How to Manage Heroin Withdrawal Symptoms

More adults in England are receiving treatment for opiate dependence, including heroin, than for any other substance group. For people who are dependent on heroin, stopping safely is an important first step towards recovery, but withdrawal can be physically and psychologically challenging and should be properly managed.

This guide explains what to expect when coming off heroin, how withdrawal symptoms can be managed safely, and where to find support. It is intended for anyone who is dependent on heroin and considering stopping, as well as family members and friends supporting them.

What happens during heroin withdrawal?

Heroin works by attaching to opioid receptors on nerve cells in the brain and body. Your own natural painkillers, the endorphins, use the same receptors. When they are switched on, nerve activity slows down, which is why heroin relieves pain and leaves you feeling calm.

The brain adapts to regular heroin use by turning its own activity up to compensate for heroin’s effects. While you keep using heroin, the drug and the adjustment balance each other out.

But when you stop, the receptors are no longer being switched on, but your brain is still turned up. This causes your nervous system to become overactive, which drives many of the symptoms of heroin withdrawal. These include flu-like symptoms, poor sleep, strong cravings, anxiety, agitation, and various gastrointestinal symptoms like heroin withdrawal nausea and heroin withdrawal cramps.

Is heroin withdrawal dangerous?

How bad opioid withdrawal symptoms are varies from person to person. For most otherwise healthy adults, opioid withdrawal feels pretty awful, physically and mentally, but it’s not usually as life-threatening as benzodiazepine or alcohol withdrawal.

If you have another health condition or certain personal needs, it’s more important to get a medical check first. That includes pregnancy, a heart or breathing problem, mixing heroin with alcohol or benzodiazepines, or if you’ve felt suicidal or seriously low before. While it’s always advisable to speak to your GP or a professional addiction treatment service before withdrawing from heroin, if any of those apply to you, that should be the first thing you do.

How long does heroin withdrawal last?

Exactly how long heroin withdrawal lasts varies with how much you were taking, how often, how long you’d been dependent, and your overall health.

Heroin withdrawal symptoms usually start between eight and 24 hours after the last dose. Physical symptoms usually last 4 to 10 days, and the first two or three days are usually the toughest before things start to ease. Some cravings and low mood can linger for weeks even after the physical symptoms fade, but these get easier with time.

How to manage heroin withdrawal safely

If you’re planning heroin withdrawal at home and have already checked with your GP, arranging professional support can still make withdrawal safer. Having someone with you means you won’t be facing the symptoms alone, and they can react if things get worse.

Wherever you’re detoxing, make sure you drink plenty of fluids, because vomiting and diarrhoea are common withdrawal symptoms and they can dehydrate you quickly. Eat when you’re able to, even small amounts, and sleep whenever your body lets you. Keep things calm and settled around you, because noise and chaos can make the rough days even harder.

This last point is crucial: Never use alcohol or other drugs to dull the symptoms without medical guidance. Mixing substances or trying to replace heroin with something can be very dangerous and potentially put your life at risk.

Medical treatment for heroin withdrawal

In most cases, professional heroin withdrawal treatment is the right path. This usually begins with a doctor or addiction specialist looking at your health and at how much and how often you’ve been using heroin. This can help them work out the right heroin detox treatment plan.

You may be offered methadone or buprenorphine, which ease symptoms and cravings, and support opioid addiction recovery. Another medicine called lofexidine is sometimes used instead, often for people who’d rather not take an opioid-based substitute.

Heroin detox done properly, with a doctor overseeing it, looks nothing like gritting your teeth through it by yourself. It is designed to keep you safe and get you through it as comfortably as possible.

Why overdose risk rises after withdrawal

Once you come off heroin, your tolerance to it starts to drop quickly, so your body can’t handle the amount it used to. That means if you go back to your old dose during or after withdrawal, there is a greater chance of overdosing.

Research on people leaving prison in England and Wales, who hadn’t been able to use heroin for a while, found that the risk of a drug-related death was around eight times higher in the first two weeks after release.

The same can happen after any heroin-free period, including a planned withdrawal. It’s one of the main reasons a planned, professionally supported approach to detox is safer.

The psychological side of heroin withdrawal

The mental side of heroin dependence and withdrawal can be just as hard as the physical side. Heroin withdrawal anxiety, low mood, a short temper, and a sense of unexplained hopelessness are all common and can last weeks.

Heroin withdrawal cravings can hit really hard and overwhelm you, partly because your brain has learned to link certain people and places with using. These reminders are called triggers, and they can bring on a craving even when you’re doing everything right.

Avoiding triggers is another reason why detoxing in a residential treatment centre like Linwood House is often the right choice. You won’t be constantly reminded of the people and places associated with heroin, and there won’t be any available if the anxiety or other symptoms feel like too much to cope with.

If you still choose to detox at home, give a wide berth to all the things that remind you of using, and have someone you can call when cravings hit hardest.

If you have severe mental health symptoms, including thoughts of suicide, or any change that worries you, get urgent help straight away. Call 999 if you’re in immediate danger, or ring Samaritans free on 116 123, day or night.

Why heroin detox alone isn’t enough

Once you’re through heroin withdrawal, you’ve dealt with the physical part of using. Working out why you first started, and what needs sorting out so you can stay away from heroin for good, requires ongoing support.

Heroin addiction treatment at Linwood House is built around rehab therapy, relapse prevention planning, peer and professional support, and proper aftercare. All of this is designs to give you the best chance of building a life without heroin. Heroin recovery takes real work, but with the right people around you and the right safety measures taken, it’s possible for everyone, including you.

Get professional help stopping heroin from Linwood House

Quitting heroin is not easy, but while it’s a challenging process, it’s a temporary one. And crucially, you don’t have to go through it alone.

Whatever stage you’re at with heroin, we’d welcome hearing from you. We’ll talk through what getting help for heroin addiction means, and how every stage of treatment looks. If you’re calling for someone you know, we can explain what the heroin withdrawal timeline looks like and what symptoms to expect.

Crucially, we can advise you on how to manage withdrawal symptoms safely and ensure your best chance of successful recovery.