Heroin withdrawal signs

What are the first, early and late signs of heroin withdrawal? Signs common during heroin withdrawal include sweating, dilated pupils, problems sleeping, and nausea. More about the course of heroin withdrawal and its signs here.

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When you take heroin for more than a few days in a row, your body starts to crave heroin and needs heroin to function. While heroin induces a state of bliss, when you stop taking heroin you will go through withdrawal.

But what are some common signs particular to heroin withdrawal? What does heroin withdrawal feel like and how long will signs continue to present themselves? More here on what to expect regarding heroin withdrawal signs as well as common heroin withdrawal treatment protocols. Plus, a section at the end for your questions about heroin withdrawal.

Signs of heroin withdrawal

Heroin withdrawal symptoms and signs manifest when the effects of heroin have worn off in the body and the opioid receptors in the central nervous system begin to clear. Even after taking heroin only once, some signs of withdrawal can appear making the process uncomfortable. Generally, signs of heroin withdrawal are provoked a few hours after heroin starts wearing off and peak from 24 to 72 hours later. Major heroin withdrawal symptoms don’t subside till about a week or more after heroin has left the system. It is important to be careful when withdrawing from heroin, sudden withdrawal by heavily dependent users who are in poor health can be fatal. And signs of trouble during withdrawal may come on so quickly that you have a hard time treating them.

Overall signs of heroin withdrawal to look out for may include the following:

  • abdominal cramps
  • cold sweats and chills
  • constipation
  • diarrhea
  • dilated pupils
  • disturbed sleep
  • depression
  • drug cravings
  • excessive yawning
  • fever
  • nausea
  • pain and cramps the body
  • priapism
  • restlessness
  • seating
  • tearing
  • vomiting

Signs of heroin withdrawal appear depending on a number of factors. In fact, severity, time of onset, and duration of symptoms will depend on the duration of use, the daily dose, and the interval between doses. Some heroin withdrawal signs such as sweating, restlessness and nausea will occur shortly after stopping heroin, while others such as problems sleeping may take more time to manifest and resolve. The process of heroin withdrawal is going to be different for each person and some signs may not come in the order you may be expecting.

First signs of heroin withdrawal

Because heroin has such a calming effect on the body, when you withdrawal one of the very first signs is restlessness. You will have a hard time calming down or getting any sleep. Other common first signs of heroin withdrawal include vomiting and diarrhea which can affect you a few hours after heroin has worn off. These first signs can last for a couple of days as your body goes through withdrawal. Restlessness and insomnia will last longer than other signs of heroin withdrawal, which diminish during acute withdrawal.

In general first signs of heroin withdrawal include:

  • anxiety
  • diarrhea
  • fever
  • restlessness
  • vomiting

Early signs of heroin withdrawal

As you continue withdraw from heroin, additional signs of withdrawal begin to show up. The next signs of withdrawal in this early phase include a change in your moods. Drug craving can also occur because your body will want to take heroin to regulate the change in your body that has been caused by detox. You may continue to have excessive bodily fluids and diarrhea. Body pain – which may become excessive – soon follows, as well as problems with sleep. These signs can continue to present themselves for a few weeks before they begin to even out and the body returns to normal. However, some of these signs of heroin withdrawal and resurface later during acute withdrawal.

Early heroin withdrawal signs include but are not limited to the following:

  • abdominal pain
  • aches
  • altered moods
  • chills
  • flu like symptoms
  • insomnia

Late signs of heroin withdrawal

While you recover from acute heroin withdrawal, you may still encounter signs of withdrawal long past the initial 3-10 days of detox. In fact, Post Acute Withdrawal Syndrome (PAWS) can occur long after there any traces of heroin have left the body. These signs of withdrawal can last months to years after initial heroin withdrawal and can make abstinence difficult. PAWS are an expected outcome after prolonged heroin use, because heroin changes brain chemistry extensively and it can take a long time to heal. Typical PAWS signs include:

  • anxiety
  • confusion
  • depression
  • sleep problems

If you are notice the appearance of these late signs of heroin withdrawal and you haven’t used heroin in a long time, this may be actually what is causing you discomfort and related to withdrawal instead of some other condition affecting you.

Signs and symptoms of heroin withdrawal treatment

There are many treatments for heroin withdrawal. It is generally recommend that you combine medical and behavioral treatments for signs that manifest during heroin withdrawal. Dual treatment will help to maintain your physical and mental health and to stay off heroin for good. There are generally four types of treatments for signs and symptoms of heroin withdrawal that aim to help ease discomfort. These include:

1. Medications and replacement therapy for heroin withdrawal

Methadone, naloxone, and buprenorphine are three prescription medications commonly used to help treat signs of heroin withdrawal such as drug craving and pain management. These opiate replacements help disrupt the opioid receptors in the brain and to help clean them out. Doctors use these medications as a way to help monitor substance abuse and slowly taper you off over time. Methadone is used to replace chemical dependency on heroin with a regular dosing regime because it is a longer acting medication. But, doctors are also finding that buprenorphine blocks the effects of heroin so that you use less, feel less withdrawal symptoms, and have a smaller rate of dependency. Other medications used in heroin withdrawal treatment may include SSRIs (selective serotonin reuptake inhibitors) and antidepressants to help regulate moods centers in the brain.

2. Medically managed heroin detox

Detox is the process of removing heroin from the body under medical supervision. Once the beginning signs of withdrawal occur, you can go through detox to treat symptoms of withdrawal that are affecting you with the use of prescribed medications and emotional support. This process address the first hours and days of withdrawal and aims at taking care of the initial process.

3. Long term heroin addiction and recovery treatment

Heroin can do a lot of damage to your body physical, mind, and emotions. Addressing the underlying emotional and psychological issues which compel heroin use is absolutely key toward promoting lifelong abstinence. Long term care for heroin addiction will help you identify triggers which cause you to use and teach you to get help before you choose to take heroin again. Inpatient or outpatient addiction treatment centers help you do just this. Seeking support groups such as Narcotics Anonymous, SMART recovery, or Rational Recovery may be helpful in treating the signs of withdrawal that occur.

4. Home heroin withdrawal remedies

While you are working with doctors and treatment facilities, there is a lot you can find at your local pharmacy or health foods store to stock your home to support signs of heroin withdrawal. Heroin withdrawal looks much like being really sick with a bad flu. What you would normally do to take care of an illness? Hot baths, muscle massage with oils or cremes, NSAIDs (non-steriodal anti-inflammatory drugs), Imodium AD and/or flu medicines are all heroin withdrawal remedies you can use at home.

Heroin withdrawal sign questions

Still have questions about signs of heroin withdrawal? Please ask them here. We will get to them personally as soon as we can.

Resources: NCBI: 4 Physical Detoxification Services for Withdrawal From Specific Substances
PubMed Health: Opiate withdrawal
NCJRS: The treatment of Opiate Addiction using Methadone
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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