ARTICLE OVERVIEW: Heroin detox and withdrawal is an extremely uncomfortable experience that requires medical supervision. Gastrointestinal symptoms are common and most people confront mood swings and/or dehydration. Relapse is possible. Medications make the process more humane and successful, especially over the long-term.
ESTIMATED READING TIME: 10 minutes.
TABLE OF CONTENTS:
- Is Heroin Withdrawal Hard?
- Is Heroin Withdrawal Dangerous?
- A List of Heroin Withdrawal Symptoms
- The Basic Timeline
- Medicines that Help
- Natural Remedies that Help
- Where to Go for Help
- Where to Find Local Help
- Your Questions
Is Heroin Withdrawal Hard?
The short answer, yes. Heroin is one of the most addictive drugs out there. Therefore, it’s also one of the hardest to quit.
But why is heroin withdrawal so hard?
The answer has to do with the way the brain changes through addiction. Heroin triggers a strong high but is extremely habit forming. Over time, the brain and body start to interpret the chemical presence of the opiate as normal, leading to drug dependence and tolerance.
How does it get to the brain?
Upon intake, heroin immediately enters the brain and attaches itself to a variety of opioid receptors. These receptors are located in different areas of the brain. Particularly, those involved with pain and pleasure, such as the reward system. From there, the opioid chemical transfers itself through neurotransmitters throughout other areas of the brain and body.
This ultimately leaves the user feeling a strong sense of euphoria. Due to heroin’s chemical structuring in the body, users may also feel the following:
- Dry mouth
- Flushing of the skin
When you decide to stop taking heroin – even if it’s just for a short period of time – withdrawal symptoms occur when you’re physically dependent. Once addicted to its chemical structure, the body and brain perceives heroin as “normal”. The brain triggers stimulant chemicals and functions to counterbalance the depressant effects of the opiate. Take away the heroin, and you’re left with the unnatural stimulant effects until they balance out again in detox (7-10 days).
The primary reason heroin withdrawals are so hard is because the symptoms are super uncomfortable. Think of symptoms that are opposite of sedation: restlessness, anxiety, sweating, headache, gastrointestinal flares…these symptoms signal the onset of withdrawal.
Is Heroin Withdrawal Dangerous?
The short answer, no. Heroin withdrawal is rarely life-threatening. However, it’s an extremely uncomfortable process. And because dehydration, mood swings, and cravings occur, it’s vital you receive professional management when you plan to quit heroin.
You still might be wondering, “Can I take withdrawal into my own hands rather than going to a treatment facility or detox clinic?” You might get the notion that you have the ability to take matters into your own hands. The problem with this assumption is that you’re probably NOT a medical professional. Treatment facilities have a way of managing withdrawal which:
- Eases the user’s withdrawal symptoms.
- Offers them a medically supervised and controlled environment.
- Gives opportunity for the user to process thoughts and emotions.
Trying to quit on your own terms can be dangerous in the sense that you’ll have no idea how your body will react. And you won’t know what to do. For example, your body can get extremely dehydrated from vomiting so frequently. Additionally, the mood swings can cause extreme thinking or irritability, and you can lash out at those around you. And the worst: you might relapse just to make the symptoms stop.
Furthermore, since most who use heroin usually aren’t surrounded by a supportive environment, relapse becomes a much bigger possibility. In fact, studies show between 40% and 60% of people who get addicted to an illicit drug end up relapsing.
So, in order to assure the safest way forward, take some precautions and consider a medical detox. Give yourself the gift of successful recovery: go to a treatment facility.
A List of Heroin Withdrawal Symptoms
Heroin, along with other opiate drugs, causes physical dependence, meaning the body adapts to it in order to survive. The opiate chemicals in the drug become “normal”. This usually develops with frequent use of the drug over a period of a few weeks or more. A physical dependence to opiate drugs means you need to use in order to prevent feeling symptoms of withdrawal.
So, once you decide you want to quit, you need a plan. Your body will need time to readjust to its native, original chemical balance, a state called “homeostasis”. This time of adjustment is called withdrawal; withdrawal manifests as a specific set of symptoms.
Have you ever gone a day or two without getting your fix?
Did you notice your body beginning to feel highly uncomfortable?
These were the early stages of withdrawal. These symptoms include:
- Increased tearing
- Muscle aches
- Runny nose
As heroin withdrawal progresses, the above symptoms become more intense, and the following symptoms kick in:
- Abdominal cramping
- Dilated pupils
Symptoms usually begin about 12 hours after your last exposure to heroin.
The Basic Timeline
Now that you’re aware of how heroin withdrawal works, you might be asking yourself, how long does it last? There is no clear answer. The amount of time a heroin detox takes all depends on your age, usage amount, and length of use. For example, older individuals who’ve been using for a longer period of time are much more likely to experience more intense and longer withdrawals.
Detox generally lasts around 7 days and begins between 6 to 12 hours after your last dose of heroin. For the following 1 to 3 days, your withdrawal symptoms will peak then, over the course of 5 to 7 days, will gradually die down.
There are two different types of withdrawals that will persist during detox:
1. Acute withdrawals – Begins with feelings of anxiety and cravings, climaxes around 36 to 72 hours, and decreases heavily within the following 5 days.
2. Protracted Withdrawal Symptoms (PAWS) – Will follow acute withdrawals and can last up to months.
With this knowledge, let’s get into the timeline of what to expect day by day while you undergo withdrawals.
Day 1 to 2 – Usually the most difficult to get through, as the harshest withdrawal symptoms persist during this time. You can expect to feel light symptoms of discomfort around 12 hours after last use. The most notable symptoms you’ll experience are muscle aches and pains. Depending on how much your body depends on heroin, you may experience extreme muscle pain during this time. Along with this, you’re also likely to receive the following symptoms:
- Anxiety and/or panic attacks
- Loss of appetite
Day 3 to 4 – You can expect the worst of your discomfort to pass during this time, but it’s not entirely over. As the medical professionals surveying you will inform, it’s important to stay hydrated. Withdrawal symptoms to be expected are the prior listed plus:
- Abdominal cramping
Day 6 and Beyond – The withdrawal symptoms will finally ease down. The body is getting back to homeostasis. There are some factors of withdrawal which may persist such as trouble sleeping and/or eating as well as nausea and anxiety. However, for the most part, the body has finished detoxing and the mind is ready to undergo psychotherapies – a treatment which sets out to reduce cravings and change an individual’s conduct based around their prior drug use.
Since psychotherapies do play a role in the withdrawal timeline, there’s no accurate way to tell how long you’ll undergo treatment. Generally speaking, most people who want to address a heroin addiction do well with medical supervision from 3 to 6 months. Medication assisted treatment and talk therapy are key to a full recovery. However, some people remain in some form of a treatment program for months to years as they find a support system through it which keeps them from relapse.
Medicines that Help
Due to the intensity of discomfort which comes alongside heroin withdrawal, medication is often given to reduce address symptoms as they occur. The medication(s) you’ll be given depends on your particular situation. Some people need more medication than others. So, you may be offered one or more of the following medications from a prescribing doctor:
Loxifidine – Approved by the Federal Drug Administration (FDA), loxifidine has been known to greatly reduce withdrawal symptoms. Though it can’t treat drug addiction in and of itself, it’s one of the most popular medications when treating heroin addiction.
Methadone – Since the 1960’s, methadone has had great success in reducing withdrawal symptoms and, in some cases, even delaying them. Methadone attaches itself to opioid receptors in a similar way heroin does. This effectively makes users crave less and gives them a better chance in preventing relapse.
Buprenorphine – a partial opioid agonist, which means the medication binds itself to opioid receptors, just not as much as full opioid agonists. In turn, this reduces withdrawal symptoms and cravings, giving individuals a better chance to prevent relapse.
Naltrexone – a blocking action against opioids which isn’t addictive nor sedative.
In order to better understand which medication is right for you, you’ll want to consult your doctor.
Still, experts find that medication in combo with psychotherapy are the most beneficial form of treatment. The idea is that you stabilize your physical state and then address your mental state. Reducing compulsive urges helps you focus on the deeper aspects of healing.
Natural Remedies that Help
Since many of heroin’s withdrawal symptoms are similar to the flu, there are natural remedies out there to ease the discomfort. Medical News Today recently wrote an article covering remedies you can find in your household that can help. However, we think that if we take a look at individual symptoms, we can figure out just how to treat them.
Chills. A flu-like symptom many people experience during detox are chills or cold-sweats. Constant shivering is usually a major factor of this. In order to warm yourself up, it’s suggested you wear extra layers such as sweatshirts or cardigans. Hot pads and warm, long showers or baths can also help.
Nausea. Since symptoms of nausea have much to do with the food and liquids you intake, you can eat and drink certain things as a means of reducing the discomfort. These include, but aren’t limited to:
- Bland foods, such as bananas, rice, or toast.
- Eating several small portions of food throughout the day rather than a few large meals.
- Avoiding foods that are high in fat and grease.
- Taking small sips of water often. Dehydration is a huge concern when it comes to withdrawal and it’s vital you intake lots of water. Instead of drinking a large amount all at once, it’s suggested – for nausea’s sake – you take a little at a time.
Shaking. In a study done by Pharmaceutical Biology, rats were tested on to see if the herb Hypericum perforatum (or St. John’s wort) could reduce the shaking involved with opioid withdrawals. Not only did the shaking cease but researchers also found the rats’ diarrhea to reduce. Another way people reduce shaking is by quitting caffeine when they quit heroin. Caffeinated drinks are known to aggravate shaking and trembling tendencies.
Trouble Sleeping. Though it’ll be difficult to hop right back into a health circadian rhythm, you want your body to have a clock of its own. This means you’ll want to develop a schedule for when you fall asleep and when you wake up. So, lying in bed at the same time every night helps. Furthermore, you might want to consider where you’re sleeping. Many people enter an inpatient program, where sleep environment cannot be controlled. Still, there are options available. For example, according to the National Sleep Foundation, people get better sleep in a room that’s a bit on the cool side – between 60 and 67 degrees Fahrenheit.
Develop Distractions. No matter what the withdrawal symptom may be, developing distractions can make a huge difference during the withdrawal process. Whether this is writing something in a journal or watching television, it can help to modify the pain you’re going through.
Where to Go For Help
In order to find help, you must fully admit want it. By admitting you’re defeated, you’re allowing something new to happen. Then, you can seek medical help. Where?
- Addiction doctors (Find an ABAM specialist)
- Psychotherapists or counselors (Find an APA psychologist member near you)
- Psychiatrists (Find an APA psychiatrist near you)
- Social workers (Your state’s Department of Health and Social Services)
- SAMHSA’s National Helpline – 1-800-662-HELP (4357)
- SAMHSA Opioid Treatment Program Directory
- Your family physician
You’ll also want to talk to your family and friends. The reason for this is throughout your journey of recovery, they’re going to be your support system. The people you can always turn back to when things get difficult. Furthermore, they can help guide you along the rest of the recovery process. If you’re a family member or friend of someone who’s a heroin addict, there are a variety of options for you to seek help for your loved one.
And when you want to find the right treatment facility, give us a call.
We’ll be happy to help.
Where to Find Local Help
A quick Google search will inform you of all the treatment facilities in your area. However, if you’re looking for a more in depth search, you can check out Substance Abuse and Mental Health Services Administration (SAMHSA) behavioral treatment search engine.
If you have any further questions pertaining to heroin withdrawal, we invite you to ask them below. If you have any advice to give for people going through withdrawal, we’d also love to hear from you. We try to provide a personal response to each comment and get back with you promptly.