Heroin Withdrawal

Heroin withdrawal can be an extremely painful and uncomfortable process. Learn more about it in this article.     

heroin withdrawal

Table of Contents

What is Withdrawal?

Withdrawal is a process that people who use drugs experience when they cease taking a substance with a high degree of addictive potential or chemical dependency potential. Many individuals who use substances, particularly hard drugs like heroin, desperately want to detox. However, the withdrawal process such as heroin withdrawal can be incredibly painful. 

Physical Dependence

The physical dependence on a drug happens when the substance is taken consistently over some time and is signaled by the appearance of withdrawal symptoms after stopping. With heroin, the body becomes used to the depressed and slowed state of the central nervous system. During heroin withdrawal, the body must reacclimate to the increased CNS activity.

Psychological Dependence

Psychological dependence is generally referred to as addiction. It is the mental disorder that makes compulsive drug use in the face of harmful consequences possible. The DSM-5 sets the criteria that determine if an individual has a substance use disorder. 

Heroin Withdrawal Symptoms

There is a wide variety of heroin withdrawal symptoms, and while not every individual will experience all of them, most people will experience several.

Those who have heavily used drugs or were using drugs for a long period may find that they experience more symptoms or that the symptoms they experience are much more severe. Depending on how the individual self-administered the drug, such as snorting heroin, smoking heroin, or injecting heroin, the withdrawal severity can be affected also.


Nausea is one of the most commonly reported symptoms of enduring heroin withdrawal and can be one of the most uncomfortable as well. Nausea will peak during the acute withdrawal stage but will fade relatively quickly.


The general emotional instability of an individual recovering from heroin’s effects will often cause them to feel agitated or irritated at even small things. This agitation can escalate in severe cases, and it may result in the individual saying things they do not mean due to mental stress. 

Muscle Spasms

Muscle spasms will be common in many parts of the body and will often create a very uncoordinated or jerky appearance. The most common locations for spasms will be in the arms and legs. However, spasms can occur in the neck be painful, as can potential spasms in the abdomen or back. 


The cravings for heroin will be very strong during the initial stages of heroin withdrawal. They can be greatly diminished and relegated to infrequent appearances, but in all likelihood, these cravings cannot be eliminated. Even individuals that have completed heroin detox and have a strong recovery report that they feel the occasional craving. 


Shaking and tremors will be common during the acute withdrawal stage and can make even the most basic tasks challenging. This symptom should only be apparent in the early stages of withdrawal and should fade quickly once the body reacclimates. 


One of the more socially uncomfortable and frustrating symptoms is the constant, uncontrollable, and profuse sweating that happens as the body reacclimates to not having heroin in the system. The sweating will peak early in the detox process, like the tremors, and should fade completely by the end of the acute stage.


Depression is common during heroin withdrawals and can be very severe. Thoughts of self-harm and suicide are not uncommon either. It is important to know that while depression will be one of the symptoms that lasts the longest, and it will greatly diminish during the post-acute withdrawal stage.

Factors That Affect How Long Heroin Withdrawal Last

Many factors affect how long and how difficult the heroin withdrawal will be. Some of these factors are below. 

Frequency of Use

How frequently an individual used heroin will be a significant factor in the severity of the withdrawal process. Those that used the drug more frequently will often find that they have a more uncomfortable and extended detox process. Individuals that used it less often may find that their withdrawal process is more manageable. 

Amount of Drug

The usual dosage that the individual would use each time will be a very strong influence on their heroin detox process. Those individuals that consistently took larger doses will find that they have a far more difficult withdrawal experience. 

Heroin Half-Life

The half-life of the heroin will play a large role in the withdrawals, particularly if the heroin is cut with other opioids. Heroin has a half-life of between two and six minutes depending on the person and the heroin.

Body Mass

Body mass will impact the withdrawal experience, but only to a relatively small extent. The majority of people who use heroin have neglected their hygiene and nutrition so they have a much lower average body mass than the general public. Lower body mass will often mean more severe withdrawals while higher body mass will often mean a gentler experience.

Metabolic Rate

The metabolic rate of the individual will determine how quickly the drug leaves their system, thereby having a significant effect on their withdrawals. Those with robust or fast metabolisms may find that they have a more comfortable detox with merely uncomfortable withdrawal symptoms.


Age is a factor in withdrawal, but like mass, it is a relatively minor one. Younger individuals will tend to have an easier time with their withdrawal while older patients will often find it more difficult. There are many variables at play, however, that it is difficult to say definitively what the detox will be like purely based on age. 

What is Brain Reward System?

The brain reward system exists to provide a reward to a pleasurable stimulus. It is supposed to serve to reinforce desirable behavior, but when the dangers of heroin are introduced, this reward system becomes twisted to the demands of the drug.

Drug Addiction and Brain

The reward system in the brain is abused by many drugs like heroin. When someone takes heroin, it forces the brain to release a huge amount of the reward chemical, dopamine, into the individual’s body. This builds a dependence on the drug quickly. 

Anti-reward System

The anti-reward system causes strong dysphoria when a pleasurable drug wears off. While it is meant to discourage future abuse of the reward system, in many cases it contributes to the desire to avoid withdrawals by using more. 

Impact on Drug Withdrawal

The reward and antireward systems are central to heroin addiction and can make withdrawals incredibly difficult. The primary reason for the increased difficulty compared to other drugs is the intense reward that its use triggers. 

Withdrawal Without Medical Help

The process of heroin detox and withdrawal can be incredibly uncomfortable or painful. Moreover, in some extreme situations, it can even be dangerous or life-threatening.

The danger of the withdrawal process can increase with the severity of the heroin habits for the person entering recovery, as those individuals coming from much more severe addictions can expect more severe and potentially medically complex detox processes. 

Risks Involved

With attempting detox and withdrawals without medical supervision, there is the potential for several complications. Some of the more dangerous side effects of heroin withdrawal can include hypertension, dangerously elevated heart rate, intense cravings, and impaired respiration, any one of which can become medically significant rapidly.  

Medications Used to Treat Withdrawal of Heroin

One of the best ways to ensure someone relapses is by forcing them to quit their drug of choice cold turkey. The good news is that there are several medications available that work to ease someone through detox and withdrawal.


This synthetic opioid agonist acts on the opioid receptors in the brain to relieve heroin withdrawal symptoms. While these receptors are the same ones activated by other opioids in opioid-dependent individuals, this medication will not produce feelings of euphoria that heroin gives.6


Buprenorphine is a partial opioid agonist, meaning it activates the opioid receptors less strongly than methadone and other full agonists. It is easily tolerated by most patients and also will not produce euphoria.6


This medication is different from the previous ones mentioned. Naltrexone is an opioid antagonist. As such, instead of activating the receptors and helping ease withdrawals, this medication blocks the opioid receptors altogether.

This effect is helpful because it ensures that any opioids consumed do not produce any of the heroin effects like euphoria or other rewarding effects.

Therapy Used to Treat Withdrawal


Cognitive-behavioral therapy is an effective treatment for drug and alcohol addiction alongside a wide array of other problems including anxiety disorders, depression, marital problems, eating disorders, and mental illnesses. The main way that it works is by teaching coping mechanisms and changing thinking patterns. 


Originally developed as a treatment for patients with suicidal thoughts and borderline personality disorder, dialectical behavior therapy is now used as a way to address mental illnesses, as well as addiction and substance abuse. One of the biggest goals with DBT is to help build the patient’s confidence and help with coping skills so they can handle stressful situations in healthier ways. 

Motivational Interviewing

This therapeutic technique is an effective way to address a patient’s addiction and substance abuse. Lack of motivation is one of the hardest things to overcome. MI is used to help build confidence and motivation in the patient, giving them the tools to stay sober. 

Treatment for Heroin Withdrawal at The PAC Program

When it comes to getting through detox, you do not have to do it alone. The team of professionals at The PAC Program can offer the support you need to get clean. 


If you or a loved one are battling a serious addiction and needs supervision and support all the time, residential treatment is a great option. It ensures that you are away from an environment that allows drug use or makes access easy. You also receive support from the staff anytime you need them. 


Outpatient treatment is another beneficial choice for recovery. Outpatient care allows you to go about your normal life, but without heroin to get you through the day. Outpatient services include counseling and going to meetings. 

Medication-assisted Treatment

If you need medication to help you through the heroin withdrawal symptoms, The PAC Program has medical professionals that can prescribe the right medication for you.

The journey to recovery can be challenging and, at times, scary. However, our team is ready to help you start that journey and regain a fulfilled and healthy lifestyle. 


If you or a loved one needs help, please call us at
623-523-4748 and our team at Blueprints For Recovery in Arizona will help.

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