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Heroin Withdrawal (Symptoms, PAWS, Length/Duration, Help and Effects)

Heroin Withdrawal

Heroin withdrawal is one of the most difficult you can put yourself through, but:

  • Can You Die From Heroin Withdrawals?
  • What are the Symptoms of heroin Withdrawal
  • How Long Does Heroin Withdrawal Last?
  • What Helps with Heroin Withdrawal?

Those are the questions you are asking us and they are the questions we will address here. This guide can help you with heroin withdrawals, post-acute withdrawal syndrome and everything else. If it’s treatment that you’re after, then visit our Heroin Treatment page instead.

The goal of this guide is to prepare you for what might come; to help you find solutions that can ease the distress; and to ensure you are better informed about heroin withdrawals.

Heroin Withdrawals

Addiction to this opiate is caused by excessive use, which itself may be caused by a number of factors. A user may be going through a hard time emotionally and mentally, and they may take solace in the drug. As with any drug that provides relief, the user will seek-out more and more of it, increasing their dose when the previous dose is no longer effective.

The thing that makes heroin so destructive is that the initial euphoria is much more potent than many other drugs, and the path to addiction is significantly shorter. When you factor in the harsh withdrawal symptoms, and the fact that a user will take more of the drug to avoid these, then you have a recipe for disaster.

Those withdrawal symptoms are one of the main reasons that addicts struggle with their addiction. They are the reason that heroin addicts suffer so much physical and mental trauma and why they are willing to do all that they can do to stop them. Addicts report using heroin to “feel normal”. By this they mean that the heroin takes away the sickness of the withdrawals and makes them feel more human.

Heroin Withdrawal Symptoms

Heroin Withdrawal Symptoms

Acute withdrawal may last for just a week or two, with the heaviest symptoms experienced in the first few days, and the onset beginning between 12 hours and 48 hours after the last dose. However, there is also a long, slow, drawn-out withdrawal which begins when acute withdrawal ends. This is known as Post-Acute Withdrawal Syndrome, or PAWS, and is what causes many addicts to relapse.

Heroin withdrawal can be a crippling experience, but the level of pain you suffer and the length of time you experience this all depends on the extent of your addiction. The following symptoms are common in heroin withdrawal:

  • Fatigue
  • Stomach Cramps
  • Hot/Cold Shivers
  • Skin-Crawling
  • Insomnia
  • Diarrhea
  • Nausea
  • Restless Leg Syndrome
  • Anxiety
  • Runny Nose
  • Watery Eyes

People going through withdrawals also report frequent yawning, a drastic change in libido and many flu-like symptoms.

Long-Term Effects of Heroin: Post-Acute Withdrawal Syndrome

Post-Acute Withdrawal Syndrome is a period of withdrawals that opiate addicts experience, and one that can last for many weeks, months or even years. PAWS is not confined to opiates, but it is more common in opiate addicts, including “lesser” opiates like codeine. The symptoms associated with PAWS include a general malaise, and an inability to experience joy. Fatigue, social anxiety and other psychological issues may also be present. No two cases are the same, but all individuals experiencing PAWS feel a desire to use again.

This is why it is important to approach treatment from both a physical and mental angle, treating the underlying issues and ensuring the patient has continued support that they can rely on.

How Long Does Heroin Withdrawal Last?

Everyone is different, but the worst symptoms tend to disappear within a couple of weeks. The desire to use again can be very high during this period, which is why it is important to tackle the addiction carefully.

Heroin Withdrawal Timeline

Heroin Withdrawal Timeline

Everyone is different and everyone will experience different symptoms. At least for the most part. There are many similarities though and the heroin withdrawal timeline–which is the time from which they stop using and then start feeling healthy–is typically very similar. That applies whether you have been using for just a year or two, or whether you have been using for decades.

The following times are after the final dose has been taken.

  • 12 to 24 hours: The first symptoms begin to take effect. Sickness begins and a general malaise is felt throughout.
  • 1 to 3 days: The withdrawals are increasing with each day.
  • 3 to 6 days: Withdrawals hit their peak. This is when they are at their worst and it’s the point where relapse is most common. However, the peak can only last for 24 hours and rarely lasts more than a couple days.
  • 6 to 10 days: The worst is over, but the addict still feels sick. Boredom and other psychological effects begin to dominate.
  • 10 to 14 Days: The withdrawals begin to fade away. The sickness lingers though and may become more psychological in nature
  • 14 Days Plus: PAWs may take effect. User feels little to no physical or psychological effects, but the cravings, boredom, the change in lifestyle and an occasional inability to feel satisfaction with life’s activities can make relapse very common.

Bear in mind that this heroin withdrawal timeline is based on our own research and experience working with addicts. It will differ from person to person based on length of use genetics, psychological, physiology and even the potency of drug used. This is also based on the user going cold turkey. If you use a taper, which is always recommended, then the symptoms will be much more prolonged but much less severe in nature.

Can You Die From Heroin Withdrawal?

An addict may be malnourished, forgoing a healthy lifestyle to focus entirely on the acquisition and use of the drug, and they may also have collapsed veins from injecting. As a street drug, you can never be sure just what’s in the heroin you are taking, and when you consider that an increase in potency and quantity could lead to overdose and death, you begin to understand just why so many addicts die every year.

In fact, in the two years between 2012 and 2014, close to 1,000 people died from heroin/morphine just in England and Wales. In the US, the numbers are much higher and they are on the increase. However, while heroin addiction, overdose and malnourishment can kill, heroin withdrawal itself is not fatal.

That’s not to say that you will be completely fine. However, the fact of the matter is that you are at a higher risk of death when you are taking the heroin and providing you taper off the drug and are careful through the process then you will make it through without issue. The withdrawals are not as severe as alcohol or certain prescription anti-anxiety drugs.

Quitting Heroin Cold Turkey

The expression “going cold-turkey” has since become synonymous with addiction, but it stems from opiate addiction and withdrawal, referring to the method of abrupt cessation, which increases the severity of the withdrawal symptoms. One of the main symptoms of withdrawal is the inability to stay warm, which is where this phrase comes from.

Drugs to Help Heroin Withdrawal

Heroin Withdrawal Drugs
Addicts often use other drugs as a way to alleviate the symptoms of withdrawal. However, many of these drugs weaken the resolve and lead to relapse, while others increase the chance of side effects. For instance, many addicts find that alcohol makes them queasy and sick, with worse than normal hangovers, while others complain that marijuana and sedatives make them dizzy. During withdrawal, your blood pressure drops and your body struggles to cope, which means it is potentially very dangerous to use other drugs.

We have listed a few drugs below that are commonly used to help with withdrawal and sickness. You may also hear about drugs like diazepam and other sedatives, as well as marijuana. But these target just a few of the symptoms of heroin withdrawal and they can make others worse. Not only that, but in the case of diazepam and xanax, they are incredibly addictive.

Kratom for Heroin Withdrawal

Heroin is a very destructive drug, and that applies whether you are injecting it, smoking it or snorting it. Withdrawals may be difficult, but with the right support and the right methods, it can be a lot easier. You can also try supplemental drugs like kratom to help. It works on similar receptors in the body and can therefore help to ease the heroin withdrawal sickness.

However, you are not depriving your body of opiates, so by using kratom for several weeks and then stopping, you will still experiencing opiate withdrawals. They might not be as severe if you have stopped the heroin, but you will also likely experience some symptoms of heroin withdrawal while using kratom.

Tramadol for Heroin Withdrawal

Many addicts prefer to use opiates when doing though heroin withdrawal and tramadol has gained some popularity in this regard. Codeine and other opiates are also used. But these are not as effective or long-lasting as methadone. Also, tramadol has completely different effects and can create more emotional and psychological problems than other opiates.

Some long-term tramadol users have reported that the withdrawals of this drug last longer and are potentially more damaging than heroin withdrawals. So, it’s not wise to replace one opiate with another and it’s even less wise if that opiate is tramadol.

Alcohol for Heroin Withdrawal

As anyone going through heroin withdrawal can attest, alcohol is not a great drug. It exaggerates many of the heroin withdrawal symptoms. It can make the digestive distress worse; make you very tried and weak; and it can have a strong effect on your psychology as well.

By using alcohol for heroin withdrawal you may be avoiding activating the same receptors that heroin activates, but you could also be making those symptoms worse, not better. What’s more, alcohol addiction and withdrawal is considered to be far more severe and damaging than heroin addiction. It is not a trade you want to make in the long-term and it’s not something that can help much in the short term either.