Heroin detox and withdrawal
Understand the stages of heroin withdrawal, the timeline for detox and the support options available.
Heroin addiction can be overwhelming, but understanding the drug withdrawal and detox process is a crucial first step towards recovery.
Here, we explore the symptoms you might experience, explain why they happen and outline what to expect during detox. We also look at the support options available to help you get back on track.
Heroin withdrawal symptoms
Heroin withdrawal can be an intense and challenging phase of recovery, but recognising the signs can help you prepare and get the support you need during this time.
Warning signs of heroin withdrawal
The onset of withdrawal symptoms is often the first clear sign that your body is reacting to the absence of heroin. Common early signs include intense cravings for the drug, yawning, piloerection (the little hairs on your arms stand up), irritability, sweating, and hot and cold flashes. These can quickly escalate as withdrawal progresses.
Heroin withdrawal causes a range of physical symptoms that can range from uncomfortable to severe. These include:
- Nausea, vomiting and diarrhoea – these symptoms are very common and usually appear first
- Muscle aches and pains – heroin withdrawal can cause your body to ache all over. For some people, this can be disabling
- Sweating, chills and fever – these symptoms are similar to flu symptoms and can vary in intensity from person to person
Many people also experience psychological symptoms when they’re withdrawing from heroin. These include:
- Anxiety and depression – the loss of heroin’s euphoric effect can lead to mood swings and emotional instability
- Agitation and irritability – it’s common for people to become quickly agitated and irritable during withdrawal
- Restlessness and difficulty concentrating – people may also find it difficult to focus or keep still, and might feel constantly uncomfortable
In some cases, heroin withdrawal can lead to severe and potentially life-threatening symptoms, such as:
- Extreme dehydration – this can be a result of vomiting and diarrhoea, and can further complicate the withdrawal process
- Respiratory distress – this is when someone experiences breathing difficulties, such as shortness of breath, rapid breathing and feeling as though they’re unable to take a full breath. These symptoms are especially common in people who already have respiratory issues, such as asthma
- Heart palpitations and blood pressure changes – this can include abnormal heart rhythms and fluctuations in blood pressure, which can lead to complications such as stroke
Heroin withdrawal timeline
Heroin withdrawal symptoms can start as soon as 6 hours after your last dose, and intensify as time goes on. Each stage of withdrawal has its own set of challenges, and symptoms can vary from person to person.
- 6 to 12 hours – you may experience early symptoms such as vomiting, diarrhoea, muscle aches, anxiety and strong cravings for heroin. These symptoms will gradually start to intensify as your body begins to react more fully to the absence of the drug
- 1 to 2 days – your withdrawal symptoms are likely to reach their peak during this period. You may experience severe nausea, vomiting and sweating, along with debilitating muscle aches and significant agitation. These symptoms are usually the most uncomfortable and can be overwhelming if you don’t have proper support
- 3 to 7 days – as the first week progresses, the peak symptoms will start to pass. However, other symptoms, such as diarrhoea, abdominal cramps and shivers may continue. Emotional symptoms, such as irritability, depression and insomnia can become more pronounced during this stage
- After 1 week – after the initial acute withdrawal phase, some people might experience protracted withdrawal symptoms, or post-acute withdrawal syndrome (PAWS). These can include ongoing emotional and psychological challenges like anxiety, poor concentration and fatigue. These symptoms are less intense but can linger for weeks to months, as the brain gradually returns to its normal state
Professional heroin detox
Professional heroin detox is a medically supervised process designed to help people safely stop their heroin use. This method involves close supervision by healthcare professionals, who help you to manage your withdrawal symptoms in a safe, supportive environment.
Benefits of medical supervision
Having medical experts on hand during drug detox is essential. They can help you manage severe withdrawal symptoms and complications, helping to keep the detox process as safe as possible for you. Their expertise is key in alleviating physical discomfort and preventing serious issues like severe dehydration or respiratory distress. They can also offer support for any psychological and emotional challenges you may experience during detox.
Attempting to detox from heroin at home without professional guidance is extremely risky. It can result in severe health problems like dehydration and respiratory issues, which can be life-threatening and need urgent medical care. Intense withdrawal may increase the likelihood of you relapsing, as the overwhelming symptoms might drive you to use heroin again for relief.
Medications and 24-hour monitoring
In a clinical setting, doctors can use medications to help ease your withdrawal symptoms. Medications can help you manage cravings, anxiety, depression, pain, nausea, diarrhoea and sleep problems, significantly improving your detox experience. Also, because you’ll be looked after 24 hours a day, your medical team will be able to adjust your treatment as needed, meaning you’ll be getting the right support at the right time, completely tailored to you.
Therapeutic techniques to manage withdrawal symptoms
As well as medical interventions, there are a number of effective therapy techniques that can be used to enhance your comfort during detox:
- Mindfulness and relaxation techniques – methods like meditation, yoga and deep breathing can help to reduce the mental and physical strain of withdrawal. These practices can help to reduce stress, clear the mind and make you feel calmer
- Nutrition and exercise – eating well and keeping active are important during detox. Good nutrition helps your body to heal, while exercise can improve your mood and boost energy. Once you’re physically up to it, light exercise can be a beneficial part of your detox routine
- Alternative therapies – therapies such as acupuncture or art therapy can also play a supportive role. These offer different ways to manage stress and emotional challenges, providing relief and a positive outlet during detox
Medications used in heroin detox
Medications such as Methadone, Buprenorphine and Naltrexone can help to ease cravings and reduce withdrawal symptoms during detox, making the process more manageable.
Here are some of the most common medications that are used:
Methadone
| What does it do? | Targets the brain's opioid receptors, like heroin, but without causing a high, reducing cravings and stabilising the user's experience |
|---|---|
| Benefits | Very effective in reducing cravings and withdrawal symptoms |
| Side effects | Can be addictive and is usually dispensed under strict supervision |
Buprenorphine
| What does it do? | Targets opioid receptors, like methadone, but has a 'ceiling effect', meaning increasing the dose beyond a certain point doesn’t enhance effects. This reduces the risk of misuse and overdose |
|---|---|
| Benefits | Less likely to be abused, making it a safer alternative to methadone |
| Side effects | Side effects may include nausea, headaches and possible withdrawal symptoms if it’s stopped abruptly |
Naltrexone
| What does it do? | Blocks opioid receptors rather than activating them, which prevents heroin from having any effect and reduces the desire to use opioids |
|---|---|
| Benefits | Helps maintain sobriety by blocking the high from heroin, best used after detox has been completed. Not addictive and doesn’t cause euphoria |
| Side effects | Requires complete abstinence from opioids to be effective, meaning it can’t be used while you’re still detoxing. It also has to be taken consistently and regularly to be effective |
Cost and accessibility of heroin detox treatment
Heroin detox is a crucial step toward recovery, but costs and accessibility can vary, depending on a number of factors. These can include:
- Location and type of care – the cost of heroin detox can vary based on where it's provided, the type of care offered, and the amenities of the detox centre
- Duration of detox - costs can also vary depending on the length of your detox. This typically ranges from 7 to 10 days, but can differ based on individual needs
- Additional services - the need for additional services, such as counselling and follow-up care, can also influence costs
- Post-detox treatment - it's generally recommended that you transition into a heroin addiction treatment programme after detox, which usually lasts for 28 days
Heroin detox can be accessed via:
- NHS – in certain areas of the UK, the NHS may provide detox services that are free at the point of service. However, there may be waiting lists that could delay treatment. Ask your GP about the services that are available in your area
- Private care options – private providers, such as Priory, can offer fast access to detox services, delivering high-quality support and expertise. We also offer a free addiction assessment to get the process started. Our detox services can be self-funded, or funded through private medical insurance
Choosing the right detox pathway for you is crucial and it should be based on your individual needs. Ensuring ongoing support after initial detox is key for successful recovery. This includes follow-up care, counselling and aftercare programmes, designed to prevent relapse. Evaluating all these factors can help you and your loved ones make an informed decision that fits with your financial situation and recovery goals.
FAQs
Discover some commonly asked questions about heroin detox and the withdrawal process.
Why do people get withdrawal symptoms?
Heroin is an opioid, a type of drug known for its painkilling properties. It works by latching onto parts of the brain known as opioid receptors. These receptors usually respond to the body's natural painkillers, endorphins. However, heroin mimics these natural chemicals much more powerfully, leading to feelings of euphoria and significant pain relief.
Heroin addiction symptoms often arise from this powerful effect on the brain’s opioid system, causing the person’s brain to depend heavily on heroin in order to feel good and function properly. When you stop or reduce your heroin use, your body struggles to adapt to its absence, leading to withdrawal symptoms.
How do I know if I need detox?
Determining whether you need detox involves looking at the extent to which heroin affects your daily life and wellbeing. You should consider detox if you get withdrawal symptoms when you try to quit, have tried to stop on your own but can’t, continue to take heroin despite the negative consequences of this, prioritise heroin over all other aspects of your life, and worry that you might overdose on heroin.
What happens during detox if I have co-occurring disorders?
If you have co-occurring conditions, integrated treatment can address your addiction and any other mental health issues you’re facing. For example, medication can be prescribed during detox to help manage symptoms of depression or other conditions, alongside your addiction treatment.
Can I continue working during detox?
Heroin detox takes place on an inpatient basis, which means you can’t go to work or work remotely during this time. Staying as an inpatient ensures that you receive all necessary care and support as you begin your journey to sobriety.
How do I know if detox is working?
You can tell detox is working if you start feeling better physically, with fewer withdrawal symptoms and less cravings for heroin. You might also feel more emotionally stable, think more clearly and start enjoying activities again.
