What to Expect During Heroin Recovery

Content medically reviewed by Vicky Magobet, PMHNP-BC, on August 27, 2021.

What to Expect During Heroin Recovery

The idea of entering heroin recovery can come with a lot of questions. What will your symptoms be like? Can heroin withdrawal be dangerous? What can you expect in the long term as you continue your life following your initial recovery? Heroin recovery can be a daunting process, but proper treatment and medical attention can help. Learning what to expect can help ease some of your concerns and prepare you for the process.

Heroin Withdrawal Symptoms

Heroin withdrawal symptoms can be mild, moderate or severe, depending on when you last used. Withdrawal symptoms include:

  • Cravings: Heroin withdrawal is often characterized by a strong desire to take the drug. Heroin is incredibly addictive, and the cravings are driven by a desire to achieve the feeling the drug produces.
  • Fever: During heroin withdrawal, fever can cause other symptoms like sweating or shivering. Cold flashes can also accompany this symptom.
  • Body aches: Body aches are common during heroin withdrawal. When using the drug, your body's pain pathways do not function normally. When deprived of the drug, the body becomes more sensitive to pain.
  • Gastrointestinal (GI) issues: Nausea, vomiting, diarrhea and abdominal pain or cramps are all common symptoms of heroin withdrawal.
  • Difficulty sleeping: Heroin withdrawal may make you feel anxious and restless, making it difficult to sleep.
  • Mood swings: Many people experience intense, varying feelings while going through withdrawal. You may have bouts of anxiety, irritability, anger and depression.

Heroin Withdrawal Timeline

It is possible for heroin users to develop a physical dependence on the drug within just a few months of use. Once you have become physically dependent on the drug, you will crave it. When you try to stop using or do not have access to the drug, withdrawal occurs.

Everyone's heroin recovery timeline is different. Symptoms can appear in as soon as a few hours and typically last for a day or two. In severe cases of withdrawal, symptoms can last for seven to 10 days. For many people, acute symptoms will resolve by this point, but some do experience post-acute withdrawal syndrome (PAWS).

PAWS shares some symptoms with acute withdrawal. For example, mood swings and difficultly sleeping are common. Other symptoms of PAWS include fatigue, brain fog, difficulty focusing and chronic pain. PAWS does not have a defined timeline. It can persist for months or years after the acute symptoms of withdrawal. Some people may consistently struggle with symptoms, while others will experience symptoms that come and go in cycles.

While everyone's withdrawal timeline is different, treatment providers can help you manage your symptoms as they arise.

Is It Possible to Die From Heroin Withdrawal?

While unpleasant, heroin withdrawal is not typically fatal. While the timeline varies from person to person, physical symptoms usually resolve. In rare cases, it is possible to die during heroin withdrawal.

If symptoms like diarrhea and vomiting persist and go untreated, it is possible to become dehydrated. Untreated vomiting and diarrhea can also result in elevated blood sodium levels. Too much sodium in your blood can cause heart failure.

When the body does not have the liquids it needs, you will feel excessively thirsty, lose consciousness eventually and sustain damage to your internal organs. Dehydration can happen quickly when you are losing your body's fluids due to vomiting and diarrhea.

While it is scary knowing that symptoms of withdrawal can be fatal, remember this is rare. Still, it is critical to seek medical attention and medically assisted detox in a supervised environment. With the right support, you can maintain safe hydration levels.

Treatments During Heroin Recovery

Treatment for heroin addiction often combines two approaches. Medication-assisted treatment (MAT) employs both medication and counseling to help clients work through detox and reach sobriety.

Medications commonly used during opioid addiction treatment include:

  • Buprenorphine: Buprenorphine is a medication that helps manage the cravings associated with withdrawal. While it can help reduce cravings, it does not cause the dangerous "high" someone experiences with heroin.
  • Methadone: Methadone is classified as an opioid agonist. This medication also reduces cravings while minimizing the "high" caused by heroin.
  • Naltrexone: Naltrexone is another opioid agonist, which helps block the effects of opioids like heroin. It is non-addictive and non-sedating.

While undergoing treatment with medication, clients in heroin recovery will also be treated with counseling and behavioral therapy. For example, you may attend individual counseling sessions and group therapy.

Long-Term Treatments After Heroin Withdrawal

Completing initial detox from heroin is a major accomplishment, but you still have steps to take on the road to sustained recovery. Whether you develop PAWS or you are looking for ways to maintain sobriety, consider a number of long-term treatment options after going through heroin withdrawal, including:

  • Self-care: Lifestyle changes can play an important role in your long-term recovery. Commit to eating a healthy diet and exercising regularly. Try to avoid situations you know are going to trigger your desire to use. Surround yourself with supportive people. Be patient with yourself, and remember that recovery is a gradual process.
  • Counseling: Counseling and behavioral therapy do not have to end after your initial withdrawal and treatment. These are excellent ongoing treatment options that can help you maintain sobriety. You may find you like attending one-on-one sessions, group therapy or a combination of both. Your therapist and your peers in your group sessions are there as resources to listen to your experience without judgment and to help you find your path forward.
  • Practice healthy coping methods: Heroin recovery can be a struggle sometimes, and that is OK. Instead of allowing yourself to become discouraged, work on accepting where you are today and engage healthy coping mechanisms to help you get through the tough times. For example, you can keep a journal or notes in your phone for times when you struggle to remember things. Again, counseling can be a useful resource to equip you with healthy coping methods.

Learn More About Medically Assisted Detox at Diamond House Detox

Detoxing from heroin safely is a critical first step in your journey to recovery. At Diamond House Detox, our team of doctors and nurses is with you throughout the entire process to help you manage your symptoms and ensure you are safe. With incidental medical services (IMS), we have experienced medical providers in-house ready to provide individualized treatment.

We work with you to get through detoxification and help build the foundation for lasting sobriety. Contact us to learn more about our treatment approach.


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  2. https://medlineplus.gov/heroin.html
  3. https://www.verywellmind.com/tips-for-withdrawal-fever-management-22373
  4. https://www.webmd.com/connect-to-care/addiction-treatment-recovery/heroin-withdrawal-symptoms
  5. https://www.verywellmind.com/what-is-post-acute-withdrawal-syndrome-22104
  6. https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512
  7. https://www.healthline.com/health/hypernatremia
  8. https://www.cdc.gov/heartdisease/sodium.htm
  9. https://www.samhsa.gov/medication-assisted-treatment
  10. https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder
  11. https://www.healthline.com/health/coping-opiate-withdrawal
  12. https://diamondhousedetox.com/services/heroin-detoxification/
  13. https://diamondhousedetox.com/residential-stabilization-for-drug-and-alcohol-abuse/medically-assisted-detox/incidental-medical-services/
  14. https://diamondhousedetox.com/contact-us/
Psychiatric Mental Health Nurse Practitioner at Diamond House Detox
Vicky is a board certified Family Psychiatric Mental Health Nurse Practitioner, certified by the American Nurses Credentialing Center. She began her nursing career in healthcare by working in the intensive care unit, and then an inpatient psychiatric hospital. After realizing the mental health needs of both the patients and the families she served, she became a Psychiatric Nurse Practitioner. Throughout her experience working with clients, she has developed a passion for those with dual diagnoses and specializes in helping individuals recognize the issues driving their substance use. This recognition has been crucial to the individual’s success in treatment. Vicky opened Diamond House Detox so that she can address these issues early on in a therapeutic environment to allow clients to transition to the next level in their recovery.
Vicky Magobet
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