Heroin Withdrawal: Symptoms, Timeline, & Treatment

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

An image of someone experiencing Heroin withdrawal

Authored By: Joe Gilmore

Table of Contents

Heroin withdrawal occurs when you stop using this fiercely addictive substance after sustained use.

An opiate and semi-synthetic opioid, heroin interacts with your brain’s natural opioid receptors, delivering pain-relieving and rewarding properties.

In your brain, you have neurotransmitters associated with mood and movement, as well as essential physiological processes. These neurotransmitters or chemical messengers are designed to deliver endorphins when required. Using a drug like heroin continuously floods your brain with endorphins, reducing anxiety while simultaneously delivering a sense of euphoria.

Neurotransmitters in the brain linked to mood, movement and core physiological processes are designed to send out endorphins or feel-good chemicals as required. Taking a drug like heroin causes the brain to be flooded with these endorphins. This brings anxiety levels down while creating a sense of enormous euphoria.

Tolerance to heroin rapidly builds as the drug triggers significant changes in brain chemistry. It is inadvisable and potentially dangerous to abruptly stop using heroin without consulting your healthcare provider.

Fortunately, clinically supervised heroin detox in a licensed medical detox center can minimize the discomfort of withdrawal. Per SAMHSA (the Substance Abuse and Mental Health Services Administration), medication-assisted treatment is effective for heroin withdrawal. What does withdrawal from heroin involve, then?

Understanding the Heroin Withdrawal

If you become physically dependent on heroin, just like any opioid, discontinuing use invariably precipitates intensely uncomfortable withdrawal symptoms.

You will experience withdrawal symptoms for the duration of the detoxification stage. With heroin and its toxic metabolites leaving your system, your body struggles to cope with this change.

For many people who have used heroin long-term, the fear of withdrawal symptoms becomes a barrier to obtaining treatment.

Fortunately, by educating yourself about what to expect as heroin withdrawal unfolds, you will see that while heroin detox is liable to be uncomfortable, the symptoms are manageable. Heroin withdrawal is also reasonably fleeting, as we’ll outline below.

Heroin withdrawal symptoms will differ from person to person. There are many factors that influence the extent and severity of these symptoms, including:

  • Duration of heroin abuse
  • How much of the drug is taken
  • Route of delivery
  • Any underlying medical conditions
  • Presence of co-occurring disorder
  • Previous opioid withdrawal history

The withdrawal symptoms that manifest during heroin detox are the inverse of the intoxicating and rewarding effects induced by the opiate. When you ingest heroin by any method of delivery, the drug suppresses some central nervous system functioning, and simultaneously boosts pleasurable feelings. The absence of heroin in the system, by contrast, triggers:

  • Increased heart rate
  • Lowered mood
  • General anxiety

As we will highlight below, heroin withdrawal symptoms can be categorized as mild, moderate, or severe.

Can You Die From Heroin Withdrawal?

Withdrawal from some addictive substances like alcohol, benzodiazepines, and opioids carries a heightened risk of complications.

If you require heroin detox, attempting to quit suddenly at home without medical liaison can be dangerous, and it could even be life-threatening.

Additionally, detoxing from heroin at home exposes you to more risk in the form of a potential relapse. During detox, your tolerance to heroin will lower dramatically. Cravings for heroin, though, are likely to remain constant. If you succumb to temptation during a home heroin detox and use a dose you would have easily tolerated before detox, this can be enough of the drug to induce an overdose.

An image of a stethoscope | Heroin withdrawal

Signs of Heroin Withdrawal

The symptoms experienced during heroin withdrawal are similar to those experienced during a bad case of influenza. The duration of symptoms is similar, too, with most heroin withdrawal symptoms peaking after 48 to 72 hours and then subsiding after about a week.

Everyone undergoes a slightly different experience during heroin detox, but these are some of the most common signs of heroin withdrawal:

  • Disrupted sleep patterns and restlessness
  • Excessive production of bodily fluids
  • Changes in mood
  • Aches and pains
  • Fever
  • Diarrhea and stomach pain
  • Nausea and vomiting
  • Cravings for heroin

Disrupted sleep patterns and restlessness

Some of the most common heroin withdrawal symptoms include disrupted sleep patterns and insomnia. Yawning and restlessness also frequently accompany heroin detox.

Excessive production of bodily fluids

You may find yourself sweating excessively, crying, and experiencing a runny nose. As your body battles to restore balance – homeostasis – excessive bodily fluids often manifest in response.

Changes in mood

As heroin withdrawal unfolds, it is normal to feel irritable, anxious, and depressed. Ensuring that you have adequate emotional support on hand as you detox from heroin is just as important as securing clinical supervision.

If feelings of anxiety and depression do not subside once withdrawal symptoms disappear, you may be suffering from an undiagnosed mental health condition like generalized anxiety disorder or major depressive disorder. In this case, dual diagnosis treatment allows you to unpack both heroin addiction and mental health disorder at the same time.

Aches and pains

Taking heroin blocks pain pathways in the body. During detox, on the other hand, a rebound effect often occurs. In addition to feeling aches and pains, you may also feel more sensitive to pain.


If you find your temperature hits 103F or above during heroin detox, seek immediate medical intervention.

Diarrhea and stomach pain

Diarrhea and frequent bowel movements characterize heroin withdrawal. These issues are frequently accompanied by stomach pain as the body initially struggles to function without heroin.

Nausea and vomiting

Nausea and vomiting during withdrawal can lead to appetite loss and generalized discomfort.

Cravings for heroin

Cravings occur partly due to a desire to feel the heroin high once more, and partly by a wish to eliminate withdrawal symptoms. Cravings can be managed to some extent through the use of FDA-approved medications during heroin detox and recovery.

Heroin Withdrawal Symptoms

The symptoms of heroin withdrawal can be debilitating and lead to a major struggle in a person’s ability to function properly.

Mild heroin withdrawal symptoms

If you have not been abusing this potent substance long-term or in large quantities, withdrawal symptoms are often surprisingly mild. These can include:

  • Yawning excessively
  • Sweating profusely
  • Runny nose
  • Tearing eyes
  • Nausea
  • Chills
  • Bone and muscle aches
  • Abdominal cramps

Moderate heroin withdrawal symptoms

For those who have abused more this substance and for longer periods, withdrawal symptoms are more intense, including any or all of the following:

  • Vomiting
  • Tremors
  • Restlessness
  • Fatigue
  • Diarrhea
  • Agitation
  • Hot flashes
  • Problems with focus

Severe heroin withdrawal symptoms

For ongoing and severe heroin dependency and addiction, you can expect a powerful physical and emotional backlash when you stop using the drug.

More severe heroin withdrawal symptoms are as follows:

  • Respiration problems
  • Uncontrollable leg movements
  • Rapid heart rate
  • Muscle spasms
  • Insomnia
  • Inability to feel pleasure
  • Hypertension
  • Depression
  • Anxiety
  • Cravings for heroin

Now for the good news after that laundry list of adverse outcomes: heroin withdrawal is a rapid process, so how long does heroin detox last?

How Long Does Heroin Withdrawal Last?

You can expect the first symptoms of heroin withdrawal to manifest during the comedown period 6 to 12 hours after the last dose. This occurs as the euphoric and rewarding effects of heroin start to wear off.

Heroin withdrawal symptoms peak from 24 hours to 72 hours after taking the drug. The side effects will start subsiding after anywhere from 5 to 7 days of heroin detox.

The brief duration of withdrawal occurs since it is a short-acting opioid. This means it will take effect quickly, but it leaves the bloodstream just as quickly.

In the event of PAWS (post-acute withdrawal syndrome), heroin withdrawal symptoms can linger for weeks, and sometimes even months.

Heroin Withdrawal Timeline

  • Heroin detox days 1 and 2: The first symptoms manifest after just 6 hours of abstinence from heroin. Pain, mainly in the form of muscle aches, develops over the course of day 1, with pain intensifying over the following day. You might also experience panic attacks, anxiety, insomnia, diarrhea, and shaking.
  • Heroin detox days 3 to 5: The most intense phase of heroin detox is characterized by nausea and vomiting alongside sweating, shivering, and abdominal cramping.
  • Heroin detox days 6 and 7: Acute withdrawal is complete within a week or so for most people. Nausea subsides, as do aches and pains. You may still feel fatigued and rundown, but you should start noticing physical improvements, too.

Overcoming Heroin Withdrawal

The most seamless method of navigating withdrawal is to detox at a licensed medical detox center. Alternatively, you could detox at the beginning of a residential rehab program for heroin addiction.

If you detox from heroin with the right emotional and clinical support in place, you will minimize discomfort and cravings for heroin, while increasing your chance of kickstarting recovery from heroin addiction without relapse.

We can help you with that here at Renaissance.

An image of people on a beach by a treatment center for Heroin withdrawal

Heroin Treatment at Renaissance Recovery

At Renaissance Recovery Center, we specialize in the outpatient treatment of a variety of addiction, including heroin addiction.

If you require a medically-supervised heroin detox, we can connect you with detox centers near you and throughout Orange County. Take advantage of medications and around-the-clock medical care to detox from opiates as safely and comfortably as possible.

Once your body is free of opiates, you’ll be ready to engage with one of our evidence-based outpatient programs. We offer the following programs:

  • Outpatient program (OP)
  • Intensive outpatient program (IOP)
  • Partial hospitalization program (PHP)
  • Remote intensive outpatient program (virtual IOP)
  • Dual diagnosis treatment program

Choose a program with the right level of support and structure, up to our most intensive PHP, the most intensive form of outpatient treatment outside of residential rehab.

Through a personalized combination of MAT, psychotherapy, counseling, and holistic therapies, you can address the psychological component of heroin addiction while utilizing medications to ease the physical aspect of opioid use disorder.

To start moving beyond heroin, reach out to our friendly team today at 866.330.9449.

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