A Complete Guide to Heroin Withdrawal and Detox Process

Heroin addiction has been a healthcare issue for a long time in the United States. According to the Substance Abuse and Mental Health Services Administration (SAMHSA ¹), in 2023, approximately 660,000 individuals aged 12 or older reported using heroin in the past year. It shows the severity of heroin use disorder in the U.S. population. Now the question is: what makes heroin so highly addictive?

ChoicePoint heroin rehab in NJ can help you overcome heroin addiction through treatment. Get in touch with us today at 844.445.2565.

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Why Consider Heroin Withdrawal Treatment?

A person who is addicted to heroin and stops using it or reduces the amount will start experiencing withdrawal symptoms within a few hours. These symptoms are very severe and can even be fatal when not supervised by a professional. The most common heroin withdrawal symptoms include anxiety, nausea, vomiting, insomnia, and more. 

Heroin Withdrawal Symptoms

Heroin withdrawal symptoms can be categorized as physical and mental. Both types can also be divided into short-term and long-term symptoms. 

Acute (Short-Term) Heroin Withdrawal Symptoms

• A strong wave of pleasure
• Warm feeling on the skin
• Dry mouth
• Arms and legs feel heavy
• Feeling of itching all over
• Nausea and vomiting
• Drowsiness for hours
• Slowed breathing

Protracted (Long-Term) Heroin Withdrawal Symptoms

• Ongoing sadness or low mood
• Trouble sleeping or staying asleep
• Consistent fatigue
• A general feeling of emotional numbness or emptiness (dysphoria)
• Not enjoying things you used to like doing (anhedonia)
• Easily annoyed or frustrated
• Memory issues
• Difficulty focusing, paying attention, or making decisions
• Strong urges or cravings to use heroin again

Mental and Behavioral Symptoms

• Anxiety and Restlessness
• Depression and Mood Swings
• Insomnia and Sleep Disturbances
• Irritability and Aggression
• Cognitive Difficulties
• Post-Acute Withdrawal Syndrome (PAWS)
• Suspiciousness 
• Delirium 
• Panic Attacks

Free Addiction Assessment

Please note this assessment is an initial self-screening, and it is not meant to be a medical assessment or clinical diagnosis of addiction. For proper diagnosis and treatment, schedule an appointment with ChoicePoint.

4 Stages And Timeline of Heroin Withdrawal

If you are wondering, “How long does heroin withdrawal last?”, the answer is complex. It depends on how long the substance is going to stay in your system, and this further relies on personal factors like:

• Metabolism
• Body weight
• The frequency of usage
• Duration of usage

Below is an average estimate of how long detox may take and what the stages of heroin withdrawal are.

1. Early Withdrawal (6–24 Hours After Last Use)

Heroin withdrawal symptoms typically begin within 6 to 12 hours after the last dose. These symptoms include anxiety, muscle aches, sweating, yawning, a runny nose, and insomnia.

2. Peak Withdrawal (1–3 Days)

After the early withdrawal stage, the symptoms begin to intensify and peak between 24 hours to 72 hours. Nausea, vomiting, diarrhea, abdominal cramps, goosebumps, dilated pupils, and rapid heartbeat are the common symptoms during this stage. This is the most challenging phase, both physically and mentally.

3. Late Withdrawal (4–7 Days)

According to the National Institutes of Health (NIH ²), with proper heroin addiction treatment under the supervision of healthcare professionals, symptoms usually begin to subside after 4 to 7 days. During this stage, emotional symptoms often intensify. Common symptoms during this stage are fatigue, irritability, depression, and continued cravings.

4. Post-Acute Withdrawal Syndrome (PAWS) (Weeks to Months)

This phase is dominated by mental symptoms that may include mood swings, anxiety, depression, disturbed sleep patterns, and persistent cravings. This stage requires continued support and counselling for a long-term recovery.

For a long-term recovery, a follow-up aftercare plays a crucial role. Feel free to talk to our specialists by booking an appointment at 844.445.2565 or on this form. 

The Most Common Trigger for Relapse

Heroin Withdrawal and Severe Psychosis: Case Study

This is a case report ³ about psychotic symptoms during heroin withdrawal. A 25-year-old man had been using heroin for two years. He experienced moderate withdrawal symptoms along with unusual psychotic features. He saw things, heard voices that weren’t real, and believed insects were crawling on his body. His physical withdrawal symptoms improved with treatment by buprenorphine and supportive care, but the psychotic symptoms persisted. Antipsychotic treatment was adjusted from olanzapine to risperidone, leading to partial improvement. This case highlights a rare presentation of severe psychosis during heroin withdrawal and emphasizes the need for awareness of dual diagnosis in addiction treatment.

Heroin Withdrawal Management: Medical Detox vs Cold Turkey

Cold turkey refers to the practice of suddenly quitting a substance use without the supervision of a medical professional. This approach is not recommended because managing withdrawal symptoms needs regular monitoring and proper medication. These withdrawal symptoms can, sometimes, become life-threatening. That’s why medical detox is considered the most effective, safe, and long-term recovery approach. It sets the foundation for further stages of complete recovery.

Comprehensive Heroin Withdrawal Treatment

Heroin withdrawal treatment demands a comprehensive approach. The following strategies are commonly used for the treatment:

1. Curbing Cravings

Curbing cravings is a critical part of heroin withdrawal treatment. The main purpose of detox is to curb these cravings and ease other withdrawal symptoms. However, a comprehensive treatment may also involve medication-assisted treatment (MAT) and therapies. 

2. Medication Management

Medication management is a crucial part of a comprehensive detox treatment and also a long-term treatment. This means that you will likely need to take certain medications beyond detox. These medications are intended to reverse the harms done to the brain by the use of strong opioids like heroin. 

The following are the medications involved in heroin withdrawal management: 

• Buprenorphine
• Naltrexone
• Naloxone

All these medications are available at ChoicePoint with the convenience of same-day delivery. If you need an emergency prescription refill, contact 844.445.2565. 

3. Behavioral Therapy

Behavioral therapies are essential to address the psychosocial issues that arise due to addiction. It also requires a lot of strength to overcome something as challenging as heroin addiction. The following therapies are used in conjunction with other treatments. 

• Cognitive-behavioral therapy sessions 
• Dialectical behavior therapy
• Individual therapy sessions
• Family therapy sessions
• Group therapy sessions 

Heroin withdrawal is the most vulnerable time. One needs to be taken care of mentally and emotionally by licensed healthcare providers

Levels of Care at Heroin Rehab at ChoicePoint

Different approaches to medical detox help clear heroin and its toxins from the body. ChoicePoint offers the following levels of care for heroin treatment:

1. Telehealth Drug Treatment Program

ChoicePoint offers various telehealth services, like drug rehabilitation, alcohol rehabilitation, cocaine rehabilitation, and substance abuse treatment programs. These cost-effective and flexible treatment options include diagnosis, detox, personalized treatment, and aftercare. 

2. Outpatient Detox

This is a flexible detox program that allows individuals to stay at home and receive care. They can perform their normal daily activities at home or work, and also receive a personalized detox program.

3. Intensive Outpatient

In an intensive outpatient program, you attend therapy sessions and return home to work according to your routine life. This program works best for those who have early signs of alcohol or drug abuse.

4. Partial Care

Partial care, also known as a Partial Hospitalization Program (PHP), is a structured treatment program where patients typically receive care at a medical or behavioral health facility for more than 20 hours per week without staying overnight. Most individuals enter a partial care program after completing their stay in an inpatient facility. People facing heroin relapse issues can also benefit from PHP.

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5 Benefits of Medical Heroin Detox At a Rehab

1. Safe Withdrawal Environment

Healthcare professionals supervise the medical detox process in a controlled and safe environment. A team of licensed medical professionals monitors the detox process 24/7 and helps manage distressing withdrawal symptoms.

2. Strong Foundation for Long-Term Recovery

Managing withdrawal symptoms is the most difficult stage of recovery. It sets the stage for the ongoing treatment that can ensure a life of sobriety.

3. Improved Physical Health

Medical detox helps the body recover from the damage caused by heroin addiction. It also reduces the risk of serious health problems and damage to the main organs like the liver and heart. 

4. Better Mental Health Support

When the residual heroin is gotten out of the system, it helps improve mental health, along with physical well-being. Mental issues such as depression, anxiety, and psychosis are addressed during the detox phase.

5. Reduced Risk of Relapse

The medical team monitors the detox stage 24/7 to manage withdrawal symptoms effectively. Clearing heroin from the body during this stage helps lower the risk of relapse after treatment.

Heroin Rehab In New Jersey

At ChoicePoint, after completion of the detox process, an individual goes through several key stages for complete recovery from heroin use disorder. Detox is just the first step. The following are the key treatments needed for a comprehensive treatment.

• Outpatient addiction treatment programs
• Behavioral therapies
• Medication-assisted treatment (MAT)
• Aftercare planning to prevent relapse.

If you are looking for an insurance-covered detox in NJ, you have come to the right place. Call 844.445.2565 or verify your insurance here.

Frequently Asked Questions About Heroin Withdrawal Treatment 

How does the severity of heroin withdrawal symptoms vary among individuals?

Many factors determine the severity of withdrawal symptoms. One of the most important factors is the duration of heroin use. If an individual has been using it for a long time, the withdrawal symptoms can be severe. Health conditions and the method of heroin use play a key role in this respect. Age factor also counts as healthier, and young individuals may experience mild symptoms.

What are the risks of attempting heroin detox without medical supervision?

Trying to detox alone, without medical supervision, can be a risky thing and can cause severe withdrawal symptoms. These symptoms include dehydration, intense cravings, and many other dangerous outcomes.

Medical help reduces the risk of severe complications, which can sometimes be life-threatening. Another issue is the likelihood of relapse. Without medical support, relapse is more likely to happen. That’s why supervised detox is strongly recommended, as it helps manage symptoms safely.

Can heroin withdrawal cause long-term mental health effects?

Yes, heroin withdrawal can lead to many mental issues like anxiety, depression, and behavioral changes. In severe cases, people can experience hallucinations, like hearing sounds or seeing things that aren’t real.

Some individuals may experience mood swings or struggle with concentration. These symptoms may last weeks or months after detox..

What is post-acute withdrawal syndrome (PAWS)?

PAWS refers to substance withdrawal symptoms that continue for an extended period. These symptoms may linger on for weeks to months and, sometimes, for more than a year. These symptoms may include anxiety, mood swings, lack of sleep, lack of normal energy, etc.

What are the warning signs that indicate medical intervention is urgently needed during detox?

If an individual experiences severe dehydration, suicidal thoughts, chest pain, or trouble breathing, they should seek immediate medical support. These are the warning signs of something serious, and even life-threatening. This is an important reason for detox in a professional healthcare setting where the patient is monitored 24/7 during the detox process.

Sources

1. SAMHSA, Center for Behavioral Health Statistics and Quality. (n.d.-b). Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/reports/rpt47095/National%20Report/National%20Report/2023-nsduh-annual-national.htm?
2. World Health Organization. (2009b). Withdrawal management. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings – NCBI Bookshelf.
   https://www.ncbi.nlm.nih.gov/books/NBK310652/
3. Sharma, S., Kumar, P., Singh, R., Sidhu, G. S., & Shah, K. (2021b). Psychotic symptoms in heroin withdrawal: a case report. Cureus.
   https://doi.org/10.7759/cureus.12620