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Guide to Heroin Detox

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Heroin is a very addictive, illegal opioid.1,2 In the United States, both heroin use and overdose deaths have been increasing for more than a decade.2 It is one of the major substance use issues affecting many areas of the country.2

But there is hope. Professional treatment centers can help you detox from heroin and support your long-term recovery from drug misuse. In this article, you will learn about the dangers of heroin use, signs of withdrawal, and how to get help.

Why Is Heroin Dangerous?

Regular heroin use affects the way a person behaves and thinks as it changes parts of the brain, leading to tolerance and dependence.2 Tolerance happens when your body needs more and more heroin to feel the same effects.2,11 Being dependent means that your body gets used to the presence of heroin so that if you suddenly reduce your dose or stop taking it, your body goes through withdrawal.2,11Since withdrawal symptoms are often very uncomfortable, this can in turn lead many to return to heroin use to ease their withdrawal symptoms.11

Both tolerance and dependence can lead to a substance use disorder (SUD).2,11 An SUD is a chronic and treatable medical disease that involves compulsive use and drug-seeking, no matter the negative social, personal, health, or legal consequences.2,11

In 2019, roughly 14,000 people died from heroin overdose in the U.S. Nearly 10,000 of those overdoses involved other opioids, mostly fentanyl.14 Fatal overdoses involving heroin also happen in combination with prescription opioids, benzodiazepines, and alcohol.

Using heroin just once can sometimes be life-threatening, as it slows down your heart and breathing.1,2 It is very easy to overdose on heroin.1,2 Heroin varies in level of purity, leading to a person taking unknown amounts (and possibly other unknown substances). This increases the risk of overdose and death over time. This is especially true if the heroin is cut with something such as fentanyl, taken with other drugs, or taken in a large dose.1,2 An overdose can cause severe breathing problems as well as coma and even death.1,2

Injection heroin use not only carries a higher risk of overdose, but also increases one’s risk of possibly fatal infectious diseases like hepatitis and HIV. 2 Repeated heroin use can also lead to other serious long-term health issues, such as:2–5

  • Severe constipation.
  • Abscesses (pockets of pus caused by infection).
  • Damaged veins, blood vessels, or organs.
  • Skin infections.
  • Severe lung infections, like pneumonia or tuberculosis (TB).
  • Infection of the heart lining (endocarditis).
  • Kidney and liver damage.

What Happens During Heroin Withdrawal?

When you are dependent on heroin, you will go through withdrawal if you stop taking it suddenly or reduce your dose. Which symptoms you’ll have and how bad they’ll be is influenced by the amount of the drug that you usually take and how often you take it. Common heroin withdrawal symptoms include:2,3,6–9

  • Muscle and bone pain.
  • Stomach issues such as diarrhea, nausea, and vomiting.
  • Anxiety.
  • Depressed mood.
  • Dilated (enlarged) pupils.
  • Hot and cold flashes.
  • Increased blood pressure.
  • Trouble sleeping (insomnia).
  • Rapid breathing and heart rate.
  • Restlessness.
  • Runny nose.
  • Sweating.
  • Watery eyes.
  • Uncontrollable leg movements.

Many of these symptoms can be intense and uncomfortable, which often leads a person to return to heroin use to ease symptoms.3 You will also likely have severe cravings during heroin withdrawal.3 Both of these together may make quitting heroin on your own extra hard.3

How Long Does Heroin Withdrawal Last?

How long withdrawal lasts and how bad symptoms are will differ from person to person. It depends on:3,9

  • The way you use the drug (injection, smoking, snorting).
  • How long you’ve taken it.
  • How much you take each time you use it.
  • How often you take it.
  • Your unique genetic, physical, and mental makeup.
  • Other substances you use or medicines you take, especially benzodiazepines and alcohol.

Heroin withdrawal symptoms usually begin within 6 to 12 hours after your last dose.3,9 Symptoms slowly get worse, becoming most intense 1 to 3 days after your last dose.2,3 Then the symptoms slowly improve over the next 4 to 7 days.2,3,9

How to Cope with Heroin Withdrawal

Getting through heroin withdrawal can be uncomfortable and painful but it is rarely life-threatening. Medical detox can help keep you safe while easing the most uncomfortable withdrawal symptoms.9,10 Your care team may give you medicines to ease drug cravings and other symptoms that may lead to using heroin again.3

When you enter detox, staff will give you a drug test and ask you questions about your overall health and substance use history.8,9 They’ll use this information to place you in the right setting and make a treatment plan that meets your personal detox and recovery needs.9,10 Detox staff can also link you to further drug rehabilitation treatment after detox. Detox is not itself a treatment for SUDs, but it is a useful first step when followed by evidence-based treatment.2

Heroin Withdrawal Medicines

Your care team may give you medicines to treat withdrawal symptoms and reduce drug craving.9 Some of these medicines may also be used in treatment after detox.2,9

doctor handing prescription medicine to a patient

Methadone and buprenorphine can be started during detox to help manage withdrawal symptoms and reduce drug cravings.2,9 Patients sometimes take smaller and smaller doses over the course of detox (called “tapering”). 12 Many patients stay on these medicines beyond detox to treat opioid use disorder and to help prevent a return to drug use or relapse.12

Lofexidine is the first non-opioid medicine approved to manage opioid withdrawal.8 It also helps reduce withdrawal symptoms, but may need to be combined with other medicines to keep you comfortable during the detox process.13

Other medicines that may help manage symptoms include:9,12

  • Blood pressure medicine (clonidine) to reduce anxiety, sweating, and feeling irritable.
  • Anti-depressants and sleep medicines to reduce insomnia and help you sleep.
  • Medicine to reduce muscle pain.
  • Medicines to prevent nausea, vomiting, and diarrhea.

Can I Quit Heroin on My Own?

It’s a good idea to talk honestly with your doctor before trying to quit heroin on your own.9 If you regularly misuse alcohol or benzodiazepines along with heroin, you may be at greater risk of dangerous withdrawal symptoms. Your doctor can better help you assess any risks you may face during withdrawal. They can also help you find the right level of detox and rehab care that will keep you safe and comfortable and meet your recovery needs.9

Quitting heroin on your own is possible, but professional detox centers can help ensure your comfort, can better manage symptoms, and can give medicines that may help prevent relapse well after detoxification.

Where Can I Find Heroin Detox?

American Addiction Centers is a leading provider of medically supervised detox and ongoing treatment for heroin or other substances. We have treatment centers throughout the United States, so it’s easy to access detox and treatment wherever you are. For more information, call our confidential helpline at 1-888-509-8965 Who Answers? .

Sources

  1. Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide.
  2. National Institute on Drug Abuse. (2018). Heroin research report.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. National Institute on Drug Abuse. (2020). Health consequences of drug misuse.
  5. Schiller, E. Y., Goyal, A., & Mechanic, O.J. (2020). Opioid overdose. Treasure Island, FL: StatPearls Publishing.
  6. World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings.
  7. Center for Substance Abuse Treatment. (2010). Protracted withdrawal. Substance Abuse Treatment Advisory, 9(1).
  8. Shah, M., & Huecker, M.R. (2020). Opioid withdrawal. Treasure Island, FL: StatPearls Publishing.
  9. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment.
  10. National Institute on Drug Abuse. (2020). Principles of drug addiction treatment: A research-based guide (Third edition).
  11. National Institute on Drug Abuse. (2018). The science of drug use and addiction: The basics.
  12. Substance Abuse and Mental Health Treatment Services Administration. (2020). TIP 63: Medications for opioid use disorder.
  13. Renfro, M.L., Loera, L.J., Tirado, C.F., & Hill, L.G. (2020). Lofexidine for acute opioid withdrawal: A clinical case series. Mental Health Clinician, 10(5), 259–263.
  14. National Institute on Drug Abuse. (2021). Overdose death rates.

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