The Heroin Withdrawal Process: A Timeline

Heroin Withdrawal Timeline, Symptoms and Detox information

The Heroin Withdrawal Process: A Timeline

As many former addicts can attest, kicking a heroin addiction can be one of the most difficult and painful experiences of your life.  The physical effect of heroin on the body makes the withdrawal process encompasses both the physiological and psychological challenges of ending an opiate addiction.  Just as no two people are the same, withdrawal from heroin addiction affects everyone differently. However, there are some generalities that can be expected by those who seek to recover at a treatment center from their opioid addiction.

While it is natural to be apprehensive when approaching withdrawal from heroin, remember that the physical and mental effects resulting from heroin withdrawal will pass with time and proper treatment.  Also, bear in mind that many aspects of heroin withdrawal can be mitigated through pharmacological or therapeutic means. These heroin treatment options can minimize the intensity and duration of the withdrawal process and enable a more comfortable transition to recovery.

There is no question that heroin withdrawal can be a difficult and painful experience at times.  Many heroin addicts continue to use even when they wish to leave their addiction behind simply to stave off withdrawal and its perceived impact.

For some, the anticipated pain and discomfort produces more mental anguish than the withdrawal itself. Depictions of drug abuse heroin withdrawal in popular media, such as movies and television, contribute to this. In many of these films and shows, the person undergoing withdrawal is shown in the thrall of complete mental and physical anguish, from bone wracking physical pain to a manic need to do anything to return to using.

These images of heroin withdrawal both over-dramatize some effects and fall short of depicting other effects that heroin users may experience when recovering. It is important to remember that these are simply dramatic depictions of a very real process that can vary substantially depending on the person, the extent and scope of their habit, and the type of recovery program they are utilizing.

What to Expect During the Heroin Withdrawal Process

The following information is for those quitting heroin use “cold turkey,” or rather without drug replacement therapy such as methadone or Suboxone treatment, or other medical treatment to help alleviate physical symptoms.

Withdrawal symptoms can begin anywhere from 6 to 12 hours from the last use of heroin.  Physical symptoms of withdrawal start moderately and increase to a peak within the first 48 to 72 hours. They generally begin to taper off by 5-10 days after last use.  Typically, people experience flu-like symptoms that increase in intensity during this period, then begin to ease over time.  The most common physical symptoms of heroin withdrawal include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Aching bones and joints
  • Yawning
  • Itching
  • Leaking of fluids from eyes
  • Excessive sweating
  • Sneezing
  • Chills and goose bumps
  • Loss of appetite
  • Restless legs
  • Insomnia
  • Desire to use again

The intensity of these symptoms is largely related to the habit of the person in drug withdrawal.  If the addict had a severe heroin addiction, one that entailed using a large amount of heroin on a daily basis over a long period of time, they will typically experience a more severe form of physical withdrawal and should detox with medical assistance.

However, if the person in question had a moderate to low use of heroin abuse over a shorter period of time, their symptoms will be more mild in comparison.  Also, it is important to bear in mind that everyone’s body is different. Certain people may experience specific physical symptoms more acutely, while not experiencing others at all.

When looking at the list of physical heroin withdrawal symptoms, many mirror the common flu or severe allergies.  Generally, heroin withdrawal, although discomforting and painful, is not a life threatening process.  There are some qualifications to this.




Many heroin users enter withdrawal at a level of dehydration greater than the general population.  Since the physical processes of withdrawal result in the expulsion of fluids through diarrhea, vomiting, and excessive sweating, dehydration can quickly become acute.

In addition, many people suffering from heroin withdrawal find that they cannot keep fluids down even if they are inclined to consume them.  Acute dehydration can quickly become life threatening, and the risk of dehydration while withdrawing from heroin underscores the importance of doing so under the supervision of medical professionals.

Cognitive Effects of Heroin Withdrawal

While the physical effects of heroin withdrawal can certainly be daunting, the mental effects of withdrawal are frequently the most difficult aspects to cope with.  Former heroin users describe the mental fatigue, depression, and anxiety they suffer as the most challenging hurdle of kicking their addiction.

During the period of time, users are suffering from the acute physical symptoms of withdrawal, they may also experience a plethora of emotional effects.  For many long-time users of heroin, the first few days to weeks are a period of adjustment. Anxiety, frustration, boredom, sadness, and fatigue are the emotions most commonly felt during withdrawal.

These are hardest to cope with during the period of physical discomfort immediately following quitting the use of heroin.  This is largely a result of the concurrent manifestation of flu-like physical symptoms with fluctuating emotions as the central nervous system begins to return to a state of normal function.

Many people experience difficulty falling and staying asleep when quitting heroin.  These periods of insomnia do not allow the mind and body to reset, which makes the withdrawal process seem longer than it would objectively.

They often cannot get a reprieve from the mental and physical symptoms of withdrawal, sometimes for days at a time. Many former heroin users describe the depression and anxiety that accompanies these periods of restlessness and insomnia as the most difficult aspect of the withdrawal process.

The cognitive effects of withdrawal that many feel after stopping the use of heroin can contribute to attempts to use other drugs to alleviate symptoms.  If these drugs fail to provide relief, the addict may relapse back onto heroin.  Many former users recall attempts to replace heroin with other narcotics such as benzodiazepines, marijuana, or alcohol.

To the person suffering through withdrawal symptoms, these drugs offer the false solace of a mild reprieve from the symptoms they are experiencing.  However, these drugs can also increase the psychological effects of withdrawal in the form of worsening depression or anxiety.  This idea of tapering off of heroin by replacing it with other street drugs is flawed, and should not be undertaken.

Remember, the goal is to recover from heroin addiction and drug use completely.  Replacing heroin with other drugs not prescribed by a medical professional only serves to continue the cycle of addiction by not fully grappling with the underlying issue of substance abuse.  In addition, certain drugs and combinations of drugs such as benzodiazepines and alcohol can be fatal if taken in conjunction with one another.

Benefits of Medically Supervised Withdrawal

If you are reading this, chances are that you or someone you know is contemplating breaking the cycle of addiction and quitting heroin.  It is vitally important that heroin withdrawal be conducted under the supervision of medical professionals.


First and foremost, medically supervised heroin detox offers the safest means to undergo heroin withdrawal.  Medical professionals can continually assess your vital signs, health, and prognosis while tailoring a treatment plan specifically for you.  As discussed, heroin withdrawal can result in extreme cases of dehydration that can lead to further health complications.  In addition, long-time heroin users can have underlying health issues that have previously gone undiagnosed, and that may become exacerbated by the withdrawal process.

Heroin addicts can suffer from compromised immune systems, organ damage, infections, and other physical ailments that can rapidly become more apparent during withdrawal.  Getting clean from heroin under the supervision of medical professionals will allow you or your loved one to have the best care and enable the immediate diagnosis of any further health complications resultant from heroin use or the withdrawal process.

Higher Success Rate

A second important reason heroin withdrawal should be conducted under medical supervision is success.  This path offers the greatest chances of success when compared to others.  Remember, the goal isn’t just to get clean from heroin, but rather to have a healthy, long-term transition towards recovery.

Relapsing is common for many with heroin addiction.  Without a treatment program in place that includes medical detox, support systems, therapy, and medical supervision, the chances of relapsing are increased greatly.  In addition, relapsing is very dangerous.  Regular users of heroin build up a tolerance to the drug over time.

When a heroin addict kicks their habit and makes it through the physical withdrawal, that tolerance is reset.  If they then begin to use heroin again they can often misjudge the strength of the drug and experience a heroin overdose. This problem is particularly prevalent today due to the fact that more and more heroin sold on the streets is cut with fentanyl, a synthetic opiate analgesic that can be 100 times more potent than street level heroin.

It is incredibly important for heroin users and their loved ones to realize that relapsing can be fatal, and to take every step possible to avoid accidental overdose and death.  The most important step you can take towards that goal is to ensure that withdrawal is conducted under medical supervision with a comprehensive treatment plan in place.

Medical Professionals Have Helpful Resources

The third reason treatment should be conducted under medical supervision is simple: medical professionals can help ease the withdrawal symptoms and transition to sobriety.  There are a number of drug replacement therapies available to medical professionals that can help assist heroin users through recovery.

Two of the most common are Suboxone and methadone.  Suboxone is a prescription medicine that contains buprenorphine and naloxone.  Buprenorphine works as an opiate agonist, meaning it binds to the opiate receptors in the body in a similar way to heroin, and can help ease the pain and cravings associated with withdrawal.  Naloxone is present to deter intravenous abuse of Suboxone; when taken intravenously it can result in the rapid onset or withdrawal symptoms.

Methadone treatment is similar to Suboxone in that it binds to the opiate receptors in the body and can help ease withdrawal symptoms and cravings.  Methadone is commonly used on a maintenance basis over a longer period of time.  Both methadone and Suboxone treatment are not used in all cases, and may or may not be part of the treatment plan formulated by you and your medical professional.

They do, however, offer another means for long time heroin users to successfully break their cycle of heroin addiction and achieve longevity in the recovery process when other treatment plans have failed.

Finding the Right Heroin Treatment Program for You

Ultimately, any attempt to undertake heroin withdrawal should be done under the supervision of a medical professional and with a clear treatment plan in place.  The heroin withdrawal process is both physically and mentally challenging.  It can expose existing health complications and may lead to the onset of depression, anxiety, and insomnia.




Because heroin is a highly addictive drug and creates a very powerful physical dependence and addiction, the withdrawal process is undertaken without support and guidance often results in a relapse of heroin use.  Relapse in these cases can prove fatal, due to the bodies’ reset tolerance or a misjudged dose of heroin.  The best route for someone to take when they are ready to end their cycle of drug-seeking behavior and addiction for quitting heroin for good is to seek out professional medical help, formulate a treatment plan, and stick to it.

The right heroin treatment program doesn’t simply address the physiological or psychological symptoms of withdrawal or drug cravings and addiction.  Rather, it offers a comprehensive detox program that helps ease the heroin withdrawal process in a safe way, while utilizing therapy, training, and support systems to ensure the underlying pattern of addiction and abuse are treated as well.

The right heroin detox treatment program also offers the security of being in the right hands throughout this process, and in doing so offers the greatest chances for a successful long-term recovery.  Understanding chemical dependence and navigating heroin withdrawal is a difficult process.  For many, it can be the most difficult undertaking of their life.  However, if done in the correct way it can be a process that only has to be experienced once.

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