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Heroin Withdrawal Symptoms, Timeline, Addiction & Treatment

Heroin Withdrawal: What is Heroin?

Heroin is a drug that reaches the brain very fast once it’s consumed, for this reason, it is very easy for a person to develop heroin addiction even from one or a few uses. Before we get to the main topic, let’s learn about what heroin is. According to the scientific piece ‘Heroin’, published by The National Library of Medicine, “Heroin is a white or brown powder or a black, sticky goo.

It’s an opioid drug made from morphine, a natural substance in the seedpod of the Asian poppy plant. It can be mixed with water and injected with a needle. Heroin can also be smoked or snorted up the nose. All of these ways of taking heroin to send it to the brain very quickly. This makes it very addictive.

Heroin Withdrawal
Heroin Withdrawal: Heroin is a drug that reaches the brain very fast once it’s consumed, for this reason, it is very easy for a person to develop heroin addiction.

Regular use of heroin can lead to tolerance. This means users need more and more drugs to have the same effect. At higher doses over time, the body becomes dependent on heroin. If dependent users stop heroin, they have withdrawal symptoms. These symptoms include restlessness, muscle and bone pain, diarrhea and vomiting, and cold flashes with goosebumps”. [1]

What Is Heroin Withdrawal?

Heroin impacts the brain reward system, increasing the user’s tolerance to the drug’s effects over time. The user eventually needs higher doses to reach the same “high” as before. When someone addicted to heroin stops using, withdrawal symptoms set in.

People battling addiction often keep using it to avoid painful symptoms of heroin withdrawal. Abusing heroin produces effects similar to painkillers like oxycodone and hydrocodone, only stronger. Withdrawal from heroin is often more intense than prescription painkillers.

Heroin Withdrawal Symptoms

Users begin experiencing heroin withdrawal between 6 and 12 hours after their last dose. Withdrawal from heroin may resemble those of prescription opioids. Because heroin leaves the user’s system faster than painkillers do, withdrawal comes about more quickly. Withdrawal often feels like a horrible case of the flu. The worst pain and discomfort lasts a week — about as long as a bad flu — with withdrawal symptoms peaking during the second or third day.

Heroin Withdrawal
Users begin experiencing heroin withdrawal between 6 and 12 hours after their last dose.

Common symptoms of withdrawal include:

  • Nausea and vomiting
  • Insomnia
  • Agitation
  • Diarrhea
  • Dilated pupils
  • Sweating
  • Anxiety
  • Abdominal cramping
  • Muscle aches

Duration Of Heroin Withdrawal

The length of heroin withdrawal from heroin depends on several factors. Some of the most important include:

  • The length of time the user abused heroin
  • The amount of heroin they took each time
  • How frequently they used heroin
  • The method by which they took heroin
  • The presence of underlying medical or mental health issues

Depending on the level and length of use, recovering heroin addicts are likely to suffer post-acute heroin withdrawal symptoms (PAWS), including poor sleep, poor concentration, increased anxiety, depression, panic attacks, fatigue, hypersensitivity, irritability, mood swings, restlessness, and memory loss. PAWS can last anywhere from 18-24 months. The effects on mood and behavior can last months after other withdrawal symptoms pass. However, as time goes by and the user remains drug-free, the symptoms will slowly begin to diminish.

Heroin Withdrawal Timeline

  • Days 1-2: Symptoms may begin as soon as 6 hours after the last dose. Pain will start to develop on the first day, typically muscle aches. These will intensify over the first 48 hours. Other symptoms during this period include anxiety, panic attacks, insomnia, shaking and diarrhea.
  • Days 3-5: By the third or fourth day, heroin withdrawal is in full swing. Symptoms during this time often include abdominal cramping, sweating, shivers and nausea/vomiting.
  • Days 6-7: A week is typically the end of what’s known as acute heroin withdrawal. During this time, the common muscle aches and nausea will taper off. Physically, former users will start to feel more normal though still worn down and tired.

Post-Acute Withdrawal Syndrome (PAWS) Symptoms of heroin withdrawal may continue inconsistently for months after acute withdrawal. These are caused by the neurological changes from heroin use. Common long-lasting symptoms include anxiety, depression, fatigue, insomnia, and irritability.

Heroin Withdrawal: Symptoms of Heroin Addiction 

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing. 

Short-term effects:  

People report feeling a “rush” (a surge of pleasure, or euphoria) when using Heroin. Nevertheless, there are other short-term symptoms of this drug, this can include: 

  • Dry mouth
  • Warm flushing of the skin
  • Heavy feeling in the arms and legs
  • Nausea and vomiting
  • Severe itching
  • Clouded mental functioning
  • Going “on the nod,” a back-and-forth state of being conscious and semiconscious. 

Long-term effects:

People who consume heroin may develop the following conditions over time:

  • Insomnia
  • Collapsed veins for people who inject the drug
  • Damaged tissue inside the nose for people who sniff or snort it
  • Infection of the heart lining and valves
  • Abscesses (swollen tissue filled with pus)
  • Constipation and stomach cramping
  • Liver and kidney disease
  • Lung complications, including pneumonia
  • Mental disorders such as depression and antisocial personality disorder
  • Sexual dysfunction for men
  • Irregular menstrual cycles for women

Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis. [2]

Treatment for Heroin Withdrawal and Addiction 

Treatment for heroin addiction includes medicine treatments and behavioral therapies. In order for a treatment to be effective, it’s important to match the best treatment approach to meet the particular needs of each individual patient. There are medicines being developed to help with the withdrawal process. The FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms.

As stated by the National Institute on Drug Abuse, medicines to help people stop using heroin include Buprenorphine and Methadone. They work by binding to the same opioid receptors in the brain as heroin, but more weakly, reducing cravings and withdrawal symptoms. Another treatment is naltrexone, which blocks opioid receptors and prevents opioid drugs from having an effect. 

Heroin Withdrawal
Heroin Withdrawal: Behavioral therapies for heroin addiction include methods called Cognitive-Behavioral therapy and contingency management.

A NIDA study found that once treatment is initiated, both a buprenorphine/naloxone combination and an extended-release Naltrexone formulation are similarly effective in addiction. Because full detoxification is necessary for treatment with naloxone, initiating treatment among active users was difficult, but once detoxification was complete, both medications had similar effectiveness.

Behavioral therapies for heroin addiction include methods called Cognitive-Behavioral therapy and contingency management. Cognitive-Behavioral Therapy helps modify the patient’s drug-use expectations and behaviors and helps effectively manage triggers and stress. Contingency Management provides motivational incentives, such as vouchers or small cash rewards for positive behaviors such as staying drug-free. These Behavioral Treatment approaches are especially effective when used along with medicines.

Reclaim your life from Heroin Withdrawal and Addiction

Heroin addiction is a serious condition that should not be taken lightly. We Level Up Treatment Center can provide you, or someone you love, the tools to recover from addiction and manage heroin withdrawal with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.


[1] Heroin – National Library of Medicine (

[2] Heroin DrugFacts – The National Institute on Drug Abuse (

[3] We Level Up Treatment Center – Heroin Detox (

[4] We Level Up Treatment Center New Jersey – Heroin Addiction Treatment (