The Federal Laws of the United States classify heroin as a schedule I narcotic, which means it is highly abused and serves no medicinal purpose. Heroin is further classified as an opiate because it comes from a natural source, the opium poppy. Opioids, such as OxyContin or Vicodin, are also highly addictive narcotic analgesics, yet they are synthetic and not from a natural source.
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Heroin Detox
Detox
Heroin Detox
Prescription opioids can be the gateway to heroin use as approximately 3 out of 4 new heroin users report the use of opioids before heroin. Because it is cheaper and more available, it has become an appealing alternative as prescription opioids have become increasingly expensive and difficult to obtain.
Detoxing from heroin can be dangerous and challenging without proper management by a medical professional. While the withdrawal itself is not lethal, many of the mental and physical effects can be deadly. An inpatient detox program will provide the best chance to achieve sobriety. It alleviates the physical symptoms that lead many people back to using to relieve physical withdrawal symptoms.
Medication-Assisted Detox and Therapy for Heroin Addiction
Anti-nausea, antidepressants, and anticonvulsants may be prescribed during detox. In addition, some drugs are specific to easing the symptoms of a heroin detox by addressing the physical and emotional effects of withdrawal and cravings.
- Methadone: a mild opiate, is used to help taper off the use of heroin.
- Subutex/Buprenorphine: helps reduce physical withdrawal symptoms such as muscle aches and vomiting
- Vivitrol/Naltrexone: hinders the receptors in the brain that react to opioids/opiates and is most beneficial to those who have completed a heroin detox
- Suboxone: Combines buprenorphine combined with naloxone to treat symptoms and hinder brain receptors that react to opioids/opiates.
Detox usually lasts about 5-7 days and is ideally begun before heroin has entirely left the system. Depending on how long or how much one has used heroin, a longer detox might be appropriate. When admitted to an inpatient program, an individual’s physical and emotional health are closely monitored throughout the process.
Heroin Withdrawal
Heroin directly affects the central nervous system, increasing levels of pleasure in the brain. During withdrawal, an individual experiences an opposite effect as the decrease in dopamine levels that result in depression-like feelings.
After continued use, a person quickly develops physical tolerance and dependence, meaning a greater amount of the substance is necessary to achieve the same high, and one needs to use the drug regularly to feel “normal.”. Since heroin is a short-acting opiate, withdrawal symptoms can surface as early as 6 to 12 hours after the substance leaves an individual’s body.
Immediate withdrawal symptoms are incredibly intense, often making it easy to relapse and potentially overdose. Symptoms include:
- Flu-like symptoms
- Shaking
- Muscle spasms
- Nausea and vomiting
- Sweating
- Anxiety
- Diarrhea
- Dilated pupils
- Abdominal cramping
- Severe dehydration
- Asphyxiation
The most challenging physical withdrawal period is usually the first week, with the most intense symptoms occurring on days two and three. However, the length and severity of withdrawal are heavily dependent on many factors. Factors include:
- Frequency of use
- Length of time of use
- Amount of heroin used
- Method of use
- Underlying medical or psychological conditions
Even after the initial withdrawal symptoms subside, a person can experience post-acute withdrawal symptoms (PAWS) for up to 18-24 months after the last use. These intermittent symptoms are the result of the changes occurring in the brain from the use of heroin. These include:
- Anxiety
- Depression
- Fatigue
- Irritability
- Insomnia
- Poor concentration
- Mood swings
- Panic attacks
- Memory loss
Heroin Withdrawal Timeline
Each individual who stops heroin use will experience withdrawal differently. However, for reference, here is a general timeline of what one might expect:
Days 1-2: Withdrawal symptoms appear as soon as 6 hours after heroin leaves the body. These can include muscle aches, anxiety, and insomnia.
Days 3-5: Symptoms become much more intense and can include nausea, vomiting, and abdominal cramping
Days 6-7: While acute symptoms generally taper off, signs of fatigue and exhaustion will still be present
Post-Acute Withdrawal Symptoms (PAWS): These symptoms can continue to appear months after acute withdrawal is complete and can last up to 18-24 months and include anxiety, depression, and fatigue.
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Medical Disclaimer: Dignity Healing uses fact-based content about recovery treatment, addiction medicine, and behavioral health conditions in order to improve the quality of life for those struggling with drug and alcohol addiction or mental health disorders. While the information provided is researched and reviewed by licensed medical professionals, it is not intended to replace professional medical guidance, diagnosis, care, or treatment. This information should not be used as a substitute for advice from a qualified healthcare provider and/or your physician.