Heroin is an illicit opioid that’s primarily used as a recreational drug, but it can be extremely addictive. If you’ve been using it for several weeks or if you’ve used it several times in high doses, you may experience heroin withdrawal when you try to quit. As an opioid, heroin can have effects all over your body. When you stop using heroin, you may feel unpleasant withdrawal symptoms all over your body as well. But is heroin withdrawal dangerous, and how can it be treated?
Learn more about heroin withdrawal and detox.
Heroin has a high risk for dependence and addiction. It’s unlikely that a single-use will lead to a substance use disorder, but a period of repeated use can cause you to develop a chemical dependence or addiction. Withdrawal symptoms are caused by the chemical imbalance in your brain after you quit a drug it’s gotten used to. When you develop a dependence on heroin, your brain adapts to its presence in your system by adjusting your brain chemistry to achieve a balance around the drug. When you stop using it, your brain chemistry will be thrown out of balance temporarily. While your nervous system and body re-adjust to life without the drug, you’ll experience withdrawal.
How can you tell if you’re dependent on heroin?
Heroin dependence can develop after a period of heavy or consistent misuse. You may be able to tell when you become dependent based on the emergence of withdrawal symptoms when you miss a dose or try to cut back. Other signs of dependence might include:
Heroin causes many of the same withdrawal symptoms that are common with other opioids. Opioids bind to receptors throughout the body. They can cause full-body effects when you take them and when you stop taking them. Heroin causes relaxation, pain relief, and sedation, and you may experience the effects of rebounding when you stop taking it. Rebound symptoms are symptoms that directly oppose the effects of the drug. For instance, since heroin causes sedation and relaxation, you may feel restless during withdrawal. Likewise, as the pain-blocking effects wear off, you may start to feel body aches and physical discomfort. Heroin, like other opioids, can also cause constipation. When you stop taking it, heroin withdrawal can cause diarrhea.
Heroin can also cause a host of other symptoms that are often compared to the flu. Symptoms can include:
These flu-like symptoms can be incredibly difficult to get through on your own without relapsing. They can also be paired with unpleasant psychological symptoms like depression, anxiety, and powerful drug cravings. When extreme discomfort combines with compulsions to use heroin again, relapse can be difficult to resist.
Heroin withdrawal’s first symptoms may show up within the first day after you quit. However, there are many variables that can change your withdrawal timeline. How much did you take in an average dose? How long were you dependent on heroin? How big was your last dose? These variables can make it so that your first symptoms show up as early as six hours after your last doses or as late as 12 hours later. Your symptoms may begin mild and increase in intensity over time. Emerging symptoms could include restlessness, yawning, and a runny nose. As your withdrawal progresses, you may feel like you’re coming down with the flu with body aches, sweating, and chills.
The length of time you experience withdrawal may also depend on several variables, but heroin withdrawal typically lasts between a week and ten days. Your peak symptoms may happen between one and three days. When symptoms peak, they’ll be at their most intense, and you may experience vomiting, nausea, diarrhea, and fever. After they reach their peak, you’ll start to feel better, though it may take several days for some symptoms to go away. The acute withdrawal phase for heroin may end around the seven-day mark. However, symptoms like anxiety, insomnia, and drug cravings may require treatment to effectively address. If these issues are ignored, they can linger for months, eventually leading to a relapse.
Heroin isn’t usually life-threatening during withdrawal, though it’s not completely without danger. Withdrawal causes flu-like symptoms. Like the flu, there are some risks, especially if you don’t seek treatment if you encounter severe symptoms. Some symptoms like vomiting, sweating, and diarrhea can cause you to dehydrate quickly. Dehydration can lead to some serious complications if you don’t drink enough water to counteract it.
For the most part, drinking enough fluids can mitigate the risk of severe dehydration during withdrawal, but there are some circumstances in which dehydration can be a serious threat. If your nausea and vomiting are severe, you may not be able to keep fluids down. If that happens, you’ll need to seek medical attention as soon as possible.
Dehydration can also be dangerous to people that are going through withdrawal without free access to water or fluids. In places without clean water or in prison situations, heroin withdrawal can be deadly because of dehydration. In fact, many fatal cases of heroin withdrawal have been in prison settings in which prisoners are going through withdrawal under the care of neglectful prisons.
Heroin withdrawal can be dangerous in an indirect way. Opioid withdrawal is notoriously unpleasant, and it represents a significant barrier to treatment and sobriety for people with substance use disorders. For people that do attempt treatment, uncomfortable withdrawal symptoms and cravings can make it difficult to achieve recovery, especially if you attempt to go through withdrawal without help. Remaining in active addiction threatens your life every day. Active heroin use is associated with higher risks of infectious diseases, financial instability, social problems, and overdose.
Heroin withdrawal can be treated in several ways. The first step is to speak to a doctor to learn more about your needs in treatment. If you enter an addiction treatment program, you will go through an intake process that will involve a medical assessment. If you are likely to experience severe withdrawal symptoms or if you have other medical needs in addiction treatment, you may need to go through a medical detoxification program. Detox is a level of care in addiction treatment that’s characterized by 24-hour treatment services from medical professionals.
In medical detox for heroin withdrawal, you may receive medications to help treat your symptoms and to increase your comfort through the withdrawal process. In treatment, you may still experience a lot of discomfort, but the risks to your health and well-being will be limited. You’ll also receive support to help you avoid a relapse when you experience moments of weakness and powerful drug cravings.
If you’ve gone through detox a few times before with little success, you may need medication-assisted treatment (MAT) to get out of a pattern of active addiction. MAT involves the use of other opioid medications to help alleviate withdrawal symptoms. Medications like buprenorphine are often used because they can ease drug cravings and withdrawal symptoms without causing intoxicating effects.
People with opioid use disorders that use buprenorphine can go about their lives and attend treatment without needing to find heroin or go through painful withdrawal. MAT often involves a combination of opioid medications and therapy options to address the underlying problems that contribute to addiction. Buprenorphine can also be used to help taper you off of heroin. This process is a lot longer than traditional detox and addiction treatment, so it’s often reserved for people with a history of chronic relapse.
After detox, you may go through the next level of care that’s appropriate for your needs. Detox is an important first step for many people in addiction treatment, but it’s usually not enough to effectively address a severe substance use disorder. If you have high-level medical or psychological needs, you may continue in an inpatient treatment program. Inpatient treatment involves 24-hour medical monitoring or clinical care.
If you’re able to live on your own safely, you can progress to an outpatient program. Outpatient treatment is split into a few categories based on the time you spend in treatment each week. Intensive outpatient treatment involves more than nine hours of treatment services each week. Partial hospitalization programs fall under the category of intensive inpatient treatment and involve more than 20 hours of services each week. Outpatient treatment with less than nine hours of weekly services is often the last stage of formal treatment, but it’s usually recommended that you continue to pursue recovery after treatment ends.
Addiction treatment involves a treatment plan that’s personalized for your needs. It will ideally address multiple issues in your life that are directly or indirectly related to addiction. Treatment may involve individual therapy, group therapy, cognitive-behavioral therapy, and other options.
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