Heroin Withdrawal Timeline, Symptoms, and Detox Treatment

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heroin withdrawal timeline and symptomsHeroin is an illicit opioid drug that can lead to severe addiction after only a few uses. Because heroin is so potent, most people who misuse the drug end up struggling with a substance use disorder. Unfortunately, heroin addiction often leads to numerous health concerns, including life-threatening overdoses.

According to the National Institute on Drug Abuse (NIDA), 1.1 million people reported using heroin in 2021.[1]

If you or a loved one suffers from heroin addiction, you might be wondering what the withdrawal timeline is like. Typically, heroin withdrawal symptoms will begin within 24 hours of your last dose and last up to a week. Thankfully, medical detox programs can provide you with medications to soothe your symptoms, keeping you safe and focused on recovery.

What is Heroin Withdrawal?

Heroin withdrawal occurs when a person who is physically dependent on heroin suddenly stops using it or significantly reduces their intake.

Heroin is an opioid drug that binds to receptors in the brain, altering the release of neurotransmitters like dopamine and affecting the brain’s reward system. Continuous use leads to the development of physical dependence, where the body adapts to the drug and requires it to function normally.

When heroin use is stopped, the body reacts because it’s no longer receiving the drug it has adapted to. This abrupt cessation triggers a series of physical and psychological withdrawal symptoms ranging from mild to severe.

The primary cause of heroin withdrawal is the body’s attempt to readjust to functioning without the drug. As the body adjusts, withdrawal symptoms subside.

Various factors influence the severity and duration of the heroin withdrawal timeline, including:

  • Extent of use/dosage
  • Method of administration
  • Length of use
  • Frequency of use
  • Polysubstance use
  • Individual body chemistry and genetics
  • Overall health and metabolism

People who use heroin more frequently or in higher doses will experience more severe and long-lasting withdrawal symptoms.

What are the Symptoms of Heroin Withdrawal?

When you are addicted to heroin, your brain and body begin to rely on it to function properly. If you suddenly stop taking it, you will experience symptoms of withdrawal as your brain believes it is missing a necessary chemical.

The common symptoms of heroin withdrawal include:[2]

  • Agitation and anxiety
  • Flu-like symptoms such as teary eyes, runny nose, and muscle aches
  • Insomnia
  • Excessive sweating
  • Frequent yawning
  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goosebumps and shivering
  • Nausea and vomiting

While heroin withdrawal is usually not life-threatening, symptoms of vomiting and diarrhea can lead to severe dehydration without treatment. You should always seek support from a medical detox center rather than attempting to overcome heroin withdrawal on your own.

How Long Does Heroin Withdrawal Last?

Typically, heroin withdrawal begins 24 hours after your last dose and can continue to affect you for 7 days. With that being said, the severity of your heroin use disorder can contribute to how long your symptoms last. For example, someone who was addicted to heroin for five years will experience a longer withdrawal timeline than a person who only abused it for a few months.

The general timeline for heroin withdrawal is as follows:

24 Hours

Within 24 hours of your last dose of heroin, you will begin to experience withdrawal symptoms. Typically, the initial symptoms are mild and may include symptoms like irritability, cravings for heroin, and slight discomfort.

24 to 36 Hours

Sometime between 24 to 36 hours, your symptoms will begin to peak, meaning they will be at their most severe. You must be receiving treatment from a heroin detox center at this point, as many people relapse during peak withdrawal.

Symptoms may include insomnia, nausea, vomiting, diarrhea, and feeling like you have a really bad flu.

4 to 7 Days

Between the fourth and seventh day of heroin withdrawal, your symptoms will begin to subside. It is common for symptoms to slowly dissipate over a few days, with each day symptoms becoming more mild than the last.

It is important to note that some individuals will develop a condition known as post-acute withdrawal syndrome (PAWS), which causes the psychological symptoms of heroin withdrawal to continue affecting them past a week, sometimes for a couple of months.[3] Thankfully, heroin detox centers are equipped to prescribe medications that address PAWS.

How is Heroin Withdrawal Treated in a Detox Program?

The goal of medical detox is to help you overcome heroin withdrawal safely and comfortably while preparing you for further treatment in either an inpatient or outpatient setting.

Upon arrival at a heroin detox center, you will undergo an initial assessment to determine your unique needs. These assessments are then used to create an individualized treatment plan, making it vital that you answer all of the questions honestly.

Once your treatment plan is created, you will be given medications to soothe your symptoms and prevent cravings from occurring. The medications commonly used to treat heroin withdrawal include:

  • Suboxone (buprenorphine/naloxone)
  • Lucemyra (lofexidine)
  • Methadone
  • Clonidine

Once your symptoms subside, you will be able to transfer into an inpatient or outpatient heroin rehab center. These programs offer a range of services, including evidence-based behavioral therapies, group counseling, and aftercare support to ensure you are ready to tackle sobriety outside of a treatment facility.

Get Connected to a Top-Rated Heroin Detox Center

If you or a loved one suffers from heroin addiction, it’s time to seek help. The first step in recovering from a heroin use disorder is attending medical detox. At Archstone Behavioral Health, we can help you overcome heroin withdrawal in a safe and comfortable setting. We approach mental health, medication management, and addiction treatment with a clinically-informed, humanist perspective. The healing that takes place at Archstone is the result of our staff, programs, amenities, and recovery community.

To learn more about our heroin detox program, contact Archstone Behavioral Health today.


  1. The National Institute on Drug Abuse (NIDA): What is the scope of heroin use in the United States, Retrieved November 2023 From https://nida.nih.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states
  2. Medline Plus: Opiate and opioid withdrawal, Retrieved November 2023 From https://medlineplus.gov/ency/article/000949.htm
  3. The Semel Institute for Neuroscience and Human Behavior: Post-Acute Withdrawal Syndrome, Retrieved November 2023 From https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS