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Heroin Withdrawal Symptoms, Detox, and Addiction Treatment

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What Helps With Heroin Withdrawal?

Heroin is an illicitly manufactured opioid drug and morphine derivative. Both the pain-relieving and the pleasurable properties of heroin are initiated through the drug’s interaction with opioid receptors in the brain. It is most often distributed on the street market as a white or brown powder, which is then commonly dissolved in liquid to be used intravenously. Heroin can also be smoked or snorted. Heroin can relieve pain, reduce anxiety, and create a sense of euphoria.

The acute withdrawal syndrome associated with heroin (and other opioid drugs) is rarely fatal, but it can be sufficiently unpleasant to discourage recovery efforts and trigger immediate relapse. The symptoms associated with opiate withdrawal are also known as dope sickness. Supervised detoxification can help minimize relapse risk while also providing medical assistance in the event of any complications.

Professional, supervised detox can provide a safe, comfortable, and medically monitored environment in which you are able to rid yourself of the drug and its toxic influences. A formally supervised program may include the use of certain medications that lessen the severity of withdrawal symptoms. This type of treatment—involving both the use of medication during detox and the prescribing of a post-detox treatment plan—is called medication-assisted treatment, or MAT. The Substance Abuse and Mental Health Services Administration (SAMHSA) endorses MAT as an effective method of treating heroin and other forms of opioid abuse.

Signs of Heroin Withdrawal

When your body has become dependent on heroin, a number of unpleasant withdrawal symptoms will arise. Physical dependence means that your body has grown so accustomed to being repeatedly subjected to a drug that it begins to function as if it requires it just to feel normal.

The avoidance of withdrawal symptoms frequently motivates continued heroin abuse, even after an individual has resolved to quit. The severity of withdrawal symptoms will depend on a variety of factors, including the average amount, potency, and frequency of heroin having been used prior to the attempt to scale back use or quit altogether. Symptoms of heroin withdrawal include:

  • Agitation.
  • Anxiety.
  • Muscle aches.
  • Insomnia.
  • Sweating.
  • Yawning.
  • Abdominal cramping.
  • Diarrhea.
  • Dilated pupils.
  • Nausea.
  • Vomiting.

What Happens During Heroin Detox?

A supervised detox program generally entails a medically monitored detoxification period designed to ensure comfort, address any physical or psychological complications that arise during withdrawal, and, ultimately, minimize the chance of heroin relapse.

Supervised detoxification may or may not be accompanied by the administration of treatment medication. Medications like methadone and buprenorphine work to decrease the severity of withdrawal symptoms and are associated with lower relapse rates. However, patients can choose to not receive medication.

Intake and Initial Evaluation

The first step for anyone entering a heroin detox program will be intake. This is where you’ll be given a medical evaluation that will help to quantify your level of heroin use and outline an appropriate plan for detox and addiction treatment.

Your evaluation will often include questions such as the following:

  • How long have you been using heroin?
  • What, if any, other drugs are you taking?
  • Do you drink alcohol and, if so, how often?
  • Have you ever received treatment?
  • Do you have other physical and/or mental health problems?

During intake, you’ll be given a thorough physical exam to assess your current health status. Your medical history and physical examination findings, in combination with your general evaluation, will help to guide your treatment, so it’s extremely important to be honest about your health and avoid downplaying your drug use and physical/mental symptoms.

Treatment Plans

Subsequently, tailored treatment options are laid out and goals for treatment are discussed.

Depending on the program and your needs, your treatment plan may incorporate the use of medications to manage withdrawal and cravings. These may include:

  • Methadone—Methadone is a relatively long-acting synthetic opioid agonist medication, most frequently administered for oral use—either in solution or as tablets. A single dose of methadone lasts anywhere from 24-36 hours and facilitates the controlled stabilization of a heroin-withdrawing patient. Methadone maintenance therapy requires users to regularly visit methadone clinics for administration. Methadone is available in a number of doses and, in most cases, its use will be slowly tapered as recovery progresses.
  • Buprenorphine—Buprenorphine is another synthetic opioid, with only partial opioid receptor agonist properties. Like methadone, buprenorphine is most commonly taken orally. It is taken sublingually (under the tongue). Buprenorphine only partially activates the brain’s opioid receptors, providing stabilizing relief from opioid withdrawal but discouraging misuse by introducing a ceiling to the euphoric effects that might otherwise be experienced with a full opioid agonist (e.g. continued heroin use).
  • Naltrexone—A compound that blocks opioid receptors—minimizing the risk of overdose, but potentially precipitating the sudden onset of heroin withdrawal symptoms. After heroin detox is successfully completed, naltrexone may be used in the longer-term to discourage opiate abuse by blocking the pleasurable sensations associated with them. For naltrexone to be effective as a preventative medication, the individual in recovery must be diligent about taking it (either daily by mouth or as a monthly intramuscular injection).
  • Suboxone (buprenorphine and naloxone)—Specifically designed to discourage heroin misuse. When administered properly, the individual will experience the effects of buprenorphine. If crushed and injected, naloxone is released, producing significantly unpleasant withdrawal symptoms.

Opioid agonist treatment drugs (methadone, buprenorphine, Suboxone) will be delivered on a tapered schedule, meaning that the dosage and frequency of administration will decrease over time. The goal is to first rid the body completely of heroin and then to carefully and comfortably rid it of any opioid influence over time. How long this takes depends on the user’s individual reaction to withdrawal symptoms and the tenacity of their opioid dependence.

Precise treatment designs will be tailored to each individual. Physical and psychological assessments, as previously stated, will determine treatment protocols, including types of medications and dosages.

Detoxing From Heroin Without Medication

It’s important to note that you can elect to go through supervised detoxification without medication. Termed “social” detox, this non-pharmacologic approach is available at some inpatient or residential programs. You’ll be given supportive care to help you through the process of withdrawal from heroin and may be provided with natural remedies to ease your symptoms. Good social detox programs will have medically trained staff and quick access to emergency care in the event that they are needed. The main benefit of inpatient social programs is that the environment will be drug- and alcohol-free so that you can begin recovery without environmental relapse temptations.

Post-Detox Addiction Treatment Types

Detox is only the first step in recovery from addiction. Once detox from heroin is complete, treatment can begin. This will typically involve therapy to uncover and address the underlying causes of substance abuse.

Therapy will vary depending on:

Behavioral therapies are the most common therapies, addressing the user’s incentive to start and continue using substances. They may be administered in the form of:

Therapy will also address cravings during and after treatment. Therapy may occur on an inpatient or outpatient basis.

Patients may elect to continue taking medications as part of medication-assisted treatment. Remember, MAT is not just the use of medication; it is medication plus therapy. Medications are used to maintain stability and sobriety, while therapy works to address the reasons behind drug use and build the skills needed to live in recovery.

Why Should I Enter a Heroin Detox Program?

The risks of continuing heroin use are significant and every hit puts you in danger. Treatment can help you clear your body of drugs and begin a new, healthy life.

While it is possible to detox alone, the heroin withdrawal syndrome can be sufficiently intense to trigger relapse, even in the most well-intentioned person.

Supervised detoxification not only ensures physical comfort and safety during the withdrawal process, but it also keeps you safe from relapse and potential heroin overdose.

Heroin Withdrawal Treatment and Rehab

Detoxification from prescription painkillers can occur in an inpatient or outpatient setting. Inpatient detox and treatment provide around-the-clock care and supervision. Given the highly addictive nature of heroin, this kind of treatment presents the best opportunity for recovery.

Inpatient or residential treatment centers provide 24/7 care, as well as varying amenities and comforts. Residential treatment centers commonly offer programs that range from 30 days to 90 days (or longer). They may offer detoxification, medication, and counseling. Certain programs may provide extra amenities and alternative therapies like yoga, meditation, and equine therapy.

If you choose to receive treatment in an outpatient rehab program, you’ll find many of the same benefits, such as trained medical staff, detoxification, and counseling, among others. These services, however, are given periodically, depending on the patient’s schedule.

Outpatient care might not be right for you if you are suffering with a particularly severe addiction or live in an environment with little support and numerous triggers to relapse. If you plan to receive outpatient therapy because you are worried about missing work, talk to your employer about your options—several employers provide paid leave for drug abuse treatment.

How to Find a Heroin Detox Program

You don’t have to continue living with an addiction to heroin. Treatment can start anyone battling a substance use problem on the path to a healthier and happier life. Rehab programs are located throughout the U.S., and a variety of treatment types is available. You can use SAMHSA’s Find Treatment tool to search for facilities. Many state government websites will provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’ Once your state website is located, substance use resources shouldn’t be hard to find, and they should provide further phone contacts for your assistance.

American Addiction Centers (AAC) is a leading provider of addiction treatment programs and has trusted rehabs across the country. Please call us free at to learn more and begin your journey to wellness and happiness.

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