Getting through a heroin detox is the first step on the road to recovery. There are a number of options available to those who want to quit heroin, including both inpatient and home detoxes.
It is important to know what to expect from a heroin detox before you begin so that you can make sure you complete the process in the most appropriate way to your situation.
The best chance you have of overcoming heroin addiction is finding a programme that works for you. With so many options available, it can be difficult to know where to look. Fortunately, there is plenty of help available.
Once a heroin addiction develops, it can be extremely difficult to break the cycle of abuse. To overcome this illness, detoxification is typically the first step on the road to sobriety. However, withdrawing from heroin is never a straightforward process. The unpleasant symptoms that accompany withdrawal from the drug can easily cause a return to substance abuse.
It is important to have realistic expectations about the detox process and to ensure that you find a suitable programme with excellent people to support you every step of the way. Read on as we explain more about what heroin detox and withdrawal is like.
How to Find a Detox Programme for Heroin
You might want to consult your doctor in the first instance, particularly if you are interested in an NHS-funded programme. Your doctor will advise you on the options available through the NHS and he or she may also be able to provide information on charity organisations that can provide help and support as you withdraw from the drug.
Inpatient programmes are also available for those who want to quit heroin; these programmes are typically provided by private clinics. If you would like some information on the programmes provided by UKAT clinics, please get in touch with us. We can provide details on the locations and costs of our clinics as well as what to expect from our programmes.
Choosing a detox clinic
There is much to think about when choosing a detox clinic. It is important to consider what type of heroin detox would be suitable for your circumstances. For example, you may want to complete the process in an inpatient clinic where you would have constant access to care and support from a team of experienced individuals who have been fully trained in the process. The location of the clinic might also be particularly important to you, as a clinic closer to home could be more convenient.
A home detox may also be possible with support from your doctor. This could be something worth considering, depending on your individual needs, circumstances, and preferences.
How to Detox from Heroin?
Heroin detox can be completed with a sudden withdrawal from the drug or with a gradual reduction over a period of time. In many instances, a replacement opioid drug such as methadone or buprenorphine will be prescribed to help reduce the impact of the withdrawal process, making it easier to cope and less likely that you will return to the drug.
In a supervised detox clinic, your care team will discuss your options with you and will decide on the best type of detox. Sudden cessation might be the quickest way of withdrawing from heroin, but it is also the most uncomfortable.
How Long Does It Take to Detox from Heroin?
The length of time that it takes to detox from heroin will differ for each individual. As heroin is a short-acting opioid drug, it leaves the system fairly quickly and so most people who withdraw from the drug suddenly will notice the first symptoms around six to twelve hours after taking their last hit of the drug.
While the process can differ for each person and can be affected by underlying mental or physical health issues, it generally lasts for between one and two weeks. For most, symptoms will peak after two or three days before subsiding within a week-to-ten-days. For those going through gradual tapering of heroin, the process could continue for much longer.
Heroin Withdrawal Timeline
A typical heroin detox tends to follow a timeline. Below is a generalised timeline of what to expect when quitting heroin suddenly.
6 to 12 hours after the last dose
The first symptoms appear within hours of the last dose of heroin being taken. The earliest symptoms are typically graded as 0 in intensity and include drug-seeking behaviour, cravings, and anxiety. As the detox progresses, other symptoms such as yawning, watery eyes, runny nose, restlessness, and sweating may appear. These symptoms are classed as grade 1 symptoms.
24 to 36 hours after the last dose
The worst of the symptoms will have appeared during the first two to three days. Grade 2 symptoms include irritability, dilated pupils, leg cramps, muscle twitches, and loss of appetite. Grade 3 symptoms are the worst and include low grade fever, increased blood pressure, stomach cramps, nausea, vomiting, diarrhoea, rapid breathing, and weakness. Most of the symptoms will peak at about 2-3 days.
7 to 10 days after the last dose
Once symptoms have peaked, they will begin to subside and usually after around seven to ten days, most will have disappeared.
More than 10 days after the last dose
Although most of the symptoms you experience will be gone at this stage, some may linger on for weeks; these might be sleeplessness, anxiety, muscle aches, and weakness. You may also experience cravings for many months.
What to expect from heroin withdrawal
Heroin withdrawal can be an unpleasant process, possibly making you feel as though you have a bout of severe flu. You are likely to feel very unwell, and many people going through the process will return to the drug in an effort to feel better.
Due to the way in which illicit drugs such as heroin affect many parts of the brain, particularly those areas responsible for clear thinking and logical reasoning, you could find yourself incapable of making good decisions. During withdrawal, your ability to think clearly can become even worse and you may get to a point where you will do anything to get your hands on the drug.
The cravings experienced during heroin withdrawal can be described as an ‘insanity’, and you might beg, plead, and manipulate to get the drug. You might exaggerate the symptoms you are experiencing or pretend to have severe symptoms just to get your carer to give in to your demands.
Although heroin detox can be extremely unpleasant and uncomfortable, know that there are ways of making it easier. It is highly recommended heroin detox take place in a dedicated facility where staff can help ease discomfort by using both pharmacological and psychological interventions.
Heroin Withdrawal Symptoms
The symptoms of heroin withdrawal vary from one person to the next. Below we list some of the symptoms you can expect during the process:
Medical Detox from Heroin
Not everyone requires a medical detox from heroin but those with a severe addiction to the drug are usually advised to consider one. A medical detox is recommended for those who are physically addicted and who have previously experienced severe withdrawal symptoms when trying to quit or cut back on their use of heroin.
It is also the preferred option for anyone with underlying mental or physical health problems. A medical detox takes place in a supervised facility where medical staff are on hand to act in the event of an emergency.
With a medical detox, your safety and comfort will be assured as specific medications can be prescribed and administered to ease any pain or suffering you might be experiencing. You should note that some medications can also help to prevent the worst symptoms from appearing at all.
Home detox from heroin
Although most doctors recommend an inpatient detox when withdrawing from heroin, there are some people who might prefer to detox in familiar surroundings. They choose to detox at home for their own privacy and because of a belief that they will find the process easier if they are with and around loved ones.
A self-detox at home is possible, but it is much riskier than detoxing in a dedicated facility as the chance of a return to drug use is much higher when not in a distraction- and temptation-free facility.
Making your own plans
If you are planning to detox from heroin at home, you will need to be fully assessed by your doctor before you can start. You will also need to have a number of people willing to sit with you at various times throughout the process. You should know that a detox can take a couple of weeks to complete and that you will need to be monitored at all times. This means that more than one person will have to agree to take shifts in sitting with you.
You will need to have a clear plan in place that will include emergency contact details in the event of an emergency. Your helpers will have to be aware of any medication you are allowed to take, and they must ensure that you have no access to it except at dosage times.
While a home detox from heroin is possible, it is usually not the best idea; also know that the chances of relapse are much greater as well. This is something to think about before beginning the withdrawal process.
Heroin detoxification programme
As you know by now, when you are ready to get started on your recovery journey, you will have to start with detoxification. You will have a number of options in terms of how your detox proceeds. Most people will detox in an inpatient facility because of the 24-hour supervision, intensive monitoring, and the option for both pharmacological and psychological interventions to ensure comfort and safety.
However, a mentioned above, not everyone wants to detox in a supervised clinic. That is why there are other options in the heroin detoxification programme. An outpatient detox may be available to you if your addiction is not so severe and/or you have plenty of support at home and believe that you can stay clean without around-the-clock supervision.
Due to the dangers associated with heroin detox, nearly all doctors will recommend a medical detox in a supervised facility. One of the risks during heroin detox is dehydration, which can lead to chemical imbalances triggering the onset of a seizure. In a supervised facility, these risks can be minimised by medical professionals.
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Heroin detox centres
Heroin detox centres are secure and safe facilities staffed by a team of doctors, nurses, counsellors, therapists, and support staff. These facilities are the ideal place to withdraw from heroin as they have the people with the medical expertise and experience to get you through the process safely and comfortably. These centres will also have the necessary equipment to ensure that any complications that do arise can be dealt with swiftly and effectively.
Detox centre stages
In a heroin detox centre then, the process of withdrawal can begin, meaning that you will spend your time being cared for by staff members fully aware of what you are going through. There could be other patients at the facility who may be at different stages of the process to you.
During the detox process, you might take part in both individual and group counselling sessions, which will help you to deal with the issues you face. These sessions can help to prepare you for rehabilitation, which typically follows detox.
Heroin detox programmes are provided by various organisations including the NHS and private clinics. You can find information on the various options in your area by accessing online information databases.
Psychological vs Physical Withdrawal from Heroin
As heroin is a drug that affects both the mind and the body, it is possible to become both physically and psychologically dependent on the drug. This means that when you try to quit or significantly cut back on your use, you are likely to experience both physical and psychological withdrawal symptoms.
Physical symptoms affect the body and can include:
- muscle pain
- bone pain
- goose pimples
- cold skin
- leg twitches
Psychological symptoms affect the mind, and these could include:
- mood swings
- anxiety depression.
Gradually Reducing Heroin vs Full Detox
As we touched upon in the above paragraphs, when you decide to quit heroin, you will have the option of withdrawing suddenly or gradually reducing your dosage over a period of time. Your care team will discuss your options and together you can formulate a plan for an efficient and effective way of withdrawing from the drug.
If you decide to have a full detox, you will quit heroin abruptly and are likely to experience a range of withdrawal symptoms; these could be mild, moderate, or severe in intensity. If you are considering a full detox, it is almost universally advised by medical professionals to do so in a dedicated clinic where you will be monitored at all times. As you now well know, there are risks associated with a sudden cessation of heroin, including hallucinations, seizures, and convulsions.
Some detox centres advocate for the gradual withdrawal of heroin instead of a full and sudden cessation. Gradually reducing the dose of heroin gives the mind and body a chance to adjust to the removal of the drug slowly, consequently lessening the impact of withdrawal. A gradual reduction can take place over the course of a couple of weeks.
Another option is an opioid-assisted detox where you will be given a substitute opioid drug such as methadone or buprenorphine. This type of therapy stops the worst withdrawal symptoms occurring while you quit heroin while also helping to stop cravings for the drug.
Causes of Heroin Withdrawal
When you use heroin, it has a significant impact on both your mind and body. After a while, you will build up a tolerance to it, meaning that your brain is not responding to the amount of the drug you are taking in the same way it did when you initially took it. If you are chasing the high you experienced the first time you took heroin, you are likely to increase the amount of the drug being taken to achieve your desire.
Unfortunately, most people find that they can never recreate the initial first high of taking heroin no matter how much of it they subsequently take. All they usually succeed in doing is developing both a physical and psychological dependence on it. When they then try to quit, they are likely to experience withdrawal symptoms. Chronic regular abuse of heroin causes the brain and body to develop a dependence, meaning that both learn to function with heroin in the system.
In fact, you may find it impossible to feel ‘normal’ unless under the influence of the drug. Your ability to experience pleasure or regulate pain will be hindered by your heroin use, so when you try to stop using the drug, your brain and body must then learn how to do this again without the help of the substance they have come to rely on. As your body and brain attempt to restore normality, you will go through a full gamut of symptoms that will, as described a few times above, make you feel quite unwell.
Remedies for Heroin Withdrawal Symptoms
The symptoms associated with heroin withdrawal can be very unpleasant, which will make you feel unwell until they have passed. In a detox facility, you now know that many of the symptoms can be eased using various medications or psychological interventions.
If you are experiencing symptoms such as nausea, vomiting, or diarrhoea, for example, over-the-counter medications can help to relieve some of the discomfort. It is important to stay hydrated too, so rehydration salts can be used, especially when suffering from vomiting and diarrhoea.
During withdrawal, holistic treatments have also proven to be beneficial in terms of relieving pain and suffering. These can also be used to help curb cravings and reduce levels of stress. Examples of these holistic treatments can include acupuncture, yoga, mindfulness, and meditation.
What Happens after Physical Withdrawal from Heroin
Withdrawing from heroin via a detox programme is just the first part of the recovery process. When detox has been completed, you might be free from drugs but there is more to recovery than just quitting heroin. You must also deal with the emotional and psychological element of the illness; this will take place during rehab.
Without rehab, the risk of relapse will be high, especially as it is possible for drug cravings to continue for many months after detox has finished.
Prolonging Heroin Withdrawal by Relapse
Avoiding a relapse is crucial during heroin detox as a return to the drug can prolong the withdrawal process. However, resisting the urge to use again is very difficult. You might already know that strong cravings for heroin occur when you quit the drug, so staying clean can be a massive challenge.
Many heroin addicts will desperately try to get their hands on the drug, and some will leave their detox facility in a desperate attempt to satisfy their cravings and relieve the pain and suffering they are going through.
Nevertheless, it is important to know that a return to heroin after a period of abstinence will not only prolong the withdrawal, it can also be extremely dangerous. Your tolerance levels will drop dramatically when you stop taking the drug, and even if you have been off it for a matter of days, a return to the same level of the drug you were taking before you quit could have catastrophic consequences. You could have an accidental overdose if taking the same amount of heroin after being off it for a couple of days.
If you do relapse during heroin detox, even just a slip up, you will have to start the process all over again. If you can stick with the programme and remember that the symptoms you are experiencing will pass, you should be able to get to a point where you are ready to begin the next stage of the process – rehabilitation.
Do You Need Rehab After Detox?
As mentioned before, detox is just one part of the recovery process for heroin addiction and while it is an effective way of treating the physical element of the illness, it does nothing to treat the psychological or emotional side of it.
What you should be aware of is that without treating both elements of the addiction, you are unlikely to achieve full and permanent sobriety. Addiction cannot be cured, only treated and in order to do this effectively, it is important to complete both a detox and rehabilitation programme.
Further Treatment for Heroin Addiction
Heroin addiction treatment includes both traditional and holistic therapies. Quitting the drug is the first step on the road to sobriety but have to also learn how to live a heroin-free life going forward; this takes place with therapy.
It is likely that you will be given a bespoke treatment plan that will include a variety of behavioural and talking therapies as well as holistic treatments. Your plan of care will be designed with your needs in mind and may include elements of the following:
- 12-step therapy
- Contingency management
- Individual counselling
- Group therapy
- Cognitive behavioural therapy
- Psychodynamic therapy
- Dialectical behaviour therapy
- Motivational enhancement therapy
- Acceptance and commitment therapy
- Family therapy
Additional therapies may be included in a tailored plan.
Heroin rehab programmes are typically inpatient or outpatient programmes that are provided by private clinics, charities, local support groups, and the NHS. These programmes vary in length, depending on whether they are residential or day care based. Inpatient programmes are condensed over weeks while outpatient programmes are longer as there is no overnight stay and fewer treatment hours each week.
The type of rehab programme you choose will depend on how severe your addiction is, what your individual circumstances are, and your budget.
Does Heroin Withdrawal Cause Depression?
As an opioid drug, there is a strong link between heroin abuse and depression. Each can increase the risk of the other, so if you have depression you are more likely to abuse a drug such as heroin and if you are a heroin user, you are more likely to suffer depression.
Heroin affects the brain and causes changes to the pleasure and reward system of the organ. Heroin induces feelings of pleasure and euphoria, and the brain quickly learns to rely on the drug for this function. After a while, you will be unable to feel pleasure unless you are under the influence of heroin. When you try to quit, your brain will have to learn how to produce the chemicals required for pleasure once more, but this can take time.
The inability to feel pleasure coupled with the unpleasant symptoms associated with heroin withdrawal, often leads to depression.
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Frequently Asked Questions
What causes heroin addiction?
Heroin addiction usually stems from abuse of the drug. Those who abuse it have assorted reasons for doing so, such as forgetting about painful memories, peer pressure, for recreational purposes, or just out of curiosity.
Nonetheless, not everyone who abuses heroin will go on to develop an addiction. Those who do often have a number of risk factors for the illness, such as a family history of addiction, unresolved traumatic experiences, environmental influences, a history of mental health problems, or early exposure to the drug.
Addiction usually develops when a person builds up a tolerance to heroin and then continues to abuse it but in higher doses. This often results in a dependence on the drug, which can be quickly followed by addiction.
Is heroin withdrawal dangerous?
Heroin withdrawal can lead to dangerous complications including seizures and convulsions if not managed effectively. Because symptoms such as diarrhoea and vomiting can result in dehydration, it is important to stay hydrated throughout.
The best place to detox in terms of ensuring comfort and safety is in a detox facility under the supervision of trained medical professionals.
What detox programme is right for me?
Your personal circumstances will determine which type of detox is right for you. You have the option of detoxing in an inpatient clinic or at home with regular visits to an outpatient facility. If you have a severe addiction, it may be wise to detox in an inpatient facility. You are likely to experience strong cravings for heroin during withdrawal so being in a secure facility where there are no temptations might help prevent a return to drug use, which could prolong your withdrawal or result in an accidental overdose.
Can heroin withdrawal kill you?
Death during heroin withdrawal is rare but there is the risk of complications, so it is important that you are carefully monitored at all times. It is also important to remember that your tolerance levels will drop quite dramatically when you quit heroin. Should you return to the drug during detox after a period of abstinence, you will risk an accidental overdose that could have fatal consequences.
What does heroin withdrawal feel like?
Most people who experience heroin withdrawal will liken it to having the flu. If you experience the gamut of possible symptoms, you are likely to have a low-grade fever, nausea, vomiting, diarrhoea, muscle aches, and chills.
The worst of the symptoms will occur during the first two to three days when they will peak and begin to subside. During that time, you will likely feel very unwell and you may experience strong cravings for heroin. The good news is that there are medications and psychological interventions that can help to relieve the symptoms.
How can you ease heroin withdrawal?
The symptoms associated with heroin withdrawal are very unpleasant and can cause you to feel very unwell. However, with over-the-counter medications and psychological interventions such as meditation and mindfulness, any discomfort you are experiencing can be eased.