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Heroin Withdrawal Symptoms, Signs, Timeline, and Recovery

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 9 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 9 minutes

Heroin withdrawal involves challenging symptoms—understanding them and the recovery timeline is important for effective management.

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Heroin’s raw components come from poppy plants, most typically found in South America, Mexico, and Asia. The usage of heroin has been illegal in the United States since 1924. Depending on the formulation, it may have a white, brown, or black appearance. The drug has many alternative names, including horse, brown sugar, smack, and crap.

Once you’ve been dependent on highly addictive substances, breaking the cycle of use can be extremely difficult. Addiction is a serious condition that kills millions of people. A person can overcome it by learning how to handle the many withdrawal symptoms during detox.

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Early & Late Stage Symptoms

What Are the Withdrawal Symptoms of Heroin

Heroin addiction can lead to overdose and death if not treated properly and promptly. A medically supervised heroin detox program should always be the first step in treating opioid use disorder like heroin.

You should detox in a clinical facility with 24-hour medical supervision. This helps prevent the pain and dangers of heroin withdrawal symptoms. Medical personnel ensure the patient’s well-being and safety throughout heroin detoxification.

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Even though heroin withdrawal is rarely life-threatening, the symptoms are so terrible that it can feel like it. You can anticipate experiencing the following in the earliest stages of heroin withdrawal:

  • Pain in muscles.

  • Tear ducts that are working too hard.

  • Yawning.

  • Diarrhea.

  • Insomnia.

  • Anxiety.

The more severe withdrawal symptoms, which often begin within the first two to five days of abstinence, include:

  • Cramping in the stomach.

  • Nausea.

  • Sweating.

  • Irritability.

  • Goosebumps.

  • Drug-induced compulsions.

  • Vomiting.

  • Depression.

  • Thinking in a cluttered state.

Some less severe signs and symptoms of heroin withdrawal can last up to a month. These include tiredness, depression, cravings, and mild discomfort. Detoxing in a medical facility with supervision is the best choice. Managing these symptoms on your own can be very difficult.

There are affordable options for addiction treatment.

Rolling Hills Recovery Center works with a variety of healthcare providers.

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Managing Intense Cravings During Heroin Detox

Extreme Cravings

Extreme cravings are a common sign of heroin withdrawal. As a result of the reduction in heroin supplies, your body is in a state of fear. Your brain knows it will feel better if you give it more substance.

You may have strong cravings. This can be risky if you are alone and not under medical care.

Cravings can be overwhelming if you aren’t in a medical detox environment. People trying to quit heroin often give in to their intense cravings despite their best efforts during detox.

This, however, should not dissuade you from your desire to quit using heroin. In reality, giving in to your cravings does not always mean you have failed to reach your goal. Just because something has not worked in the past does not imply that it will fail in the future.

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How Heroin Withdrawal Develops

Why Does Heroin Withdrawal Occur?

Opioid addiction is possible with all opioids. To get high, you’ll need to take a larger dose of heroin when you’ve developed a tolerance. Psychological and physical dependence on the substance is possible over time.

The brain’s nerve receptors are altered when you use opioids regularly for an extended period. They become entirely reliant on heroin to get by. Reducing the amount of heroin that you use may cause withdrawal symptoms. You are feeling withdrawal symptoms because your body is used to having the substance in it.

Medical professionals at a detox clinic will help clients with the physical symptoms of heroin withdrawal. This support aims to make achieving sobriety easier and less painful.

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The Heroin Withdrawal Process

Heroin Withdrawal Timeline

Heroin withdrawals can begin within six hours of the previous dose being taken. Several variables affect the severity and duration of withdrawal symptoms:

  • How have you been using heroin.

  • How much heroin you’ve been using and its strength (and purity).

  • Method of use (smoking, snorting, or injecting).

  • Addictions, relapses, or withdrawal symptoms in the past. 

  • Co-occurring illnesses such as mental illness.

  • Your general well-being or a specific health condition.

  • Whether or not you’ve been using other drugs in addition to heroin.

The following is a typical withdrawal timeline for heroin:

Days One and Two

Symptoms can manifest themselves as early as 6 hours following the last dose. During the first day of quitting, you may experience muscle pains and joint pains. Over the first two days, these symptoms will become more pronounced. Anxiety, panic episodes, sleeplessness, trembling, and diarrhea are common during this period.

Days 3 through 5

Withdrawal begins to take hold on the 3rd and 4th days. Abdominal tightness, sweating, shivering, nausea, and vomiting are common symptoms throughout this period.

Days 6 through 7

A week is generally the length of the acute withdrawal stage. By this time, your aching muscles and nausea should have subsided. Physically, the user will improve with time, but they will still feel worn out and exhausted.

PAWS (Post-Acute Withdrawal Syndrome)

Symptoms of withdrawal may recur for months after the onset of acute withdrawal. Neurological alterations are brought on due to heroin usage. The most common long-term effects include agitation, anxiety, depression, and exhaustion.

A variety of mental health issues may accompany heroin addiction. Co-occurring mental diseases with heroin addiction include:

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Small Steps Towards a Drug-Free Life From Heroin

Treatment is complicated, and quitting heroin can be extremely difficult if you are struggling with heroin addiction. However, living a drug-free life is your main goal. You will feel like giving up and quitting on yourself at times.

Keep your loved ones and close friends close during these important times. They can give you the support you need. You do not have to go through treatment alone.

The best part is that you do not have to take the more significant steps overnight. Take the smaller ones and improve on yourself as you move through your recovery journey. Also, remember to enjoy yourself as you continue.

Frequently Asked Questions About Heroin Withdrawal:

What is Heroin and How Does it Affect the Brain?

Understanding heroin: Heroin is an opioid drug made from morphine. Morphine comes from a natural substance found in the seed pod of some poppy plants.

When heroin enters the brain, it rapidly crosses the blood-brain barrier due to its high lipid solubility. Once inside, it changes back into morphine. It then binds to opioid receptors.

This affects areas that deal with pain and reward. This leads to intense feelings of euphoria, which contribute to its high potential for addiction.

How Does Heroin Cross the Blood-Brain Barrier So Quickly?

Heroin’s chemical structure allows it to be more fat-soluble than other opioids like morphine. This higher lipid solubility allows heroin to quickly cross the blood-brain barrier. This leads to fast and strong effects on the central nervous system. The quick onset of action is one reason heroin is highly addictive.

How Does Dependence on Heroin Develop?

Dependence on heroin develops as the body adapts to the presence of the drug. Over time, neurons in the brain adjust their functioning, leading to tolerance (needing more of the drug to achieve the same effect). Physical dependence means that the body requires heroin to function normally, and stopping use leads to withdrawal symptoms.

Can Short-Term Heroin Use Lead to Addiction?

Short-term drug abuse can indeed lead to developing an addiction. Heroin’s potent effects on the brain’s reward system can quickly foster dependence, even after a few uses. The drug’s ability to create intense euphoria makes it highly addictive.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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