Heroin Withdrawal Timeline

depression person going through heroin withdrawal

When people suffering from heroin use disorder start detox and addiction treatment, it is essential to understand what to expect.

One common question people have is, “What is the heroin withdrawal timeline?” They want to know how long they will experience withdrawal symptoms before they subside.  

What to Expect During Heroin Withdrawal

Heroin withdrawal is the process of the body ridding itself of the drug and healing from heroin use. Withdrawal occurs as the body and brain heal.

Heroin causes chemical and neurological changes in the brain that affect mental and physical well-being. Most people should expect to experience a range of withdrawal symptoms that can vary in intensity and severity.  

An Overview of Heroin Withdrawal Symptoms Timeline

The occurrence of withdrawal symptoms during the heroin withdrawal timeline will vary from person to person. They vary based on the duration and frequency of use, dosage taken, and whether there are co-occurring mental health issues. It also depends on the extent of heroin addiction.

One of the most common symptoms experienced is cravings for heroin. Cravings occur because the body has become accustomed to the drug. It expects more of the drug to induce the desired effects regardless of any negative consequences. 

Another common symptom is mood changes. People can become anxious, irritable, depressed, or agitated. Mood changes occur as the body is trying to heal from the damage heroin caused. 

People also usually experience sleep disturbances, such as insomnia, interrupted sleep, and restlessness. It is vital to remember these are just some of the more common symptoms experienced during the withdrawal process. 

Initial Withdrawal Phase

The initial withdrawal phase usually begins within the first 6 to 12 hours after last using heroin. The withdrawal symptoms are typically mild and easy to manage over the next day or 2. However, the longer one goes without heroin, the more frequent and intense the withdrawal symptoms will become. 

Peak Symptoms

The heroin withdrawal timeline peak symptoms occur between 2 to 7 days, depending on the individual. During this period, the symptoms will become more intense and frequent. Some people with long-term heroin abuse can also experience severe withdrawal symptoms. 

Final and Subsiding Symptoms

Sometime between 5 days and up to 2 weeks after last using heroin, the withdrawal symptoms begin to subside. People will notice the intensity, frequency, and severity lessen. Eventually, the withdrawal symptoms will stop as the body restores balance. 

However, some people can experience lingering psychological withdrawal symptoms. This is referred to as PAWS (post-acute withdrawal syndrome). PAWS can last anywhere from several more weeks to months or sometimes longer. The duration of PAWS can be related to how long a person abused heroin. Fortunately, PAWS symptoms also subside over time. 

Heroin Withdrawal Symptoms Timeline: Psychological Symptoms

The psychological withdrawal symptoms of heroin can start occurring during the initial withdrawal phase. The most common one is cravings for heroin. People can also experience anxiety and irritability. As one moves into the peak withdrawal phase, cravings, irritability, and anxiety can continue and become more intense and frequent.

Other psychological withdrawal symptoms experienced during this time are insomnia and depression. Within a week of quitting, people can also experience mood swings, irritability, and agitation. These can also intensify and become more frequent.

After 2 weeks, most psychological symptoms should have subsided. However, if the individual experiences PAWS, symptoms could include cravings, sleep disturbances, anxiety, depression, and irritability. 

Heroin Withdrawal Symptoms Timeline: Physical Symptoms

The heroin withdrawal symptoms timeline will include various physical symptoms at multiple stages. During the initial withdrawal phase, people could experience:

  • Body aches and pains
  • Stomach cramps
  • Headaches
  • Runny nose
  • Watery eyes

As one moves into the peak phase, physical withdrawal symptoms include initial symptoms as well as: 

  • Nausea
  • Vomiting
  • Fever
  • Diarrhea
  • Dehydration
  • Muscle spasms
  • Excessive sweating
  • Chills
  • Severe stomach cramps

All of the physical withdrawal symptoms should fully subside within a week or 2 of quitting heroin. 

Risks of Quitting Heroin Cold Turkey

Quitting heroin cold turkey has certain risks when a person does not obtain medically supervised detox. While a rare occurrence, death is possible when withdrawal is not supervised. Vomiting and diarrhea can cause dehydration. 

Most people do not think about remaining hydrated because of the physical and emotional discomfort they are in during withdrawal. As a result, this can trigger hypernatremia and cardiac arrest (heart failure). 

Another risk of quitting cold turkey is an increased risk of accidental overdose and death. As the body starts the detox process, it starts healing from the damage caused by heroin abuse. When the withdrawal symptoms become too intense and severe, relapse is common. Relapse occurs because the person wants to make the withdrawal symptoms stop.

However, since their body has already started the detox process, tolerance levels have also decreased. Unfortunately, the person does not know this. So, they use the same amount of heroin as before, which could trigger an overdose. Another overdose cause is taking more heroin than before, believing the higher dose will help the withdrawal symptoms stop faster. Without immediate medical help, the person could potentially die. 

Detox and Heroin Addiction Treatment in Texas

The safest way to manage the heroin withdrawal timeline is with medically supervised detox and heroin addiction treatment. At The Prairie Recovery, we provide round-the-clock monitoring, medication-assisted treatment, and personalized treatment plans. Our compassionate and caring team is ready to help you overcome heroin addiction in a safe and supportive environment.

Contact us today to discover the path to a brighter, heroin-free future. 

Picture of Robert Hilliker, PhD, LCSW‑S, LCDC (Medical Reviewer)
Robert Hilliker, PhD, LCSW‑S, LCDC (Medical Reviewer)

Robert is deeply committed to serving others and is passionate about hope and despair in clinical treatment. With over 20 years in addiction and mental health, he has experience in private practice, clinical supervision, and program management, co-founding The Lovett Center and Ethos. He earned a Master’s degree from the University of Houston’s Graduate College of Social Work, which honored him as a 50 for 50 Alumni in 2019. His education includes fellowships at the Center for Psychoanalytic Studies and The Menninger Clinic, where he held leadership roles and received the Menninger Clinic Pillar Award for Integrity. The Houston Business Journal recognized him as a 40 Under 40 Class of 2018 Honoree.

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