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How Long Does Heroin Withdrawal Last? | What Are the Stages?

Heroin is a dangerously addictive opioid, and prolonged use has repercussions that extend beyond the user. The economic burden alone from opioids costs the United States nearly $78.5 billion each year, stemming from addiction treatment costs, healthcare, and criminal justice involvement. Unfortunately, one of the primary reasons stopping the drug is such a challenge is heroin withdrawal.

The influx of opioid prescriptions in the 90s led to the opioid crisis, which claims 128 lives each day. When the government implemented new restrictions for prescribing, doctors turned away from using the medications. Many of those who were dependent or addicted to their drugs turned to heroin for pain relief. 

Heroin is extremely addictive, and the withdrawals are severe enough to push someone straight back into using. Let’s take a look at the symptoms and timeline. 

What Is Heroin Withdrawal?

Although heroin withdrawal symptoms may only last a week or so, symptoms can become severe, including:

  • Abdominal pain
  • Nausea
  • Shaking
  • Sweating
  • Agitation
  • Nervousness
  • Muscle spasms
  • Depression
  • Cravings for heroin

If you’re looking to stop heroin, you must seek medical detox to do it safely. A detox team will provide medications and therapy to alleviate the worst symptoms and decrease the risks of the process.

Another reason people turn to heroin is the cost of prescription medication on the street. Drugs like Vicodin or OxyContin are expensive when obtained on the black market, and heroin is considered a cheaper and more potent alternative. According to CNN, nearly 50 percent of young heroin users abused a prescription opioid first. 

The U.S. Centers for Disease Control and Prevention (CDC) report that heroin abuse has nearly doubled for Americans between 18 and 25 over the past ten years. In 2013, 8,200 people lost their lives due to heroin overdose, almost four times the number of heroin-related fatalities in 2002.

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Heroin Withdrawal Symptoms

Heroin withdrawal will vary from one person to another based on several factors. How long was heroin abused? How much was used each time? What method of administration did the person use? These factors will determine how dependent the body and brain are on the drug, which will determine the duration and severity of withdrawals. A person with mental illness or prior opioid withdrawal could have a more intense experience.

As an opiate, heroin suppresses specific functions in the central nervous system, such as blood pressure, heart rate, temperature regulation, and respiration. The drug also binds to opioid receptors and increases chemicals in the brain responsible for pleasure. When the drug is abused, the person will experience a rush of pleasure. However, during withdrawal, the effects are the complete opposite, and instead of euphoria, sedation, and reduced heart rate, a person will experience anxiety, low mood, and rapid heart rate. 

Withdrawal symptoms will range in severity based on the duration of abuse and level of dependence. For a person who hasn’t abused heroin extensively for months or years, withdrawal may not last as long or be as severe. 

Mild heroin withdrawal symptoms include:

  • Tearing
  • Runny nose
  • Abdominal cramps
  • Nausea
  • Chills
  • Sweats
  • Yawning
  • Restless leg syndrome
  • Muscle and bone aches

Moderate heroin withdrawal symptoms include:

  • Goosebumps
  • Tremors
  • Fatigue
  • Diarrhea
  • Agitation
  • Restlessness
  • Vomiting
  • Inability to concentrate

Severe withdrawal symptoms include:

  • Depression
  • Anxiety
  • Insomnia
  • Rapid heart rate
  • Hypertension
  • Impaired respiration
  • Muscle spasms
  • Drug cravings
  • Inability to experience pleasure

Although heroin withdrawal isn’t considered life-threatening, some psychological or medical complications could arise and become life-threatening. You should always seek professional help if you plan on stopping heroin.

Depression could lead someone to ponder suicide, for example, meaning you should never abruptly stop using heroin without the right channels of care. Professionals can offer several methods to help you manage side effects and keep you safe.  

Heroin Detox Duration

Unlike other opioids, heroin is considered short-acting, meaning it takes effect rapidly but always exits the bloodstream fast. Heroin withdrawal symptoms can arise in six to 12 hours after the last dose, peak in two to three days, and last anywhere from five to ten days in total. Again, this is heavily dependent on how long someone used the drug. In some cases, once acute withdrawals pass, the individual could experience post-acute withdrawal syndrome (PAWS), which can last weeks, months, or even years. 

"Withdrawal" spelled out in wooden tiles

Medical detox usually starts before heroin exits the system and can last anywhere from five to seven days. For a person who is heavily dependent on heroin, detox could last up to ten days to be safe. The process incorporates therapy and medications that allow the brain and body to recover from its dependence on heroin. Heart rate, blood pressure, temperature levels, and breathing are monitored to help keep the person safe and secure for their time in detox. 

Stages of Heroin Withdrawal

Heroin withdrawal will occur in stages, and it’s important to know these if you’re about to go through the process. 

Early Stages

During the early stages of withdrawal, the symptoms should start around six to 30 hours after you’ve last used heroin. The early stages of withdrawal will produce the following symptoms:

  • Muscle pain
  • Irritability or anxiety
  • Tiredness
  • Body aches
  • Sweating
  • Trouble sleeping

Later Stages

Around 72 hours after your last heroin dose, you’ll experience the peak symptoms, which are typically at their worst. During this stage, the early symptoms could become severe. These symptoms will likely include:

  • Diarrhea
  • Nausea
  • Stomach ache
  • Vomiting
  • Chills

Heroin Withdrawal Treatment

As we’ve mentioned several times throughout this article, treatment is a vital step to help get you off heroin. Treatment centers can provide you with medications you otherwise wouldn’t get alone. These will shorten the withdrawal process and make the symptoms less severe. Some of these medications include:

  • Naloxone, which reverses and treats heroin overdose
  • Naltrexone, which helps prevent relapse
  • Clonidine hydrochloride, which treats common symptoms
  • Buprenorphine, which is used alongside naloxone during withdrawal for a reduction in symptoms or by itself after detox to prevent relapsing

In other more severe cases of heroin addiction, doctors could prescribe methadone during withdrawal. As you progress, they’ll wean your dose to help reduce dependence. If you’re interested in these treatment options, you must speak to an addiction specialist to help you learn more. 

Potential Risks of Withdrawal

Although withdrawal can be painful, the benefits will outweigh the risks once you get sober from heroin. Unfortunately, as you might expect, there are risks involved, including:

  • Aspiration (breathing in your vomit)
  • Lung infections caused by aspiration
  • Excessive vomiting or severe diarrhea, which may cause dehydration and a loss of electrolytes
  • Seizures

If you want to find out how withdrawal can affect you, it’s essential to speak with a doctor and discuss any medical conditions you might have. Keep in mind, the risks of withdrawal are significantly less dangerous than the risks of continued heroin abuse. 

Keys to Coping with Heroin Withdrawal

If you’re ready to stop using heroin, having support is vital. The stronger your support system, the more likely you’ll succeed in overcoming heroin addiction. If you don’t have a big family or many friends, the recovery community is a great place to meet people who share your same interests in getting sober. If you’re ready to stop using heroin, you have an entire community behind you ready to help.

Sources

MedlinePlus (February 2021) Opiate and Opioid Withdrawal. Retrieved from https://medlineplus.gov/ency/article/000949.htm

NIDA (February 2021) Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis

CDC (N.D.) Today’s Heroin Epidemic. Retrieved from https://www.cdc.gov/vitalsigns/heroin/index.html

Semel Institute for Neuroscience and Human Behavior (N.D.). Post-Acute Withdrawal Syndrome. Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS

CNN (June 2016) Unintended Consequences: Why Painkiller Addicts Turn to Heroin from https://www.cnn.com/2014/08/29/health/gupta-unintended-consequences/index.html

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