification is absolutely necessary. Withdrawal from alcohol and benzodiazepines can be deadly and no one should ever detox alone.

In general,  heroin addiction and subsequent withdrawal causes poor health. You may not intend to neglect your body, but addiction leaves little room for self-care. Insomnia caused by withdrawal coupled with other effects of addiction, such as lack of proper nutrition and self-care, can affect your overall health in the long run.

Yes, it’s best to overcome heroin addiction and restore your health and well-being, but it’s a feat best accomplished with the help of those who know how to safely taper off use of opioids. Maintaining safe levels of opioids in the body until a time when your body can handle stopping use of them is necessary to a safe recovery. This can be achieved in detoxification.

Heroin Addiction Detoxification

With quality care in medically supervised detox, you can safely taper off of heroin. During detoxification, you’ll also receive medication if you need it to help ease withdrawal symptoms, reduce any pain or discomfort, and help you taper off use of opioids altogether.

Therapy and counseling will be coupled with detoxification when you’re in stable condition so you can begin healing from the internal effects of addiction as well as the physical. After detoxification is complete, you’ll continue an intensive program combining several treatment modalities for a comprehensive healing approach.

Heroin affects the body in complex ways, especially if it’s been abused for a long period of time. That means many aspects of health are affected by abuse of the drug, and treatment must address each of these simultaneously to ensure a complete recovery.

How Long Does a Heroin Detoxification Take?

For those who need it, detox will usually be the first step in addiction recovery. Medically supervised detoxification typically lasts from five to seven days, but for those suffering from years of abuse, this process can take up to 10 days or more. During this time, you’ll be monitored by licensed, professional clinicians and staff who will track your breathing and heart rates, blood pressure, and body temperature at regular intervals.

There is no set limit for how long detox will last; it is up to you, your body, and your progress as determined by those caring for you. However, it’s not the duration of detox that matters. Instead, it’s what you’ll get out of it: a body that is back to a substance-free level and ready to heal.

Medication-Assisted Therapy (MAT) for Heroin Addiction

The best way to ease withdrawal and make sure you don’t become too uncomfortable is through monitoring the level of opioids in the body and careful tracking of vital body functions. Medication can greatly help during this phase of recovery. One of the most commonly prescribed medications in a detox setting is buprenorphine, an opioid with low potential for abuse.

Some people think that getting an opioid agonist medication like buprenorphine is simply replacing one opioid addiction with another, but that is not the case. Heroin is a powerful, potent, addictive opioid. Buprenorphine is still an opioid but works differently in the brain and body than other opioids.

Buprenorphine is a partial agonist opioid, marketed under several brand names including Suboxone, Subutex, and Zubsolv. Heroin is a full agonist, which is the reason it binds to opioid receptors and causes such powerful effects. An antagonist medication works to fully block the effects of opioids. However, blocking the effects from someone who is newly recovering and still in withdrawal is not always effective and can be detrimental to recovery.

A partial agonist like Suboxone works similarly to other full agonists, like heroin, but on a much smaller scale. As explained by the National Alliance Of Advocates For Buprenorphine Treatment, the following are some of the benefits of Suboxone treatment for those in detoxification and addiction recovery:

  • A decrease in euphoria, which decreases the likelihood of dependence
  • Less potential for abuse
  • A ceiling to opioid effects
  • Mild withdrawal experience overall

How do full agonist medications work in comparison to partial agonists? Full agonist medications are in the same category as heroin. That is, they cause similar reactions and results in the brain and body, and are equal in terms of risk of abuse and addiction.

That’s why buprenorphine is often more successful in helping those in detoxification for heroin addiction compared to other full agonist medications like Methadone. Buprenorphine (Suboxone) produces effects similar to heroin on a reduced scale, so there is less risk of addiction while allowing you to slowly taper off use of heroin. Yet it also blocks other opioids at the same time, providing you with less risk of continued addiction.

With appropriate dosage, careful monitoring, and correct administration, people taking Suboxone during detoxification may see greatly reduced cravings, blocked effects of other opioids, and experience greatly decreased use or cease use of illicit drugs, and success in treatment.

Heroin Addiction: Other Treatment Methods

Treatment goes much further than just detoxification. In fact, detoxification is just the first step in the recovery process. Once detoxed, individuals will enter a residential treatment program. These programs can last anywhere from thirty days to well over a year.

Most drug rehab centers recognize that recovering from heroin addiction will take time, effort, and a comprehensive treatment plan. For true success in treatment, several methods are often integrated to form a single, all-inclusive program.

You may not know exactly which treatment methods you’ll require right away, so the first step is usually a full clinical assessment. This allows you and the staff and clinicians caring for you to determine your treatment needs and address each accordingly. You’re most likely to flourish in treatment when all your needs are being met.

For example, if you come to treatment with an existing mental health condition (known as a dual diagnosis), this should be assessed and the appropriate treatment determined (i.e. counseling or medication). Most programs require participation in individual and group therapy, methods proven to help those recovering from addiction.

Other methods may focus on getting you out and active, building skills, and regaining confidence and a sense of self. Recovery from heroin addiction is as much about building a fulfilling life and restoring self-confidence as it is healing your physical health.

To ensure that you get the most out of drug rehab, and get proper care during withdrawal in detoxification, you’ll want to find a rehab center that works for you. The best rehab centers can provide you with access to custom, individualized plans that meet your unique needs while helping you meet your recovery goals.

Detoxification In Private Rehab

Detoxification can be a harrowing process, and that’s why entering a private rehab may give you the greatest chance at recovery success. A private rehab can provide the excellent quality of care needed to complete detoxification, therapy, and your treatment program.

Private rehabs are often in remote, serene settings, surrounded by natural landscapes. This may seem secondary to treatment, but location is important to recovery. Getting yourself away from the environment of abuse can make a difference in recovery outcomes. Attending a rehab that removes you from your usual environment and surrounds you in a new, tranquil one may be the change you need to make strides toward healing.

Finally, private rehabs can guarantee a low ratio of staff and clinicians per client, a variety of evidence-based treatment modalities, and access to leisure activities for relief and fulfillment during recovery. Each of these aspects can be great components of a successful recovery outcome. Here at, we can connect you to rehab centers that will provide all of these treatment components and more.

Find a Heroin Detoxification Program Today

If you’re struggling with heroin addiction or heroin withdrawal, detoxification may be the first thing you need in addiction recovery. We can help you find the best place for detox and treatment, and to begin your recovery journey. Contact us today.

Center For Substance Abuse Research - Heroin

Centers For Disease Control And Prevention - Heroin Overdose Data

National Alliance Of Advocates For Buprenorphine Treatment - What Exactly Is Buprenorphine?

National Institute On Drug Abuse - Heroin

U.S. National Library Of Medicine - Opiate And Opioid Withdrawal

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