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Heroin Withdrawal Symptoms: What You Need to Know

By Jon McKenna
Medically Reviewed by Fritz L. Hershey, PsyD, MFT on February 03, 2021
Learn what to expect during heroin withdrawal, how long the symptoms may last, and what the risks to your health are.

If your heroin use has spiraled into addiction, then the rush of the high can plunge into unpleasant and even dangerous withdrawal symptoms after a few hours without the drug. Guidelines from the World Health Organization (WHO) compare a typical case of heroin withdrawal to a very bad case of the flu. “Opioid withdrawal can be very uncomfortable and difficult for the patient,” the WHO notes.

The National Institute on Drug Abuse (NIDA) says common symptoms of heroin withdrawal  include:

  • Restlessness
  • Muscle and bone pain
  • Insomnia
  • Diarrhea
  • Vomiting
  • Cold flashes with goosebumps, a.k.a. “cold turkey”
  • Uncontrolled leg movements

Those discomforts can become serious enough that the WHO guidelines recommend that users ask their primary care physician about methadone treatment and heroin withdrawal.

Indeed, death is even possible during heroin withdrawal if you have certain other medical conditions, NIDA warns. Someone who has preexisting conditions is most vulnerable to the changes in heart rate, diarrhea, and vomiting that are part of withdrawal, Donald Rogers tells WebMD Connect to Care. He’s a community outreach director with The Recovery Village outside Philadelphia.

“A major concern with heroin withdrawal is dehydration and the desperate emotional state that accompanies the process,” adds Rich McDonald, clinical director at Wasatch Crest Treatment Services in Park City, Utah. “Even if the withdrawal itself is not dangerous, dehydration can cause significant issues with heart rate and other normal body functions.”

The WHO also recommends that pregnant women who are addicted avoid heroin withdrawal due to the increased risk of miscarriage and early delivery.

Heroin Withdrawal Timeline 

Users may develop a mild heroin use disorder within the first few months, according to Rogers—and from there zip through moderate to severe addiction within weeks.

At that point, someone who is physically dependent on heroin and suddenly can’t get any more of the drug, or tries to stop using, may show withdrawal symptoms within a few hours. McDonald says the symptoms typically last from 36 to 48 hours, but severe cases occasionally drag on as long as 7 to 10 days. Sometimes, milder but persistent withdrawal conditions drag on far longer.

If you believe a loved one or friend is going through heroin addiction, what are the most productive tactics? “The best thing you can do is first start a conversation that you’re noticing a difference in them,” Rogers recommends. Assuming emergency medical care is not needed, “recommend that they go see their primary care physician, with the goal of eventually pursuing treatment.” 

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Treatment & Resources for Heroin Addiction