Heroin Detox

Heroin is a powerful opioid that may be mixed with cocaine, fentanyl or other substances. Unfortunately, this opioid quickly causes addiction and may lead to serious, potentially life-threatening, withdrawal symptoms. That’s why you should understand the withdrawal symptoms that could occur and why getting treatment is the first step to getting sober.

What Is Heroin?

Heroin is an opioid drug that is derived from morphine. Morphine is a natural substance that can be made from the seed pod of the opium poppy, which is where the name “opioid” comes from[1].

Heroin goes by many names, some of which include hell dust, smack and big H. It’s not a legal drug, even though it does have some of the same effects as prescription painkillers.

People take heroin by sniffing it, smoking it, snorting it and injecting it into the body. Sometimes, it is mixed with cocaine or fentanyl, which can be deadly.

Is Heroin Addictive?

According to the United States Drug Enforcement Administration[2], heroin is a Schedule I drug. Schedule I drugs are controlled substances and are illegal within the United States.

Schedule I drugs, chemicals and substances have no recognized medical use in the United States. They are also known to have a high potential for abuse. Heroin is just one of many Schedule I drugs that can be found on the black market today.

What Is Heroin Withdrawal?

Heroin withdrawal happens when a person who normally takes heroin suddenly stops doing so or significantly reduces the amount they ingest, snort or inject. Withdrawal symptoms last around a week on average, but those symptoms could be serious.

Heroin withdrawal is more likely when someone uses heroin regularly or at high doses, but it can happen as soon as after the first dose, depending on how much was taken and the individual’s reaction to the drug.

What Are the Symptoms of Heroin Withdrawal?

There are many different symptoms of heroin withdrawal that a person may go through as they stop taking the medication. Some may be serious, but they typically range from mild symptoms to acute.

What Are the Mild Withdrawal Symptoms?

The mild symptoms of withdrawal from heroin may include:

  • Sweating
  • Abdominal cramping
  • Chills
  • Muscle and bone aches
  • Runny nose
  • Nausea
  • Yawning

What Are the Moderate Withdrawal Symptoms?

The moderate withdrawal symptoms that heroin users may experience include:

  • Diarrhea
  • Restlessness
  • Tremors
  • Goosebumps
  • Fatigue
  • Agitation
  • Trouble concentrating
  • Vomiting

What Are the Severe Withdrawal Symptoms?

Severe withdrawal symptoms can be dangerous. For those with these symptoms, it’s important to seek medical care as soon as possible. If the individual is not breathing well or is having severe cardiovascular symptoms, it’s vital to call 911.

Some of the severe withdrawal symptoms someone who stops taking heroin may experience include:

  • Drug cravings
  • Muscle spasms
  • An inability to feel pleasure
  • Impaired respiration
  • Depression
  • Anxiety
  • Insomnia
  • Hypertension
  • Rapid heart rate

How Long Does Heroin Withdrawal Last?

Heroin withdrawal can begin as soon as six to 12 hours after a person’s last dose of heroin. The peak withdrawal period is between days 1 and 3, while those symptoms will begin to subside within a week after that.

Withdrawal from heroin typically peaks within a few days of the last dose taken. Morphine, which is what heroin is derived from, is usually still visible in a person’s blood for up to three days[3] after the last dose. That’s why the peak happens after a few days have passed. At that time, the level of the drug in the person’s system has decreased so much that the body is beginning to look for it. If the person doesn’t take it, then withdrawal symptoms will continue.

What Is Post-Acute Withdrawal Syndrome?

Post-acute withdrawal syndrome refers to symptoms of withdrawal that happen for weeks, months, or even years after taking the last dose. Post-acute withdrawal syndrome has some specific symptoms[4] including:

  • Depression
  • Irritability
  • Anxiousness or panic
  • Trouble with cognitive tasks, such as memory recall or problem-solving
  • Obsessive-compulsive behaviors
  • Pessimism
  • Increased sensitivity to stress
  • Cravings
  • Trouble maintaining social relationships

Who Is at Risk of Post-Acute Withdrawal Syndrome?

Some people may be at a greater risk of going through post-acute withdrawal syndrome than others. For example, those who have taken heroin for long periods of time at high levels are more likely to have changes in the brain that could lead to long-term symptoms.

Is Withdrawing from Heroin Dangerous?

Heroin is incredibly addictive. That’s why it’s usually a good idea for those who are addicted to heroin to go through detoxification with the support of a medical team. There are good medications and treatment plans that detoxification clinics can help patients try, so they can get sober safely.

Withdrawal from opiates can be deadly, especially if that withdrawal is combined with the withdrawal from other substances, like alcohol or benzodiazepines. It’s more likely that a patient will face life-threatening symptoms if they choose to quit cold turkey or decide to do an at-home detox.

Trying to quit cold turkey is also more likely to result in relapses and possible overdoses.

How Long Does It Take to Go Through Medical Detox?

How long it takes someone to go through medical detox will depend on a few factors, such as how much heroin the patient uses or how often they take a dose. Long-term users are more likely to need more time to go through detoxification than those who have used for only a short time.

When going through a medical detox, heroin withdrawal symptoms normally begin within six to 12 hours. Then, patients will see the withdrawal peak at around day two or three. Following that, there will be another five to ten days of moderate or mild withdrawal symptoms as the drug fully leaves the system.

Detoxification treatment is normally started at around day two or three since the patient’s last dose of heroin. This is because that’s when the withdrawal symptoms are least manageable and most likely to result in relapsing or dangerous symptoms. Medical detox makes it more comfortable to go through those withdrawal symptoms, since the providers can make sure the patient is hydrated, receives medications as needed and is kept as comfortable as possible.

Medical detox will go on for around five to seven days, though it could be longer for some people. Someone who is heavily dependent on heroin may enter a 10-day detox program or even longer.

The goal of a detox program is to get the drug safely out of the person’s body. Once that happens, they will go on to intensive rehabilitation to address the underlying dependency or addiction.

Should You Go to a Medical Detox Facility to Manage Withdrawal Symptoms?

It is a good idea to go to a medical detox facility to manage withdrawal symptoms. Withdrawal symptoms may include a higher heart rate, high blood pressure, difficulty breathing, changes in the temperature of the body and others. These are manageable with medications, but they may be unsafe if left unmonitored.

Fortunately, there are several medications that have been approved to treat heroin dependency. Some of them can be used during the detox process to make it more comfortable.

Are There Medications That Can Help With Heroin Withdrawal?

Yes, there are. The three main medications used to help with heroin withdrawal[5] include:

  • Methadone (Methadose or Dolophine)
  • Buprenorphine (Subutex)
  • Naltrexone (Vivitrol)

Each one works a little differently. Methadone is a slow-acting opioid agonist. It’s taken by mouth and reaches the brain over time, so that the individual is less likely to get “high” but will still see the positive effects in minimizing withdrawal. This drug is only dispensed on a daily basis in approved treatment programs.

Buprenorphine is a partial opioid agonist. It does not produce the high seen with full opioids. It relieves cravings without the dangerous side effects that you would see with opioids. Suboxone is one form of buprenorphine and can be taken by mouth or sublingually. It also has naloxone in its mixture, so it is nearly impossible to get high off the medication. If Suboxone is injected, the naloxone causes withdrawal, so it must be taken as directed.

Naltrexone is the last medication that is typically prescribed for withdrawal. This is an opioid agonist and blocks the action of an opioid. It isn’t sedating and won’t cause an addiction. It is a long-acting form when taken under the brand Vivitrol.

Some other medications may be used to help minimize symptoms that are uncomfortable, such as nausea or tremors. For example, the detox program may prescribe antidepressants, anticonvulsants or anti-nausea medications. These are symptom-specific medications, so the ones that a patient gets will depend on their withdrawal symptoms and what they need (or don’t).

What Is Suboxone’s Role in Detox?

Suboxone, a form of buprenorphine, is usually prescribed as a maintenance medication. It may be prescribed for at-home use for outpatients, or it may be closely monitored in an inpatient setting. Burepenorphine is also used as a relapse prevention measure, because it inhibits cravings and other withdrawal symptoms.

Buprenorphine does reach a plateau, which means that taking more of it than prescribed is unlikely to lead to abuse. This is beneficial for patients who may not want to take medications for fear of becoming addicted to something new.

Do People Need Rehabilitation Treatment Following Detox?

While it’s possible to go through detox and get clean without going on to rehabilitation, it’s normal for detox to take place as a part of the rehabilitation program and treatment plan. Typically, patients will detox prior to entering into a rehabilitation clinic for further treatment through behavior therapies, dual-diagnosis treatment or others.

There are many kinds of rehabilitation programs, such as inpatient, residential, outpatient, intensive outpatient, partial hospitalization and others. Medication-assisted treatment may be advised for some who struggled with long-term dependency or addiction as well.

Get Help with Heroin Withdrawal at Harmony Place

At Harmony Place, we know how difficult it can be to get sober. Whether you or someone you love is struggling with a dependency or addiction to heroin, it’s important for you to know that there is help available. On our website, you can chat with one of our helpful substance abuse counselors now, or you can call us at 1 (855) 652-9048. We would like to talk to you about how you can come to our facility and work through this challenging time in your life with all the support you need.

We offer services such as detoxification, outpatient treatment, aftercare for alumni, recovery home, clinical care, relapse prevention, dual-diagnosis treatment and so much more. Reach out, and we will be more than happy to help you on your path to sobriety.

[1] National Institute on Drug Abuse. What Is Heroin?

[2] The United States Drug Enforcement Agency. Drug Scheduling

[3] Mayo Clinic Laboratories. Opiates

[4] Semel Institute for Neuroscience and Human Behavior. Post-Acute Withdrawal Syndrome

[5] National Institute on Drug Abuse. What are the treatments for heroin use disorder?