Heroin Withdrawal Symptoms, Signs, & Timeline

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Heroin is a fiercely addictive Schedule I narcotic. If you become dependent on heroin, you will experience intensely unpleasant withdrawal symptoms if you stop using the drug.

According to SAMHSA (Substance Abuse and Mental Health Services Administration), 1.1 million U.S. adults used heroin in 2021, with over 1 million over-18s reporting heroin addiction in the same year. This makes heroin the most addictive of all substances of abuse.

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Today’s guide highlights these crucial issues:

  • What is withdrawal from heroin?
  • What are the most common withdrawal symptoms of heroin?
  • Detoxing from heroin safely – is this possible?

You will also discover how to connect with ongoing heroin addiction treatment after detoxing from heroin with medical supervision.

Symptoms of Heroin Withdrawal

Heroin withdrawal symptoms, otherwise known as heroin detox symptoms, present when someone who is dependent on heroin stops using the drug. The symptoms of withdrawal from heroin are a physical and psychological response from a system accustomed to the continuous presence of opioids.

Any sustained use of heroin triggers the development of tolerance and physical dependence. Tolerance to heroin starts forming rapidly, meaning that more heroin is required to deliver the initial effects. Increasing the amount of heroin or the frequency of doses accelerates the development of physiological dependence. Dependence is characterized by heroin withdrawal symptoms which manifest when someone reduces or discontinues their use of opioids. 

The heroin withdrawal symptoms that present during a heroin comedown are not typically life-threatening, but they can be aggravating and painful. Additionally, the vomiting and diarrhea that occur during heroin withdrawal can lead to an imbalance of electrolytes, severe dehydration, and potentially deadly outcomes.

Withdrawals from heroin start anywhere from 6 to 12 hours after the last use of heroin. The acute phase of heroin withdrawal can last for 4 to 10 days. The onset and duration of heroin withdrawal hinges on factors that include: 

  • Amount of heroin used
  • Frequency of heroin use
  • Duration of heroin use
  • Physical health
  • Mental health
  • Co-occurring health conditions
  • Other medications or addictive substances used

The short-term symptoms associated with heroin detox are so uncomfortable and distressing that many people return to heroin use rather than managing symptoms. This is why it is crucial to engage with a supervised medical detox. Attempting to withdraw from heroin at home without medical guidance and supervision is not only dangerous but could even be life-threatening.

Symptoms List

Heroin withdrawal can cause a range of short-term symptoms, including:

  • Insomnia and sleep disturbances
  • Elevated body temperature
  • Increased breathing rate and blood pressure
  • Fast pulse
  • Dilated pupils
  • Heightened reflexes
  • Sweating
  • Watery discharge from eyes and nose
  • Muscle spasms and cramps
  • Nausea 
  • Vomiting
  • Diarrhea
  • Bone pain

Protracted heroin withdrawal, also known as long-term heroin withdrawal, can cause ongoing impairments even after acute withdrawal. Symptoms may include:

  • Anxiety
  • Depression
  • Irritability
  • Continued fatigue
  • Feeling down or emotionally dull (dysphoria)
  • Reduced interest or pleasure in activities (anhedonia)
  • Short-term memory problems
  • Impaired concentration and decreased attention
  • Difficulty making decisions
  • Heroin cravings

Returning to heroin use to alleviate post-acute withdrawal symptoms can be dangerous. After withdrawal, tolerance to opioids is reduced, increasing the risk of overdose for individuals who relapse. 

An image of a woman shedding tears as she gazes out the window, depicting the difficulties of heroin withdrawal symptoms

Signs of Heroin Withdrawal

Some common signs of heroin withdrawal may include:

  • Muscle aches and pains: Heroin withdrawal is associated with muscle cramps, spasms, and pain, especially in the legs and back.
  • Gastrointestinal distress: Nausea, vomiting, and diarrhea commonly occur during heroin withdrawal. These symptoms can cause dehydration and electrolyte imbalances if not managed properly.
  • Psychological symptoms: Withdrawal from heroin can trigger a range of psychological symptoms, including anxiety, irritability, and depression. People may also experience difficulty concentrating, memory problems, and mood swings.
  • Autonomic symptoms: The autonomic nervous system may also be affected during heroin withdrawal. This may involve symptoms like sweating, flushing, and chills. Some people may also experience an elevated heart rate and blood pressure, as well as rapid breathing.
  • Cravings: Heroin withdrawal is frequently accompanied by intense cravings for the drug. These cravings can be difficult to resist and may persist long after other withdrawal symptoms have subsided.

How Long Do Heroin Withdrawals Last?

The severity and duration of heroin withdrawal may vary depending on several factors, including the duration, extent, and frequency of use, as well as the route of administration, underlying physical health conditions, and co-occurring mental health disorders.

Here is a breakdown of the timeline of heroin withdrawal symptoms:

Acute phase (6 to 12 hours)

Heroin withdrawal symptoms typically start within 6 to 12 hours after the last dose of heroin. During this phase, you may experience physical symptoms such as muscle aches, nausea, and sweating. You may also experience psychological symptoms such as anxiety and agitation, which can make it difficult to sleep.

Days 1 to 3

The first few days of heroin withdrawal are often the most challenging. Heroin withdrawal symptoms typically peak within 2 to 3 days of the last use, with intense physical symptoms like vomiting, diarrhea, and body tremors. Psychological symptoms such as depression, irritability, and drug cravings may also present.

Days 4 to 7

After the first few days, heroin withdrawal symptoms start to subside. Physical symptoms like nausea and vomiting may decrease, while psychological symptoms such as anxiety and depression may still be present. Drug cravings may also persist during this time.

Weeks 2 and beyond

By this point, the acute phase of heroin withdrawal should have ended, and your body should have naturally removed the drug from your system. That said, you may still experience post-acute withdrawal symptoms such as depression, anxiety, and drug cravings, which can last for weeks or even months. It is vital to seek support during this time to manage these symptoms and prevent relapse.

Heroin Addiction Treatment

Heroin addiction is a chronic, relapsing brain condition that is incurable. Fortunately, a range of effective treatments are available and proven effective. Scientific research has shown that integrating both pharmacological and behavioral therapies can lead to increased rates of employment, reduced risk of infectious diseases and criminal behavior, and improved overall brain function and behavior.

When those with opioid use disorder decide to quit, they often experience severe withdrawal symptoms that can trigger relapse. However, medications can be highly beneficial in the detoxification stage, easing cravings and other physical symptoms. Lofexidine is the first non-opioid medication approved by the FDA to reduce opioid withdrawal symptoms.

There are three types of medications used to treat opioid use disorder:

  • Opioid agonists
  • Partial opioid agonists
  • Opioid antagonists

 Methadone, a slow-acting opioid agonist, has been used since the 1960s and is still an excellent option for patients who don’t respond well to other medications. Naltrexone, an opioid antagonist, blocks the action of opioids and is not addictive or sedating, but patient compliance can be challenging. Buprenorphine, a partial opioid agonist, relieves drug cravings without producing dangerous side effects, and its novel formulation (Suboxone) contains naloxone to prevent attempts to get high by injecting the medication.

Effective behavioral therapies for opioid use disorder include contingency management and CBT (cognitive-behavioral therapy). Contingency management uses a voucher-based system to reward patients for negative drug tests, while cognitive-behavioral therapy helps modify expectations and behaviors related to drug use and improves coping skills for dealing with life stressors. It’s essential to tailor the treatment approach to meet the specific needs of each patient. With a combination of pharmacological and behavioral therapies, individuals with heroin addiction can overcome their addiction and achieve a healthier, happier life.

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Get Treatment for Heroin Addiction at California Detox

If you have developed an addiction to heroin, kickstart your recovery with a supervised heroin detox at California Detox in Laguna Beach. Take advantage of FDA-approved medications and continuous clinical care during your withdrawal from heroin.

Following detox, you can move directly into one of these ongoing treatment programs at our luxury beachside treatment facility:

  • Inpatient programs (residential rehab)
  • PHPs (partial hospitalization programs)
  • IOPs (intensive outpatient programs)
  • Dual diagnosis treatment programs (for co-occurring disorders)

All treatment programs deliver individualized heroin detox and addiction treatment that combines science-backed and holistic treatments, such as:

  • Psychotherapy
  • MAT (medication-assisted treatment)
  • Individual counseling
  • Group therapy
  • Family therapy
  • Holistic therapies
  • Aftercare

Call admissions today at 949.694.8305 and take immediate steps to break the cycle of heroin addiction.


The duration of heroin withdrawal can vary from person to person depending on factors like frequency of use, amount of heroin used, and individual physiology. That said, most people start to experience withdrawal symptoms within 6 to 12 hours after the last use of heroin. Withdrawal symptoms from heroin typically persist for 5 to 7 days.
The signs of heroin withdrawal symptoms may include anxiety, restlessness, insomnia, muscle aches, nausea, vomiting, diarrhea, and sweating.


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