Heroin Withdrawal and Detox

Written by Jonathan Strum

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

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Last Updated - 1/17/2023

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Updated 01/17/2023

Going through heroin withdrawal on your own can be difficult, but a medically assisted detox program can make the process much easier to handle.

Heroin withdrawal symptoms can be incredibly uncomfortable and even dangerous in some cases. Often, these discouraging symptoms are what prevent people from quitting this powerful drug and finding lasting sobriety.

Fortunately, there are effective ways to safely detox from heroin, avoid difficult withdrawal symptoms and begin the recovery journey. The following provides an overview of heroin withdrawal symptoms, why they occur and how you can safely overcome them through professional rehab treatment.

Heroin Withdrawal

Opioids are powerful drugs that can lead to physical dependence and psychological addiction. The process typically begins when a person develops an opioid tolerance, meaning their body becomes used to the opioids they are using. The person will need to take higher doses to feel the same effects, and their body and brain may start depending on the drug in order to feel normal and function properly. If the person stops using opioids after developing dependence or addiction, they will experience withdrawal symptoms. 

Opioid withdrawal can be extremely difficult to go through alone, and it’s one of the biggest reasons why people relapse when trying to quit. However, it’s also the reason why medically assisted detox is so effective for people struggling with heroin addiction: these programs make a safer, more comfortable withdrawal process possible.

Heroin Withdrawal Symptoms

  • Everyone has a slightly different experience when ending heroin use. However, the first set of withdrawal symptoms that develop may include: 
  • Yawning
  • Anxiety
  • Muscle spasms
  • Irritability and aggression
  • Muscle aches
  • Sweating
  • Insomnia
  • Runny nose
  • After the initial rush of symptoms, other symptoms that can occur throughout the heroin withdrawal process include:
  • Rapid heartbeat
  • Dilated pupils
  • Diarrhea
  • Paranoia
  • Fatigue
  • Stomach cramping
  • Nausea and vomiting
  • High blood pressure

Heroin Withdrawal Timeline

Heroin withdrawal can begin eight to 12 hours after the last heroin dose.

Symptoms often worsen over the next two to three days, then resolve over the next seven to 10 days. However, the timeline can be longer or shorter based on factors like age, weight, frequency and length of heroin use, dose amounts and more.

Medication for Withdrawal Symptoms

Heroin detox medications are able to help with both psychological and physical symptoms of withdrawal. The most common types of medications used for heroin detox and treatment include methadone and buprenorphine, which can be used to help people gradually taper off opioid use. In many cases, however, naltrexone may be a better choice than either medication. This is because it isn’t habit-forming, it reduces cravings for heroin and it prevents people from getting high if they relapse.

Other medications may also be provided to help relieve certain withdrawal symptoms. Symptoms and their treatments include:

  • Insomnia: Temazepam or promethazine 
  • Nausea: Metoclopramide or prochlorperazine
  • Abdominal cramps: Hyoscine
  • Diarrhea: Kaolin or loperamide
  • Muscle cramps: Quinine
  • Headaches: Acetaminophen or ibuprofen
  • Agitation: Diazepam

Heroin Detox Options

Heroin detox is the process of eliminating heroin from the body. It can last as long as it takes for withdrawal symptoms to subside — around seven to 10 days — although the exact duration can vary depending on the person.

Detox is a necessary part of quitting heroin. However, complications like uncomfortable withdrawal symptoms and extreme cravings can tempt a person to relapse.

Trying to quit heroin at home without medical supervision can be challenging. Without medical support, withdrawal symptoms can become overwhelming and cravings may lead to relapse.

View Sources

American Society of Addiction Medicine. “National Practice Guideline for the Use […]nvolving Opioid Use.” June 1, 2015 Accessed November 29, 2021.

U.S. National Library of Medicine. “Opiate and opioid withdrawal.” MedlinePlus, November 23, 2021. Accessed November 29, 2021.

World Health Organization. “Clinical Guidelines for Withdrawal Manag[…]e in Closed Settings.” 2009. Accessed November 29, 2021.

National Institute on Drug Abuse. “What are the immediate (short-term) effects of heroin use?” June 2021. Accessed November 29, 2021.


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