Heroin abuse is a growing problem around the country. According to the Centers for Disease Control and Prevention, heroin use more than doubled among young adults between the ages of 18 and 25 in the past 10 years. Even occasional heroin use is dangerous because it is a powerful opiate that is highly addictive.
Though it is unlikely that individuals will develop a full-blown addiction to heroin with just one use, it can be the start to a cycle of compulsive, drug-seeking behaviors that eventually result in addiction. The National Institute on Drug Abuse (NIDA) estimates that 23 percent of people who try heroin develop a dependence on it. Once someone is addicted to it, the idea of quitting is scary because the withdrawal process can be hard; however, with the right approach and a proven treatment plan in place, quitting heroin and preventing relapse is entirely possible.
What Makes Heroin So Addictive?
According to the Drug Enforcement Administration, heroin is the most rapidly acting of all opiates. Users can inject, smoke, or snort it, but pure heroin is usually smoked or snorted. Because heroin hits the brain so quickly, it is incredibly addictive. Users crave that initial euphoria, and they will seek it again and again. Eventually, they build up a tolerance to the drug and need to take more of it to feel the same desired effects. When an individual continues to take high doses of heroin, the body becomes dependent on it. People who have developed a dependence on heroin will have withdrawal symptoms if they stop using it.
General Withdrawal Timeline
The intensity and duration of withdrawal symptoms vary among individuals, but there is a general timeline that most people undergoing withdrawal can expect. For most clients, withdrawal symptoms typically arise 6-12 hours after the last dose, peak around 72 hours later, and subside within seven days. It is important to keep in mind that protracted withdrawal symptoms can last for months following treatment. When it comes to acute withdrawal, this is what individuals can expect:
- Days 1-2: The first two days of withdrawal tend to be the most difficult because this is when symptoms are most severe. Withdrawal symptoms usually appear within 12 hours of the last dose. The most common symptoms during this stage are pain and muscle aches. Other early withdrawal symptoms include insomnia, loss of appetite, and diarrhea. Anxiety and panic attacks may also occur.
- Days 3-5: By the third day, the most uncomfortable symptoms have usually subsided; however, they may not have disappeared entirely. It is important to maintain a balanced diet at this stage of withdrawal in order to strengthen the immune system and aid in the recovery process. Many people experience shivers, vomiting, and abdominal cramping during this time.
- Days 6-7: When people reach day six of withdrawal, they are well on the road to recovery. The worst of the withdrawal symptoms have usually subsided by this point. People may still have trouble eating and sleeping, and many experience nausea and anxiety beyond day six.
- Day 8 and beyond: Excessive heroin use changes the circuitry of the brain at the cellular level, which can result in withdrawal symptoms beyond one week. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), protracted withdrawal occurs when symptoms persist beyond the generally expected timeline. Some of the most common symptoms of protracted withdrawal from heroin are anxiety, depression, fatigue, irritability, and insomnia.
A quality treatment program can help clients get through acute withdrawal and give them the tools they need to combat and eventually recover from protracted withdrawal.
What Other Factors Influence Withdrawal?
There are a lot of factors that can influence the intensity of withdrawal symptoms, but there is no way to predict just how quitting heroin will affect users until they have actually stopped taking it. According to a study originally published in The British Journal of Psychiatry, at least two psychological factors affect the severity of withdrawal symptoms. These factors are neuroticism and the degree of distress that the person expects to undergo in withdrawal. Both factors are related to anxiety. When a person knows what to expect after quitting heroin, it can reduce anxiety about going through withdrawal
Other factors that can affect the severity and duration of withdrawal symptoms are the individual’s health before undergoing withdrawal and the extent of the addiction, including the average dosage and frequency of use.
Undergoing medical detox is the first step on the road to recovery. Because addiction affects the body in both physical and psychological ways, it is important that individuals who are quitting heroin have access to quality healthcare while undergoing withdrawal. The team overseeing the medical detox phase will be able to address both the physical and physiological symptoms of withdrawal, making them more manageable for their clients.
Though heroin withdrawal symptoms aren’t usually life-threatening, potential complications could arise. When individuals attempt to go through withdrawal on their own, they run the risk of relapsing as symptoms peak. In medical detox, though, clients will receive help every step of the way. Some of the medications that clients may be given to ease the worst of the withdrawal symptoms are:
According to SAMHSA, drugs like buprenorphine, naltrexone, and methadone help keep cravings and the most intense withdrawal symptoms at bay, and clients may take them during treatment and beyond. Taking medication for a heroin addiction is similar to taking medication for heart disease or diabetes, and it is not merely replacing one addiction for another. In some cases, medicated treatment is necessary; for others, medications are not required. Once clients reach a stable place in their recovery, their doctor can taper them off any medications that they needed up to that point.
In addition to easing withdrawal symptoms, doctors and healthcare staff members at a medical detox program can also prevent dangerous complications from arising during withdrawal and treat any symptoms if they do arise. For example, though heroin withdrawal alone does not produce seizures, they can occur if the user took other drugs in addition to heroin, and is suddenly withdrawing from those substances as well. Dehydration is another complication of heroin withdrawal because diarrhea and vomiting are common.
Long-term heroin use can also lead to serious health problems, which can be diagnosed and addressed upon entering treatment. The most common long-term side effects of abusing heroin include:
- Liver disease
- Kidney disease
- Skin disease and abscesses
- Hepatitis B and C
- Chronic pneumonia
- Collapsed or scarred veins
- Blood clotting, which can lead to heart attack, stroke, and pulmonary embolism
- Respiratory depression
The US National Library of Medicine reports that in 2014, approximately 435,000 people used heroin. If the NIDA estimation is correct and nearly a quarter of them developed a dependence on it, that means more than 100,000 people will have to go through withdrawal when they quit.
Facing withdrawal can feel overwhelming, but the symptoms can be managed with proper treatment, and no one has to go through it alone.
If a loved one is suffering from an addiction to heroin, there is hope. Family and friends can support their loved one during the withdrawal phase and subsequent recovery program. With proper help, recovery is within reach.