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Heroin Withdrawal & Detox

Last Updated: December 21, 2023

Editorial Policy | Research Policy

Heroin withdrawal can be overwhelming, but success is possible with help.

If you or a loved one uses heroin, the prospect of quitting heroin can be overwhelming. The possibility of withdrawal symptoms and cravings can be scary to face, but help is available. Heroin withdrawal can be manageable with medical assistance. By knowing what heroin withdrawal is, you can plan to overcome the detox process and set yourself up for a heroin-free life.

Causes of Heroin Withdrawal

Opioids like heroin can cause a phenomenon called tolerance when taken over time. Tolerance means that your brain has become used to the drug’s presence in your system. When you are tolerant to a drug, you need to take steadily higher doses to get the same effects you did at first. Tolerance often occurs alongside physical dependence, which means that your body now relies on the drug to feel normal.

When you are tolerant and dependent on heroin, stopping or cutting back on the drug can cause your brain chemistry to change temporarily, leading to unpleasant withdrawal symptoms as your body struggles to adjust. Specifically, the locus coeruleus (LC) in your brainstem releases high amounts of the neurotransmitter (brain chemical) norepinephrine during withdrawal. This chemical causes many of the temporary withdrawal symptoms you may experience. 

Heroin Withdrawal Timeline: How Long Does Heroin Withdrawal Last?

Heroin withdrawal symptoms typically last for around a week. That said, everyone has a unique withdrawal experience. Although heroin withdrawal can vary from person to person, it often follows a pattern. The following time frame is common:

  • Onset of Withdrawal: Heroin withdrawal typically starts within 12 hours of the last use as the drug leaves your body. Specific withdrawal symptoms may vary from person to person.
  • Peak Withdrawal: Heroin withdrawal increases in intensity for 24 to 48 hours after the last use. During this phase, your body is attempting to adjust to being without a drug on which it has become dependent.
  • Completion of Withdrawal: Heroin withdrawal typically improves around three to five days after the last use as your body adjusts to being without the drug. That said, certain symptoms like anxiety, depression and sleep problems may linger for weeks or months, improving with time.

Heroin Withdrawal Symptoms

Heroin withdrawal symptoms can occur at any time during the withdrawal process and may vary from person to person. Symptom severity may also vary, with some people experiencing milder symptoms than others. Typical symptoms include:

  • Runny eyes and nose
  • Sweating
  • Goosebumps
  • Yawning
  • Big pupils
  • Agitation 
  • Anxiety
  • Muscle aches 
  • Insomnia
  • Abdominal cramping
  • Diarrhea
  • Nausea and vomiting

When left untreated, heroin withdrawal symptoms can be difficult to manage and may lead to cravings and relapse in severe cases. Fortunately, medical assistance can help alleviate withdrawal symptoms before they become problematic.

Heroin Withdrawal Management

Some people want to try to quit heroin without help. This can mean stopping the drug cold turkey at home. However, trying to quit heroin without help can lead to severe withdrawal symptoms that increase the risk of relapsing. Detoxing with medical assistance is, therefore, the preferred method of quitting heroin.

Quitting Heroin Cold Turkey

Quitting heroin cold turkey means stopping the drug suddenly, even if you have become dependent on a high dose. Due to the brain’s dependence on heroin, the person often experiences intense withdrawal symptoms. As a result, quitting heroin cold turkey is not recommended.

Detoxing from Heroin at Home

Detoxing from heroin at home without help can be very tricky. It is important to consider the challenges that can occur during detox. These can include:

  • Whether a trusted person is available to help monitor your withdrawal symptoms and call for medical help if needed
  • Whether your living environment supports sobriety or would coax you back into heroin use
  • Whether you are prepared for intense withdrawal symptoms and cravings
  • Whether you have food and beverages you can tolerate when feeling poorly to keep your strength up

Overcoming withdrawal symptoms without help is extremely difficult, and experts instead recommend seeking medical assistance for detoxing from heroin.

Medication-Assisted Treatment (MAT) for Heroin Withdrawal

Heroin withdrawal is best done with professional help. For this reason, MAT is recommended to help ease you off heroin and prepare you for a full recovery. MAT combines medications with interventions like therapy to treat your addiction and increase your chances of long-term sobriety. 

The medications used for MAT include both methadone and buprenorphine-based products. Methadone and buprenorphine are long-acting opioids that work by reducing heroin cravings, helping to keep you sober. If you slip up and use heroin while on methadone or buprenorphine, the drugs will block the high you would normally feel from heroin, helping you to avoid using it again.

Methadone is a first-line treatment for opioid addiction that has been around for decades. The drug is taken by mouth and is dispensed from specially licensed outpatient methadone clinics. You obtain methadone from a clinic in person on a daily or near-daily basis.

Buprenorphine is an alternate first-line choice for opioid addiction. Unlike methadone, the drug is not only available as an oral dosage form but also as a long-acting injection. Also, unlike methadone, oral forms of buprenorphine can be dispensed from any pharmacy. However, injectable forms of the drug must be administered in a doctor’s office.

Other medications can also be used as add-on treatments to help you overcome withdrawal. These medications include acetaminophen or ibuprofen for pain.

Deciding on Where to Detox in Kansas City

It is important to choose a medical detox facility that can meet your needs as you plan your heroin-free life. Factors to consider include staff experience with heroin and the available levels of care. At The Recovery Village Kansas City Drug and Alcohol Rehab, we have a personalized 16-bed medical detox unit and offer various heroin addiction treatment options to support your recovery after detox. This includes residential rehab and aftercare options to help you stay heroin-free for life. Contact us today to learn how we can help you get on the road to recovery from heroin.


American Society of Addiction Medicine. “National Practice Guideline for the Treatment of Opioid Use Disorder.” December 18, 2019. Accessed December 18, 2023.

Substance Abuse and Mental Health Services Administration. “Protracted Withdrawal.” July 2010. Accessed December 18, 2023.

World Health Organization. “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.” 2009. Accessed December 18, 2023.

Kosten, Thomas R.; George, Tony P. “The Neurobiology of Opioid Dependence: Implications for Treatment.” Addiction Science and Clinical Practice, July 2002. Accessed December 18, 2023.

U.S. Department of Justice, Drug Enforcement Administration. “Drugs of Abuse.” December 2022. Accessed December 18, 2023.