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Heroin is made from morphine, derived from the Asian opium poppy plant.
The addictive chemical is the opioid.

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What is heroin?

Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

How do people use heroin?

People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, a practice called speedballing.

What are the effects of heroin?

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Prescription Opioids and Heroin

Prescription opioid pain medicines such as OxyContin ® and Vicodin ® have effects similar to heroin. Research suggests that misuse of these drugs may open the door to heroin use. Data from 2011 showed that an estimated 4 to 6 percent who misuse prescription opioids switch to heroin and about 80 percent of people who used heroin first misused prescription opioids. More recent data suggest that heroin is frequently the first opioid people use. In a study of those entering treatment for opioid use disorder, approximately one-third reported heroin as the first opioid they used regularly to get high.

This suggests that prescription opioid misuse is just one factor leading to heroin use. Read more about this intertwined problem in our Prescription Opioids and Heroin Research Report.

Short-Term Effects

People who use heroin report feeling a "rush" (a surge of pleasure, or euphoria). However, there are other common effects, including:

dry mouth

warm flushing of the skin

heavy feeling in the arms and legs

nausea and vomiting

severe itching

clouded mental functioning

going "on the nod," a back-and-forth state of being conscious and semiconscious

Long-Term Effects

Injection Drug Use, HIV, and Hepatitis

People who inject drugs such as heroin are at high risk of contracting the HIV and hepatitis C (HCV) virus. These diseases are transmitted through contact with blood or other bodily fluids, which can occur when sharing needles or other injection drug use equipment. HCV is the most common bloodborne infection in the Unites States. HIV (and less often HCV) can also be contracted during unprotected sex, which drug use makes more likely.

Read more about the connection between heroin and these diseases in our Heroin Research Report.

People who use heroin over the long term may develop:

insomnia

collapsed veins for people who inject the drug

damaged tissue inside the nose for people who sniff or snort it

infection of the heart lining and valves

abscesses (swollen tissue filled with pus)

constipation and stomach cramping

liver and kidney disease

lung complications, including pneumonia

mental disorders such as depression and antisocial personality disorder

sexual dysfunction for men

irregular menstrual cycles for women

Other Potential Effects

Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see "Injection Drug Use, HIV, and Hepatitis").

Can a person overdose on heroin?

Yes, a person can overdose on heroin. A heroin overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death. Heroin overdoses have increased in recent years.

When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and long-term mental effects and effects on the nervous system, including coma and permanent brain damage.

How can a heroin overdose be treated?

Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Sometimes more than one dose may be needed to help a person start breathing again, which is why it's important to get the person to an emergency department or a doctor to receive additional support if needed. Read more in the Substance Abuse and Mental Health Services Administration's Opioid Overdose Prevention Toolkit.

Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN ® Nasal Spray and KLOXXADO ®). Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone who is overdosing.

The rising number of opioid overdose deaths has led to an increase in public health efforts to make naloxone available to at-risk persons and their families, as well as first responders and others in the community. Some states have passed laws that allow pharmacists to dispense naloxone without a prescription from a person's personal doctor.

Read more about naloxone in Naloxone DrugFacts.

Is heroin addictive?

Heroin is highly addictive. People who regularly use heroin often develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects. A substance use disorder (SUD) is when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. An SUD can range from mild to severe, the most severe form being addiction.

Those who are addicted to heroin and stop using the drug abruptly may have severe withdrawal. Withdrawal symptoms-which can begin as early as a few hours after the drug was last taken-include:

restlessness

severe muscle and bone pain

sleep problems

diarrhea and vomiting

cold flashes with goose bumps ("cold turkey")

uncontrollable leg movements ("kicking the habit")

severe heroin cravings

Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown some loss of the brain's white matter associated with heroin use, which may affect decision-making, behavior control, and responses to stressful situations.

How is heroin addiction treated?

A range of treatments including medicines and behavioral therapies are effective in helping people stop heroin use. It's important to match the best treatment approach to meet the particular needs of each individual patient.

There are medicines being developed to help with the withdrawal process. The FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms.

Medicines to help people stop using heroin include buprenorphine and methadone. They work by binding to the same opioid receptors in the brain as heroin, but more weakly, reducing cravings and withdrawal symptoms. Another treatment is naltrexone, which blocks opioid receptors and prevents opioid drugs from having an effect. A NIDA study found that once treatment is initiated, both a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in addiction. Because full detoxification is necessary for treatment with naloxone, initiating treatment among active users was difficult, but once detoxification was complete, both medications had similar effectiveness.

Behavioral therapies for heroin addiction include methods called cognitive-behavioral therapy and contingency management. Cognitive-behavioral therapy helps modify the patient's drug-use expectations and behaviors, and helps effectively manage triggers and stress. Contingency management provides motivational incentives, such as vouchers or small cash rewards for positive behaviors such as staying drug-free. These behavioral treatment approaches are especially effective when used along with medicines. Read more about drug addiction treatment in our Treatment Approaches for Drug Addiction DrugFacts.

Points to Remember

Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of various opium poppy plants.

Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, called speedballing.

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

People who use heroin report feeling a "rush" (or euphoria). Other common effects include dry mouth, heavy feelings in the arms and legs, and clouded mental functioning.

Long-term effects may include collapsed veins, infection of the heart lining and valves, abscesses, and lung complications.

Research suggests that misuse of prescription opioid pain medicine is a risk factor for starting heroin use.

A person can overdose on heroin. Naloxone is a medicine that can treat a heroin overdose when given right away, though more than one dose may be needed.

Heroin can lead to addiction, a form of substance use disorder. Withdrawal symptoms include severe muscle and bone pain, sleep problems, diarrhea and vomiting, and severe heroin cravings.

A range of treatments including medicines and behavioral therapies are effective in helping people stop heroin use. However, treatment plans should be individualized to meet the needs of the patient.

Learn More

For more information about heroin, visit our:

References

1. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry. 2014;71(7):821-826. doi:10.1001/jamapsychiatry.2014.366.

2. Carlson RG, Nahhas RW, Martins SS, Daniulaityte R. Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: A natural history study. Drug Alcohol Depend. 2016;160:127-134. doi:10.1016/j.drugalcdep.2015.12.026.

3. Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addict Behav. 2017 Nov;74:63-66. doi: 10.1016/j.addbeh.2017.05.030. Epub 2017 May 23. PubMed PMID: 28582659. https://www.ncbi.nlm.nih.gov/pubmed/28582659

4. Centers for Disease Control and Prevention (CDC). Multiple Cause of Death, 1999-2015. CDC WONDER Online Database. https://wonder.cdc.gov/mcd-icd10.html. Accessed April 4, 2017.

5. Li W, Li Q, Zhu J, et al. White matter impairment in chronic heroin dependence: a quantitative DTI study. Brain Res. 2013;1531:58-64. doi:10.1016/j.brainres.2013.07.036.

6. Liu J, Qin W, Yuan K, et al. Interaction between dysfunctional connectivity at rest and heroin cues-induced brain responses in male abstinent heroin-dependent individuals. PloS One. 2011;6(10):e23098. doi:10.1371/journal.pone.0023098.

7. Qiu Y, Jiang G, Su H, et al. Progressive white matter microstructure damage in male chronic heroin dependent individuals: a DTI and TBSS study. PloS One. 2013;8(5):e63212. doi:10.1371/journal.pone.0063212.

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Heroin DrugFacts | National Institute on Drug Abuse

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Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

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Not quite the heroine...

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A rush of pleasure accompanied by "heavy" arms and legs. Skin flushes and warms, and the mouth gets dry. This is often accompanied with nausea, vomiting, and severe itching.

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Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors. People who use heroin typically report feeling a surge of pleasurable sensation-a "rush." The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors. With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. Nausea, vomiting, and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function is clouded; heart function slows; and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage.

Opioids Act on Many Places in the Brain and Nervous System

Opioids can depress breathing by changing neurochemical activity in the brain stem, where automatic body functions such as breathing and heart rate are controlled.

Opioids can reinforce drug taking behavior by altering activity in the limbic system, which controls emotions.

Opioids can block pain messages transmitted through the spinal cord from the body.

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What are the immediate (short-term) effects of heroin use? | National Institute on Drug Abuse

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Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors.11 People who use heroin typically report feeling a surge of pleasurable sensation-a "rush." The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors.

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User becomes drowsy for several hours, with slowed heartbeat, breathing, and mental function. The breathing can get so low that it may cause a coma,

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Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors. People who use heroin typically report feeling a surge of pleasurable sensation-a "rush." The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors. With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. Nausea, vomiting, and severe itching may also occur. After the initial effects, users usually will be drowsy for several hours; mental function is clouded; heart function slows; and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage.

Opioids Act on Many Places in the Brain and Nervous System

Opioids can depress breathing by changing neurochemical activity in the brain stem, where automatic body functions such as breathing and heart rate are controlled.

Opioids can reinforce drug taking behavior by altering activity in the limbic system, which controls emotions.

Opioids can block pain messages transmitted through the spinal cord from the body.

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What are the immediate (short-term) effects of heroin use? | National Institute on Drug Abuse

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Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors.11 People who use heroin typically report feeling a surge of pleasurable sensation-a "rush." The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors.

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Long-term use of heroin causes the chemicals and hormones of the brain to be imbalanced. It can also eat away at certain parts of your brain, affecting decision making, stress response, and impulse control. The body also builds a very fast tolerance to the drug, causing much more heroin to be needed to reach the same high.

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Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain's white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced abruptly.

Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and leg movements. Major withdrawal symptoms peak between 24-48 hours after the last dose of heroin and subside after about a week. However, some people have shown persistent withdrawal signs for many months. Finally, repeated heroin use often results in heroin use disorder-a chronic relapsing disease that goes beyond physical dependence and is characterized by uncontrollable drug-seeking, no matter the consequences. Heroin is extremely addictive no matter how it is administered, although routes of administration that allow it to reach the brain the fastest (i.e., injection and smoking) increase the risk of developing heroin use disorder. Once a person has heroin use disorder, seeking and using the drug becomes their primary purpose in life.

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What are the long-term effects of heroin use? | National Institute on Drug Abuse

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Repeated heroin use changes the physical structure13 and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed.14,15 Studies have shown some deterioration of the brain's white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.16-18 Heroin also produces profound degrees of tolerance and physical dependence.

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All American Girl - Heroin Super Bowl Commercial

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"All American Girl" is NCADA's second anti-heroin PSA. Premiering during Super Bowl 50, it aims to ignite and elevate the conversation about the realities and catastrophic consequences of opioid and heroin use in our community. Join the conversation on Instagram with #heroin.

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It can cause neonatal abstinence syndrome (NAS).  The heroin addiction gets passed to the baby and the baby can be born addicted to heroin.  This can cause seizures, tremors, and death. They often use morphine to wean the baby off of the drug.

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Ordering Publications

Call 1-877-643-2644 or:

APA style citation

NIDA (2014). Heroin. Retrieved , from https://www.drugabuse.gov/publications/research-reports/heroin

​Research Reports

This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.

Lesson Plan and Activity Finder

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How does heroin use affect pregnant women?

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Ordering Publications Call 1-877-643-2644 or: NIDA (2014). Heroin. Retrieved , from https://www.drugabuse.gov/publications/research-reports/heroin This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest. Lesson Plan and Activity Finder

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Sage Prairie Treatment Facility

Burnsville, MN

New Leaf Sober Living

Anoka, MN

Sovereign Health Pain Program

Minneapolis, MN

Living Free Recovery Services

Minneapolis, MN

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YES
-Nearly 600,000 in 2015 had a heroin disorder which includes health issues and disabilities.
Physical Effects of Addiction - muscle and bone pain, diarrhea, cold chills and
Psychological Effects of Addiction - strong cravings and intense high

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Hotlines:

1-800-725-0922

1-877-393-4424

Website:

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Imagine, for a moment, the analogy of a child trapped in a well. After an unlucky slip, the toddler falls into a dark pit. His only comfort is the solid ground upon which he lands. Every other element causes fear - the fall, the darkness, the isolation and uncertainty.

Heroin addiction is a lot like that. Except there's no solid ground upon which to land. Heroin abusers tumble into addiction's abyss with nothing to stop the fall except jail, death or complete loss of everything in life. I know because I took the tumble. But there is a way out.

I'm not writing this article from an academic perspective. I'm not a therapist, psychiatrist or psychologist. What I have to offer is my experience quitting heroin. I've also worked with many addicts and their families to help nourish freedom from heroin addiction. So I've seen what works and what doesn't.

I know how to quit heroin because I've done it. And you can too. I've been sober from heroin and other mind-altering substances for two years. Not particularly long when it comes to staying sober from alcohol or marijuana. Heroin, however, is a different animal.

This article is structure to reflect the process that usually occurs when someone quits heroin. There's the precovery stage, where a heroin addict wants to get sober but can't quit. This stage can sometimes last years, but it can be expedited with the exercises listed below.

Then there's the withdrawal and detox phase. A lot of people can't quit heroin because of painful withdrawal symptoms. I'll show you that, regardless of your method of heroin detox, it is possible to fight through heroin withdrawal.

Next there's early recovery. This phase is usually defined as anyone with less than one year sober from mind-altering substances. During this time, many people relapse due to post-acute withdrawal symptoms or a weak program of recovery. Heroin addicts who stay sober for one year or longer usually follow four simple suggestions. They actively work with a sponsor, designate a home group, meditate regularly and have sober friends.

Finally, there's the long-term recovery phase. In this stage, a heroin addict has been sober for more than one year, is stable financially and emotionally and works a solid program of recovery.

Unfortunately dope is hardest drug to stop abusing. It beats out cocaine, crack cocaine, methamphetamine, prescription drugs and alcohol in the difficulty department. That's the bad news.

The good news is sustained sobriety - consistent abstinence - from heroin is possible. It's no walk in the park. But most good things in life require commitment and perseverance. Staying sober from heroin is no different.

There are a variety of methods to quit using heroin. I've tried to include all of them in this article even if I disagree with the particular practice. Some have higher success rates than others which I've noted next to the method's name.

For many heroin addicts, the financial resources to detox and enroll in an inpatient heroin treatment program are simply not there. These individuals must grow a very strong desire to stop using, as the process to get clean will be much more difficult.

Bill Dinker (author of this article) Discusses Heroin Epidemic on Huffington Post

Step 1 - Precovery: Time for emotional / personal reflection and exploration

Precovery is a term coined by addiction researcher William White that describes the phase in addiction characterized by an internal dialogue within the addict. Here, a heroin addict starts to grow weary of an addicted life. William White states that:

"Precovery involves several simultaneous processes: physical depletion of the drug's once esteemed value, cognitive disillusionment with the using lifestyle )a "crystallization of discontent" resulting from a pro/con analysis of "the life"), growing emotional distress and self-repugnance, spiritual hunger for greater meaning and purpose in life, breakthroughs in perception of self and world, and (perhaps most catalytic in terms of reaching the recovery initiation tipping point) exposure to recovery carriers - people who offer living proof of the potential for a meaningful life in long-term recovery. These precovery processes reflect a combustive collision between pain and hope."

There's quite a lot to consider there. All White is saying is drug addicts go through a process where they no longer hold substances on a pedestal, get tired of living an addicted life and desire something more for themselves.

It's worthwhile to note that this esteemed addiction researcher cites "recovery carriers" as the most effective element in helping someone sober up. That's a fancy way of saying that when the Big Book of Alcoholics Anonymous came up with its fundamental principle of one alcoholic / drug addict helping another alcoholic / drug addict to stay sober, they were right.

The precovery stage can occur over months, years or decades. With the right tools and exercises, precovery processes can be expedited. These exercises can include guided reflection on substance abuse history, how it has affected the lives of others and other difficult questions. It's important for someone considering a sober way of life to examine their past.

Start by asking yourself some of the following questions:

Am I a truly happy person on heroin, or am I just using the drug to hide my inner discontent?

How has heroin impacted my life in negative ways?

What have I lost as a result of heroin addiction?

What will happen to me if I continue to abuse dope?

How do I perceive myself in light of my addiction to heroin?

How do I think others perceive me in light of my addiction to heroin?

Can I ever be the person I want to be and continue to abuse dope?

Do I lie, cheat or steal in order to obtain heroin?

Am I able to develop lasting relationships while using heroin?

How would my life improve if I stopped using dope?

What do I really desire to do with my life, and how is heroin keeping me from achieving my dreams?

It's not easy, especially for a heroin addict, to ask these questions and answer them honestly. I used heroin to keep my internal discontent from surfacing. I didn't want to deal with my emotions and cowered in fear whenever they surfaced.

Yet the emotional pain these questions may bring will go a long way in fueling the decision to change. Ask and answer honestly. Write your answers down on a sheet of paper. If you aren't willing to do something this simple, then you probably aren't ready to quit heroin.

Step 2 - Develop a willingness to stop using heroin

In my experience, I had a desire to stop using heroin long before I quit. It's very tough to continue abusing a drug when deep down, all you want to do is stop. After almost one year of IV use, the voice in my head telling me I was "in too deep" grew too loud to ignore.

I believe a willingness to quit heroin can come from a variety of factors. These elements can be present in spite of persistent use of the drug. Heroin can't numb emotional states like depression and isolation forever. These feelings eventually arise despite perpetual intoxication.

I had already explored many of the questions presented above during the precovery stage. These factors also drove my decision to get sober:
Depression
From an emotional perspective, I felt completely detached from everything, like all feelings had vanished. I was a character in The Walking Dead, heroin version - an emotionless zombie. Instead of craving human flesh, I fed off the needle.

Shortly before I got sober, my roommate looked at me and said, "You used to laugh and joke around. You never do that anymore." He was right. I had absolutely no personality. I walked around in a heroin haze 24 hours a day.
Isolation
As I progressed in active heroin addiction, I found myself more and more isolated from friends and family. Even when I was around those I loved, I wasn't genuinely present. My mind fantasized about the next fix.

I'd cut time short with loved ones to go get high. I took a few vacations while addicted to heroin and was dejected the entire trip. A truly diabolic characteristic of heroin addiction is its ability to turn the things you used to love into things that make you miserable. Quality time with family and friends became another activity that kept me from doing what I wanted to do: get high.

So I did what all heroin addicts do. I cut ties with those who cared about me. I only left my house to score dope or buy necessary paraphernalia.

Depression and isolation were two sides of the same coin. The more depressed I became, the more I isolated from others. The more I isolated from others, the more depressed I became.
Loss of property
I showed up to detox from heroin with only a car to my name. That car barely ran too. My priority was getting high, not regular automotive maintenance. As a result, the car I had was on its last legs.

For most heroin addicts, automotive ownership is unusual. In addition to any possession of value, many pawn or sell their car. They might take out loans at a "check 2 cash" business. Once all of their property is gone, junkies (a term that is only okay to use if you've been one) start stealing from others. Unfortunately, the ones closest to them are usually the target. Addicts feel comfortable stealing from the ones who love them because it is easier and less risk.

Most family and friends of heroin addicts won't call the cops to report stolen property. As a loved one, a junkie can more easily access their property than a run-of-the-mill thief.

Almost all heroin addicts will not seriously consider sobriety until they have exhausted almost all of their resources and property. There are, however, exceptions. Some do sober up prior to losing everything they hold dear. I was one of the lucky ones.
Loss of identity
It's scary to look in the mirror and not recognize the person you see. It wasn't just my physical appearance. I literally did not know who I was anymore.

Now that I'm sober, I know the precise reason for feeling that way - I had become a different person. I was a junkie. Nothing more, nothing less. Since I'd never been a slave to the needle before, I now realize that I was merely a walking heroin deposit box. Heroin went in. That's it. My sole purpose for life was receipt, use and storage of dope.

Any personality traits, good or bad, were gone. I only existed to shoot dope.
Legal consequences
There are two types of legal consequences: actual and imagined. I've experienced both.

It's ironic that I was never arrested during my time abusing heroin and opiates. But I'd certainly endured some difficult legal problems. There was the high-speed chase, against interstate traffic, at 120+ mph. There was the high-stakes poker bust that was featured on the front page of the newspaper and headlined the local TV news broadcasts.

Booze, pot and benzodiazepines (Xanax) were the common thread in my arrests. But as my heroin use progressed, more and more of the people I knew who abused opiate-based drugs were getting arrested.

I knew it was just a matter of time for me. When you break the law in multiple ways on a regular basis, and I wasn't smart enough to evade trouble forever. Even in a heroin haze, images of police busting down my door plagued me.

Though I wasn't a spiritual man at the time, I became desperate. The night before I used for the last time, I said a foxhole prayer. It'd been a long time since I prayed. Out of sheer terror, I said, "God, please get me sober. Just no jail this time."

Exercises to develop a willingness to quit heroin

Write a list of things you want to accomplish in life, but cannot due to addiction. This list should include:
Financial goals

Would would you like to own one day (a house, a particular car, etc)?

What benevolent causes would you donate to if in a financial position to do so?

Would you start a savings account? If yes, how much would you like to save?

How much will you need to retire comfortably?

Do you want to invest in stocks or start a 401(k)?

Professional goals

What have you always aspired to be in life?

Do you have to have a particular type of education to qualify for that profession?

Once you get that job, what would you like to accomplish professionally (if you start at an entry-level position)?

Personal Goals

What kind of person would you like to become?

What kind of ethics do you want to practice?

Do you want to get married and have a family?

What kind of qualities will you look for in friends?

What are you willing to do to get sober?

Feel free to add any additional questions of your own design. Highlight the supplied answers and keep them readily accessible in a wallet or purse. Whenever you are tempted to use again or feel dedication slipping, reread your goals. For more resources to help cultivate a willingness to quit heroin, please see the end of this article.

Step 3 - Heroin withdrawal, detox and treatment

Heroin withdrawal symptoms are incredibly uncomfortable. It's like the flu on steroids. Between withdrawals and mental compulsion, few make it through heroin detox alone.

Withdrawal symptoms vary from person to person. A variety of factors influence how severe and how long someone experiences withdrawal discomfort. Age, health, duration of use, method of use and amount of use are the primary elements.

What are heroin withdrawal symptoms?

Feverish chills - your body will go from feeling very cold to very hot, similar to a fever. There will be no happy medium, but fortunately, there is something you can do to alleviate this symptom.

What to do to help - take a hot bath as often as possible.

Depression - your body became accustomed to releasing "feel good" chemicals like endorphins when you used heroin. Now that you've stopped using, your body doesn't know what to do. In all likelihood, you'll endure bouts of severe depression. In some cases, heroin withdrawals can fuel suicidal thoughts.

What to do to help - surround yourself with positivity. Watch uplifting movies, listen to feel good songs and read motivating books. Make a short list of people you trust and call them if necessary.

Insomnia - almost every heroin addict will struggle to sleep during the acute withdrawal period (5-7 days). After acute withdrawal ends, many still experience bouts of "post-acute withdrawal syndrome." During this time, recovering heroin addicts have difficulty sleeping and an increased sensitivity to stress.

What to do to help - melatonin, valerian root, magnesium (200mg or less) and calcium supplements (600mg) taken together at night and lavender-based aromatherapy. Exercise will also help, but most people in heroin withdrawal are unable to do much other than rest on a bed or couch.

Restless legs - my least favorite heroin withdrawal symptom. I couldn't keep my legs still for almost three weeks. This is accompanied by general unease and an anxious state of mind.

What to do to help - a hot bath works wonders here too. I also found walking short distances back and forth helped. Some people think antihistamines help with restless legs, but I can't vouch for its effectiveness.

Aching muscles - your body is probably going to feel very sore, like you've been exercising too much.

What to do to help - a hot bath alleviates this symptom too. Another tip is to just get up and walk or run. Most heroin addicts don't feel like doing anything while withdrawing. But if you can just walk or run for 15-30 minutes, it will help immensely.

Anxiety - you will feel a lot of social awkwardness. You almost have to relearn how to community with Earthlings.

What to do to help - Once you're feeling better, start getting to know recovering heroin addicts. Talk to them in private about what they did to get through the social anxiety and awkwardness.

Upset stomach - you can count on diarrhea and vomitting. The severity of these sypmtoms vary from person to person. I had more problems with diarrhea and didn't really vomit much.

What to do to help - Take Immodium (over the counter) for upset stomach. You can also ask a doctor to prescribe Phenergan (generic: Promethazine) for nausea. Phenergan is only available by prescription.

Kindling - Kindling is a term that refers to the phenomenon observed by heroin addiction researchers. They found that heroin withdrawal symptoms became more severe and prolonged the more a heroin addict cycled through abuse and detox. Simply put, withdrawal sypmtoms become more difficult with each successive attempt to quit. I've observed this phenomenon firsthand as many heroin addicts report to me that it was harder and harder to kick the habit the more times they tried.

What to do to help - There isn't much that can be done to alleviate the phenomenon of kindling aside from staying clean after you complete the detox phase.

You should also avoid caffeine, as this may heroin withdrawal symptoms worse. Drink lots of fluids, particularly Gatorade or something with electrolytes. Orange juice or Vitamin C supplements have also been reported to ease heroin withdrawal symptoms.

Wikipedia has a more in-depth article on heroin withdrawal symptoms.

What factors affect the severity of heroin withdrawal symptoms?

The following factors influence the severity of heroin withdrawal symptoms.

Your age can play an important role in the severity of heroin withdrawal symptoms. Generally, the older the person, the more severe the withdrawals. Younger individuals enjoy speedy recovery time, though this may not be the case if other contributing factors are present.

Overall health also plays a role in the severity of symptoms. Most heroin addicts enter the detoxification phase in poor health. They are malnourished, underweight and lack a healthy exercise regimen. What little they do eat is often low in nutritive value.

Health conditions like Hepatitis, HIV or diabetes can magnify the side effects of detox from heroin. Other conditions, like asthma, can also make heroin withdrawal symptoms more acute. It is strongly recommended that anyone with preexisting health conditions seek immediate medical attention if undergoing detox from heroin.

The amount of times heroin is used, on average, throughout the day plays an important role in withdrawal symptoms. The amount used is equally important too. Generally, the more frequent the use, and the higher the dose, the worse the symptoms will be.

In addition to frequency and amount of use, the length of time a heroin addict uses contributes to the length of time and pronunciation of withdrawal symptoms. Over time, heroin begins to change the body's biochemistry. Though many of these changes can be reversed with continuous sobriety, some may be permanent.

Heroin can be snorted, smoked or used intravenously with a hypodermic needle. People who used heroin intravenously will probably suffer more during the detox phase than people who smoked or snorted it.

The purity of a substance, in this case heroin, can make the detox phase more difficult. In general, stronger heroin (more pure) makes withdrawal symptoms more severe. There are two types of heroin - black tar and china white. Black tar heroin that is purchased as a brown powder tends to be more potent than black tar heroin that is already a gummy in texture. China white heroin that is purchased in rock form is usually more potent than china white heroin purchased in powder form.

Individuals co-addicted to substances like alcohol, benzodiazepines (Valium, Xanax), other opiates (Lortab, Percocet, Oxycodone) may experience the withdrawal effects of these drugs too. It is strongly suggested that people co-addicted to alcohol and benzodiazepines undergo heroin detox at an inpatient detox facility or addiction treatment center. Complications from alcohol and benzodiazepine detox can be life-threatening.

There is a phenomenon known as "kindling" which states that withdrawal symptoms become more severe each time a person goes through detoxification. For example, a heroin addict detoxing from the first time will not experience side effects as bad as a heroin addict detoxing from the third time.

Maintenance medications like Suboxone are often used to assist in the detox phase. But these medications can cause withdrawal symptoms too. It is often said that they only "delay the inevitable." Many, however, appreciate the assistance they provide. I believe it is important for a heroin addict to be prepared to experience some pain during the detox phase. Some do not, yet many addicts endure withdrawal symptoms in spite of maintenance medications.

Heroin detox and treatment

This is the most difficult phase heroin addicts face on the road to recovery. There are five options to detox from heroin. Each have their pros and cons, some better than others. Many simply don't make it through the "dopesickness." It's really hard to kick the habit alone. I've personally never heard of anyone staying sober from heroin for good without help, though I'm sure there are isolated exceptions.

If you are considering this critical step, it is very important to reach out to family or friends that may assist with this process. Inpatient heroin detox centers can be expensive without health insurance. And even with health insurance, the costs can be substantial.

It is also be shown that heroin detox alone is ineffective. For the best results, an inpatient/residential heroin treatment program should complement heroin detox. It is strongly suggested that heroin addicts spend a minimum of 90 days in an inpatient/residential recovery center.

Lack of financial assistance from family, friends or a church should not be a deterrent. There are state-funded facilities and vocational rehabilitations that can offer treatment for people with no resources.

The SAMSHA Treatment Facility Locator or the toll-free number at the top right of this screen can be an excellent way to find heroin treatment programs. Regardless of your financial capability to pay for care, there are options to help you find sustained recovery from heroin addiction.

What options are available for heroin detox?

There are 6 options for heroin detox, listed below in order of my personal preference.

This option is the least preferred and has the lowest rate of success. A cold-turkey heroin detox simply means a heroin addict stops using dope without any assistance.

There are some pros to this approach. Heroin withdrawal symptoms won't last as long, but they will be more acute. It is also the most cost-effective choice.

I'm not a big fan of this approach because of the morbid thoughts that can accompany a cold-turkey heroin detox. Kurt Cobain's shocking suicide occurred while he was in acute heroin withdrawal.

Many heroin addicts attempt this method with minimal success. The term "warm-turkey" refers to the use of lesser drugs, like Xanax or weaker opiates, to taper off of heroin.

The problem with this approach is a drug addict usually ends up abusing both heroin and the lesser drug. That happened to me when I tried to quit IV heroin by using Xanax, a drug from the benzodiazepine family.

I also tried using oxycodone, commonly known on the street as "Roxies" or "Roxy", to quit heroin. This method also failed miserably.

I've never heard of this practice working. The only stories I've heard are ones similar to mine, where the problem was compounded by adding an additional substance to the mix.

The only way I can see this method working is if someone without a substance abuse problem administered the lesser drug on a scheduled taper. But this is never something I would recommend, as it puts an innocent person in a dangerous situation. It would also be illegal because they do not have the credentials to administer drugs in this fashion.

Heroin detox with over-the-counter medication

This is a practice that I've heard works for some heroin addicts. The process involves a cocktail of over-the-counter medication. It usually includes ibuprofen, anti-diarrhea medication, sleep aids like melatonin, antihistamines and cough syrup.

The ibuprofen helps with body aches. Anti-diarrhea medication alleviates stomach knots. Melatonin assists with sleep, though most heroin addicts in acute withdrawal will get little, if any, sleep. Antihistamines have been reported to help with restless legs, and the cough syrup helps with body chills.

I never attempted this approach, but I know it doesn't offer the best recipe for success.

Heroin detox with prescription medication

Some heroin addicts decide to go to a Suboxone or Methadone clinic. There are mixed opinions on the effectiveness of this practice. Some experts cite a significant reduction in the rates of relapse. Others note that the person is simply swapping one addiction for another.

There are also serious side effects from long-term use of Suboxone, Methadone or other maintenance medications. Subutex and the newest medication, Zubsolv, carry risks that a patient needs to know prior to entering medicated treatment for opiate or heroin addiction.

I wonder if these experts have heard the phone calls I've received from men and women desperate to get off maintenance medications. The withdrawal symptoms, particularly in the case of Methadone, are more severe than heroin (see opiate withdrawal timeline chart above).

This is a viable option, but I would rather see someone enter medication-assisted treatment with a plan to taper off the medication at some point.

According to WebMD, side effects of Suboxone are, "nausea, vomiting, drowsiness, dizziness, constipation, or headache... If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To prevent constipation, eat a diet adequate in fiber, drink plenty of water, and exercise. Consult your pharmacist for help in selecting a laxative (such as a stimulant type with stool softener).

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Severe (possibly fatal) breathing problems can occur, especially if this medication is abused, injected, or mixed with other depressants (such as alcohol, benzodiazepines including diazepam, other narcotics). Get medical help right away if you have any very serious side effects, including: fainting, fast/irregular heartbeat, severe dizziness, mental/mood changes (such as agitation, confusion, hallucinations), slow/shallow breathing, unusual drowsiness/difficulty waking up.

This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: dark urine, persistent nausea/vomiting/loss of appetite, severe stomach/abdominal pain, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing."

The biggest problem I have with Suboxone is that many addicts sell the drug in order to fund their opiate or heroin habit. When I was using, Suboxone was readily available from a number of black market suppliers.

The other problem too, as mentioned by WebMD, is the complications that can occur when the medicine is mixed with other drugs. When you are dealing with substance abuse problems, there's often more drugs than just heroin in the mix. I liked alcohol, marijuana, pills - pretty much anything that altered my state of mind. And I wasn't the odd man out in this regard. Most heroin addicts enjoy mixing drugs.

Heroin detox at an inpatient medical facility

This option and the next one are the best methods. An inpatient medical/detox facility or treatment center will usually provide a short taper on Suboxone, usually 5-7 days. There may be additional medications prescribed to assist with sleep, like Trazodone, or anxiety and blood pressure, like Clonidine.

There's no question that heroin detox is tough, regardless of the method chosen. But at an inpatient facility, you won't have the temptations of the outside world. You demonstrate, by choosing to enter this phase of recovery, that you are serious about getting clean.

The downside is that medical care like this is often costly. Those without health insurance often find it difficult to find someone willing to contribute financially. This is understandable, as many heroin addicts end up alienating even those that love them the most.

Again, there are state-funded centers that can assist those who are serious about sobriety but lack the necessary resources to pay for treatment services.

Heroin detox at a residential addiction treatment center

This is my favorite approach because it combines the best of both worlds. The heroin addict will be detoxed in a safe, controlled environment and receive treatment.

Some staff members at addiction treatment centers will likely have experience of their own with opiate and heroin addiction. It is very helpful for a heroin addict to know that there are people that understand. These staff members can also guide them on the road to recovery, having travelled it themselves.

Heroin addicts will also learn the tools necessary to stay sober at a residential addiction treatment center. In addition to staff, it is almost certain that some patients at these centers will come from a heroin background. Identification with peers is critical to sustained recovery.

What options are available for heroin addiction treatment?

Individuals seeking treatment for heroin addiction come from a variety of backgrounds. Many people think of a heroin addict as someone who lives on the streets and begs for money. Sometimes this is true, but in many cases, heroin addicts aren't living on the streets.

Almost all cases of heroin addiction involve some level of "enabling" by family and/or friends. Family members are usually in denial that a loved one is addicted to heroin. This is understandable given the stigma present in our society with respect to addiction.

With the financial support of family and friends, most heroin addicts will struggle to find quality treatment. This is a shame because there are facilities that admit heroin addicts with no resources. The demand for free treatment, however, is high and supply is low. Thus, the process for admission requires more of the addict. To secure free addiction treatment, an addict must demonstrate exceptional willingness.

The quality of a heroin treatment program is important. Yet more important is what happens after a recovering heroin addict leaves the facility. Some centers have loose processes in place to assist recovery in the post-treatment phase. There are a few, however, that dedicate substantial resources to providing support in the transition from treatment to the real world.

Ask prospective addiction treatment centers what level of support they offer after the program is completed. Make sure you get direct answers. Some admissions coordinators are skilled in deflecting questions with sketchy answers. For example, you might ask, "Have you studied your program outcomes (results), and if so, what are they?" In turn, an admissions coordinator might respond with, "It works 100% of the time for people that work it." This isn't a valid response and should raise red flags.

Quality addiction treatment centers track outcomes carefully. You should be wary of centers that claim success rates based on only those who respond to the study. It's also not valid for a center to survey program participants only once. Outcome studies should be carried out over a minimum of one year, include all program participants, count non-respondents as relapsed and inquire multiple times.

More on addiction treatment centers and outcome studies.

There are five options for heroin addiction treatment.

The upside to these facilities is cost. A program's price is a primary concern for families, especially those that have supported an addict in unhealthy ways. The downside is that most addicts will receive a lower standard of care. They will also participate with individuals who are mandated by the court system to attend treatment. These people often demonstrate a poor attitude and heavy resistance to healthy change.

State-funded vocational rehabilitation centers

Again, cost is the prime benefit of a vocational rehabilitation center. In these facilities, program participants work in order to pay for treatment. I feel these centers do a good job of teaching addicts that nothing in life comes for free. There's a certain level of responsibility that comes when someone has "skin in the game." The downside is that they may not receive a quality level of care, and there may be people in the program simply trying to complete conditions of a plea bargain.

Christian-based or faith-based recovery centers

These facilities tend to be low in cost, but as anyone in recovery knows, addicts usually demonstrate strong resistent to organized religion. Appropriate candidates for faith-based programs should come from a Christian background. They should also profress a willingness to incorporate elements of their faith into recovery.

Most of these organizations suggest Celebrate Recovery, a faith-based 12 step program, as the vehicle for sustained sobriety upon program completion. Celebrate Recovery isn't nearly as populated as organizations like Alcoholics Anonymous, so an addicted loved one might struggle to build a healthy network of peer support.

Private heroin addiction treatment centers

Most addiction treatment centers accept health insurance to help cover the cost of program tuition. I believe there's a common misconception within the family that health insurance will cover all the costs. In virtually every case, this is simply not true.

Despite what some admissions coordinators say, health insurance usually covers 50-60% of the cost of addiction treatment. And that's assuming there's substance abuse coverage included within the plan. I've also received calls where health insurance suddently denied the patient's claim. In this scenario, family is left to face a situation where their loved one will be discharged from the center unless family agrees to cover substantial costs out-of-pocket.

For this reason and many others, some recovery centers do not accept health insurance. They require 100% of tuition payment out-of-pocket. The upside here is that if your loved one is on your health insurance plan, you won't face increased premiums or get dropped from coverage. The downside is that program tuition can cause a heavy financial burden on the family. At the same time, they won't have to worry about the insurance company suddenly denying the claim.

Private heroin addiction treatment centers often possess the resources to track outcomes with integrity. This allows you to know that your loved one is going to a facility that will teach the tools necessary to stay sober. At that point, it is up to the addicted loved one to put the tools into practice. The best way to find out what centers are reputable is to talk with someone in recovery. Make sure they aren't compensated by the facility as a paid referrer. Please see "How to Choose a Good Drug Rehab" for more information on determining an appropriate facility for your loved one.

Luxury heroin addiction treatment centers

I really feel that I should be forthcoming here and state that I do not support luxury treatment centers. Period.

These facilities offer amenities similar to a resort-style vacation. I'm not saying they don't try to help people. I'm also not saying the programs are bad. I am against luxury treatment centers because I don't think they set a person up for success in the real world. Most people won't return to a lavish life of massages, accupuncture and tanning. It's certainly not recommended as part of a healthy program of recovery.

There's nothing wrong with these amenities. But when I'm speaking with someone considering a luxury treatment center, I ask them, "Do you want to get sober or do you want a vacation?"

Some might respond by saying, "Why not both?" While I understand their sentiment, if you want the best chance to stay sober, go to a facility with a focus on recovery, not vacation-style accomodations.

How do I stay sober from heroin?

A lot of heroin addicts don't have a problem quitting, they have a problem "staying quit." This is where perseverance in a program of recovery pays dividends.

When sober, there are going to be highs and lows. Early recovery can seem like a rollercoaster, but I think it's important to know that is does smooth out.

A solid program of recovery provides tools necessary to meet the good times with a level head and the bad times with a support system. Both skill sets will be critical to sustained sobriety.

In my two years of abstinence from heroin and other mind-altering substances, I've found the following elements critical to staying sober and healthy.

This is the most important aspect in a quality program of heroin recovery. I think it's important to have someone who guides you through the recovery literature, someone who gives genuine feedback and someone who provides support when times get tough.

A good sponsor has one job - take you through the steps as directed in the literature. That's it. Even Dave Navarro of Jane's Addiction says that sustained recovery isn't possible without a spiritual way of life.

More on characteristics of good sponsorship.

12 step meetings offer a place for you to build new, healthy friendships based on sobriety. You can find candidates for sponsorship and opportunities for service work. You can also start to establish a network of peer support and learn effective methods people have practiced to maintain their own sobriety.

Go to a variety of meetings before you settle on a home group. A home group is just a meeting you enjoy that serves as a home base on your road to recovery.

Selfless acts give me a sense of purpose that was completely missing in my addicted life. I've found service work incredibly rewarding. Service work also gives you a way to get plugged into the recovery community.

I can't overstate how much mindfulness meditation has helped me stay sober. This practice allows me a solid measure of physical, mental, emotional and spiritual relief from the day-to-day demands of life. My morning usually begins with 20 minutes of mindfulness meditation to set the tone for a smooth day.

More on mindfulness meditation and addiction recovery.

More on getting through your first year sober.

I hope you've found this article helpful. It represents virtually everything I've found beneficial to my own recovery, and the input of others who've walked the road. I'd love to hear from others in recovery from heroin addiction too.

About the Author

Bill Dinker is a nationally recognized substance abuse recovery expert. He has multiple appearances on the Huffington Post, where he commented on the state of opiate addiction treatment and the heroin epidemic. Bill devotes thousands of hours of his time on the phone counseling families of alcoholic and addicted persons in his role as Director of Admissions at Discovery Place. Author of over 70,000 original words on substance abuse recovery, he is personally sober as an alcoholic, marijuana, cocaine, opiate and heroin addict. Bill received his degree in the Liberal Arts with a minor in business, magna cum laude, from Aquinas College. Mr. Dinker offers his recovery consultations free of charge for families or anyone seeking direction, knowledge and support for a family member, spouse, friend, patient, client or employee.

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Quit Heroin - The Comprehensive Guide to Heroin Recovery

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Imagine, for a moment, the analogy of a child trapped in a well. After an unlucky slip, the toddler falls into a dark pit. His only comfort is the solid ground upon which he lands. Every other element causes fear - the fall, the darkness, the isolation and uncertainty.

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Percentage of Teens who use Heroin in the U.S. in 2016

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Percentage of Teens who use Heroin in the U.S. in 2016

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Past Month: 20%
Past Year: 30%
Lifetime: 70% of 12th Graders

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Heroin | National Institute on Drug Abuse

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Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia.

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1. Highly addictive drug made from morphine
2.  Part of the class of opioids
3. Is a mind altering substance
4.  Almost 80% of people misused opioids before using heroin
5. Made from the resin of the poppy plant
6. Can be injected or snorted
7.  Can clog the blood vessels that lead to the lungs,  kidneys, or brains
8. In 2014 it was found that 900,000 people ages 12 and older had used heroin in the past year
9. In 2013 roughly 8,000 people died from an overdose
10. Deaths of females from heroin overdose have doubled since 2002

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Watch Truth About Drugs Documentary Video & Learn About Substance Addiction. Get The Facts About Painkillers, Marijuana, Cocaine, Meth & Other Illegal Drugs.

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Heroin Statistics - Facts About Heroin Addiction, Use & Death - Drug-Free World

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Use of heroin can lead to...
-  Insomnia
- Constipation
- Lung Complications
- Sexual Dysfunction
- Irregular Menstrual
Cycles
- Depression
- Antisocial Personality
Disorder
- Infections

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NIDA. (2018, June 8). Heroin. Retrieved from https://www.drugabuse.gov/publications/research-reports/heroin

​Research Reports

This series of reports simplifies the science of research findings for the educated lay public, legislators, educational groups, and practitioners. The series reports on research findings of national interest.

Lesson Plan and Activity Finder

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What are the medical complications of chronic heroin use?

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No matter how they ingest the drug, chronic heroin users experience a variety of medical complications, including insomnia and constipation. Lung complications (including various types of pneumonia and tuberculosis) may result from the poor health of the user as well as from heroin's effect of depressing respiration.

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As prescription painkillers become harder to divert, obtain, and alter, many people addicted to opiates are turning to heroin as the answer.

Heroin may be a cheaper alternative to powerful and addictive drugs like OxyContin and Vicodin, and CNN reports that close to half of injection heroin users abused a prescription opioid drug first.

In the past decade, the Centers for Disease Control and Prevention (CDC) reports that heroin abuse has doubled for Americans aged 18-25. In 2013, approximately 8,200 people died from a heroin overdose, which is close to four times the number of heroin-related overdose fatalities in 2002.

Heroin is highly addictive. Due to its powerful withdrawal symptoms, those who are dependent on heroin should access medical detox in order to wean off the drug.

Range of Withdrawal Symptoms

Heroin withdrawal will not be the same for everyone.

The longer someone uses heroin, how it was abused, and how much was taken each time will all be factors in how dependent the brain and body are to the drug. Therefore, the severity and duration of withdrawal will vary as well. Someone with a history of mental illness or addiction may be more likely to become more dependent on the drug faster.

Heroin is an opiate drug that suppresses some of the functions of the central nervous system, like heart rate, blood pressure, respiration, and temperature regulation. It also binds to opioid receptors, increasing chemicals in the brain that are responsible for feelings of pleasure. When heroin is abused, a rush of pleasure occurs, and when it is removed, the opposite effect happens.

Withdrawal symptoms range in accordance with how much the brain relies on heroin and how much of its chemical structure has been altered with its abuse.

For someone who didn't abuse heroin in massive doses for months or years, withdrawal may be more tempered and not last as long.

Mild withdrawal symptoms:

Moderate withdrawal symptoms:

Severe withdrawal symptoms:

Withdrawal from heroin isn't generally considered life-threatening on its own; however, some of the medical and psychological symptoms may have complications that may be life-threatening.

Depression may lead someone to consider suicide, for example. Heroin should never be stopped suddenly without the support of medical and/or mental health professionals who can employ multiple methods for managing the side effects of withdrawal and keep individuals safe.

Duration of Detox

Heroin is a short-acting opioid, meaning that it takes effect rapidly but also leaves the bloodstream quickly. The National Highway Traffic Safety Administration (NHTSA) estimates that heroin withdrawal symptoms start within 6-12 hours of the last dose, peak in 2-3 days, and last 5-10 days in total.

Detox is the method of removing heroin from the body. Since withdrawal can peak after a few days of the last dose, detox in a substance abuse treatment center that offers medical detox may be the most comfortable way to purge the drug from the body and avoid relapse.

Medical detox starts before heroin completely leaves the system and usually takes between 5 and 7 days. For someone who is more heavily dependent on heroin, detox may last a little longer, up to 10 days. Medical detox may use medications and therapy to help the body and brain recover from heroin's effects. Blood pressure, heart rate, breathing, and temperature levels are all monitored to help keep individuals safe and secure throughout the entire process.

Managing Withdrawal at a Heroin Detox Center

The American Society of Addiction Medicine (ASAM) estimates that 517,000 Americans battle heroin addiction. Heroin is classified as a Schedule I drug by the Drug Enforcement Administration (DEA), which means that it is considered to have a high rate of abuse and potential for addiction, and no medicinal uses in this country.

There are several medications approved to treat heroin dependency, some of which may be used during detox to control the more uncomfortable physical and emotional withdrawal side effects, as well as to keep cravings to a minimum. Ideally, this process is undertaken at a professional heroin detox center.

Heroin may be replaced with a longer-acting opioid to relieve withdrawal symptoms and drug cravings, and adjunct medications may also be used to treat specific symptoms. Anti-nausea medications, antidepressants, and anticonvulsants are some examples of symptom-specific medications.

Withdrawal and Suboxone

As a general practice, individuals who receive rehab treatment will undergo medical detox and then intensive therapy treatment. Heroin and other opioids are unique in that there are prescription medications available to assist with both withdrawal and abstinence maintenance. In the case of heroin, a person in recovery may be treated with buprenorphine (Suboxone), methadone, or naltrexone. Each medication can have different introduction times but all will require either an in-clinic visit or a prescription for at-home use. This particular discussion focuses on heroin withdrawal and Suboxone.
As PsychCentral discusses, the U.S. Food and Drug administration approved buprenorphine (branded drugs include Suboxone and Subutex) for the use of opioid withdrawal and as a maintenance therapy. In terms of the withdrawal process, these medications are regarded for their ability to suppress symptoms, including cravings. In this way, buprenorphine and its branded medications serve as a relapse prevention measure. Further, when used as a form of abstinence maintenance therapy, buprenorphine has a lower potential for abuse compared to methadone. Some studies report one-year sobriety rates for those on buprenorphine to be between 40 and 60 percent.

But buprenorphine, particularly Suboxone, is also sometimes used for a separate purpose than its intended use. Some heroin abusers purchase Suboxone on the street as part of a strategy to maintain addiction. These individuals use Suboxone to stave off painful or uncomfortable withdrawal symptoms in between heroin uses. The Suboxone often comes from individuals who have lawful prescriptions and choose to sell the pills. Some individuals who use Suboxone between heroin doses may do so as a way of "chipping,"which is slang for using heroin recreationally without becoming clinically addicted. Chipping, by way of Suboxone use or not, is a highly dangerous behavior and can lead to physical dependence and then addiction.

Heroin Dependency Treatment

Methadone has long been used for the treatment of heroin addiction. It is a long-acting opioid that is substituted for the shorter-acting drug.

Methadone stays active in the bloodstream for an entire day in most cases, meaning that less of the drug will need to be taken at a time. Methadone works to minimize heroin withdrawal by activating the opioid receptors in much the same way as the drug itself, although with less of the intense and rapid onset of euphoria that heroin produces.

Methadone is federally regulated and usually given out as a pill once a day. Methadone doses can be gradually tapered down over time, until the individual's brain catches up and starts producing its "happy cells" on its own. Methadone does still have the potential for creating dependency on it as well, especially if it is abused and taken in higher than intended doses. Other options and medications may be preferable for many individuals.

Another product that is also a partial opioid agonist and long-acting opioid is buprenorphine. Buprenorphine has the added bonus over methadone of reaching a plateau after a certain amount is taken, thereby reducing its abuse potential. Naloxone may also be added to buprenorphine products to block the opioid receptors and keep users from wanting to take more heroin for fear of the onset of withdrawal symptoms when the naloxone is activated. Naltrexone is another opioid antagonist that blocks opioid receptors and can be used for the long-term maintenance of heroin abstinence.

Individuals should be very clear with their drug use history and disclose the correct information about the last dose in order to avoid precipitated withdrawal during detox. If someone takes an active opioid antagonist drug while an opioid agonist, such as heroin, is still in the bloodstream, withdrawal symptoms may be more dangerous and may start suddenly, which is called precipitated withdrawal.

This can be avoided by a drug assessment done upon entering detox. Medical detox can provide a controlled environment that can help prevent any other drug abuse as well.

Medical detox functions optimally as a part of a comprehensive opioid dependency treatment program that will also include further support and services.

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Heroin Withdrawal Timeline, Symptoms and Treatment

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As prescription painkillers become harder to divert, obtain, and alter, many people addicted to opiates are turning to heroin as the answer. Heroin may be a cheaper alternative to powerful and addictive drugs like OxyContin and Vicodin, and CNN reports that close to half of injection heroin users abused a prescription opioid drug first.

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It is most commonly injected with a syringe into a vein or muscle. It can also be snorted, sniffed or smoked.