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Heroin Withdrawal: Symptoms, Timeline, & Treatment

image of man representing heroin withdrawal

Heroin, an illicit opioid, is derived from morphine, a natural substance found in the opium poppy plant. According to data from SAMHSA (Substance Abuse and Mental Health Services Administration), 1.1 million U.S. adults reported using heroin in 2021. Among those, over 1 million developed heroin addiction (opioid use disorder).

Sustained use of heroin triggers the development of both tolerance and physical dependence on the drug. Tolerance manifests when the body adjusts to heroin’s continuous presence, requiring higher doses for the desired effect. Additionally, abrupt reduction or discontinuation leads to heroin withdrawal symptoms. Heroin withdrawal manifestation occurs due to physical dependence.

Heroin Withdrawal Symptoms

During detox for heroin, individuals who are dependent on the drug will experience an array of symptoms of heroin withdrawal.

Acute (short-term) heroin withdrawal symptoms

Signs of heroin withdrawal are usually present after 8 to 24 hours. The duration of acute withdrawal varies from 3 to 10 days based on factors like frequency, dose, and duration of heroin use, as well as individual and genetic factors. Short-term symptoms, often distressing and uncomfortable, may include:

  • Elevated body temperature
  • Increased breathing rate
  • Fast pulse
  • Insomnia or sleep disturbances
  • Dilated pupils
  • Unusually heightened reflexes
  • Sweating
  • Goosebumps
  • Watery discharge from eyes and nose
  • Muscle spasms or cramps
  • Bone pain
  • Nausea and/or vomiting
  • Diarrhea

Protracted (long-term) heroin withdrawal symptoms

Protracted withdrawal, persisting after acute withdrawal, involves enduring impairments. Symptoms may include:

  • Anxiety
  • Depression
  • Sleep disturbances
  • Continued fatigue
  • Dysphoria (general sense of feeling down or emotionally dull)
  • Anhedonia (loss of interest or pleasure in activities)
  • Irritability
  • Short-term memory problems
  • Decreased attention, impaired concentration, and difficulty making decisions
  • Drug craving

Returning to heroin use may be tempting to alleviate these distressing symptoms. However, individuals withdrawing from heroin should recognize their reduced opioid tolerance, increasing the risk of overdose upon relapse. It is almost always beneficial to seek support and maintain abstinence for sustained recovery

woman looks away representing heroin withdrawal timeline

Heroin Withdrawal Timeline

The following heroin withdrawal timeline is a general guideline, and individual experiences may vary.

Early symptoms (8 to 24 hours)

Withdrawal can begin within hours after the last heroin dose. Symptoms may include anxiety, insomnia, increased heart rate, and elevated blood pressure. Fast pulse, dilated pupils, sweating, and goosebumps are common.

Peak acute symptoms (days 1 to 3)

Intensity peaks within the first 72 hours. Symptoms may include nausea, vomiting, diarrhea, muscle spasms, bone pain, and heightened reflexes. Psychological distress such as irritability and insomnia can be pronounced.

Continued acute withdrawal (days 4 to 10)

Symptoms persist, but their severity begins to subside. Physical symptoms like sweating and digestive issues may continue. Psychological symptoms such as anxiety and depression may endure.

Post-acute withdrawal (beyond day 10)

Protracted withdrawal may set in, characterized by lingering symptoms. Anxiety, depression, sleep disturbances, fatigue, and drug cravings can persist. Short-term memory problems and difficulty concentrating may endure.

Long-term recovery (varies)

Complete recovery varies, and individuals may continue to experience subtle psychological symptoms. Building a supportive network and seeking professional help can contribute to sustained recovery. Continued abstinence is crucial, as a reduced opioid tolerance increases the risk of overdose. Navigating the heroin withdrawal timeline can be challenging, but seeking medical and psychological support is central to a safe and successful recovery journey.


Can you die from heroin withdrawal?

While heroin withdrawal itself is generally not fatal, the symptoms can be severe and uncomfortable. That said, complications arising from dehydration, electrolyte imbalances, or pre-existing health conditions can lead to serious medical issues. Those going through withdrawal should seek medical supervision and support to streamline the heroin detox process.

How long does heroin withdrawal last?

For those wondering how long do heroin withdrawals last, most symptoms peak within 72 hours and gradually subside over the following week. Some psychological and physical symptoms may persist for weeks or months, though. The length and intensity of withdrawal depend on factors such as overall health, the duration of heroin use, and the presence of any co-occurring disorders.

Can a heroin addict recover?

Yes, heroin addiction is treatable, and many individuals can achieve long-term recovery with the right support and treatment. Effective approaches often include a combination of medication-assisted therapy, counseling, and support groups. Recovery is a lifelong process, and ongoing support can be essential for maintaining abstinence and achieving a fulfilling, drug-free life.

Heroin Withdrawal Treatment

Opioid replacement therapy employs a prolonged-release opioid medication to minimize drug cravings and withdrawal symptoms without inducing a euphoric state. Gradually, the dosage of these medications can be tapered under controlled conditions until the person achieves opioid-free status.

The two FDA-approved opioids for heroin withdrawal treatment are methadone and buprenorphine. Buprenorphine is often preferred due to its more favorable side-effect profile. Suboxone, a specific buprenorphine product used in opioid detox, contains naloxone, an opioid receptor blocker to deter abuse attempts.

Additional medications may be incorporated during heroin detox to address specific symptoms. Sedatives, such as benzodiazepines, and clonidine (which aids in reducing withdrawal symptoms), are among the medications utilized.

Approximately half of those with substance use disorders also grapple with mental health conditions like depression or anxiety. Identifying and addressing underlying mental health issues significantly enhances recovery success rates and plays a central role in restoring overall health and functionality.

Ongoing treatment to address heroin addiction symptoms is often provided through comprehensive programs offered in both inpatient and outpatient settings. These programs are designed to address the physical, psychological, and social aspects of heroin addiction.

Inpatient rehab, otherwise known as residential rehab, offers a structured and immersive environment where individuals can focus solely on their recovery. In these programs, participants reside at the treatment facility for a specified duration, typically from 30 to 90 days. The structured nature of inpatient rehab provides a safe and supportive environment, often incorporating individual and group therapy, counseling, educational sessions, and holistic approaches such as yoga or art therapy. Medical professionals closely monitor the detoxification process, and the continuous availability of support contributes to a higher level of accountability and motivation.

Outpatient rehab programs offer more affordability and flexibility by enabling people to receive treatment while living at home. This option is suitable for those with a stable home environment and a strong support system. Outpatient programs vary in intensity, with some requiring daily attendance and others meeting a few times a week. Treatment may include counseling, group therapy, and educational sessions. Outpatient rehab is often recommended for those with milder addiction cases or individuals transitioning from inpatient care. How can you get help right away, then?

a man celebrating which represents getting heroin withdrawal treatment

Find Treatment for Heroin Withdrawal at Drug Rehabs Centers

Finding heroin addiction treatment can be challenging with so many options at your disposal. Reaching out to Drug Rehabs Centers can help you choose the most suitable program for your needs and the severity of your addiction.

Begin your recovery with supervised medical detox at a drug rehab or licensed medical detox center near you. We can connect you with a variety of suitable facilities near you.

Following detox, you will likely need to engage with ongoing treatment in an inpatient or outpatient setting. We can put you in touch with treatment providers offering interventions at all levels of intensity.

Call (844) 739-2005 for immediate assistance in moving beyond heroin addiction.

Juan Bonnet
Author: Juan Bonnet


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