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What are the symptoms of heroin withdrawal?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Heroin addiction is tough to kick. When you go off the drug, your body experiences brutal withdrawal symptoms. These are extremely unpleasant at best, and life-threatening at worst. Don’t try to go through the process on your own. The specialists at Ardu Recovery Center can make the process much easier with targeted therapies and round-the-clock care. Contact us to see how we can help.

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Our specialized heroin detox facility provides medications to alleviate withdrawal symptoms and medical supervision for the detox process.

With compassion and care, our drug addiction treatment center can help ease your discomfort.

What happens to your body when you stop using heroin?

Regular heroin use alters brain communication pathways and hormone levels. It changes the brain’s wiring and chemistry over time, making it dependent on heroin’s effects. When you stop using, your body and brain react intensely to the sudden absence of the toxins they were adjusted to.

Heroin withdrawal refers to the unpleasant and sometimes dangerous physiological and psychological symptoms that occur when you stop or dramatically reduce use. Withdrawal symptoms range from flu-like effects to severe depression, relentlessly intense cravings for heroin, and even potential self-harm ideation. 

Koob and Volkow explain how heroin use affects dopamine, a neurotransmitter that regulates motivation, pleasure, and mood. During heroin’s rush, surging dopamine and opioids flowing in the region regulating motivation condition the user to repeat use. When heroin leaves, dopamine levels drop while stress chemicals in brain areas controlling emotion rise. This gives way to the awful aftermath of withdrawal-induced dysphoria, anxiety, and distress, further perpetuating addictive use.

It’s not uncommon for people trying to get straight to relapse over and over again. This repetitive relapse occurs because the withdrawal sparks overwhelming cravings and instant relief temptation. People addicted to heroin haven’t yet developed coping strategies to resist. 

Until the addiction circuits can re-stabilize without heroin’s influence, they need a medically supervised detox to ease this volatile transitional phase.

Learn about our opioid detox services. Our extensive experience and proven protocols help you to safely, comfortably, and effectively detox from a wide range of substances including fentanyl, oxycodone, codeine, and other opioids.

What are the physical symptoms of heroin withdrawal?

When you try to kick heroin, your body may go into shock from losing its chemical crutch, especially if you have been addicted for years. The physical symptoms of withdrawal from heroin resemble flu symptoms—just much worse.

Here are the most common physical signs your body is going through heroin withdrawal:

  • Bone and muscle pain
  • Abdominal cramping, diarrhea
  • Nausea and vomiting
  • Chills and excessive sweating
  • Dilated pupils, watery eyes
  • Insomnia
  • Restless leg syndrome
  • Appetite changes

The physical symptoms of withdrawal already constitute intense suffering. The bad news is, the concurrent mental and emotional fallout can be equally devastating.

Read more about the devastating effects of heroin abuse on your health.

What are the psychological symptoms of heroin withdrawal?

As if intense physical effects aren’t bad enough, psychological withdrawal symptoms target emotions, personality, and perception. They can inflict damage through depression, cravings, and even hallucinations. 

The psychological symptoms of heroin withdrawal include:

  • Drug cravings
  • Anxiety and restlessness
  • Mood swings
  • Depression
  • Lack of motivation
  • Mental fog
  • Hallucinations
  • Suicidal ideation

With compassionate medical and emotional support, you can develop healthy coping strategies until your mind regains balance and heroin cravings diminish. Drug detox is an important first step in recovery where your body tries to return to its normal rhythm. Detox should be followed by continued addiction treatment where you can focus on healing both body and mind. 

We support you on your way to well-being as you process the psychological impacts of addiction and withdrawal. Our rehab program promotes a life free of heroin and other addictive substances, allowing you to thrive and achieve your full potential.

Heroin withdrawal timeline

The withdrawal timeline can depend on the person’s history—the severity of their dependence, their physical and mental health status, genetics, and how well they care for their body during recovery.

Here’s what the heroin withdrawal timeline may look like:

  • Days 1-2: muscle aches, anxiety, and sweating are the first withdrawal symptoms to appear.
  • Days 3-5: you may experience vomiting, diarrhea, high fever, and uncontrollable shaking as the acute phase of withdrawal peaks.
  • Days 6-7: the most intense physical symptoms improve, but you may still experience exhaustion, insomnia, and depression.
  • Week 2: the physical symptoms largely subside, while the psychological symptoms (mood swings, cravings, lack of motivation) persist.
  • Weeks 3-4: you may still experience cravings, insomnia, and concentration issues in the post-acute withdrawal phase.
  • Month 2 and beyond: some people may be over withdrawal symptoms, while others may still experince lingering effects.

Some effects of quitting heroin drag on well beyond the initial acute physical symptoms. This persistent cluster of protracted withdrawal effects is known as post-acute withdrawal syndrome or PAWS.

PAWS involves prolonged withdrawal during which symptoms such as brain fog, low energy, anxiety, and drug cravings persist for weeks or months. Though frustrating, these symptoms tend to slowly improve over time as the brain heals.

At Ardu, we offer inpatient and outpatient drug treatment services that can assist you through both the acute and post-acute withdrawal phases. Our inpatient drug rehab services and residential treatment programs allow patients to live on-site for a period of time to receive the treatment and support they need. 

If you choose our intensive outpatient treatment, you will be scheduled for appointments at our center where you will receive medical and emotional support.

Is heroin withdrawal dangerous?

If heroin withdrawal isn’t handled right, with enough fluids and proper medical care, it can turn life-threatening. 

Monitoring and medication have to be employed to manage complications of common symptoms of withdrawal. That’s why having health pros supervise heroin detox makes all the difference. Our experts at Ardu will notice and prevent complications associated with heroin withdrawal, so you can get clean, and do it safely.

Opioid addiction and withdrawal shouldn’t be taken lightly. With the right treatment plan and support network, you can set your own pace through the withdrawal process. 

Ardu is here to help. 

This is a place to truly reset your life onto the right path. I learned such great healthy habits to live by. The staff are AMAZING, so caring and friendly. I consider everyone I met at Ardu family. I truly hope the person looking for an amazing place to begin their new journey starts here.

Ashlee Partridge


Do you need help going through heroin withdrawal?

If you or a loved one is struggling with heroin addiction, know that recovery is achievable with proper treatment and support. It is challenging to overcome the emotional and physical dependence on heroin, but with the right help and support, countless people have built happy, fulfilling lives in recovery.

We offer comprehensive drug detox services to help you safely and comfortably detox from heroin. Our experienced medical staff will develop an individualized treatment plan tailored to your unique needs and situation.

Our medical detox program provides 24/7 care and effective medications that alleviate unpleasant withdrawal symptoms. We use prescription medications as needed on a case-by-case basis to make the heroin detox process as comfortable as possible.

In addition to medical detox, we offer holistic detox therapies such as nutritional therapy, yoga therapy, IV amino acid therapy, and massage. Our mind-body approach can help relax the nervous system and restore balance as your body adjusts to life without heroin.

Many people with an addiction to heroin can also face co-occurring mental health issues such as depression, anxiety, trauma, or bipolar disorder. This combination of opioid use disorders and co-occurring disorders is known as a dual diagnosis.

Some of the dual diagnosis treatment services we offer include:

Each type of therapy helps to address the underlying causes of addiction and build healthy coping behaviors. You can choose to attend individual therapy sessions, be a part of group therapy, or both. A customized combination of individual and group psychotherapies addresses all aspects of heroin addiction to give you the best chance of lifelong recovery.

Don’t let you or your loved one become another statistic in the “war on drugs.” Reach out to Ardu today and our caring specialists will be ready to work with you on a personalized treatment plan and get you on the road to recovery.

Brandon Okey

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Symptoms of heroin withdrawal FAQ

When are withdrawal symptoms the strongest?

Opioid withdrawal symptoms—such as those from heroin—peak in severity during the acute opioid withdrawal phase which occurs around 3-5 days after the last heroin use. This mirrors the time it takes for the drug to be fully eliminated from mu-opioid receptors in the brain and body. 

The acute phase brings the most intense physical and psychological symptoms of opioid withdrawal syndrome, including muscle spasms, nausea, drug cravings, anxiety, and depression. These symptoms result from changes in neurotransmitters as well as stress hormone levels as the body struggles to regain homeostasis without opioids. 

What is one of the first signs of withdrawal?

Some of the first signs of opioid withdrawal setting in within the first 1-2 days after stopping using heroin or other opioids include flu-like symptoms like runny nose, anxiety, muscle aches, stomach pains, and intense drug cravings as the brain responds to the abrupt lack of external opioids. Psychological aspects also emerge early on, with agitation, irritability, and drug cravings starting just hours after the last dose, as the reward system becomes hyperactive.

How long does a withdrawal take?

The initial stages of withdrawal from substances like heroin last approximately 5-7 days on average as the majority of physical symptoms peak then slowly improve around a week after last use. However, the overall opioid withdrawal timeline includes protracted withdrawal or PAWS, which can persist for weeks or even months after the initial manifestations fade. This is characterized by psychological symptoms like low energy, impaired concentration, sleep disruptions, and persistent drug cravings.

What is the most serious form of withdrawal?

The most dangerous type of withdrawal is untreated severe alcohol withdrawal, which can progress to delirium tremens with hallucinations and potentially fatal seizures if not managed with proper medical care. Some complications of opioid withdrawal such as severe dehydration, abnormal vital sign changes, heart issues, and metabolic abnormalities can also become life-threatening without clinical monitoring, especially during the peak of acute withdrawal distress.

How do you prevent withdrawal symptoms?

If you want to prevent dangerous withdrawal symptoms, you should:

  1. Slowly taper opioid medications under medical supervision
  2. Avoid abrupt discontinuation of substances like alcohol or benzodiazepines
  3. Adhere closely to prescription instructions
  4. Enrol in medication-assisted treatment programs or professionally supervised detoxification protocols to manage symptoms safely

When you’re going through withdrawal, it’s important to seek help from addiction medicine specialists or facilities—like Ardu—that provide psychological support and holistic therapies to further reduce the risks of adverse withdrawal symptoms.

What are medication-assisted treatments for heroin addiction?

Medication-assisted treatments include methadone, buprenorphine, and extended-release naltrexone are FDA-approved pharmacological therapies combined with counseling for the treatment of heroin addiction. They may also help prevent withdrawal symptoms. These opioid medications activate receptors to reduce cravings and withdrawal distress while blocking euphoric effects. Dual treatment plans with medication, behavioral interventions, psychosocial support, and outpatient services boost addiction recovery outcomes long-term by targeting both the physiological and psychological aspects.

How does family history impact heroin addiction risk?

Genetic makeup contributes moderately to heroin addiction risk. Having a family history of substance abuse or mental illnesses like depression or antisocial personality disorders does increase the likelihood of developing heroin use disorder due to hereditary factors affecting areas like impulsivity, compulsivity, and drug metabolism rates. Environmental influences more strongly determine if initial heroin experimentation turns into addiction. Supportive family therapy helps offset relapses amid intense cravings by motivating continued treatment.

What are the risk factors for developing opioid addiction?

Several key risk factors make people more vulnerable to escalating from initial opioid use for pain relief to full-blown physiological and psychological opioid dependence. These include:

  • Mental illnesses or family history of drug abuse
  • Substance use during adolescence while the brain still develops
  • Improperly high doses of prescribed opioids
  • Mixing drugs
  • Relying on short-acting opioids to induce more rapid highs and lows
  • Easy access to illicit opioids 

These risk factors facilitate loss of control over opioid use. It’s important to understand both personal and environmental risk factors and try to motivate prevention and prompt intervention before severe opioid addiction develops.


Koob, G. F., & Volkow, N. D. (2016). Neurobiology of addiction: A neurocircuitry analysis. The Lancet. Psychiatry, 3(8), 760. https://doi.org/10.1016/S2215-0366(16)00104-8

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