Heroin (diacetylmorphine) is commonly referred to as “H“, horse, brown, black, tar, and smack. It is an opioid analgesic that was originally created by C.R. Alder Wright in 1874 when he added two acetyl groups to morphine. Heroin by itself isn’t an active drug, however when it enters the human body, it gets converted into morphine. It becomes extremely addictive due to the sedative effect it has on the opioid receptors of the brain. It is usually ingested via injection, snorting, and sometimes by smoking.
Although the drug itself is considered highly addictive, many people also become addicted to the ritual associated with self-administration. Heroin is a Schedule 1 drug in the United States – meaning that under no circumstances can anyone receive a prescription for this drug. Additionally, it has such a high potential for abuse that it is illegal to possess or distribute heroin. Some individuals use heroin to help ease chronic pain symptoms, while others use it simply as a recreational drug experience.
Due to the fact that the addiction potential is high, many people have tried to withdraw from heroin without success. In most cases, chronic users need some sort of intervention and professional help in order to successfully come off of this drug. Practitioners will generally recommend trying something like opioid replacement therapy – which involves using a partial-opioid agonist like Suboxone or Methadone to help ease withdrawal symptoms. With that said, many people have successfully kicked the habit of heroin.
Factors that influence Heroin withdrawal include…
If you are planning on withdrawing from heroin, there are some factors that may play a role in influencing the severity of your symptoms. These factors include things like: time span over which you have used, your individual tolerance, addiction, personal factors, and whether you decide to quit cold turkey.
1. Time Span
How long have you been using heroin? Most individuals that have been using heroin for a long term on a consistent basis are going to have a more difficult time coping with the withdrawal. People that have used heroin for a shorter duration are more likely to have an easier time coming off of this drug with the proper intervention and/or professional help. The longer you use this drug, the more likely it is that you have developed a greater tolerance and dependence – thus making it more difficult to quit.
2. Dosage (5 mg to 60 mg) / Tolerance
People that have been using heroin on a consistent basis for an extended period of time have likely built up some sort of tolerance. When people start using heroin, they tend to use just enough to get them a high. They keep chasing their first high by using more and more – which further increases their tolerance.
The method of usage also may play a role in determining how addicted someone becomes. In general though, people that are dosing at the higher ends of the spectrum (40 mg to 60 mg) will likely have a more difficult time withdrawing because they clearly have built up a tolerance.
3. Addiction / Dependence
How addicted to heroin are you? Since this is a Schedule 1 drug, most people become highly addicted. It is addicting because it gives a person a high unlike anything they’ve ever experienced. A person may start to use heroin as an escape from reality and turn to it consistently just to cope with the everyday stressors of life.
This is one of the most addicting drugs (arguably the most addicting) and a person who takes it can quickly become dependent. If you have been addicted for a long time, the withdrawal symptoms that you experience may be more severe than someone who recently started using.
4. Individual Factors
Many individual factors play a role in determining how easy or difficult it is for you to withdraw from heroin. Certain people have such a tough time during the acute stages of withdrawal that they simply cannot help but using the substance again. Other people have good social support networks, professional support, etc. and are able to kick the habit.
It is thought that individuals with less addictive personalities and lower sensitivity to withdrawal symptoms recover the fastest. Additionally people that have healthy habits such as: daily exercise, eating healthy, etc. are thought to experience a quicker recovery.
5. Cold Turkey vs. Tapering vs. Replacement Therapy
How do you plan on quitting heroin? Are you going to quit cold turkey and face the most severe symptoms head on? Or would you rather conduct a gradual taper? Most people that attempt to quit by tapering have a difficult time restraining themselves and gradually weaning off of the drug simply because it is highly addicting.
Once a tolerance has been established, a person will have a difficult time gradually cutting the dose – in fact, most people want to continue increasing their dose. For this reason, a more viable option is to consider getting professional help and/or possibly trying opioid replacement therapy. Replacement therapy involves transitioning to a less-powerful opioid drug such as Suboxone or Methadone and working with a doctor to gradually transition off of it.
It should be noted that although quitting cold turkey is difficult, many people have had to deal with symptoms without any opioid replacement (e.g. people that get thrown in jail). It is thought that quitting cold turkey results in the most intense symptoms, but some have argued that it’s the best way to quit.
Heroin Withdrawal Symptoms: List of Possibilities
Below are some common symptoms associated with heroin withdrawal. If you’d like further information regarding opiate withdrawal symptoms, be sure to talk to a professional. Keep in mind that the list of symptoms below may not affect everyone equally. Some people may experience a less severe withdrawal than others.
- Anxiety: The anxiety that you experience when you first quit heroin may be very extreme to the point of panic attacks. You may be so anxious that you feel nervous everywhere you go and during every activity. Realize that this is merely a symptom of withdrawal and will improve over time.
- Body aches: Most people experience body aches and pains when they quit heroin. In part this may be due to the fact that the body’s natural endorphins have become depleted. In part these aches are due to the acute withdrawal, but they also may be due to low endorphin levels.
- Chills: You may feel chilled for the first couple weeks when you quit using this drug. If you find yourself feeling excessively chilled, just know that it’s a common symptom.
- Cravings: Most people experience intense cravings to use heroin at some point during withdrawal. You may experience both physical and psychological cravings – your body craves the drug for functioning and you would feel better psychologically with it. It is important to focus on recovery and taking things one day at a time. The longer you are off heroin, the more your cravings will subside.
- Cramps: Some people experience intense cramps around their body. Perhaps the most obvious area to experience cramps is in the abdominal region.
- Crying spells: A person may cry excessively as a result of experiencing extreme depression during withdrawal. Another type of “crying” that a person withdrawing from heroin may experience is that of “watery eyes.” May people cannot help that their eyes water excessively during withdrawal.
- Depression: During the first few weeks of withdrawal, depression may hit you hard. The initial depression may be very intense and make life difficult to cope with. You may feel completely hopeless and suicidal. Just know that the depression will get better and you will recover.
- Diarrhea: Using heroin and other opiates tends to result in constipation. When you come off of the drug, one extremely common withdrawal symptom is that of diarrhea. The diarrhea may be pretty extreme so it is recommended to take some Imodium (available over-the-counter).
- Dilated pupils: Since using an opiate like heroin results in constriction of the pupils, when you stop using the drug, your pupils may dilate. To someone that doesn’t know what’s going on, they may appear excessively large.
- Dizziness: A very common withdrawal symptom from any drug is that of dizziness. You may feel especially dizzy during the first few days of functioning without the drug. This will usually improve within a couple of weeks.
- Fatigue: If you feel excessive fatigue, just know that it is completely normal. You are likely going to have no energy or very limited energy during withdrawal. After weeks pass, you should notice gradual improvements in energy levels.
- Flu-like symptoms: The combination of the aches, chills, sweats, and diarrhea can make the withdrawal feel eerily similar to experiencing the flu. Most people will report flu-like symptoms that can be difficult to cope with while they last. Just know that these physical symptoms will eventually pass as your body adjusts to being sober.
- Headaches: Some people experience significant headaches when they quit heroin. These headaches may be light or intense – it totally depends on the person. Do what you can to ease the pain that you are experiencing by drinking plenty of water, relaxing, and considering OTC headache relief.
- Insomnia: It is common to experience insomnia when you stop heroin. The insomnia may be difficult to cope with. Many doctors prescribe a medication like Clonidine to help with insomnia and other symptoms. In any event, you can expect to have a skewed sleep cycle for awhile.
- Irritability: You may become very irritable when you quit using heroin. People around you may notice that you are acting very aggressive and that you are difficult to socialize with. Your best bet for coping with irritability is be conscious of it, and do your best to not to get too caught up in your emotion.
- Itching: Many people report itchiness all over their body when they stop heroin. The itches can be extremely uncomfortable and there really isn’t a major solution for this problem. Some have suggested that taking baths can help ease the itches.
- Mood swings: You may notice that you are subject to crazy mood swings when you stop this drug. One minute you may feel agitated and aggressive, the next you may feel completely depressed and hopeless. Usually you will not experience too many positive “moods” during the early stages of withdrawal, but as you stay sober, you will begin to notice some good days and your mood stabilizing.
- Nausea: This is an uncomfortable symptom that most people experience coming off of drugs, including heroin. The nausea may be relatively minor for some people, but for others it can be extreme enough to lead to vomiting.
- Runny nose: In addition to having watery eyes, another common physical symptom associated with heroin withdrawal is a runny nose. It may be beneficial to keep some tissue around because you may need to continuously blow your nose.
- Sleep changes: During withdrawal most people notice changes in their sleep patterns. A person may have insomnia for a period of time, then feel extremely tired and have to sleep for a long period of time. You may find yourself getting excessively tired during the day and then have problems sleeping steady throughout the night.
- Sneezing: A person may find themselves sneezing excessively during withdrawal. After a few weeks this symptom should ease up. In other words, you won’t be sneezing as often once you have allowed some time to pass.
- Suicidal thoughts: For some people, the depression that they experience during withdrawal becomes overwhelming. It may lead to a person experiencing suicidal thoughts. If you feel suicidal, talk to someone and get yourself some help. On the same token, realize that your emotions will improve.
- Sweating: You may experience profuse sweating when you first come off of this drug. You may find yourself sweating all day and throughout the night. Just know that this is a very common symptom and that over time, you will sweat less.
- Tiredness: Excessive lethargy and tiredness is very common when you stop using heroin. In people that have used this drug consistently for a long term, the tiredness may be unbearable. You may want to sleep all day during the first week or so of withdrawal.
- Vomiting: To go along with the flu-like symptoms, some people actually vomit when they stop taking heroin. This is their body’s natural response to functioning without a drug that it has become dependent upon.
- Yawning: Many people report excessive yawning when they withdraw from opiates like heroin. The yawning may last for an extended period of time even after the heroin is fully out of your system. Some people have reported yawning up to a month after their last dose of heroin.
Heroin Withdrawal Duration: How long will it last?
As was already mentioned, there are a number of different factors that influence withdrawal from heroin. In most cases, the acute symptoms of withdrawal will be very difficult to deal with for the first couple weeks. Heroin has a half life of 2 to 3 hours, meaning that the drug leaves your body pretty quickly. The severe physical withdrawal symptoms typically clear up within a couple weeks of being off of heroin (i.e. about 10 days).
Most people experience the most difficulties dealing with what is referred to as “PAWS” (post-acute withdrawal syndrome). This refers to symptoms that a person experiences long after the drug is out of their system. Usually these post-acute withdrawal symptoms manifest as psychological symptoms, but they can also be physical ones. Post-acute symptoms are a result of your brain and body trying to recover and reset their homeostatic functioning after powerful and/or extensive drug usage.
If you are having a very difficult time dealing with symptoms, it is advised to consider seeking the help of a therapist and/or professional to talk about what you are experiencing. If the social support isn’t enough, you may want to seek the help of a psychiatrist, who could prescribe medications such as: Clonidine, Xanax, and/or Suboxone (for replacement therapy) to help cope with symptoms. Understand though that getting on another drug to help with heroin withdrawal may result in you becoming addicted to the new drug – therefore some individuals do not recommend going this route.
Perhaps the best thing you can do for yourself is recognize the symptoms that you are experiencing, and realize that they will eventually go away. Some people find it beneficial to talk to others on forums that have gone through the same thing. You may want to turn to a forum and post your progress and/or interact with others that are also facing the same problem so that you can get some more personal advice. If you would like to share your experience in the comments section below, feel free to do so – you may really help out someone else.