Heroin Withdrawal Symptoms, Timeline & Detox

Written by Jonathan Strum

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

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Last Updated - 9/15/2023

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Updated 09/15/2023

Heroin is a highly addictive opiate drug derived from morphine that can easily and quickly lead to addiction. The high users experience with each hit of heroin causes them to seek the drug more and more often in an effort to achieve a euphoric state. But heroin wreaks havoc on the body and can be extremely difficult to stop using once a habit has been formed. Withdrawal symptoms can seem overwhelming when you try to stop the drug, but these symptoms are easier to overcome with medical help.

Addiction to opiates has become an increasingly serious and devastating problem in the United States. Heroin overdose deaths have been steadily decreasing since 2017, but it still kills thousands of Americans a year. Between February 2022 and March 2023, more than 5,000 Americans died of a heroin overdose.

Anyone who is addicted to heroin and looking to quit is certainly making the right decision, but the road to recovery will be a challenge. It all starts with detox.

During the first few hours and days after quitting heroin use, the body will undergo a series of uncomfortable and sometimes painful symptoms. Intense withdrawal symptoms can increase the chances of relapse. Detoxing from heroin use can even be dangerous if not done in a medically supervised environment.

Symptoms of Heroin Withdrawal

As heroin leaves your system, you will experience a number of physical and psychological effects. How long it takes to get through detox depends on several factors, including your health, how long you have been using heroin and how strong your addiction is. Heroin withdrawal can consist of many different symptoms, including:

Flu-like Symptoms

Flu-like symptoms such as sweating, goosebumps, runny nose and watery eyes are common heroin withdrawal symptoms. These symptoms occur because of the increased release of a neurotransmitter called norepinephrine in the brain during heroin withdrawal. 

Depression, Anxiety and Irritability 

Mood changes like depression, anxiety, irritability and even agitation are typical heroin withdrawal symptoms. Although these mood changes generally resolve within a week of stopping heroin, in some cases, they may persist for weeks or months after stopping the drug.

Muscle Aches and Pains

Heroin withdrawal can often come with muscle aches and pain as the brain and body struggle to adapt to the drug’s absence. Analgesics like acetaminophen (Tylenol) can help relieve these symptoms.

Nausea and Vomiting

Nausea and vomiting are also typical side effects of heroin withdrawal. Although very unpleasant, they are not often dangerous. However, excessive vomiting during heroin withdrawal can lead to complications like dehydration, which can be fatal in serious cases.

Stomach Pain

It is common to experience stomach and abdominal pain during heroin withdrawal. These symptoms are often due to abdominal cramps. To support your recovery, however, it is important to maintain adequate nutrition and hydration throughout withdrawal, even if your stomach is hurting.

Sleeping Issues

People may experience insomnia while withdrawing from heroin. In some cases, insomnia can linger for weeks or months following heroin discontinuation. 


Fever is an uncommon heroin withdrawal symptom in adults and would not generally be expected. However, fever can be a symptom in children undergoing opioid withdrawal.

Other Symptoms

Other heroin withdrawal symptoms can occur and may happen alongside or in place of other withdrawal symptoms. These include:

  • Enlarged pupils
  • Yawning
  • Diarrhea

How Long Does Heroin Withdrawal Last?

Heroin withdrawal is a highly individualized experience. Generally, heroin withdrawal takes less than a week. However, certain symptoms may persist for weeks or months after withdrawal is complete.

Heroin Withdrawal Timeline

Heroin withdrawal does not follow a strict timeline, and withdrawal symptoms can occur at any time during the withdrawal process. However, as a general rule of thumb, heroin withdrawal tends to follow a general timeline:

  • Within 12 hours of the last dose: withdrawal symptoms begin
  • Within 24 to 28 hours of the last dose: withdrawal symptoms intensify
  • Within 3 to 5 days of the last dose: withdrawal symptoms resolve

In some cases, certain withdrawal symptoms may linger for weeks to months. These symptoms include fatigue, anxiety, depression and insomnia.

Detoxing in a Medically Supervised Environment

It can be tempting to quit heroin cold turkey. However, doing so increases your risk of withdrawal symptoms and overwhelming cravings, putting you at risk for relapse. Instead of going through withdrawal and detox alone, entering a reputable detox facility can allow professionals to monitor and treat any withdrawal symptoms you may experience. If necessary, you may receive appropriate medications to help you detox safely and comfortably.

In a medically supervised detox setting, many different medications can be used to treat your withdrawal symptoms, easing your detox and setting you up for long-term success off heroin. If medically appropriate, medication-assisted treatment (MAT) with methadone or buprenorphine products like Suboxone may be prescribed. Other medications may also be prescribed to help you through other withdrawal symptoms, including:

  • Insomnia: Temazepam or promethazine 
  • Nausea: Metoclopramide or prochlorperazine
  • Abdominal cramps: Hyoscine
  • Diarrhea: Loperamide
  • Headaches: Acetaminophen or ibuprofen
  • Agitation: Diazepam

There are plenty of Ohio addiction treatment resources available to help you through the withdrawal phase of recovery. They can guide you to the appropriate treatment facility that will help you finally overcome your substance use disorder.

Call us today to learn about admission to a detox center and treatment facility.

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