The Federal Laws of the United States classify heroin as a schedule I narcotic, which means it is highly abused and serves no medicinal purpose. Heroin is further classified as an opiate because it comes from a natural source, the opium poppy. Opioids, such as OxyContin or Vicodin, are also highly addictive narcotic analgesics, yet they are synthetic and not from a natural source.
Prescription opioids can be the gateway to heroin use as approximately 3 out of 4 new heroin users report the use of opioids before heroin. Because it is cheaper and more available, it has become an appealing alternative as prescription opioids have become increasingly expensive and difficult to obtain.
Detoxing from heroin can be dangerous and challenging without proper management by a medical professional. While the withdrawal itself is not lethal, many of the mental and physical effects can be deadly. An inpatient detox program will provide the best chance to achieve sobriety. It alleviates the physical symptoms that lead many people back to using to relieve physical withdrawal symptoms.
Medication-Assisted Detox and Therapy for Heroin Addiction
Anti-nausea, antidepressants, and anticonvulsants may be prescribed during detox. In addition, some drugs are specific to easing the symptoms of a heroin detox by addressing the physical and emotional effects of withdrawal and cravings.
Methadone: a mild opiate, is used to help taper off the use of heroin.
Subutex/Buprenorphine: helps reduce physical withdrawal symptoms such as muscle aches and vomiting
Vivitrol/Naltrexone: hinders the receptors in the brain that react to opioids/opiates and is most beneficial to those who have completed a heroin detox
Suboxone: Combines buprenorphine combined with naloxone to treat symptoms and hinder brain receptors that react to opioids/opiates.
Detox usually lasts about 5-7 days and is ideally begun before heroin has entirely left the system. Depending on how long or how much one has used heroin, a longer detox might be appropriate. When admitted to an inpatient program, an individual’s physical and emotional health are closely monitored throughout the process.
Heroin Withdrawal
Heroin directly affects the central nervous system, increasing levels of pleasure in the brain. During withdrawal, an individual experiences an opposite effect as the decrease in dopamine levels that result in depression-like feelings.
After continued use, a person quickly develops physical tolerance and dependence, meaning a greater amount of the substance is necessary to achieve the same high, and one needs to use the drug regularly to feel “normal.”. Since heroin is a short-acting opiate, withdrawal symptoms can surface as early as 6 to 12 hours after the substance leaves an individual’s body.
Immediate withdrawal symptoms are incredibly intense, often making it easy to relapse and potentially overdose. Symptoms include:
Flu-like symptoms
Shaking
Muscle spasms
Nausea and vomiting
Sweating
Anxiety
Diarrhea
Dilated pupils
Abdominal cramping
Severe dehydration
Asphyxiation
The most challenging physical withdrawal period is usually the first week, with the most intense symptoms occurring on days two and three. However, the length and severity of withdrawal are heavily dependent on many factors. Factors include:
Frequency of use
Length of time of use
Amount of heroin used
Method of use
Underlying medical or psychological conditions
Even after the initial withdrawal symptoms subside, a person can experience post-acute withdrawal symptoms (PAWS) for up to 18-24 months after the last use. These intermittent symptoms are the result of the changes occurring in the brain from the use of heroin. These include:
Anxiety
Depression
Fatigue
Irritability
Insomnia
Poor concentration
Mood swings
Panic attacks
Memory loss
Heroin Withdrawal Timeline
Each individual who stops heroin use will experience withdrawal differently. However, for reference, here is a general timeline of what one might expect:
Days 1-2: Withdrawal symptoms appear as soon as 6 hours after heroin leaves the body. These can include muscle aches, anxiety, and insomnia.
Days 3-5: Symptoms become much more intense and can include nausea, vomiting, and abdominal cramping
Days 6-7: While acute symptoms generally taper off, signs of fatigue and exhaustion will still be present
Post-Acute Withdrawal Symptoms (PAWS): These symptoms can continue to appear months after acute withdrawal is complete and can last up to 18-24 months and include anxiety, depression, and fatigue.
If you or a loved one is addicted to heroin, do not wait to get help. An inpatient heroin detox program can help you to successfully detox and begin recovery in a safe, healthy way.