Heroin Withdrawal & Detox Timeline

Heroin is one of the most addictive drugs available, so people can become addicted to it after trying it just once. Roughly 586,000 Americans currently have a heroin use disorder. For many of these people, the potential of withdrawal is one of the main reasons they are not trying to get clean. Understanding what withdrawal is and how it works can help you make the right choices as you work to overcome a heroin addiction.

What Is Heroin Withdrawal?

Heroin withdrawal refers to a set of symptoms that you will most likely encounter once you quit using heroin. Heroin withdrawal happens due to the complex way heroin affects your brain. Once you have been abusing heroin repeatedly for a while, your brain starts changing the levels of hormones it makes. Certain hormone levels are elevated to counteract heroin’s sedating effect while other hormones are reduced to compensate for the extra levels of mood-boosting chemicals that heroin gives you.

Eventually, this leads to a physical dependence. Your body will no longer function normally without heroin in your system. The chemical levels that are affected by heroin do more than just alter your mood since several of them are used to perform essential bodily functions. If you quit taking heroin at this point, you will start to feel seriously ill. This sensation is heroin withdrawal.

Are Withdrawal and Detox the Same Thing?

It is important to note that heroin withdrawal and detox are two separate things. These two conditions often get confused because they are closely related. Understanding the differences between them can help you better identify your needs. Detox is the process of cleaning your body of toxic materials. Your body does this naturally as your liver eliminates all traces of heroin from your bloodstream.

Meanwhile, withdrawal is the process of your body dealing with the physical dependence it has developed. Withdrawal is a longer process with more intense side effects. Your body can manage withdrawal by itself, gradually adjusting chemical levels to stop the unpleasant symptoms, but you can also get professional help to ease the process. Withdrawal can be treated with the right medical care. Many clinics use the phrase “medical detox” to refer to the process of helping you through withdrawal symptoms, but according to the World Health Organization, a more accurate term for this care might be withdrawal management.

Heroin Withdrawal Signs

Often, people describe withdrawal as feeling like an absolutely awful case of the stomach flu. The exact time span of withdrawal symptoms can vary quite a lot. Usually, it shows up about half a day after your last heroin dosage and lasts about a week. The most common physical symptoms of withdrawal will include:

  • Trouble sleeping
  • Nausea
  • Runny nose and watery eyes
  • Aching muscles
  • Chills and goosebumps
  • Muscle spasms

Withdrawal also comes with some very intense mental and emotional effects. Many people withdrawing from heroin feel extreme anxiety, so they may frequently have panic attacks. Those who are withdrawing are often agitated, confused or aggressive. Some people have chronic fatigue regardless of how much they sleep. Heroin cravings will be very intense during withdrawal.

The Heroin Withdrawal Timeline

For a person struggling with heroin withdrawal, having a full picture of the heroin withdrawal timeline can make it easier to weather the stress and discomfort. The timeline starts as soon as a person takes their last dose of heroin.

Day 1: 24 hours after the last dose, withdrawal symptoms will definitely have appeared. Generally, they start with aches, pains and stomach cramps.
Days 4- 5: After the peak, withdrawal symptoms will start to taper off, but they will still remain very strong and unpleasant for a few days.
Days 8 – 14: Most withdrawal symptoms are gone by this point, but people may continue to feel worn out and tired from the intensity of withdrawal.

What Factors Affect Withdrawal?

The onset time, severity and length of withdrawal are not the same for every person. Instead, there are several factors that can cause your withdrawal to be different from standard withdrawal symptoms and time periods. The type of heroin you use can affect when withdrawal starts with longer-acting heroin causing withdrawal to start later than expected. Typically, those who have been abusing larger amounts of heroin or who have had a heroin use disorder for a longer amount of time will have more severe withdrawal symptoms. Your personal health and metabolism can also affect how quickly your body recovers. Those who are in good physical health may have a slightly shorter withdrawal time.

Is Heroin Withdrawal Dangerous?

For most people, the main danger of heroin withdrawal is that it tempts them back into abusing heroin. However, it can also have several other dangerous effects on a person. If vomiting and diarrhea are severe enough, a person may become dehydrated. In some cases, this dehydration may even be life threatening if a person does not get medical treatment right away. The anxiety and agitation common in heroin withdrawal may cause people to harm themselves while under excessive mental strain. Withdrawal puts the body under a lot of stress, so those with physical or mental conditions like cardiovascular disease, depression or diabetes will be particularly vulnerable to those conditions during this time.

How to Treat Withdrawal Symptoms

Heroin withdrawal treatment is unpleasant, but it is not inevitable. There are several things you can do to reduce the severity of withdrawal.

Medical Monitoring

The most basic form of treatment is having a medical expert available to keep an eye on you during detox. This type of heroin withdrawal treatment is particularly important if you have any underlying medical conditions. Having health care professionals present ensures that someone can provide treatment if dangerous symptoms like irregular heart rates or dehydration occur. It can still be helpful even if you are not in physical danger. Having someone present to monitor your condition can be a valuable form of mental support that helps you resist cravings.

Medications to Reduce Withdrawal

Heroin withdrawal treatment is a little different from other types of drug withdrawal because there are several synthetic, heroin-like substances that can be used to almost entirely remove withdrawal symptoms. These synthetic opioids only partially activate the brain, so they remove the worst of withdrawal without being addictive or getting you high like heroin would. The most common medication used for maintenance therapy is methadone, a long-acting opioid that you can take orally as a pill or liquid. Another popular option is buprenorphine which is taken as an oral medication underneath the tongue. It has even fewer opioid-like effects than methadone, but it still manages to reduce withdrawal.

Most of these medications are designed to be tapered off. Slowly, under the guidance of a medical professional, you will lower your dose of the medication until you can quit using it altogether. Gradually tapering off of the drug can almost entirely halt withdrawal symptoms. When done correctly, methadone maintenance therapy or another heroin replacement medication can keep you from noticing withdrawal at all.

Medications to Address Symptoms

If you want help with withdrawal symptoms but do not feel comfortable taking methadone or other heroin-like medications, you can still get help. There are many medical treatments that can help with the various symptoms you experience during withdrawal. For example, non-addictive painkillers can be used to address muscle aches, or anti-diarrheal medications can help you deal with an upset stomach and bowels.


Since withdrawal is not just a physical problem, it is a good idea to go ahead and begin the therapy aspect of rehab as soon as you start withdrawal. This can help you get a jump start on the hard work of fighting your addiction. Since withdrawal often tests your resolve to get clean, therapy at this point can help you focus on your reasons to overcome heroin addiction. Counselors can give you coping methods for dealing with some of the mental struggles of withdrawal and help you calm down when you are feeling particularly depressed or anxious.

Does Heroin Cause Post-Acute Withdrawal Syndrome?

Once the worst of withdrawal is over, there still may be some unpleasant symptoms to come. Heroin is one of the drugs that can cause post-acute withdrawal syndrome, or PAWS. As the name implies, this is a type of withdrawal that stretches on long after the main withdrawal symptoms are over. PAWS symptoms are rarely physical. Instead, they are often mood-related or psychological. Most people with a mild or moderate heroin use disorder will not get PAWS. It is more likely to happen in those who have been abusing the drug for a very long period of time.

In general, PAWS symptoms are similar to depression. Those with PAWS may constantly feel fatigued, struggle to find joy in relationships or hobbies, and feel negative emotions towards themselves or others. It is often characterized by mood swings, irritability or anxiety, and people with PAWS often feel foggy and have trouble focusing. PAWS tends to come and go in cycles. You may feel completely great for weeks and then have a few days where PAWS symptoms are very strong. During these episodes, people often feel very low. They may have strong drug cravings or struggle to even get out of bed. For most people, PAWS lasts about six to eight months, but it can linger for up to two years.

Get the Right Care at Green Mountain Treatment Center

If you or a loved one has a heroin addiction, Green Mountain Treatment Center is here to help. At our flagship location in beautiful Effingham, NH, we provide care to men and women aged 18 or older. At our medical detox facility, you can get support as you go through heroin withdrawal. We provide monitoring around the clock with medical professionals always available to handle emergencies. Our treatments can help cut back on cravings and discomfort, so you can focus on getting healthy again.

Once your withdrawal symptoms subside, Green Mountain Treatment Center will continue to help you fight your heroin addiction. The counselors at our rehab facility will craft an individual treatment program with a combination of counseling and therapy to help you fight cravings, find healthier coping skills and rebuild your life. With our clinically proven methods of fighting addiction, you can identify and overcome the triggers that lead to drug abuse. We incorporate a variety of holistic therapies like meditation, yoga and exercise to help lift your mood and improve your health as you recover.

Do not let addiction control your life. Green Mountain Treatment Center can give you the tools you need to get through heroin withdrawal and addiction. Take the first step towards sobriety by giving us a call today.

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