Heroin Withdrawal Signs, Symptoms, & Treatment Demystified

Discover the signs, symptoms, and treatment of heroin withdrawal. Get the support you need on the road to recovery.

Leora BH Staff
March 14, 2024

Understanding Heroin Withdrawal

When it comes to heroin addiction, understanding the process of withdrawal is essential for individuals seeking recovery. This section will delve into what heroin withdrawal entails and provide a timeline of the withdrawal process.

What is Heroin Withdrawal?

Heroin withdrawal is a set of physical and psychological symptoms that occur when a person dependent on heroin abruptly stops using the drug. Withdrawal is the body's natural response as it adjusts to the absence of the substance it has become reliant on. The severity and duration of heroin withdrawal symptoms can vary based on factors such as the individual's level of dependence and the duration of heroin use.

Timeline of Heroin Withdrawal

The timeline of heroin withdrawal can provide insight into the progression of symptoms. It's important to note that individual experiences may vary, and the timeline can be influenced by various factors.

Symptoms and Time Periods of Drug Withdrawal

  • Within 6-12 hours of withdrawal, initial symptoms such as muscle aches, restlessness, and drug cravings may begin. Other symptoms may include excessive yawning, runny nose, teary eyes, goosebumps, and dilated pupils [2].
  • Symptoms typically peak during the 1-3 day period. Physical symptoms like sweating, chills, nausea, vomiting, diarrhea, and abdominal cramping are common. Psychological symptoms such as depression, anxiety, and restlessness may also intensify [3].
  • Symptoms gradually subside over the course of 5-10 days. Although the intensity of symptoms may decrease, individuals may still experience residual effects, such as fatigue and mood swings.

It's important to note that withdrawal from heroin can be a challenging and uncomfortable experience. Withdrawal symptoms can be distressing both physically and psychologically. Seeking professional help and support is crucial during this period to ensure a safe and successful transition to recovery.

Understanding the nature and timeline of heroin withdrawal can provide individuals with the knowledge they need to seek appropriate treatment and support. By reaching out to healthcare professionals and support services, individuals can navigate the road to recovery with the guidance and assistance needed for a successful transition.

Signs and Symptoms of Heroin Withdrawal

When a person who is dependent on heroin suddenly stops using the drug, they may experience a range of withdrawal symptoms. These symptoms can be both physical and psychological in nature.

Physical Symptoms

Physical symptoms of heroin withdrawal can manifest within 6-12 hours after the last dose and peak around 1-3 days. They typically subside after about a week. Common physical symptoms include:

  • Excessive yawning
  • Runny nose
  • Teary eyes
  • Goosebumps
  • Dilated pupils
  • Sweating
  • Chills
  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal cramping

It's important to note that the severity of these physical symptoms can vary from person to person. Additionally, the intensity of withdrawal symptoms may be influenced by factors such as the duration and frequency of heroin use, as well as individual differences in metabolism and overall health.

Psychological Symptoms

In addition to physical symptoms, individuals going through heroin withdrawal may also experience a range of psychological symptoms. These symptoms can include:

  • Muscle aches
  • Restlessness
  • Depression
  • Anxiety
  • Intense drug craving

The psychological symptoms of heroin withdrawal can be challenging to cope with and may contribute to the overall discomfort experienced during the withdrawal process. It's essential for individuals going through withdrawal to have access to appropriate support and resources to help manage these symptoms.

It's important to remember that everyone's experience of heroin withdrawal is unique. The timeline and severity of symptoms can vary depending on individual circumstances. Seeking professional help from healthcare providers or addiction specialists can provide crucial support and guidance during this challenging period.

By recognizing the signs and symptoms of heroin withdrawal, individuals and their loved ones can better understand the physical and psychological challenges that may arise during the recovery process. This understanding can help facilitate informed decisions about seeking appropriate treatment and support.

Treatment Options for Heroin Withdrawal

When it comes to treating heroin withdrawal, a comprehensive approach is necessary to address both the physical and psychological aspects of addiction. Two common treatment options for heroin withdrawal include medication-assisted treatment and behavioral therapies and counseling.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) is a widely used approach for managing heroin withdrawal. This treatment involves the use of medications to help individuals safely and comfortably navigate through the withdrawal process. Medications such as methadone, buprenorphine, and clonidine are commonly prescribed to alleviate withdrawal symptoms and reduce cravings for opioids.

These medications work by targeting the same receptors in the brain that are affected by heroin, helping to minimize withdrawal symptoms and prevent relapse. Methadone and buprenorphine, in particular, are opioid agonists that can help individuals gradually taper off heroin, while providing a stable and controlled dose to manage withdrawal symptoms and cravings.

It's important to note that medication-assisted treatment should always be administered under the supervision of a healthcare professional. The dosage and duration of medication use should be carefully monitored and adjusted based on the individual's needs and progress.

Behavioral Therapies and Counseling

In addition to medication-assisted treatment, behavioral therapies and counseling play a crucial role in the overall treatment of heroin withdrawal. These therapeutic approaches address the psychological and emotional aspects of addiction, helping individuals develop coping mechanisms, manage cravings, and make positive changes in their lives.

Behavioral therapies, such as cognitive-behavioral therapy (CBT), contingency management, and motivational interviewing, are commonly used in the treatment of heroin withdrawal. These therapies provide individuals with the tools and skills to identify and change negative thought patterns, develop healthier coping strategies, and build a strong support system.

Counseling sessions, either in an individual or group setting, offer a safe and supportive environment for individuals to explore their feelings, address underlying issues related to addiction, and receive guidance from trained professionals. By combining medication-assisted treatment with behavioral therapies and counseling, individuals have a comprehensive approach to addressing both the physical and psychological aspects of heroin withdrawal.

It's important for individuals seeking treatment for heroin withdrawal to work closely with healthcare professionals and addiction specialists who can assess their specific needs and develop a personalized treatment plan. By combining medication-assisted treatment with behavioral therapies, individuals have a higher chance of successfully managing withdrawal symptoms, reducing cravings, and achieving long-term recovery.

Managing Severe Heroin Withdrawal

Severe heroin withdrawal symptoms can pose serious risks to individuals going through the withdrawal process. It is important to understand and address these risks to ensure the safety and well-being of those experiencing severe withdrawal.

Risks of Severe Withdrawal

Severe heroin withdrawal symptoms can include intense physical and psychological discomfort. Some of the risks associated with severe withdrawal include dehydration, electrolyte imbalances, and the potential for aspiration if vomiting occurs while unconscious. These risks emphasize the importance of seeking appropriate medical support and supervision during the withdrawal process.

Medical Supervision and Support

To effectively manage severe heroin withdrawal, medical supervision and support are crucial. Medically supervised detox programs provide a safe environment for individuals going through withdrawal. These programs offer proper monitoring, medication administration, and support from healthcare professionals.

Medication-assisted treatment (MAT) is commonly utilized in the management of severe heroin withdrawal. Medications such as methadone, buprenorphine, and lofexidine can help alleviate withdrawal symptoms and cravings, providing individuals with a more comfortable and controlled detoxification process. These medications are administered under medical supervision to ensure safe and effective treatment.

In addition to medication, behavioral therapies and counseling play a pivotal role in the management of severe withdrawal. These therapies aim to address the underlying psychological aspects of addiction and provide individuals with coping mechanisms and support to navigate the challenges of withdrawal.

It is important to note that sudden withdrawal from buprenorphine, a medication used in MAT, can lead to psychiatric onset symptoms such as aggression, suicidal thoughts, and auditory hallucinations in some cases. This highlights the significance of proper medical supervision and gradual tapering of medication dosage to minimize potential risks.

By seeking appropriate medical supervision and support, individuals experiencing severe heroin withdrawal can receive the necessary care and assistance to manage the challenges associated with withdrawal. These resources can provide a safe and supportive environment, helping individuals navigate the road to recovery with reduced risks and improved outcomes.

Seeking Help for Heroin Withdrawal

When it comes to heroin withdrawal, seeking help and support is crucial for a safe and successful recovery journey. There are various helpline and support services available to assist individuals experiencing heroin withdrawal symptoms. Additionally, in Canada specifically, there are resources and programs designed to address substance use disorders and provide the necessary support during this challenging time.

Helpline and Support Services

If you or someone you know is struggling with heroin withdrawal or substance use, reaching out to helpline and support services can provide valuable assistance. The Substance Abuse and Mental Health Services Administration (SAMHSA) operates a National Helpline that offers free and confidential treatment referrals and information for individuals and families facing mental and/or substance use disorders, including heroin addiction and withdrawal symptoms.

Helplines provide a compassionate and non-judgmental space where you can speak with trained professionals who can guide you towards appropriate resources and treatment options. They can offer support, answer questions, and provide information on local services available to you.

Resources in Canada

In Canada, there are various resources and services dedicated to helping individuals with heroin withdrawal and substance use. Health Canada provides a range of support services, including crisis lines, online support groups, harm reduction centers, and provincial health and support services. These resources can connect you with professionals who specialize in addiction treatment and offer guidance tailored to your specific needs.

It's important to note that seeking help for heroin withdrawal in Canada may involve accessing provincial health services and support programs. These programs can provide vital assistance in managing withdrawal symptoms, facilitating safe detoxification, and offering ongoing support throughout the recovery process.

Remember, you don't have to face heroin withdrawal alone. There are dedicated professionals and services available to provide the care and support you need during this challenging time. Whether it's through helpline services or resources in Canada, reaching out for help is an important step towards your recovery journey.

Psychotic Symptoms During Opioid Withdrawal

During the process of opioid withdrawal, individuals may experience a range of symptoms, including physical discomfort and psychological distress. While psychotic symptoms are rare during opioid withdrawal, certain studies have associated them with the withdrawal of synthetic opioids like tramadol, oxycodone, and buprenorphine.

Rare Psychotic Symptoms

Psychotic symptoms during opioid withdrawal are not commonly observed, but there have been reported cases. For example, a 25-year-old male with a history of heroin use experienced symptoms such as a runny nose, diarrhea, headache, and leg cramping pain, alongside irritability, delusions of parasitosis, auditory and visual hallucinations during withdrawal. In this case, treatment with antipsychotics like olanzapine was successful in managing the psychotic symptoms [5].

The absence or deficiency of endogenous opioid endorphins, which act as inhibitory neuromodulators of dopamine activity in the brain, can potentially increase dopamine release and turnover during withdrawal, leading to psychosis [5]. It is important to note that these psychotic symptoms are relatively rare and not typically associated with opioid withdrawal.

Management and Treatment

In rare cases where opioid withdrawal is associated with psychotic symptoms, early administration of antipsychotics is crucial to manage the distressing acute psychiatric manifestations. Thorough psychiatric evaluation is recommended to rule out underlying causes and comorbidities that may contribute to psychotic symptoms.

It is worth mentioning that several clinical cases have reported psychiatric onset symptoms within a few days of buprenorphine withdrawal. These symptoms, including aggression, suicidal thoughts, and auditory hallucinations, emerged after the sudden withdrawal of buprenorphine in the dose range of 6 to 8 mg per day.

The management of psychotic symptoms during opioid withdrawal requires a comprehensive approach that includes not only addressing the withdrawal symptoms but also addressing any underlying psychiatric conditions. Therefore, a thorough evaluation by a healthcare professional is necessary to determine the appropriate treatment plan and to ensure the safety and well-being of the individual experiencing these rare psychotic symptoms.

Managing Severe Heroin Withdrawal

When it comes to managing severe heroin withdrawal, it is crucial to address the potential risks and provide appropriate medical supervision and support. Severe withdrawal symptoms can pose serious health risks, and receiving professional care is essential to ensure the safety and well-being of individuals going through this challenging process.

Risks of Severe Withdrawal

Severe heroin withdrawal symptoms can lead to various complications if not properly managed. Some of the risks associated with severe withdrawal include:

  • Dehydration: The body loses fluids through sweating, vomiting, and diarrhea, which can lead to dehydration. It is important to replenish fluids to prevent complications related to dehydration.
  • Electrolyte Imbalances: The loss of fluids during withdrawal can disrupt the body's electrolyte balance. This can result in electrolyte imbalances, which may have adverse effects on various bodily functions.
  • Aspiration: Severe withdrawal symptoms, such as vomiting, can pose a risk of aspiration if it occurs while the individual is unconscious. Aspiration can lead to serious respiratory issues and should be monitored and managed in a controlled environment.

Medical Supervision and Support

To manage severe heroin withdrawal effectively, it is recommended to seek medical supervision and support. Medically supervised detox programs provide a safe environment for individuals going through withdrawal. These programs offer proper monitoring, medication administration, and support from healthcare professionals.

In a medically supervised detox program, healthcare professionals can closely monitor the individual's vital signs, hydration levels, and overall well-being. They can administer medications, such as methadone, buprenorphine, or clonidine, to help manage withdrawal symptoms. These medications can alleviate the intensity of withdrawal symptoms and facilitate a smoother transition.

Additionally, healthcare professionals can provide psychological support and counseling to address the emotional and psychological challenges that often accompany heroin withdrawal. Therapy and counseling can help individuals develop coping strategies and provide them with the necessary tools to navigate the recovery process successfully.

By seeking medical supervision and support, individuals can have access to the necessary resources and expertise to manage severe heroin withdrawal effectively. This not only ensures their safety but also increases their chances of successful recovery. Remember, reaching out for professional help is a crucial step towards the road to recovery.


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Leora Behavioral Health offers a comprehensive addiction treatment program to help you get your life back on track. Our trained professionals will work with you to develop a personalized treatment plan that meets your unique needs. If you or someone you know is struggling with addiction, reach out to Leora Behavioral Health today.

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