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Heroin Withdrawal | Timeline, Symptoms, Detox

Heroin use is a growing epidemic in the United States. In fact, the use of heroin in the U.S. nearly doubled between 2007 and 2012. Most experts agree that the rise in heroin addiction stems from the abuse of narcotic painkillers, such as Oxycontin and Vicodin. However, because heroin is cheaper and often easier to get than prescription medications—despite that it is illegal— use of the drug, and subsequent addiction and overdose, continues to increase. 

Users are lured into using heroin because it creates a strong high or a sense of euphoria. But soon the body becomes dependent on the drug, causing unpleasant side effects and cravings. Because of this, heroin withdrawal can be hard to do on your own. Understanding the heroin withdrawal process and getting professional medical treatment can help increase your chances for a successful recovery from heroin addiction. 

What Are the Heroin Withdrawal Symptoms?

Heroin withdrawal symptoms are not life-threatening, but they can be very uncomfortable.

Symptoms of heroin withdrawal usually begin within about 12 hours after last using the drug and may include:

  • Sweating
  • Teary eyes
  • Runny nose
  • Frequent urination
  • Diarrhea
  • Abdominal cramps
  • Nausea
  • Vomiting
  • Muscle spasms
  • Headaches
  • Bone pain
  • Dilated pupils
  • Elevated blood pressure
  • Irregular heartbeat
  • Dysphoria
  • Anxiety
  • Irritability
  • Insomnia
  • Craving opioids
  • Piloerection (“goosebumps”)

What Are the Stages of the Heroin Withdrawal Timeline?

Heroin withdrawal symptoms usually begin within about six to 24 hours after last use. The most severe physical symptoms occur around days two to four and start to lessen by day seven. Psychological symptoms such as depression, anxiety, insomnia, and an increase in cravings for the drug may last for several weeks or even months. While heroin withdrawal is not life-threatening for people who are otherwise healthy, other coexisting conditions, whether medical or psychiatric, may make the process a little more complicated. Stages of heroin withdrawal include:

Early heroin withdrawal symptoms

  • Anxiety
  • Cravings for the drug
  • Increased respiratory rate
  • Sweating
  • Yawning
  • Tearing
  • Runny nose
  • Dilated pupils
  • Stomach cramps

Later heroin withdrawal symptoms

  • Goosebumps
  • Tremors
  • Muscle spasms
  • Irregular heartbeat
  • High blood pressure
  • Fever and chills
  • Anorexia
  • Nausea
  • Vomiting
  • Diarrhea

This timeline may vary depending on certain factors. Factors and complications that might affect the stages of heroin withdrawal include:

This timeline may vary depending on certain factors. Factors and complications that might affect the stages of heroin withdrawal include:

  • Aspiration, which means vomiting and then breathing the contents into the lungs. Aspiration can result in a lung infection.
  • Dehydration as a result of vomiting and diarrhea, which can disturb the body’s electrolyte balance.
  • Returning to drug use after withdrawal, which can easily result in overdose due to the body’s lowered tolerance to the drug.
  • Withdrawing from more than one substance
  • Co-existing medical or psychiatric conditions

Why Should I Detox?

Withdrawing from heroin can be difficult, and quitting “cold turkey” can actually put you at risk of complications or abandoning the withdrawal process. A professional, medically assisted detox program ensures that you are carefully monitored in a safe environment while your body goes through the difficult, and sometimes painful, detoxification process as it eliminates the physical need for the drug. Your medical team can administer medications to help relieve the cravings and make sure your body has enough fluids and electrolytes. Your team will also provide professional mental and emotional support during this challenging time to help make the withdrawal process successful.

What Is the Next Treatment Step?

Addiction treatment for heroin follows three standard steps or stages: detox, residential, and outpatient. Once patients have completed the treatment program, they are considered alumni. Following a structured program under the guidance of an experienced treatment team is critical to achieving a safe, successful heroin withdrawal process. Here are descriptions of each level of heroin withdrawal treatment:

During the first stage of heroin withdrawal treatment, the goal is to achieve medical stabilization with a detox. The medical team, which includes doctors, nurses, and support staff, will give you a complete medical assessment to determine your level of addiction and any additional medical needs you may have. The assessment will include a medical exam and urine or blood tests to screen for drugs. Depending on these results, your physician may also require additional testing such as additional blood tests, including a CBC (complete blood count), chest X-ray, ECG (electrocardiogram), and testing for other diseases, including HIV, hepatitis C, and tuberculosis (TB) because many people who abuse heroin and other opioids intravenously also contract these diseases.

Once the doctor has these test results, a detox plan will be created for you. Then, under the care of your medical team, you will begin the detox process. Detoxing includes a combination of detox medications, such as methadone, buprenorphine, clonidine, and naltrexone, as well as emotional support as you begin addiction therapy. 

Once you have completed the heroin detox, the next stage is to continue treatment in an inpatient, or residential, facility. You’ll live full-time at the residential treatment center while undergoing a supportive, rigorous, and structured treatment program at least five days a week. This program will address your emotional and mental health needs to help you begin the process of returning to your life outside the treatment center. Learning positive life skills, coping mechanisms, and techniques to help prevent relapse is critical during this stage so that you will be better prepared for long-term recovery. 

After you have finished inpatient treatment, you will then transition into an intensive outpatient program, which may include partial hospitalization. This stage of your journey provides key counseling and treatment services you may need as you return home. Emphasis is placed on continuing to build life and coping skills and relapse prevention education so that you can develop a healthy routine and enjoy your day-to-day life. You may enter partial hospitalization (PHP) as part of the outpatient process. 

Partial hospitalization allows patients to live in on-campus apartments under less supervision as they begin to ease into the goal of moving home. PHP allows more independence after completing the inpatient detox and therapy program, but it still requires daily treatment and therapy programs five days a week, usually for at least six hours per day.


Once you have completed the treatment program, you will have the opportunity to join other treatment center alumni for aftercare, including weekly support groups and social events. These opportunities to meet other program graduates can help you develop new friendships and build social support as part of your goal for long-term recovery success.

Start Your Journey to Recovery Today

Overcoming a heroin addiction may seem daunting. But there is hope with Ocean Breeze Recovery. Contact our admissions specialists for free and confidential help. They’re here to listen and walk you through the process so that you know what to expect from our evidence-based services. Once you speak with a specialist, you will feel prepared to make an informed decision about your plans for treatment.

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Our specialists can also check with your private health insurance to see if your treatment costs will be fully covered. Remember, you don’t have to do this alone. Call us today at 844-554-9279 or reach us online, and let us help you get started on your journey to recovery.


WebMD. (2018, May 20) Heroin: What You Need to Know. Retrieved from

NIDA. 2020, May 29. What is the scope of heroin use in the United States? from

Merck Manual. (2018 March) Opioid Toxicity and Withdrawal. O’Malley, G.., & O’Malley, R. Retrieved from

U.S. National Library of Science. (2018, November 13) MedlinePlus. Opiate and Opioid Withdrawal. Retrieved from

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