What Are the Symptoms of Heroin Withdrawal? Everything to Know

Medically Reviewed By Alyssa Peckham, PharmD, BCPP
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If you stop taking heroin after frequent or heavy use, you likely will experience heroin withdrawal symptoms. Knowing them may help you manage them and reach out for support. Heroin is an opioid prone to causing your body to become dependent on the substance. When you ingest an opioid such as heroin, it quickly enters your brain. It binds with the opioid receptors that control pain, pleasure, heart rate, and breathing.

When you stop taking heroin, your brain and body need time to readjust. This can cause physical and psychological symptoms.

This guide explains more about the symptoms you may experience with heroin withdrawal and what a typical withdrawal timeline looks like. It also discusses how to treat heroin withdrawal symptoms, when to contact a doctor and more.

What are the symptoms of heroin withdrawal?

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Withdrawing from heroin may cause severe discomfort and cravings. Possible symptoms you may experience with heroin withdrawal include:

  • diarrhea
  • vomiting
  • problems with sleeping
  • severe pain in your muscles and bones
  • cold flashes and goosebumps
  • uncontrollable leg movements
  • severe heroin cravings

Learn more about the common symptoms of opioid withdrawal.

What is the timeline for heroin withdrawal symptoms?

The withdrawal process will be different for each person. The type and severity of symptoms you may experience can depend on how frequently you use heroin and whether you use any other drugs.

A 2015 study from the Centers for Disease Control and Prevention found that 96% of people who had used heroin within the past year had also used at least one other drug.

Your doctor can provide more information about what your withdrawal symptoms may look like.

Heroin withdrawal symptoms generally begin within 6–24 hours after the last time you used heroin. They will usually peak around 48–72 hours.

Symptoms of heroin withdrawal typically last 5–7 days. However, problems with sleeping and mood changes can last several weeks or years or even become lifelong, depending on the severity of heroin use.

Learn more about withdrawal.

What are the treatments for heroin withdrawal? 

The best approach to heroin withdrawal is to start treatment with medications for opioid use disorder (MOUD) as soon as medically appropriate.

These medications target withdrawal symptoms and the core symptoms of addiction. For methadone, this can be very quickly after withdrawal symptom onset, whereas your doctor may recommend buprenorphine shortly after withdrawal onset. Naltrexone cannot be used to manage acute withdrawal symptoms.

MOUD can reduce the need for inpatient detoxification services, according to the Substance Abuse and Mental Health Services Administration.

Doctors and nurses will also give you supportive medication to ease cravings and uncomfortable symptoms you may experience during withdrawal. They will also provide you with access to behavioral therapy to help you find ways to manage your symptoms and cravings.

Treatments and medications are tailored for each person, depending on their needs. You may receive:

  • medication such as lofexidine or clonidine to reduce the intensity of withdrawal
  • anti-inflammatory medications such as ibuprofen
  • anxiety medication such as clonazepam
  • bismuth subsalicylate for diarrhea or an upset stomach
  • ondansetron or prochlorperazine for nausea or vomiting
  • medication such as zolpidem to help you sleep
  • cognitive behavioral therapy to help you manage your symptoms and behaviors
  • contingency management, which involves offering motivational incentives for positive behaviors

It is also important to drink plenty of fluids, as opioid withdrawal can lead to severe fluid loss. Your doctor can advise you on how much water you should drink daily.

Learn about how to find the right opioid use disorder treatment.

When should I see a doctor?

Contact your doctor if you are ready to stop using heroin. They can help you find the right place and support system to help you through the process.

If you are pregnant, contact your doctor before beginning any withdrawal program. The opioid withdrawal process can cause miscarriage or fetal distress, according to the American College of Obstetricians and Gynecologists.

After the management of withdrawal, you and your doctor may discuss continuing MOUD to enhance the recovery and remission process.

Can you die from heroin withdrawal?

The heroin withdrawal process is not usually life threatening.

However, if you become severely dehydrated due to fluid loss during withdrawal, the electrolyte imbalances that could occur can cause heart issues and possibly even death.

This possibility is another reason your doctor may recommend that you go to a healthcare facility where healthcare professionals can watch you closely during withdrawal.

They can ensure you do not become too dehydrated and help you manage other symptoms you may experience during heroin withdrawal.

Learn more

Summary

Heroin is a drug highly prone to causing physical and psychological dependence, which may lead to withdrawal symptoms once stopped. Symptoms can last from 5 days to a few weeks. In some cases, symptoms can be lifelong, so it is important to find support to help you manage them.

Most doctors recommend MOUD with supportive medications during the initial stage of withdrawal, followed by continued MOUD alongside psychological therapies such as cognitive behavioral therapy or contingency management.

Heroin addiction and withdrawal can be complex. Care and treatment from healthcare professionals can help you understand and manage your symptoms. They can answer any questions and support you as your body readjusts during withdrawal.

Seeking help for addiction may seem daunting and possibly even scary, but several organizations can provide support. 

If you believe that you or someone close to you is experiencing addiction, you can contact any of the following organizations for help and advice:

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Medical Reviewer: Alyssa Peckham, PharmD, BCPP
Last Review Date: 2022 Sep 28
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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