Withdrawal from Heroin

Heroin withdrawal can start as early as 6 hours since the last dose and at the latest 12 hours.

Last updated: June 1, 2018
Heroin sick on the couch

Withdrawal symptoms usually last 7 to 10 days with the peak being between days 1-3.

Some people do suffer from post-acute withdrawal syndrome can causes withdrawal symptoms to continue for weeks, months or even years though to a lesser extent. That said, withdrawal is somewhat dependent on how the drug was taken, for how long it was taken, and the amount taken. This is also not factoring in what other street drugs or additives the heroin was combined with that may make the symptoms last longer or be felt in greater force.

Heroin Withdrawal Symptoms

Symptoms typically last for one week, but peak around days 1-3. The following symptoms can range from mild to severe, including:

  • Nausea
  • Increased agitation
  • Depression
  • Anxiety
  • Sweating
  • Shaking
  • Abdominal pain
  • Muscle spasms
  • Extreme craving for heroin

It’s important to note the cravings because, heroin rewires the brain to have the same response to heroin as the body naturally does to hunger. Your body treats the drug like it is an actual need; you become dependent on the substance.

Heroin Withdrawal Timeline

Foremost, heroin withdrawal will not be the same for everyone. The method which heroin was taken, amount, and duration of use are all heavily factored in. In general, it lasts 5-10 days, the peak of which occurs 24 hours after the last dose and continues for 3 days.

Heroin binds to opiate receptors in the brain, decreasing the body’s sense of pain and increasing the amount of dopamine being transferred. Dopamine creates a pleasurable sensation in the body, so when heroin is removed, it has the opposite effect.

During an average withdrawal, this is what a user can expect:

First 24 Hours: Because symptoms usually stat 6-12 hours after your last dose, the symptoms experienced in the first 24 hours range from mild to moderate. Users tend to experience nausea, vomiting, diarrhea, restlessness (and subsequently fatigue), as well as goosebumps and tremors. In addition, the cravings make it extremely difficult to focus or concentrate on anything else.

Days 1-3: This time frame is usually when the withdrawal symptoms are at their peak and therefore the most severe. This includes everything addressed in the first 24 hours, but users can also experience depression, hypertension, a rapid heart rate, depressed or impaired breathing, muscle spasms as well as increased anxiety, trouble sleeping (insomnia), and depression.

Days 4+: This is when the symptoms tend to peter out, usually ranging from mild to moderate. The vomiting usually stops, but the nausea is still present, as well as abdominal pain and cramps. There may be sweats, chills, and bone aches as well as fatigue – this is usually when you’re able to finally sleep again.

Withdrawal is not life-threatening, but depression is. During heroin withdrawal, it’s common for many people to experience depression. This is why it’s recommended to confide in friends, family members, or doctors if you plan on quitting outside of a treatment center. This way you don’t feel alone and know you can reach out.

Heroin Treatment

Many people recommend treatment centers to endure heroin withdrawal. It’s challenging enough to fend off the cravings, let alone the withdrawal symptoms that go along with it. In reality, 7-10 days of withdrawal are not that long, but the cravings can create the sensation it’s much longer. When you pair the cravings with depression and the lack of sleep, many people relapse. For this reason, rehabilitation clinics and treatment centers are recommended to assuage the symptoms of withdrawal.

Most treatment centers offer medical detox to help remove heroin from your system while managing the effects of withdrawal. Detox typically starts before withdrawal sets in – prior to the six hour mark from your last dose. Medical detox involves a combination of medication and therapy to help curb the effects of withdrawal while removing the substance from your body. Throughout the entire process, your physical wellbeing is measured to ensure your heart rate is normal and your breathing doesn’t become too shallow.

After the initial detox process, most facilities provide therapy treatment.

Drugs to Treat Heroin Withdrawal

One of the biggest challenges for heroin addicts to overcome during withdrawal is pain. Heroin suppresses pain receptors in the brain and increases dopamine. When detoxing from heroin however, even feeling “normal” can feel painful. Because heroin is an opioid (pain reliever), many assume it’s hopeless to be given drugs to help with pain, when that’s what they’re detoxing from, however this is not the case.

There are several drugs that can be used to help someone detox and recover from opioids:

  • Buprenorphine
  • Methadone
  • Naltrexone

The Food and Drug Administration (FDA) has approved buprenorphine to be used for opioid withdrawal and treatment. Buprenorphine usually comes in the form of Suboxone or Subutex and they are less addictive and harder to abuse than opiates, but help suppress withdrawal symptoms – especially cravings. These drugs are usually provided during outpatient visits and need a prescription to be used at home.

One of the challenges with this however is some heroin users will use this drug in conjunction with heroin. It’s referred to as “chipping” in which a user never becomes clinically diagnosed as someone suffering opioid addiction. In addition, because Suboxone can stave off symptoms and cravings, many of these heroin users still use daily, but don’t suffer withdrawal every 6-12 hours.

Meanwhile, methadone is regarded as a short-term fix as it’s still addictive and possible to abuse – resulting in a substitution addiction – but it’s a better alternative to heroin. Methadone is able to reproduce many of the effects of heroin without the sudden euphoria and the effects last 24 hours – it’s similar to weening someone off the drug. As a result, it is federally regulated and only 1 pill is prescribed per day.

Finally, naltrexone is usually used in conjunction with buprenorphine. Naltrexone blocks opioid receptors, thereby cutting down cravings for heroin.

These medications can be extremely helpful in curbing withdrawal symptoms and recovering from heroin. Get help if you’re trying to get clean.


Want someone to talk to?

Online therapy can break the cycle and turn negative thoughts into positive ones.

Get Started

How to build new habits

I Am Sober is an app that helps you get some control back in your life.