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Heroin Withdrawal Signs and Symptoms

Heroin's raw components come from poppy plants, most typically found in South America, Mexico, and Asia. The usage of heroin has been illegal in the United States since 1924. Depending on the formulation, it may have a white, brown, or black appearance. The drug has many alternative names, including horse, brown sugar, smack, and crap.


Once you've been dependent on addictive substances, breaking the cycle of use can be extremely difficult. Addiction is a severe condition that can be overcome if the individual understands how to deal with the myriad symptoms of withdrawal that occur during detoxification.

Signs and Symptoms of Heroin Withdrawal

Heroin addiction can lead to overdose and death if not treated properly and promptly. A medically supervised heroin detoxification program should always be the first step in treating opioid dependence, such as heroin.


It would help if you detoxed in a clinical facility with 24-hour medical supervision to prevent the agony and hazards of heroin withdrawal symptoms. The patient's well-being and safety are ensured throughout heroin detoxification under the supervision of medical personnel.


Even though heroin withdrawal is rarely life-threatening, the symptoms are so terrible that it can feel like it. You can anticipate experiencing the following in the earliest stages of heroin withdrawal:


  • Pain in muscles

  • Tear ducts that are working too hard

  • Yawning 

  • Diarrhea

  • Insomnia

  • Anxiety 


The more severe withdrawal symptoms, which often begin within the first two to five days of abstinence, include:


  • Cramping in the stomach

  • Nausea 

  • Sweating

  • Irritability 

  • Goosebumps

  • Drug-induced compulsions

  • Vomiting 

  • Depression

  • Thinking in a cluttered state


However, some less severe signs and symptoms, including weariness, depression, cravings, and minor discomfort, may last up to a month after heroin withdrawal symptoms have subsided. Detoxing in a medical facility under medical supervision is the best option because managing these symptoms alone can be pretty challenging.


Medically Reviewed:


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Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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Extreme Cravings

Extreme cravings are a common sign of heroin withdrawal. As a result of the reduction in heroin supplies, your body is in a state of fear. Your brain knows it will feel better if you give it more substance. You'll have intense cravings, which might be dangerous if you're experiencing them on your own without proper medical supervision.


Cravings can be overwhelming if you aren't in a medical detox environment. People trying to quit heroin often give in to their intense cravings despite their best efforts during detox.


This, however, should not dissuade you from your desire to quit using heroin. In reality, giving in to your cravings to use does not always imply that you have failed to attain your goal in the first place. Just because something has not worked in the past does not imply that it will fail in the future.

Why Does Heroin Withdrawal Occur?

Opioid addiction is possible with all opioids. To get high, you'll need to take a larger dose of heroin when you've developed a tolerance. Physical and psychological dependence on the substance is possible over time.


The brain's nerve receptors are altered when you use opioids regularly for an extended period. They become entirely reliant on heroin to get by. Reducing the amount of heroin that you use may cause withdrawal symptoms. You're experiencing withdrawal symptoms because your body has become accustomed to the presence of the substance in your system.


Medical professionals at a detox clinic will address the physical symptoms of heroin withdrawal to help clients achieve a state of sobriety more painlessly.

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Heroin Withdrawal Timeline

Heroin withdrawals can begin within six hours of the previous dose being taken. Several variables affect the severity and duration of withdrawal symptoms:


  • How have you been using heroin

  • How much heroin you've been using and its strength (and purity)

  • Method of use (smoking, snorting, or injecting) 

  • Addictions, relapses, or withdrawal symptoms in the past 

  • Co-occurring illnesses such as mental illness 

  • Your general well-being or a specific health condition 

  • Whether or not you've been using other drugs in addition to heroin 


The following is a typical withdrawal timeline for heroin:

Days One and Two

Symptoms can manifest themselves as early as 6 hours following the last dose. During the first day of quitting, you may experience muscle pains and joint pains. Over the first two days, these symptoms will become more pronounced. Anxiety, panic episodes, sleeplessness, trembling, and diarrhea are common during this period.

Days 3 through 5

Withdrawal begins to take hold on the 3rd and 4th days. Abdominal tightness, sweating, shivering, nausea, and vomiting are common symptoms throughout this period.

Days 6 through 7

A week is generally the length of the acute withdrawal stage. By this time, your aching muscles and nausea should have subsided. Physically, the user will improve with time, albeit they will still be worn out and exhausted.

PAWS (Post-Acute Withdrawal Syndrome)

Symptoms of withdrawal may recur for months after the onset of acute withdrawal. Neurological alterations are brought on due to heroin usage. The most common long-term effects include agitation, anxiety, depression, and exhaustion.


A variety of mental health issues may accompany heroin addiction. Co-occurring mental diseases with heroin addiction include:



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The Bottom Line

Treatment is complex, and withdrawal from heroin is a nightmare; however, living a drug-free life is your ultimate goal. You will feel like giving up and quitting on yourself at times. So, keep loved ones and close friends closer during these crucial times to give you the necessary support; you do not have to go through treatment alone.


The best part is that you do not have to take the more significant steps overnight. Take the smaller ones and improve on yourself as you move through your recovery journey. Also, remember to enjoy yourself as you continue.

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Signs and symptoms of heroin withdrawal
Extreme cravings
Why does heroin withdrawal occur?
Heroin withdrawal timeline
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