Heroin Withdrawal Timeline, Tips, and Symptoms


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The truth is that heroin is unfathomably dangerous, and no amount of positive spin can make it anything but a deadly poison. One of the less savory elements of this addiction is heroin withdrawal that always accompanies abuse.

What Is Heroin, and How Does It Work?

To set the scene, we need to clarify what heroin is, and how it works. Heroin is a type of drug known as a depressant, meaning that it artificially dampens the speed at which the brain sends electrical signals to the rest of the body, hence why users feel pleasantly lethargic after they take a hit. Heroin is usually found as a white powder that is snorted. It can also be rolled into paper and smoked, or even consumed orally. These methods, however, dilute the effects of the heroin on the mind. Another form of administration is to heat the power and dissolve it into a sludgy, dark brown liquid, which is then injected into a user’s veins. While there is usually a delay between a snort and the high (perhaps as long as 10 minutes), injecting the heroin gives the user that blast of euphoria in a matter of seconds. Not only does it make this method of abuse more popular, it also creates a much stronger addiction to heroin. Such is the potency of this method that injection is also the most common way that addicts fatally overdose. They are so knocked out by the heroin that their bodies literally forget to breathe, a doctor and addiction psychiatry residency program director tells CNN. Unsurprisingly, heroin is considered a Schedule I drug in the United States; it has no legitimate medical purpose, it has an extremely high likelihood for developing physical or psychological dependency in its users, and it cannot be used with any degree of safety.

What Are the Effects of Heroin?

Heroin has a number of immediate effects on the body, many of which are not enjoyable:

  • Flushed skin
  • Dilated pupils
  • Runny nose, runny eyes, and dry mouth
  • Lethargy in the limbs
  • Reduced breathing and heart rate
  • Inability to focus or remain lucid

Due to the extreme addictiveness of heroin, users may find that they have to take more and more of the drug as they chase the same sensation they got when they first started. In addition to deepening their dependence on heroin, it also means that trying to get off heroin becomes much more difficult and a lot more dangerous. After continued exposure to the drug, the user’s brain becomes so sensitized and dependent that cutting off the heroin supply will leave the mind and body starved and incapable of functioning normally.

This is when heroin reveals its truly ugly side, as even the most well-intentioned users find themselves going back to their supply when the symptoms of withdrawal become too much to bear. A writer for XO Jane compares the sensation to being underwater and deprived of oxygen, and the director of a treatment center for health care professionals in Minnesota describes it as being in a state of constant depression – one that will never lift. “The anticipation of withdrawal,” he says, “is oftentimes worse than the actual thing.” Some of these symptoms of heroin withdrawal can include:

  • Cold sweats
  • Depression and anxiety
  • Loss of appetite
  • Unstable moods
  • Muscle cramping
  • Nausea and vomiting
  • Diarrhea
  • Seizures

The various sensations of withdrawing from heroin can be likened to being in the grips of a particularly bad case of the flu, which has led to the slang term “super flu” being used to describe the withdrawal stage.

These symptoms are not life-threatening in and of themselves (unlike withdrawing from alcohol, for example, which can be fatal on its own), but they might induce a user to take heroin or other dangerous substances to alleviate the physical and mental distress. That action might be lethal, especially if the user takes too much of the drug in order to compensate for how debilitating the withdrawal effects can be. In addition to the physical effects of heroin withdrawal, addicts also experience feelings of loneliness, despair, and a desperate compulsion to use the drug again, making them especially prone to making an ill-advised decision. Heroin withdrawal symptoms usually kick in around 12 hours after the user has their last dose of heroin. They tend to peak around one to three days later and gradually subside between five and seven days after they first arose, although some symptoms may persist, albeit in milder forms. In cases of extreme heroin abuse (either in terms of volume consumed or duration of abuse), it may take weeks, or even months, for the withdrawal effects to fully subside, a condition known as post-acute withdrawal syndrome.

Like most forms of treatment for a substance abuse problem, correcting heroin dependency will start by slowly adjusting the user’s body and mind to a lack of heroin. Since this does mean that the user will be exposed to the symptoms of heroin withdrawal mentioned above, it is imperative that detoxification not be attempted alone or with people who do not have any kind of medical training or credentials. The temptation to relapse while in the throes of muscle spasms, diarrhea, vomiting, or uncontrollable tremors will be too much for an addict to withstand. The danger of overdosing on heroin while in such a susceptible state is too great to risk.Furthermore, self-detox deprives the patient of receiving anti-anxiety prescription medications to help them through the process. Suboxone is a popular choice of drug for this purpose – as mentioned in the XO Jane blog above, Suboxone is specially designed to counter both the opioid and the withdrawal effects of heroin, while being of a mild enough potency to avoid the risk of causing a brand new addiction. Alternatively, PsychCentral touts methadone as a common medication for opioid addiction, and it has been a standard avenue of treatment for more than 30 years.


DBTOnce the addict makes it through the withdrawal stage (which, as stated, could last for as long as a week), she is ready to begin therapy. Without addressing the mental and emotional reasons why she turned to heroin – whether as an attempt to self-medicate her way out of a stressful situation, whether she did it simply for enjoyment, or if there were other causes – the addict is more prone to relapsing than she would be if she went through a course of psychotherapy. When the user is physically and mentally ready to start therapy, a trained mental health counselor will talk with her in great detail and depth about the conditions in her life that prompted the heroin use. There may be factors at play that the patient doesn’t even realize exist – past traumas, unacknowledged feelings, or buried desires – that a therapist will carefully and precisely bring to light, to show the patient what fueled her heroin use. Once these factors are determined, the therapist will help the patient understand how these factors caused the patterns of thought and behavior that led to heroin experimentation and reached the point of addiction. It is only from grasping the relationship between all these points that the patient can begin to unlearn her destructive thoughts and actions. With this in mind, the therapist can teach the patient any number of coping skills and positive thinking strategies, all with the intention of training the patient to better resist the lure of temptation the next time it presents itself.

Further forms of treatment can include aftercare support (in the form of 12-step programs) or taking up various hobbies and activities, to give the patient a healthier and more productive outlet for her time, energy, and moods.

Heroin is one of the most devastating and debilitating drugs out there. One writer even described it as “the perfect whatever drug” for how easily and insidiously it wraps itself around a user. More than 4.2 million people have tried heroin at least once, according to the National Institute on Drug Abuse, in October 2014, the Centers for Disease Control’s Morbidity and Mortality Weekly Report released figures that showed fatalities as a result of heroin overdoses were on the rise in 28 states across the United States. Heroin doesn’t have to be a death sentence. There are a number of treatment options and plans available to you. Here at Futures of Palm Beach, we can answer your questions about treatment and heroin withdrawal. Please call us today, and let us help you find your way back from heroin abuse.

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