READING SUMMARY: Heroin can provoke serious withdrawal symptoms. To quit it safely, you may need to enroll into a medical detox and then enter a rehab program. Medications such as buprenorphine, clonidine, and methadone can help.
TABLE OF CONTENT:
- What Happens When You Stop
- Can I Just Stop?
- Withdrawal Symptoms
- Post Acute Withdrawal
- Cold Turkey
- Medical Detox
- Medications that Help
- What To Do Next?
- Do I Have a Problem?
What Happens When You Stop
If you’ve been using heroin daily for a couple of weeks or more, your body begins to adapt. This is because heroin is a strong opiate that affects the brain as a depressant. To accommodate these effects, the brain begins to send chemical signs for certain functions to “speed up.” Over time, you begin to function normally only with the drug. In other words, you can become physically dependent on heroin quickly and adapt to its central nervous system depressant effects.
What happens when you stop taking heroin is that you go through a period of withdrawal. During withdrawal, you’ll experience a variety of predictable symptoms, some of which are very difficult. During this time, the body is seeking homeostasis after a period of “speeding up” certain functions and system. It takes time to get back to its original, “non-heroin” induced state.
How long does it take to detox from heroin? It takes time to resolve these symptoms. Acute symptoms peak around 72 hours after your dose but can persist for 7-10 days after you stop taking heroin. Protracted withdrawal symptoms related to mood and sleep disorders can persist for weeks or months later.
Can I Just Stop?
Unfortunately, quitting heroin all of a sudden does not always positively help long term recovery and abstinence. It is not a question of self control or willpower. Drastic dose reduction is very difficult when the body has developed dependence on heroin over time. In these cases, the body manifests specific [uncomfortable] symptoms if it doesn’t receive its dose.
The intensity of withdrawal symptoms varies by individual but extreme discomfort is common. And to avoid withdrawal, some people relapse into heroin use, especially outside of medical settings.This is why the best way to stop taking heroin is WITH MEDICAL SUPERVISION. You may be prescribed medications during heroin detox, or asked to gradually decrease dosage in or to taper the withdrawal. Make sure you consult a medical professional any time you want to stop taking heroin in order to increase your chances of a successful withdrawal.
Stopping heroin comes with side effects. If you are ready to undertake this step, you can anticipate the following side effects to occur:
- Abdominal cramps
- Aches & body pains
- Decreased appetite
- Muscle spasms
- Panic attacks
- Runny nose
- Sleep disorders
- Watery eyes
You can expect these symptoms to manifest a few hours after your last dose, and peak around 42-72 hours later. The intensity and duration of these symptoms will depend on your dosing history and the type of user you used to be. The heavier the use, the longer and more intense the symptoms. If you like to learn more about the timetable of these symptoms, check out our visual presentation of heroin withdrawal over time.
Post Acute Withdrawal Symptoms (PAWS)
Protracted withdrawal, as defined by medical professionals, is the presence of specific signs and symptoms common to acute withdrawal that persist beyond the generally expected acute withdrawal timeframe. Their appearance is not psycho-somatic. Chronic substance use causes molecular, cellular, and neurocircuitry changes to the brain that affect emotions
and behavior and that persist through the weeks and months after you quit heroin.
In fact, many people experience these signs and symptoms after acute withdrawal from heroin. The most common symptoms of protracted withdrawal during heroin detox include:
- Difficulty concentrating
- Difficulty making decisions
- Impaired impulse control
- Impaired problem solving
- Loss of interest in sex
- Persistent fatigue
- Problems with short-term memory
- Sleep difficulties
It is common for many people to experience difficulty feeling pleasure, or anhedonia, for months after they quit heroin. Heroin PAWS get better over time.
These symptoms take time to resolve, and are a true phenomenon! SAMHSA has produced a newsletter about protracted withdrawal with more details about symptoms and suggestions for how to address them. Just know that if you’re feeling bad – even after 6 months or longer – things will get better!
It takes time to reverse extreme brain changes after taking heroin. And know that it’s not just you. You are not crazy! Adaptive changes in the central nervous system may lead to affective changes that persist for many weeks or longer beyond acute withdrawal.
Due to its highly addictive properties, suddenly stopping heroin can cause severe withdrawal symptoms and provoke relapse. Instead, plan withdrawal with a detox clinic or your doctor. Talk to a medical professional, or check in at an addiction treatment facility and let the process be supervised. It does not mean that you are weak. In fact, medical supervision will significantly increase the chances of successful recovery. Not only can withdrawal symptoms be made less uncomfortable, you will receive the emotional, social support that you need.
While it is possible to go cold turkey off heroin and reduce the detox time, it is unnecessary and not what doctors recommend. Quitting heroin suddenly can cause serious withdrawal symptoms and it’s highly likely that you relapse if using this method. There are various other ways to stop taking heroin aimed at minimizing the severity of withdrawal symptoms.
The safest way to stop taking heroin is under medical supervision. The following professionals can help treat you directly or refer you to assessments and services in your area:
- An addiction specialist (MD)
- A clinical social worker
- A licensed clinical psychologist
- A medical doctor
- A psychiatrist
To begin, anyone coming off heroin requires a set of physical and mental assessment(s). You have to determine your individual level of physical dependency and the possibility of addiction. This stage requires medical assistance because remaining objective is critical at this point. Assessments also direct future treatment recommendations based on best practices.
Once you determine your level of dependency, work out with the doctor what is the safest way to stop taking heroin. If the doctor recommends checking in at a detox clinic or another facility, follow the suggestions. Medical detox clinics offer 24-7 supportive care in a safe environment. In some cases doctors, recommend a method called tapering which is the gradual reduction of your heroin doses. In other cases, heroin withdrawal will be triggered through prescription medications and then symptoms will be treated as they occur.
Once heroin is our of your system, you may be referred to longer term inpatient or outpatient rehab. The goal of these treatments are to address psychological issues of dependence, or co-occuring mental health issues which compel heroin use. Detox is only the FIRST STEP to getting better. Psychological, behavioral, and opiate substitution therapies can be combined to help you lead a life free of heroin.
Medications that Help
Many medications are used to ease heroin withdrawal symptoms. The World Health Organization suggests that buprenorphine and methadone are ‘essential medicines’ for an effective treatment of heroin addiction. Furthermore, this NIDA supported study shows that once a treatment is initiated, a buprenorphine/naloxone combination and an extended release naltrexone are similarly effective in treating heroin addiction. Below is a list of medications commonly used during detox from heroin:
Antidepressants. Every person who undergoes heroin detox should be checked out for depression and/or other mental health disorders. In some cases, antidepressants such as SSRIs or trazodone can be very helpful.
Heroin replacement medicine. Methadone and buprenorphine are mostly used as replacement therapy. These medications delay withdrawal and cut cravings.
Relapse prevention medications. Naltrexone blocks the action of heroin in the brain. It is often used in combination with methadone or buprenorphine.
Symptomatic medications. These medications address withdrawal symptoms as they appear. These can include:
- Clonidine addresses anxiety, agitation, sweating, runny nose, cramping, and muscle pain.
- Dicyclomine hydrochloride is used to treat abdominal cramps.
- Diphenoxylate and Loperamide are anti-diarrheal medications.
- Hydroxyzine and Promethazine can prevent or reduce nausea and vomiting.
- Methocarbamol is used to treat body pain and muscle cramps.
More than 43,000 New York State citizens benefited from buprenorphine and methadone in 2017.
NOTE: Replacement therapy can be a two-edged sword. Report euphoric effect to your doctor so you do not trade one addiction with another.
What To Do Next?
Heroin can pull you deeper and deeper into the chains of addiction, so you may need professional assistance. Moreover, you may lose control over your life after long-term use of heroin…
But, don’t worry, addiction is a curable disease!
STEP 1: Focus on your problem. You are using heroin, so stop living in denial, and accept the fact that you have a substance use disorder. The sooner you see your problem, the better.
STEP 2: Motivation for change. Identify the reasons that will help you get off heroin food good. Find motivation that will turn your life around. Just to be honest, it won’t be easy.
STEP 3: Seek help. Heroin addiction is one of the hardest to overcome, so you may not be able to solve this problem by yourself. Seek help from addiction professionals.
Do I Have a Problem?
Heroin is one of the most addictive substances that exist. If you are using it, the chances that you have a problem are enormous. Actually, the American Society of Addiction Medicine (ASAM) found out that about 23% of people who use heroin develop addiction.Moreover, the 2016 National Survey on Drug Use and Health reported that about 475,000 people aged 12 or older were current heroin users. The same report shows that about 626,000 people aged 12 or older had a heroin use disorder.
So, get honest with yourself. In order to verify whether you have a substance abuse problem or not, take a look into Diagnostic and Statistical Manual of Mental Disorders (DSM-V). It presents 11 criteria for the diagnosis of addiction behavior following:
- Take the drug in larger amounts or longer than intended.
- Want to cut down/stop using drug but fail to succeed.
- Spend a lot of time obtaining, using, or recovering from the use.
- Experience cravings and an uncontrollable need to use the drug.
- Fail to perform normally at work, home, or at school due to drug use.
- Continue to use, even when it causes problems in relationships with family, friends, and partners.
- Give up important social, occupational or recreational activities because of use.
- Use the drug again and again, despite being aware of harmful risks and side effects.
- Continue to use despite the risk of developing health problems or worsen physical or physiological condition.
- Need more drug to get the desired effect (tolerance).
- Experience withdrawal symptoms which can be relieved by taking higher dose (dependence).
If you fall under some of these criteria, you may have a serious problem with heroin. The next step is consulting with a professional to be diagnosed with the severity of your addiction.
The NSDUH report of 2016 also showed that an estimated 21.0 million people aged 12 or older needed substance use treatment, which makes about 1 in 13 people.
You may be that person! Don’t wait, turn your life around.
Rehab can help you start over. The professional staff in rehabs are there to help you achieve physical and mental balance. Plus, you get a chance to start fresh and healthy life.
When you search for a rehab program, you will need to decide between two options: inpatient or outpatient.
Inpatient rehabs offer 24/7 care and medical supervision of their patients. In fact, patients stay at the facility during the whole program. The inpatient programs may last from 1 up to 6 months. During these months, addiction professionals offer constant care that prepares you for life after rehab. The common services include:
- Individual therapy sessions.
- Group therapy sessions.
- Health education about recovery.
- Community support.
Outpatient rehabs provides nearly the same services as inpatient programs, but they do not offer constant care because no one lives at the facility. Patients come for a few hours, several days per week. The programs include visitation hours with an addiction counselor who tracks your progress.
Ready To Quit?
Are you or a loved one using heroin? Do you exhibit the signs and symptoms of heroin addiction? The good news is: You can stop using heroin and recover for good.
Stopping heroin is not merely a question of detoxing your body from its metabolites. It is a long term process which takes determination and patience. Since heroin changes your brain activity, be prepared that it may be hard, and very uncomfortable.
When you are ready to kick the habit, make sure you have these three supports:
- Personal motivation. Make a pros-and-con list of all positive and negative things that addiction may put on you. In that list you will find the reasons to stop taking heroin for good.
- Medical resources. Once you find personal motivation, it’s time to educate yourself about your addiction. Learn what are the effects, and what to expect during withdrawal. This is the time when you may consider enrolling into medical detox clinic.
- Emotional support. Heroin habit is hard to kick, so be sure that you will get all support you need from your family and friends. If your surrounds are supportive, you will get your sobriety more easy.
Got Any Questions?
Do you still have questions about stopping heroin? Please write to us in the comment section below. We will try to respond to all legitimate queries as soon as possible.
Reference Sources: NCBI: Physical Detoxification Services for Withdrawal From Specific Substances
NIH: What are long term effects of heroin use
U.S. Department of Veterans Affairs: Research Report Series on Heroin
All of the information on this page has been reviewed and verified by a licensed medical professional.