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What Are Heroin Withdrawal Symptoms?

April 22, 2020
heroin withdrawal symptoms explained

The following blog has been reviewed by an expert. For more information, please see our editorial policy.

According to a recent report by the United Nations, an increase of 30 per cent is observed in the people consuming narcotics worldwide as compared to the last study as conducted in 2009. An estimated 35 million (close to 13%) people struggle with substance abuse disorder or addiction.

Heroin or opioids addiction withdrawal presents a large concern when it comes to challenges faced during drug withdrawals, owing to its intense withdrawal symptoms.

Heroin withdrawal can be challenging especially if you have attempted it earlier on your own but its painful symptoms took over resulting in a relapse. Thus, preventing you from getting heroin out of your life. In such scenarios, the best course of action is to reach out for help.

In this blog, we aim to give you an overview of what heroin withdrawal symptoms are, covering the following topics:

  • What is heroin?
  • What are the heroin withdrawal symptoms?
  • What are the problems associated with heroin withdrawal?
  • What are the symptoms of heroin withdrawal?
  • How do you prepare for heroin withdrawal?
  • How long does heroin withdrawal last?
  • What is the timeline for heroin withdrawal?
  • What is the treatment of heroin withdrawal?
  • How to deal with heroin withdrawal?
  • What is the follow-up care for heroin withdrawal?

What is heroin?

Heroin is a highly addictive opioid drug made from morphine, which comes from the seed pod of certain varieties of poppy plants. Heroin is sold as a white or brown powder, typically containing fillers like sugar or starch, so the percentage of heroin varies. It is also sold as a black sticky substance known as black tar heroin which is a result of its crude processing methods and contains impurities. It can be snorted, smoked, or injected. Some of the common names for heroin are smack, horse, big H and brown sugar. With prescription drugs becoming harder to obtain, divert and alter, many people addicted to opioids turn to heroin as the answer. 

What Are Heroin Withdrawal Symptoms?

With regular use, tolerance develops in one’s body such that the person eventually needs more heroin to achieve the same level of high.

Meanwhile, the body tries to maintain balance so it adapts in a way that it basically relies on the drug to function and one has to keep taking heroin to avoid withdrawal symptoms. In other words, when a person develops a physical dependence on heroin and then starts to cut back on it or stop using it, symptoms that are opposite to the drug’s effects start to set in. This is known as heroin withdrawal or ‘dope sickness’.

What Are the Problems Associated With Heroin Withdrawal?

Heroin withdrawal can be very uncomfortable. The fastest way to relieve the withdrawal symptoms is to reuse heroin—compelling the person to be stuck in the addiction. However, continuing to use will likely result in medical and social consequences such as disruptions in the family and workplace, health issues, violence, crime, and even death. This poses one of the major problems associated with heroin withdrawal.

Symptoms at Different Stages of Heroin Withdrawal?

The complication level of withdrawal varies from person to person based on their level of dependency as well as their existing medical conditions. Heroin withdrawal symptoms usually peak between 48 to 72 hours after the last consumption and stay just for a week or so in most cases. It typically is not life-threatening but the withdrawal symptoms in some cases might be severe and dangerous.

Many have compared heroin withdrawal to a terrible flu. Below are some of the common symptoms faced:

  • Nausea
  • Abdominal pain
  • Excessive sweating
  • Excessive yawning
  • Sleeplessness
  • Shaking
  • Nervousness
  • Anxiety
  • Agitation
  • Depression
  • Muscle aches
  • Cravings for drugs
  • Restlessness
  • Runny nose
  • Low energy
  • Extreme thirst
  • Very dry mouth
  • Little or no urination
  • Fever
  • Irritability or disorientation
  • Rapid heartbeat
  • Rapid breathing
  • Sunken eyes

The second phase is usually marked by the following:

  • Diarrhea
  • Abdominal cramps
  • Nausea and vomiting
  • Dilated pupils
  • Rapid heartbeat
  • Goosebumps

How Do You Prepare for Heroin Withdrawal?

The battle with heroin withdrawal might be challenging. The level of challenge depends upon the intensity of addiction, the duration of dependency and various other factors. However, once you make it through the initial days when withdrawal symptoms are at its peak, the journey eventually eases down. As you decide to begin with your withdrawal journey, it’s important to tell a few of your family members and close friends whom you trust.

Also, stay in constant touch with your doctor and only begin this journey on your own at home if they approve it understanding your medical conditions. For example, people with pre-existing heart conditions or diabetes should not attempt heroin withdrawal at home. At any point, if you feel the repercussions of withdrawal are going beyond what you can bear, get in touch with your doctor immediately.

As mentioned above, people can develop a physical dependence on heroin as their body is used to its presence. So, stopping heroin suddenly or drastically cutting-back may cause strong reactions and withdrawal symptoms.

Therefore, it’s important to be prepared if you want to go through heroin withdrawal on your own. It is advisable to adopt the route of slowly tapering down its intake rather than cutting it off completely to avoid a strong withdrawal reaction. Without support or medical management, withdrawal makes it difficult for some not to relapse to using heroin again.

It’s also important to keep your body hydrated to overcome the dehydration caused by frequent vomiting and diarrhea. So while you are beginning or are into the process, keep drinking plenty of water and hydrating fluids. Intake of electrolyte solutions is also helpful in keeping your body hydrated.

How Long Does Heroin Withdrawal Last?

Heroin is short-acting which means that it affects the body rapidly with high intensity but also leaves the bloodstream quickly. So, heroin withdrawal symptoms start to appear 5 to 12 hours after the last dose is taken, peak between 2 to 3 days and usually last for about 5 to 10 days.

The number of days for which the heroin withdrawal symptoms last may vary from person to person. While in usual cases the physical withdrawal symptoms last about a week, for some, it might also go as long as a month or more.

It can take months or a year for the body to get back to normal, but these symptoms are going to look different from the initial withdrawal symptoms.

What Is the Timeline for Heroin Withdrawal?

Below is the timeline for heroin withdrawal as observed in most of the cases:

  • Symptoms of heroin withdrawal start: 6-12 hours after the last dose
  • Symptoms of heroin withdrawal peak: 48-72 hours after the last dose
  • Symptoms of heroin withdrawal subside/ start to alleviate: 1 week after the last dose

Medical Diagnosis for Heroin Withdrawal

Before starting the treatment for heroin withdrawal, the healthcare provider or doctor you are consulting will do your thorough medical evaluation wherein they will

  • Ask you questions related to your medical history, heroin use
  • Conduct your physical examination
  • Run a urine and blood work test to confirm heroin use and other metrics associated with its presence
  • Conduct other medical tests based on the analysis of physical examination and the patient’s medical history. These may include liver function tests, complete blood count test (CBC), electrocardiogram (ECG), chest x-ray and testing for hepatitis C, HIV, and tuberculosis (TB) as it’s observed that most of the people who have developed heroin tolerance also have one or more these diseases.

Treatment for Heroin Withdrawal

There are various prescription drugs available for helping treat heroin dependence and maintaining heroin abstinence, some of the most common ones being Buprenorphine, Methadone, or Naltrexone. Some of them are given to control the medical and emotional withdrawal symptoms, like cravings.

The time at which the doctor decides to introduce these individual drugs into the body depends on which phase of heroin withdrawal someone is currently in, severity of the addiction, medical and psychological condition of the patient and other relevant factors. In general, the medications are provided to individuals undergoing medical detox in substance abuse treatment and rehab facilities followed by intensive therapy treatment. Otherwise, these medications have to be taken based on prescription by the doctor or will be provided during in-clinic visits to the doctor.

How to Deal With Heroin Withdrawal?

If you want to undergo withdrawal on your own or under medical supervision and care, there are certain things you must ensure. First and foremost, it is best not to do it all on your own. Instead, keep someone who you trust informed about it so that they have your back throughout this difficult but truly worthy phase. It is a must to visit a specialist doctor to get the approval that you are medically fit to attempt heroin withdrawal at home. They will guide you based on the medical examination and running various medical tests such as blood work to evaluate the level of heroin or damages caused due to its presence in your body.

Heroin detox is the process that an individual aiming for heroin withdrawal undergoes, typically under medical supervision in a substance abuse rehabilitation center. Supervised detox is an option for those who do not want to, or for other reasons, cannot go through it alone. It is, in fact, the safest and most comfortable way for heroin withdrawal.

The detox process is usually started before heroin completely leaves the body and usually lasts about 5 to 7 days. Although, for some, it may last about 10 days. It incorporates medications and therapy under close monitoring to ensure safety while heroin leaves the body. Regular medical check-ups including blood pressure, heart rate, temperature, and blood work are also done to evaluate the progress of detox.

What Is the Follow-up Care for Heroin Withdrawal?

Following the ‘acute’ opioid withdrawal, wherein the initial withdrawal symptoms subsides, you will remain in the ‘protracted’ withdrawal phase for about six months. Unlike acute withdrawal in which the body experiences physical withdrawal symptoms, the withdrawal symptoms in the protracted withdrawal phase are primarily psychological and emotional. 

It is advisable to remain regular with your follow-up visits to the doctor and make sure you follow all the provided guidelines and precautions. The absence of which might cause a relapse. To minimize the risk of relapse, it’s important that you seek ‘psychological interventions’ like counseling and therapy, and follow the guidelines of the doctor. If you have experienced frequent relapses while attempting heroin withdrawal on your own, then it is highly  recommended to visit specialists or undergo heroin detox under medical supervision.

While heroin withdrawal can be a challenging and frustrating process, with willingness, conviction and the right support, it is possible. If you are reading this blog, then chances are you are looking for heroin withdrawal options for either yourself or your loved one. Please be sure to know that you are on the right path. Hopefully, this blog helped you gain some useful insights on heroin withdrawal. Moving ahead in your journey, we would recommend you to please visit a specialist doctor or addiction treatment centre to get required professional support.