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Heroin Withdrawal: A User’s Guide to Detox

Content Synopsis

Heroin Withdrawal—What is it and How Long Does it Last?

Withdrawal is the process an addict goes through as their body flushes out all traces of heroin. The process usually takes between 5 and 7 days.

Common symptoms include:

  • Muscle, bone and stomach cramps
  • Nausea, vomiting, and diarrhea
  • Profuse sweating
  • Anxiety
  • Insomnia

This article will provide an in-depth look at the detox process and offer some advice for limiting these symptoms.

“One of the main reasons I kept shooting up for so long was that I was afraid of what withdrawals would feel like. Detoxing wasn’t easy, I’ll tell you that, but it wasn’t nearly as bad as I thought it was going to be.” — Anonymous Northpoint patient

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Opioid Addiction: A Dangerous Epidemic

There’s never been a more crucial time for addiction education. According to provisional stats from the National Center for Health Statistics, more than 15,000 Americans died from a heroin overdose during 2017. This was more than a 20% increase in only two years.

The National Institute on Drug Abuse estimates that nearly 170,000 people begin using the drug every year. This means that we can expect to see an increase in overdose rates as the years go on.

One thing that we can attribute to the overdose rate is a lack of treatment. Those addicts who fail to seek treatment are far more likely to die from using the drug. If we can educate more addicts on what treatment is, where they can find it and what happens during detox, we’ll be able to save more lives.

Understanding the Heroin Withdrawal Process

If you’re an addict yourself or know someone who is, you know that no one looks forward to withdrawals. Detox is a notoriously unpleasant process. It has such a reputation for being painful that many addicts put off quitting in order to avoid having to live through it.

But what causes drug withdrawals? What makes them so uncomfortable? Why is it that we must suffer through such intensity just to get clean?

Well, here’s the deal: when you use heroin for a long enough period of time, you reprogram your brain to think that the drug is something you need to survive. Your basic functions warp and shift to accommodate the drug. Once the connections between your brain and organs are altered by a foreign substance, reversing that process is difficult.

Essentially, withdrawals are the result of your body trying to re-calibrate itself after a long period of drug use. No matter which drug you’re addicted to, this process will occur when you try to quit. Cocaine, methamphetamine, marijuana, nicotine and even coffee all have their own unique withdrawal symptoms.

The symptoms of dope withdrawal, however, are known to be particularly undesirable.

Addicts will experience a combination of both physical and psychological side effects.

Some physical side effects include:

  • Vomiting and diarrhea: The most important part of detox is getting the drug and any byproducts out of your system. One way that the body handles this is through the digestive system. As a result, you’ll find yourself spending a lot of time in the bathroom during detox.
  • Sweats: In addition to vomiting and diarrhea, your body will also get rid of the drug through your sweat glands. As a result, most addicts in withdrawal find themselves dripping in sweat.
  • Chills: The chills, or “shivers” as they’re known among addicts, are prompted by a fluctuation in body temperature. Your temperature increases to trigger sweating so that you can expel more toxins quicker. Note: if you’re doing a home detox, take your temperature consistently. If your temperature rises above 103 F (40 C) and stays that way for longer than an hour, you should seek immediate medical attention.
  • Muscle and bone pain: Over time, chronic opiate use can take a toll on your muscles and joints. It’s usually not severe, but it’s enough to cause some pain. When you use drugs, they tend to numb your nervous system and you don’t feel the pain in your bones. During detox, however, you start to feel this accumulated pain all at once. These pains tend to go away by the time you’ve finished detoxing.
  • Tremors: If you’ve ever used opiates, you know that the drug can cause your body to shake uncontrollably for small amounts of time. These short shakes, known as “drug-induced tremors” are the result of your nervous system adjusting to the chemical. When you withdraw, your nervous system must re-adjust to the absence of the chemical, which causes you to start shaking again.
  • Physical exhaustion: Heroin withdrawals are tiring. Your body is required to work overtime as it tries to cope with the situation. The neurotransmitters in your brain will be bouncing all over the place, your nervous system will be a wreck and you’ll find yourself extremely tired. However, because the cravings and anxiety are so bad, many addicts find themselves unable to sleep during detox. This compounds the exhaustion, making it exponentially worse.
  • Hypertension: Hypertension, or high blood pressure, occurs when your heart is pumping at a speed too fast for your arteries to handle. This occurs during detox because opiate addiction tends to slow down your heart rate over time. When you quit, therefore, your heart starts beating normally again and your arteries aren’t always prepared to accommodate the flow. If you detox in a professional facility, your doctor may prescribe medication to treat this symptom.
  • Breathing trouble: Your lungs are another part of the body that are severely impacted by opiate addiction. When you’re under the influence of these drugs, your nervous system causes your breathing rate to slow down. Over time, your average breathing rate drops drastically. Once you cease using the drug, your lungs will start working at a much faster pace, which can actually be quite painful. Some addicts actually experience permanent lung damage as a result of their addiction.

Some psychological side effects include:

  • Severe cravings: All addicts in recovery will experience severe and ongoing cravings. These cravings are essentially your brain trying to trigger you to relapse. Once you’re addicted to something, your brain is programmed to believe that the substance is necessary for your survival. Cravings are generated as a survival mechanism in a confused effort to keep you alive.
  • Anxiety: As your body flushes all of the leftover opiates out of your system, your brain has to adjust itself. After all, it has become dependent on having the drug in it. It may struggle to adjust properly which will cause you to feel anxious for quite a while after you quit. Post-addiction anxiety can last for months, so many doctors prescribe meds to help their patients cope with this.
  • Depression: One of the reasons why heroin is so pleasurable for its users is that it provides the brain with an enormous rush of dopamine. As you become addicted to the drug, you get used to having a constant supply of dopamine running through your brain. Once you cut yourself off, of course, this supply goes away and your mood might sink as a result. This depression is often made worse by the fact that addicts have to come to grips with the choices they made while on drugs.
  • Emotional numbness: Some addicts find themselves unable to enjoy anything for a few months after they get sober. This feeling might be accompanied by depression and anxiety, as well. Like depression, it’s the result of a lack of dopamine in the brain. It may take some time before the addict is able to appreciate experiences other than taking drugs.
Heroin Withdrawal Profile

Can Opiate Withdrawals Kill You?

In very rare cases, heroin withdrawal can be deadly. Detox usually takes a turn for the worse when the addict becomes too dehydrated. As your body expels the drug outward, it also expels massive quantities of water as well. When you become too dehydrated, your organs may stop functioning properly.

As an article in Addiction, the official journal of the Society for the Study of Addiction, points out, the majority of these deaths occur in places where the addict has no access to medical treatment. Patients in jail, they say, are far more likely to die during detox because they are often deprived of the water they need to withdraw safely.

It’s crucial, therefore, that you make sure you drink enough water while you’re going through withdrawals if you want to avoid deadly complications.

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The Withdrawal Timeline

The duration of heroin withdrawals will vary from addict to addict. It’s dependent on a number of different factors including their age, the severity of their addiction and whether or not they have any co-occurring disorders.

However, the whole process usually doesn’t take any longer than seven days, even in addicts with a severe addiction.

An average withdrawal timeline will look something like this:

First 48 hours: Within 12 hours of their last dose, an addict will start to experience withdrawal symptoms. If the individual is a chronic user and accustomed to having the drug in their system at all times, they may start to feel ill in as little as six hours.

During these first two days, the addict will experience severe nausea, vomiting, and diarrhea. It’s also likely that they’ll sweat profusely. These are all signs that the user’s body is expelling the drug and its byproducts out of their system. These chemicals exit the body through the digestive system (which explains the vomiting and diarrhea) as well as the pituitary glands (hence the extreme sweating).

As the drug leaves their body, the addict will begin to feel anxious and irritated. They’ll experience strong cravings for the drug. They might consider relapsing or even suicide, so it’s important that they are supervised during this time.

48-72 hours: The next stage in the timeline might be the hardest. Your symptoms will “peak”, meaning that the worst day of withdrawal takes place during this stage. Nausea, cramps, and aches will all grow increasingly worse until around Day 3 or 4. It will be uncomfortable, but it’s important to remind the addict that they are making a good decision and that they will feel better soon.

Due to the combination of pain and cravings, anxiety and restlessness will also get worse during this time. Many addicts report being unable to sleep during this time. They should try their best to get some rest if possible so that their body can work on repairing itself.

It’s also crucial, here, that the addict attempt to eat something or at least take vitamins. As the body detoxifies from opiates and expels them outward, it also pushes out vital nutrients. These nutrients are necessary for the organs to repair any damage that has been caused so the addict needs to replenish their system as soon as possible.

72 hours+: In most cases, physical symptoms will completely subside by Day 5. Under certain circumstances, however, these symptoms may continue.

In nearly every case, the addict will continue to feel anxious or depressed for several weeks after they detox. This can be attributed to a number of different reasons. The addict will continue to experience cravings, for example, which can make them feel on-edge. Also, many addicts experience a post-rehab clarity in which they start to remember the things they said or did while high. These feelings tend to fill the addict with regret.

It’s important, therefore, that they addict gets into a rehabilitation program as soon as possible. In order to avoid relapsing, they’ll want to speak with a therapist who can help them to overcome the initial feels of guilt that many addicts feel when they start getting sober.

Factors That Can Affect the Detox Timeline

As it was pointed out above, the length of the heroin withdrawal timeline can fluctuate depending on the person. Several different factors can make it last for a longer or shorter period of time. These factors include:

Physical health: A healthy body is a key to a quick detox. Your liver, in particular, is crucial to the detoxification process. If you have a healthy liver, it will be able to process all of the chemicals rapidly and to get them out of your system fast.

Age: Unfortunately, it often takes older folks a bit longer to detox than young people. This is likely due to the factor that younger people generally have healthier livers and their bodies can process chemicals much faster. On top of this, older drug addicts are more likely to have been using dope for years and are withdrawing from a more severe dependency.

Length of addiction: If you’ve been using for a long time, your symptoms are going to last far longer than someone who’s picked up the habit recently. Your brain and other organs will be much more dependent on the drug and are going to give you a harder time when you cut them off from it.

Purity of their batches: Many drug dealers “cut” their supply with other materials to increase their profit margins. By mixing baking soda or other store-bought items, they can make more money on each bag they sell. As a result, users often take strange chemicals into their body that impact the liver’s ability to process drugs. If you accumulate enough of these substances in your liver, it could lead to a longer withdrawal timeline.

Other drugs used in combination: When you mix heroin with other drugs like alcohol, cocaine or benzos, the cocktail can produce new chemicals that are harder to process than H by itself. These byproducts can create a blockage in your system that limits your body’s ability to metabolize them properly.

Method of consumption: When it comes to the length of the detox timeline, how you take drugs is just as big of a factor as what drugs you’ve taken. When you inject or “mainline” the drug, you place it directly into your bloodstream. Because it is essentially a toxin, your body works very rapidly to try and get rid of it. This makes the detox process a bit (and we mean a very tiny bit) faster. If you smoke or snort the drug, however, it will accumulate in your organs in much larger quantities, making detox take a little longer.

Location of detox: When you detox in a professional treatment facility, you’ll be under the supervision of medical doctors. These doctors will do what they can to expedite the withdrawal process, making sure that there are no complications along the way.

Tapering vs. cold turkey: Some doctors will have their patients taper off of the drug for a week or so before having them commit to detox. The reason for this is that the tapering method makes withdrawals much less of a shock to your system.

It’s important to point out here that weaning off of the drug is not recommended unless done under the supervision of a doctor. If you want to quit cold turkey from home, we highly recommend that you contact a doctor before doing so.

Why Detoxing from Home is Not a Good Idea

We get a lot of questions from addicts who want to know if they can detox from home. Some of them worry that they don’t have the time or money to commit to a formal treatment program. Others are just skeptical about the whole idea of detox programs.

Our answer: Yes, it’s completely possible to go through heroin withdrawals on your own and you can quit cold turkey but we really don’t recommend it.

To get an idea of why we endorse professional detox, check out this video from the BBC’s Drugland:


In this video, Tom, a young drug addict, makes a few important points about the importance of formal treatment:

“The first time, I did it full-on cold turkey. It’s five days of sheer hell.”

Tom very accurately describes the experience of going through withdrawals. He explains that he was “horrendously sick” and spent the majority of his time on the toilet. “I had green fluids flying out both ends simultaneously,” he says, “Sweat went through two thick floor cushions into the carpet.”

As anyone who’s ever been through the experience knows, this is, in fact, the case. Withdrawals certainly aren’t easy or pleasant. However, these symptoms can be drastically reduced by a medical professional. In a formal detox program, a doctor may prescribe small, decreasing doses of opiates to limit the severity of withdrawal symptoms.

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“It didn’t last very long because I didn’t really want to stop taking. I wasn’t ready.”

Unfortunately, Tom’s story is a common one among heroin addicts. They prepare themselves mentally to quit but, once the withdrawal symptoms kick in, they relapse shortly afterward.

“Then, things went crazy for about five years,” Tom says, explaining that he returned to using after his first attempt to get sober.

Sadly, this is the case for many people. The side effects of detox are just too intense for them to abstain from using. They take a hit to end the suffering and find themselves right back in the life they wanted to escape from.

“It’s very uncomfortable. It’s not pleasant but it’s bearable, it’s doable. It’s achievable.”

Telling us that he checked into a professional detox facility, Tom explains how the treatment program eased up his symptoms. With the help of prescribed meds that enabled him to wean off slowly, the process became much easier.

He also says that his treatment center helped him to reconnect with the world around him. “When this finishes, I’ll moving onto rehab and I’ll be able to engage with people, look them in the eye,” he says, “I’ll be able to appreciate the beauty of nature, things I haven’t noticed for years.”

As of the video’s publication date, Tom has been sober for longer than a year. This should serve as an inspiration to anyone struggling with an addiction.

Which Medications are Used to Treat Heroin Withdrawals?

There are a number of different medications used in detox treatment. Each of these meds has its own upsides and downsides. Every doctor has a different philosophy about which meds work the best.

A few popular withdrawal drugs are:

Buprenorphine: Buprenorphine is a chemical used in Opioid Replacement Therapy (ORT) programs. These programs are rooted in the idea that by supplying the addict with tiny amounts of opioids, their cravings will be fed and they can focus on recovery.

This chemical is found in two products: Subutex and Suboxone. Patients will be given a monthly supply of one of these drugs to help them fight off cravings as they work through the early days of sobriety. Because these drugs contain opioids themselves, they can be abused and carry a risk of addiction. It is important, therefore, that patients in an ORT program understand that these substances are only supposed to be used for a short period of time.  

Methadone: This is another common opioid replacement drug. It’s found in a product called Dolophine. We used to see methadone used a lot more often, but due to its high potential for abuse, most doctors have leaned toward other alternatives.

There are strong regulations around methadone, so users are required to obtain their dose on a daily basis. This makes using it difficult for some recovering addicts as many people don’t have time to report to a methadone clinic every day. In the future, it’s likely that we’ll see this drug disappear from the market completely.

Naltrexone: This chemical is currently found in only one product: Vivitrol. Unlike buprenorphine or methadone, which both mimic the effects of heroin, naltrexone actually prevents the addict from feeling the effects of opiates. This means that a recovering addict will not be able to get high off of any opiates even if they choose to relapse.

Vivitrol is a popular product because each dose lasts for 28 days. The addict receives one dose per month for as long as their prescription lasts. It is administered via injection.

This drug doesn’t technically treat withdrawal symptoms. Instead, it eliminates the incentive to use. As a result, the addict will be unable to take opiates and will, therefore, be able to adjust to life as a drug-free person without having the urge to relapse.

If you think that naltrexone might be the detox drug for you, click here to learn more:

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How Much Does Medical Detox Cost?

We understand that many people are turned off by the idea of paying for detox. There is a common misconception that it costs too much money. Some people simply don’t have the funds to cover the costs associated with treatment which is why we do our best to accommodate every patient.

Most insurance providers cover the costs of detox. Drug addiction is a medical condition, so it’s likely that your provider will be happy to help you pay for treatment.

To verify that your insurance will pay for detox, please click here:

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Don’t have insurance? No worries! Northpoint is happy to set up a payment plan that will enable you to withdraw from heroin now and pay us back later. No addict should have to go through the process alone, so we’re happy to help you out until you can get the money to us.

Please reach out to us if you’ve decided it’s time to quit. A member of our staff will help to find a payment plan that works for you.

How to Help Someone Detox at Home

If you have a friend or family member that’s going through heroin withdrawals but refuses to check into a treatment center, there are a few things you can do to help them. Some things you should do are:

First and foremost, you should make sure that they know you’re proud of them for trying to quit. Even if they’ve hurt you at some point in the past, this is not the time to bring that up. They may want to be alone or quiet during the process, but don’t take this personally. The symptoms can be painful. You can offer encouragement simply by being present and offering help where you can.

As the addict withdraws, they’ll start to see their addiction in a clearer light. They’ll remember some of the things that they did while they were high. If you’re helping someone detox, it’s not your job to make them feel any worse than they already do. If you really care about them, you’ll avoid saying anything mean or judgmental during the process. This could make the situation worse and could even trigger them to relapse.

It was pointed out above that most addicts that the majority of people who detox at home don’t make it through the process. Most of them end up relapsing. It’s important, then, that you don’t do anything to enable a relapse. This includes buying them drugs, obviously, but also giving them money. Any food, water or vitamins you give them should be purchased by you. If they want to relapse, let them do it on their own.

Of course, you want to make sure that they drink enough water to stay safe. This can be difficult because the addict will likely be throwing up. They may not want to consume anything, even water. It’s vital that you stress the importance of staying hydrated and convince them to drink water, even if it’s just tiny sips.

They may not want to eat anything until a few days in but you should try and get them to do so. Bring them some high-fiber food such as whole wheat bread, black beans or leafy vegetables. These foods will target the digestive system and help to move out the excess opioids fasters.

If the addict is feeling well enough to eat some fruits and vegetables, they should do so. During withdrawals, addicts lose a lot of vitamins and minerals. Healthy foods can help to restore their nutrient levels. Of course, they may feel too sick to eat anything. In that case, they should take some vitamins accompanied by at least a small bit of bread.
Once they’ve finished detoxing, you might want to convince them to check into a drug rehab program. They will be a bit more clear-headed after they’ve gone through withdrawal, so even though they refused to seek medical detox they could be convinced to go to rehab. Getting support at a professional treatment center is the best way to reduce the risk of a relapse.

Be Careful—The Risk of Overdose is Higher after Detox

It may be surprising, but overdose deaths are actually more common among those who’ve been through detox before. We’ve seen this happen in a number of famous cases, most notably the death of Philip Seymour Hoffman.

Like many recovering addicts, Hoffman had been sober for quite some time when he relapsed. Because of this, his system was not prepared to handle the amount of heroin he injected. As a long-time drug user, however, Hoffman thought he knew how much it would take to get him high.

The problem is that, when you’re addicted to a drug, you build up a tolerance for it over time. That tolerance decreases when you get clean. People who relapse, however, often don’t account for the fact that their tolerance has gone down. Oftentimes, they relapse by taking the same amount of the drug they would have taken before they got sober. If the addict takes enough to shut down their nervous system, it’s likely that their heart and lungs will stop.

This happens to individuals all of the time, so it’s important to keep this in mind as you fight to stay sober.

Heroin Rehab Offers Continued Support After You Finish Withdrawals

Medical detox is a valuable resource for any addict. It will help you overcome your chemical dependency on the drug.

Chemical dependency, however, is only one aspect of your addiction. Just because you’ve cleared the drug out of your system doesn’t mean that you’re cured. If you want to stay sober for the rest of your life, you’ll need to address the psychological and emotional aspects of your condition.

Rehab is a place that helps you to overcome the psychological hurdles that come with addiction.

In a drug rehab program, you’ll spend time with therapists and addiction specialists that will work with you to develop psychological tools for fighting the urge to use. These individuals will also help you to understand the mental and emotional roots of your addiction.

You’ll also meet with other recovering addicts for group support sessions. In these meetings, each addict will spend time sharing their story and providing updates on the status of their recovery.

Our staff has been where you are right now. It will be helpful for you to spend time with other people that understand what you’re going through and want to support you as you strive to get clean.

What Types of Rehab Programs are Available?

There are several different types of drug treatment programs. Some programs are inpatient-based, meaning that you’ll live in the rehab center for a few weeks. This is a fantastic option for people who want to spend time focusing on staying sober.

Other programs are outpatient-based, which means that the addict will report to the facility on a daily basis. They’ll have a similar schedule to rehab inpatients but will leave once they’ve completed their meetings for the day. This option works well for addicts who have school, work or family obligations that they can’t afford to miss.

The Benefits of Inpatient Rehab for Heroin Addiction

Northpoint Recovery is an inpatient treatment center. Our patients check in for a few weeks after they’ve finished withdrawing to spend time with top-notch addiction professionals. A normal session lasts roughly 28 days.

We understand that not everyone has the time to commit to a month of intensive treatment. However, we also believe that it’s the most effective form of treatment for drug addiction.

Here are some benefits offered by an intensive program like ours:

24/7 assistance: When you’re living in a rehab facility, you’ll have 24-hour access to addiction professionals who’ve seen it all. No matter what type of physical or psychological symptoms you’re experiencing, there will be someone present who can help to treat it.

No temptation to relapse: The urge to call your dealer and pick up a bag of dope will be completely eliminated. It’s easier to commit to recovery when that choice goes away. By the time you check out of the program, you’ll have spent a month preparing to reenter the real world and you’ll be much more equipped to manage your cravings.

Customized care: Every addict has different needs. The doctors on-staff at our facility will work to assess your particular situation and offer you the best possible forms of treatment. They’ll address any co-occurring disorders, prescribe any medications that you need and provide you with hyper-personalized care.

A network of support: It’s easy to feel like you’re the only person who struggles with addiction. In reality, however, hundreds of thousands of people are fighting the same battle you are. In rehab, you’ll spend time getting to know others who are dealing with the same issues as you. You’ll each provide support and encouragement to one another, helping each other to work toward a happier, healthier life.

Getting Through Withdrawals is the First Step Toward Recovery

No one wants to go through heroin withdrawals. But, if you want to move beyond addiction, they’re a necessary step

Here at Northpoint Recovery, we can help to make the process a little easier. Our staff will provide the personalized treatment you need to get clean.

Please give us a call if you need help. We want to help you get on the path to a better life as soon as possible.

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