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Heroin Withdrawal

Whether an addict is going through recovery, or in the midst of a difficult heroin addiction, chances are they will feel the pain of heroin withdrawal symptoms. Heroin withdrawal is both the fear of every heroin user, and a glimpse of the light at the end of the tunnel. Which one depends upon the state of the individual – and their readiness to admit that they have a problem.

Heroin Withdrawal and Addiction

An individual who is addicted to heroin will be more likely to experience heroin withdrawal the longer and longer they go without a “fix” of their drug. If the individual is used to getting a dose of heroin every 10 hours, for example, they will begin to experience withdrawal symptoms anywhere from 12 to 14 hours after their last dose.

Withdrawal From Heroin and Drug Rehab

The first and some say most important step in the drug rehab process is heroin detoxification. This is the process by which the individual’s system is cleansed of all the harmful toxins found in illicit drugs. Heroin detox is considered one of the most intense, challenging detoxification processes, whether during heroin withdrawal treatment at home or one in a specialized heroin treatment center.

Approximately two days into the heroin detox process, the individual will begin to experience heroin withdrawal symptoms – as their body struggles to produce any pleasurable sensations without the aid of the drug. This is a crucial moment in the recovery process. The individual will either make it through these symptoms (with the assistance of treatment professionals onsite), or will find them too difficult to endure, inevitably leaving the heroin treatment program and relapsing back into drug use.

For this reason, every drug rehab center that offers detox from heroin is staffed by experts who understand the unique challenges that heroin withdrawal presents, and which may be difficult to overcome during an attempted heroin withdrawal treatment at home.

These individuals provide support during the tough times, and regular medical attention if necessary. If there is “hand holding” that needs to be done, the detox professional will be there. And if the individual is thinking about quitting the program, you can rest assured that the rehab staff will give them every reason to stay.

Heroin withdrawal treatment - gabapentin and clonidine

Heroin Withdrawal Symptoms

Quitting heroin and starting on the road of recovery makes way for considerable improvements in one’s health, well-being, and overall quality of life. But the relatively brief period of withdrawal after stopping heroin use is associated with flu-like withdrawal symptoms which may be more or less severe, depending on the person’s level of tolerance, duration and frequency of use, and other factors. Although the symptoms may only last a week or so, withdrawal can be life-threatening.

As the body starts to rebound, the person experiences the onset of the following symptoms:

  • Mood changes
  • Runny nose and teary eyes
  • Shivering
  • Muscle aches

For individuals attempting heroin withdrawal treatment at home for the first time with the help of a loved one, it is important that they are well-informed about the stages of the detoxification process so they prepare for the upcoming challenges. Supportive measures that can facilitate the process and enable a safe withdrawal with minimized symptoms include a medically supervised medication regimen and professional guidance and counseling.

Deaths From Heroin Withdrawal

Withdrawal from heroin, especially during heroin withdrawal treatment at home is not a common occurrence, but it may happen. It is especially common among prison inmates suffering from heroin addiction who go into sudden, unsupervised withdrawal.

Withdrawal can prove fatal due to excessive vomiting and diarrhea which can lead to rapid dehydration and hypernatremia, which are high levels of sodium in the body. All of this can lead to heart failure. This is one of the key reasons to join inpatient treatment in a specialized detox facility where the process will be performed under medical supervision and with the support of addiction specialists.

What Comes After Heroin Withdrawals?

For the heroin user who has yet to come to terms with their heroin drug addiction, the end of withdrawal usually means finding their next fix. But for the individual who has taken the important steps necessary to enter heroin treatment, getting through withdrawal means overcoming their physical addiction to heroin – and moving forward with heroin counseling, aftercare, and a new life and a brighter future, especially for young victims of the disease. Checking into a specialized treatment facility with medically-assisted detox is the safest and most reliable way to start a clean, healthy and happy lifestyle.

Frequently Asked Questions

What Does It Mean to Go into Withdrawal?

Withdrawal consists of mental and physical effects experienced by an individual who has stopped or abruptly reduced the intake of an addictive substance such as heroin. The safest and most effective method to go into withdrawal is typically under professional supervision, with the help and support from addiction and healthcare specialists.

Only a strong support system can ensure long-term recovery. Ongoing professional counseling may be necessary even long after the completion of the detox process.

What Are the Causes of Heroin Withdrawal?

A person starting recovery from a heroin addiction needs to go through the detoxification process of eliminating heroin and its toxic metabolites from their body, which is commonly known as detox. Heroin withdrawal is a major part of the detox process.

Although withdrawal does not last long, it is a challenging experience that can be more or less severe depending on other circumstances, especially frequency, duration, and method of heroin use.

What to Expect From Heroin Withdrawal?

For a heroin user willing to address and overcome addiction, withdrawal is a necessary step in the detoxification process. Although the experience can be a difficult and challenging one, and it is important that the individual is prepared for the peak of the withdrawal symptoms, there are options to go through the withdrawal and detox process in a safe, controlled, and comfortable way.

Attempting heroin withdrawal treatment at home with the help of loved ones can be immensely stressful. This may be the case even in the most supportive living situation that the individual recovering from heroin addiction perceives as safe and secure, as the onset of increasingly uncomfortable withdrawal symptoms can be rapid.

What Happens to Your Body During Drug Withdrawal?

The symptoms of heroin withdrawal and their severity depend on the duration, frequency, amount, and method of heroin use. While the body tries to rid itself of heroin and other toxins, the person is likely to experience the following symptoms of heroin withdrawal:

  • Mood swings (nervousness, agitation, depression)
  • Runny nose and teary eyes
  • Nausea
  • Sweating
  • Shivering and shaking
  • Abdominal pain
  • Muscle aches and spasms

Since withdrawal and detox can be extremely unpleasant, people suffering from heroin addiction may be reluctant to take this initial step in their recovery process. The fear of withdrawal could render them incapable of escaping their addiction and ultimately changing their life for the better, which is the reason why many users are unwilling to even attempt treatment.

But withdrawal does not have to be terrible. The experience can be much safer and more comfortable, especially if an individual is not alone in starting recovery. With the help and support from loved ones and professionals, they can take part in specialized detox and withdrawal programs, designed to make long-term recovery possible through the use of medications and therapy.

What Does Heroin Withdrawal Feel Like?

In addition to the flu-like physical symptoms, the person experiencing heroin withdrawal can experience psychological symptoms:

  • Confusion
  • Anxiety
  • Aggression

Withdrawal is not only difficult on the individual experiencing the symptoms directly but also on the individuals supervising the process. Professionals are better equipped to cope with the unpleasant experience and remain collected and supportive throughout the process than friends and family who lack the knowledge and expertise in dealing with heroin withdrawal.

For chronic heroin users, entering an inpatient detox program may be the safest and most efficient option. Outpatient detox, on the other hand, such as heroin treatment at home, is meant for patients who have not been addicted for a long time and who have only used small amounts of the substance. Even when done at home, a heroin withdrawal treatment should be medically supervised.

Outpatient heroin treatment can only be efficient in a stable, secure, and supportive environment, provided that the individual makes regular visits to a treatment center, whether for medication replenishment or observation, counseling, or tests.

How Long Does the Heroin Withdrawal Process Take?

In and of itself, each opioid drug comes with a different withdrawal time. Factors affecting the withdrawal time as well as the severity of withdrawal include:

  • Duration of use
  • Frequency of use
  • Method of use
  • Amount used

The first symptoms of heroin withdrawal are expected to begin during the first 24 hours, although the early onset of withdrawal could start as early as four hours from the last use.

It is between 36 and 72 hours that the individual will experience the peak of the withdrawal. For the majority of individuals, the symptoms of withdrawal will last between 7 to 10 days. Again, this depends on the duration and frequency of use: for chronic users of heroin, the symptoms may last up to three to four weeks.

What to Take for Heroin Withdrawal?

Opioid replacement therapy using naltrexone, methadone, and buprenorphine (Suboxone) is FDA-approved for heroin withdrawal treatment. It involves the use of a long-acting opioid medication. The purpose of this is to minimize withdrawal symptoms and curb cravings for the highly addictive drug without causing a high.1 The dose of the drug is gradually decreased in a slow, safe, and controlled manner.

Individuals with addiction may also suffer from mental health disorders which also need to be addressed to make way for long-term recovery.2 For this reason, treating the powerful symptoms of heroin withdrawal is best done

Certain over-the-counter medications can help with withdrawal and pain symptoms. These include gabapentin and clonidine.

Gabapentin for Heroin Withdrawal Treatment

Gabapentin is an FDA-approved drug used to help control certain types of seizures, postherpetic neuralgia, a specific type of nerve pain, as well as heroin withdrawal symptoms.3 It is commonly prescribed for the treatment of heroin tolerance and heroin withdrawal-related pain, with the following considerations in mind:

  • Gabapentin can be addictive as well, which is why the treatment must be controlled and administered under medical supervision.
  • It is important not to stop gabapentin treatment suddenly, but to taper off the drug slowly and gradually in order to avoid withdrawal symptoms.

Clonidine for Heroin Withdrawal Treatment

Although primarily used in the treatment of high blood pressure, clonidine is sometimes used for its ability to help with alcohol and narcotic withdrawal.4 The drug is especially beneficial for individuals going through opioid detoxification and withdrawal and seeking experience relief of the associated symptoms.

When using clonidine for heroin withdrawal treatment, individuals should be mindful of the following:

  • It is important to use clonidine responsibly. Clonidine abuse such as combining clonidine with opiates to amplify their effect can result in severe withdrawal symptoms, possibly compounded with the symptoms of opiate withdrawal.
  • Clonidine treatment during heroin withdrawal must be supervised by a medical professional.
  • Tapering off the drug must be done in stages to avoid the risks of going into withdrawal.

Is It Bad to Quit Cold Turkey?

Unlike a medically supervised detox which relies on counseling, withdrawal medications, and other supportive measures to manage withdrawal and detox symptoms, and which is more likely to lead to a favorable outcome, quitting cold turkey could be dangerous in addition to being difficult. The effect of undertaking detox in a do-it-yourself setting could be damaging for a range of reasons.

Quitting the drug abruptly can lead to a rapid onset of withdrawal symptoms. These can be extremely difficult to endure, making the desire to use again and put a stop to the symptoms overwhelming. Self-tapering heroin use without support or assistance from professionals comes with a high risk of relapse and overdose.5

Namely, in an effort to overcome the severe symptoms of withdrawal as soon as possible, the person may unknowingly take a higher dose of heroin than they should, which can result in a fatal outcome.

Seeking Help With Heroin Withdrawal

An individual recovering from addiction will require ongoing support and an approach based on compassion and understanding. However intimidating the notion may sound, there is no better way to start the journey toward recovery than with professional assistance and guidance. Trained addiction specialists can help your loved one through the challenging process of heroin detox and withdrawal management.6

Recovery from a heroin addiction is a lifelong process, but with the help of experienced admission navigators, your loved one can restore their quality of life one day at a time. Schedule a consultation now.

Let’s verify your coverage for treatment at an American Addiction Centers location. Your information is always confidential.


  1. National Institute on Drug Abuse. (2020). Heroin Research Report Overview.
  2. SAMHSA (2020) Substance Use Disorder Treatment for People with Co-Occurring Disorders TIP 42.
  3. U.S. National Library of Medicine. (2020) Gabapentin.
  4. U.S. National Library of Medicine. (2020) Clonidine.
  5. National Institute on Drug Abuse. (2019). Heroin DrugFacts.
  6. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.

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