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Heroin Withdrawal Symptoms, Timeline, and Treatment

Heroin use in the United States is at an all-time high. Heroin is a potent opiate with an intense effect on the brain reward system. The user quickly develops a need for higher doses to reach the same “high” as before. However, when someone suddenly stops taking these types of substances they can struggle with heroin withdrawal symptoms that can sometimes bring life-threatening consequences. 

What is Heroin?

Heroin is an addictive painkiller synthesized from morphine, which comes from poppy plant seeds. Because these seeds make opium, heroin and morphine are both considered opiates. The side effects of heroin are similar to painkillers like oxycodone and hydrocodone, only stronger. Heroin binds to the brain’s opioid receptors and produces an intense euphoric “high” that users crave and eventually rewires the brain’s reward system, which is one of the reasons people become addicts.

Heroin is available as a white or brown powder, or can also be available in black powder, also known as black tar heroin.

Symptoms of Withdrawal from Heroin

Because heroin is so highly addictive, heroin withdrawal symptoms can kick in even after a few hours of the last dose. Once someone develops a physical dependence for heroin, they’re almost bound to experience withdrawal symptoms when they stop taking it, even after just one dose. Most of the time, heroin withdrawal resembles those from prescription opioids. However, heroin leaves the body faster than prescription painkillers, which makes withdrawal symptoms appear more quickly. 

Overall withdrawal feels like a severe case of the flu. The discomfort can last weeks and the severity of the symptoms fluctuate as the drug exits the system. Most common heroin withdrawal symptoms include:

  • Nausea and vomiting
  • Insomnia
  • Agitation
  • Diarrhea
  • Dilated pupils
  • Sweating
  • Anxiety
  • Abdominal cramping
  • Muscle aches

Heroin Withdrawal Timeline

The duration of heroin withdrawal depends on various factors. From the length of time, the user abused heroin and the amount of heroin they took each time, to the method by which they took heroin and the presence of co-occurring mental illness.

  • Days 1-2: Withdrawal symptoms can start even six-hour after the last dose. Muscle aches will start by the end of day one. These will intensify over the next day or so. Other symptoms such as shaking, diarrhea, insomnia, anxiety, and panic attacks might appear as well. 
  • Days 3-5: By the third day, heroin withdrawal symptoms are in full swing. People often experience abdominal cramping, nausea and vomiting, sweating, and shivers. In addition, they might feel tired, have trouble sleeping, and express overall body weakness. 
  • Days 6-7: By the end of the first week, most heroin addicts will reach acute withdrawal. Here, muscle aches and nausea taper off. Users might still feel tired and worn down, but overall their symptoms should improve. Anxiety, panic attacks, and other psychological symptoms will still happen.

Post-Acute Withdrawal Symptoms

Post-acute withdrawal symptoms (PAWS) can continue even after six months of someone’s last dose. These come and go as waves and might require medical attention to control. The most common symptoms of withdrawal  include:

  • Intense and persistent anxiety
  • Insomnia
  • Difficulty performing complex tasks
  • Difficulty concentrating
  • Loss of sex drive
  • Depression

Heroin Withdrawal Treatment Plan

The first step to help someone struggling with heroin withdrawal symptoms is to follow a detox protocol. Quitting cold-turkey and by themselves can be troublesome and lead to life-threatening consequences, such as an overdose. Doing so in a medical facility with supervision can help monitor and control symptoms like panic attacks and suicidal behavior. 

Heroin detox often involved tapering down from the drug. In this case, a physician will manage the reduction of the dose or prescribe a lesser potent opioid, such as methadone, buprenorphine, and naltrexone. The goal here is to determine the severity of addiction rather than the drug, to understand the treatment plan fully. 

Sometimes patients enter medication-assisted programs to help their withdrawal process and reduce their symptoms. However, these are on a case-by-case basis and depend on a myriad of factors. 

Heroin Addiction Treatment Options

Unfortunately, heroin detox is rarely enough to help someone achieve long-lasting recovery. Most people need to seek help from a drug treatment center to find the right treatment. Depending on the severity of their addiction, a specialist might recommend either an inpatient or outpatient setting. Other modalities will include individual counseling and support groups to encourage recovery. 

Comprehensive Addiction Treatments

Inpatient Programs: These offer a temptation-free environment that’s designed to help people in recovery. In this case, people check into a living drug rehab facility, and they attend meetings and therapy sessions while remaining in a supervised environment. 

Outpatient Programs: For those with mild heroin addiction, an outpatient rehab program might be an option. In this case, they have a more flexible program that allows them to maintain their daily schedule and responsibilities like attending school, work, or caring for their family. 

Medication-Assisted Programs: While rare, long-time heroin addicts might experience the worse withdrawal symptoms. To prevent these symptoms from harming them physically and psychologically, a physician might recommend specific prescription medications to help through the withdrawal process under a medically supervised program. MAT programs are also helpful for those struggling with mental health conditions that could make the withdrawal process even worse.

Individual Therapy: Beyond the detox process, it’s paramount to tackle the addiction. Through individual therapy, people can understand what drives addictive behavior and see if there’s an underlying cause of their addiction. 

Group Therapy: Building a healthy and sober support team is a critical element of addiction recovery. By attending group meetings or 12-step programs, individuals can continue their sober life and continue to learn relapse prevention techniques, even months after detox. 

Aftercare Programs: Addiction isn’t one thing people can shove under the rug. The remnants of addiction often stay with them for the rest of their life. To help users find happiness and purpose in their lives, aftercare programs offer relapse prevention classes, life skills, and other essential tools for a successful life after treatment. 

Seek Substance Abuse Treatment

If you or someone you know is struggling with heroin abuse, don’t wait any longer. Countless treatment options can help them conquer their drug abuse and manage any withdrawal symptoms. Remember, quitting potent drugs like heroin alone can be life-threatening. It’s essential to have the support and supervision of drug addiction specialists by your side. 

At Lighthouse Recovery Institute, we believe in offering customized drug addiction treatment programs. We look at each program on a case-by-case basis to cater to whatever your needs are to get better and walk towards recovery. From detoxification programs to group meetings and more, everyone in our team is committed to helping you win the battle of addiction. 

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