Heroin Withdrawal & Detox: Causes, Timeline & Symptoms

Last Updated: December 1, 2023

Editorial Policy | Research Policy

Taking a comprehensive approach to heroin detox recovery that supports physical, mental and emotional well-being can be helpful for long-term success. 

Withdrawal from heroin can be difficult, scary and even life-threatening. Attempts to break free and regain control are met with substantial physical and psychological symptoms, presenting a challenge for those seeking to reduce or stop heroin use. Understanding the process helps. With knowledge of the timeline, symptoms and available support, steps can be taken toward recovery more confidently. 

Causes of Heroin Withdrawal

Two potential withdrawal causes exist, including:

  • Stopping or lowering the dose of heroin quickly 
  • Using a medication acting as a reversal agent or partial agonist like naloxone or buprenorphine, respectively

Tolerance is built with repeated heroin use and higher doses are needed to achieve the same effect. Brain chemistry adapts to repeated use, establishing a new normal state over time. Abruptly removing or blocking heroin throws off this balance, and withdrawal symptoms begin. 

Heroin Withdrawal Timeline: How Long Does Heroin Withdrawal Last?

Because of the short half-life of heroin in the body, withdrawal symptoms can begin relatively quickly. The timeline is often broken down into four distinct phases centered around symptom severity and the time since the last dose: 

  • Symptom onset, 6–12 hours after the last dose
  • Symptoms peak in 36–72 hours
  • Symptoms taper off in four to seven days
  • Post-acute phase, sometimes lasting months 

Continued support is crucial in the weeks and months after the initial withdrawal symptoms subside. Relapse can be prevented with consistent, non-judgmental social support among family or friends and attending follow-up treatment programs

Heroin Withdrawal Symptoms

The symptoms of withdrawal can vary between individuals but are ultimately consistent with opioid withdrawal symptoms overall: 

Early Symptoms

  • Anxiety
  • Muscle pain
  • Cravings

Peak Symptoms

  • Nausea and vomiting
  • Diarrhea
  • Sweating and chills
  • Insomnia
  • Dilated pupils
  • Cravings

The physical symptoms of withdrawal peak within several days and tend to taper off over a week. Short-acting opioids like heroin are often associated with increased symptom severity, adding to the discomfort and dangers of attempting to detox at home. Symptom severity can also vary depending on the dosage and frequency of use and other underlying health conditions. 

Post-Acute Symptoms

  • Anxiety
  • Depression
  • Mood swings
  • Irritability
  • Insomnia
  • Persistent cravings 

In the weeks and months following the initial detox, physical symptoms will have subsided, but psychological symptoms often persist, and any underlying mood disorders may resurface. This is why support continues to be important on the path toward recovery. 

Heroin Withdrawal Management

Heroin withdrawal symptoms are uncomfortable and daunting, but withdrawal’s initial effects are not life-threatening with proper care. The dangers of further damage lie in the potential for dehydration and electrolyte imbalances. If left untreated, multiple systems can be affected, resulting in outcomes like kidney failure or seizures. These imbalances carry the potential to become deadly. 

Quitting Heroin Cold Turkey

Abruptly stopping heroin is possible but will initiate withdrawal symptoms. The severity of these symptoms will depend on how long heroin has been used, the level of dependence, the dose used and how often it is administered. These symptoms can also vary between individuals, making it difficult to predict how any one person will respond. The help of healthcare professionals is always advised to help ensure your safety. 

Detoxing From Heroin at Home

If you or a loved one is considering navigating heroin detox at home, there are some important things to keep in mind: 

  • Due to reductions in tolerance after initial withdrawal, dangerous or life-threatening heroin overdoses during any potential relapses may be more likely.
  • Studies show that Medication-Assisted Treatment (MAT) is effective and can save lives. 
  • Recovery is a complex, life-long process. Long-term success and safety are more likely with the help of dedicated professionals. 

Removing the stigma from seeking help with using any opioid is important, whether it be the support of family and friends or the help of a team of healthcare providers. Multiple professional support levels are available, such as confidential hotlines, remote telehealth options and outpatient treatment programs that allow you to stay home. 

Medication-Assisted Treatment (MAT) for Heroin Withdrawal

Medications have become a mainstay in withdrawal management and longer-term therapy for individuals in recovery. These medications can help ease the symptoms of withdrawal and help reduce the number of relapses and overdoses with continued use. Several medications commonly used in this setting are: 

  • Buprenorphine, often combined with naloxone (e.g., Suboxone)
  • Methadone
  • Naltrexone
  • Naloxone

In recent years, legislation has shifted to destigmatize support for opioid use disorder management further and promote improved access to these medications. As of December 2022, the Mainstreaming Addiction Treatment Act (sometimes also referred to by the acronym MAT) was enacted, simplifying the process of supplying buprenorphine. 

Deciding on Where to Detox in Indiana

Taking a comprehensive approach that supports physical health and mental and emotional well-being can be very helpful for long-term success. The Recovery Village Indianapolis provides quality, compassionate, evidence-based care tailored to individual needs. Take the next step on your path to recovery by reaching out today.


Shah, Mansi; Huecker, Martin R. “Opioid Withdrawal.” National Library of Medicine, July 2023. Accessed September 28, 2023.

Kosten, Thomas R.; George, Tony P. “The Neurobiology of Opioid Dependence: Implications for Treatment.” Science & Practice Perspectives, July 2002. Accessed September 28, 2023.

Kosten, Thomas R.; Baxter, Louis E. “Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment.” The American journal on addictions, January 2019. Accessed September 29, 2023.

Smyth, B. P.; Barry, J.; Keenan, E.; Ducray, K. “Lapse and relapse following inpatient treatment of opiate dependence.” Irish Medical Journal, June 2010. Accessed September 29, 2023.

Srivastava, A. Benjamin; Mariani, John J.; Levin, Francis R. “New directions in the treatment of opioid withdrawal.” Lancet, June 20, 2020. Accessed September 28, 2023.

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