Heroin addiction is characterized by the compulsive use of heroin, an inability to control the intake and the deliberate seeking of the drug. Heroin dependence, on the other hand, means that a person is at risk for developing withdrawal symptoms when they stop using the opioid. Heroin addiction is behavioral; heroin dependence is biological.

Part of heroin dependence is heroin withdrawal, which is characterized by a wide range of physical, emotional and behavioral symptoms. These signs and symptoms take place after a person stops using heroin, with effects ranging from irritability to insomnia.

In this post, we are going to explore the heroin withdrawal timeline so that you know what to expect. Some of the information we will cover includes when withdrawal symptoms begin, how long they last and their intensity. We will then discuss the importance of coming off this drug in a safe, supportive environment.

When Does Heroin Withdrawal Begin? How Long Does it Last?

Heroin represses the brain, whereas withdrawal activates it. Heroin withdrawal symptoms usually start within 8 hours from the last use, but they can begin as early as 4 hours for heavy users. In other words, when a heroin user is ready to use again, they begin to feel withdrawal symptoms.

As with other drugs, withdrawal effects from heroin are generally worse for the first couple of days. Symptoms peak after 48 to 72 hours and then start to taper off. From beginning to end, heroin withdrawal lasts about 7-10 days. The intensity of these effects varies between individuals. Addicts who have been abusing the drug for a long time and in high quantities tend to suffer worse. The overall health of the addict also plays a role.

What are the Most Common Withdrawal Symptoms?

The heroin withdrawal symptoms timeline usually begins with craving the drug, dilated pupils and anxiety. When the body doesn’t get the drug, users will often experience an increased resting respiratory rate, a runny nose, sneezing, fatigue, and physical pain.

As the symptoms progress, addicts may have an elevated heart rate, loss of appetite, lack of energy, nausea and diarrhea and insomnia. Again, the symptoms vary based on the person, but these are typical withdrawal effects that most users go through in the first few days.

Below is a list of the most common signs and symptoms of heroin withdrawal, in order.

• Heroin cravings

• Anxiety

• Dilated pupils

• Increased respiration

• Runny nose

• Sneezing

• Fatigue

• Goosebumps

• Chills

• Physical discomfort

• Stomach cramps

• Muscle aches

• Nausea

• Vomiting

• Diarrhea

• Insomnia

Can Heroin Withdrawal Be Deadly?

The heroin withdrawal timeline is unpleasant, but it is rarely deadly, especially when the user is in good health. That doesn’t stop heroin users from feeling like they are going to die, however. The reality is that they are much more likely to die from heroin use rather than withdrawal symptoms. In fact, when heroin detox is done in a supportive environment with medical staff on hand, it’s a relatively safe process.

During the detox process, it is important to be aware of underlying medical conditions that may complicate recovery. These conditions can usually be treated effectively while the person recovers. One issue of concern, though, is consuming a psychostimulant during detox. Heroin withdrawal makes the brain hyperactive, so adding a stimulant like cocaine can lead to fatal seizures. Again, detoxing in a medically supervised environment prevents this from happening.

What are the Options for Heroin Detox?

The reason why people continue using heroin is because of the withdrawal symptoms. When the brain is telling them that they will die without the drug, and their body is putting them through misery, they are led back to the drug time and time again.

To assume that the entire withdrawal process can be handled in the comfort of home is not practical. That’s not to say that it hasn’t been done, but it is not stacking the cards in the person’s favor. Almost every in-home opiate detox fails, especially when the user knows that one phone call can take all of their misery away.

Let’s take an objective look at the options for heroin detox, including going through withdrawal at home. This way, you can make an informed decision for your circumstances.

• Inpatient Medical Hospital Detox. Some hospitals have programs that allow heroin addicts to detox under medical supervision. However, these programs have been found to be largely ineffective due to their lack of personalized care and the types of medication used. Additionally, patients are often placed on lockdown or in psychiatric units, resulting in greater anxiety.

• Detox Facility/Treatment Center. This method is most commonly recommended for addicts and should be followed by a residential recovery program like The River Source. The environment is controlled, and the medical staff has a wide variety of medication (holistic and conventional) to ease heroin withdrawal symptoms.

• At-Home Opiate Detox. Stopping heroin use cold turkey is something that many heroin addicts try at one time or another. They may use other drugs to control their withdrawal symptoms, such as benzodiazepines, marijuana or other types of opiates. Unfortunately, there is little or no success at detoxing from opiates at home.

• Medication Management: Suboxone. Suboxone is the most commonly used maintenance medication used today. Suboxone contains naloxone that prevents recovering addicts from using heroin intravenously. However, the use of Suboxone has mixed feelings within the treatment community. Some feel that Suboxone can complement a healthy recovery regimen while others believe that patients are not truly sober.

• Medication Management: Methadone. Methadone is another type of medication management program for treating heroin addiction, but again, opinions vary greatly. Methadone has two big drawbacks. First, methadone is addictive in itself and has a long withdrawal period, lasting up to 21 days. Second, regular doctor visits are necessary to maintain the healthy use of methadone.

• Medication Management: Zubsolv. One last drug that is being considered as a viable treatment for heroin addiction is Zubsolv, which has a faster dissolve time, is absorbed by the body quicker and tastes like menthol compared to an orange. Because it has better bioavailability, the medication can be taken in smaller dosages with the same effectiveness as Suboxone. It’s unclear if Zubsolv will take the place of Suboxone one day.

As you can see, there are pros and cons to the various detox options available. Detoxing at home almost always fails and should be avoided. If a person truly wants to get sober, they need to detox in a controlled environment where their symptoms can be managed, and heroin isn’t a phone call away. Though these detox programs are more expensive than detoxing at home, there are many ways to afford them, such as through private or public health insurance.

Medication management is costly and may require weekly doctor visits. Plus, the opinions on these medications vary. While they have worked for some patients and have contributed to them staying clean and sober, other recovering addicts feel that the drugs are marginally effective. Not to mention, it’s possible that a drug like methadone will be exchanged for heroin, so the person isn’t genuinely sober.

How to Best Cope with Heroin Withdrawal Symptoms

The River Source always recommends detoxing from an opiate in a safe, medically supervised environment. Our treatment center utilizes a variety of treatment modalities that help our patients go through the withdrawal process safely and effectively. This doesn’t mean that we erase the pain and discomfort and make detox pleasant. But it does mean that we use every tool available to get our patients through this period with their symptoms managed.

Let’s take a closer look at the various treatments available that we use during the heroin withdrawal timeline.

• Benzodiazepines. In the first 12-24 hours, we use certain benzos to reduce anxiety and help patients rest. Examples include Klonopin or Clonazepam.

• Muscle Relaxers. Muscle relaxers reduce muscle pain and physical discomfort, plus allow our patients to rest easier.

• Sleep Medication. The more patients can sleep, the better. This speeds up the healing process and allows the body to recover.

• Suboxone. For the first 3-5 days, we introduce Suboxone to help manage cravings.

• Naturopathic Treatments. Homeopathic remedies are a staple of our treatment program. We provide oral vitamin therapy, IV vitamin therapy, amino acid therapy, infrared sauna treatments, massage therapy, and acupuncture during the detox phase.

• Vitamin IV Therapy. Vitamin IV therapy is used to restore the body with essential vitamins and nutrients. Contained in our IVs is magnesium, high b’s and c’s, complex b 5, 6 and 12’s, calcium and zinc. Each patient is given a unique blend based on their age, weight and other factors.

Personalized Treatment for River Source Patients

Before starting an opiate withdrawal program, The River Source assesses each individual patient. We want to make sure that we are the right fit for the patient. It’s also important that we understand the health of the person, underlying complications and co-occurring health conditions. Finally, all treatment plans will include a combination of medical and naturopathic treatments along with 24-hour staff support.

Once the detox process is complete, The River Source offers a robust residential treatment program that includes counseling, life skills workshops and family support. When treatment starts immediately after detox, the risk of relapse is significantly reduced. This is why our rehabilitation program recommends detox, inpatient treatment, and continuing care, in that order, with each phase building on the next.

The River Source is here to serve your needs. We have experience treating heroin withdrawal and recovery, and we are proud to be a part of many sober journeys. To learn more about our programs or to begin recovery for yourself or a loved one, call us today.