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Heroin Withdrawal Timeline and Duration of Symptoms

Heroin Withdrawal Timeline and Duration of Symptoms

Approximately 948,000 people used heroin in 2016 – driven largely by young adults ranging from 18-25 years of age. 170,000 of these users tried the drug for the first time in 2016 – almost doubling the number of new users from the year before.

Heroin can cause physical and psychological dependence of users, and the body quickly becomes tolerant of the effects. When a heroin user stops or cuts back for a short period, they will experience withdrawal symptoms that can be incredibly uncomfortable. Heroin withdrawal can vary from person to person, however, some symptoms are found to be universal.

How Long Before Users Experience Withdrawal?

Physical heroin dependence can vary depending on the person. The amount consumed, previous addiction, age, gender and frequency of use can play a large role in how fast heroin will become all-consuming. Once addicted, a heroin user will experience withdrawal soon after the effects of heroin subside.

Between 8-24 hours from last use, users experience:

  • Anxiety and agitation
  • Muscle pain
  • Insomnia
  • Runny nose and watery eyes
  • Sweating
  • Yawning

In peak withdrawal (24-48 hours), symptoms are more severe and slowly worsen over the course of this phase. Symptoms such as diarrhea, sleeplessness and agitation are common. The adverse reactions may be lessened with the help of medical intervention.

Peak withdrawal symptoms include:

  • Stomach cramps and diarrhea
  • Dilated pupils
  • Goosebumps
  • Nausea and vomiting
  • Sensitivity to stimuli

Certain medications can be used to help alleviate the symptoms of withdrawal for patients, including FDA-approved Lofexidine (brand name Lucemyra), Clonodine (for anxiety) and Methadone (for craving and pain control). Additional medications can be used to combat individual symptoms as they arise. Intravenous fluids may be used to prevent dehydration, certain sleep medications are safe to help with restlessness, and some analgesics or compresses can help with aches.

How Long Do Withdrawal Symptoms Last?

Late symptoms can last up to 10 days from the last use. These symptoms will slowly become less harsh, although the process is still very difficult. While the symptoms of heroin withdrawal can be agonizing, they are not deadly. But some users are so put off by the prospect of an aggressive withdrawal, they avoid treatment altogether, or relapse later, which can lead to death.

It is believed that by alleviating these symptoms, the likelihood of relapse and overall success will be improved. The severity of withdrawal depends on the amount of heroin normally consumed, and how frequently. Different types of heroin, such as black tar or white powder, can impact the length of time spent in active withdrawal. If the drug is commonly mixed with other substances like cocaine (often called a “speedball”), withdrawals may be intensified or take longer to overcome.

Tests and Monitoring for Medically-Assisted Withdrawal

A physician will need information regarding your medical history and drug use. A physical exam will be performed, and a drug screening will allow your provider to see what needs to be done. Your physician may request further testing to provide the best care and rule out any hurdles you may face in treatment.

Some of the tests your provider may administer include:

  • Blood panel and liver function testing
  • A complete blood count to determine the red and white blood cells/platelets
  • Chest X-ray
  • Electrocardiogram (heart tracing)
  • Hepatitis C, HIV and tuberculosis screening

After your initial exam, treatment options will be decided. The easiest and safest course is often chosen to make withdrawal and detox as comfortable as possible. Your provider will link you to other support and help you to make sense of your treatment goals. Medical monitoring can help the rehab staff see how your body reacts to detox, and treat problems accordingly.

Withdrawal Safely

Attempting to detox from heroin without the help of medical professionals can be very dangerous. An effective, safe recovery requires medicine, counseling and all-around support. If you or a loved one is struggling with heroin addiction, we’re here to help you find relief. Contact our friendly staff for advice, contacts and resources for a safe and healthy recovery.


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