Heroin withdrawal that is not medically-induced is typically not life-threatening, despite the tremendous discomfort the person may endure. That said, in rare cases, persistent vomiting and diarrhea may result, and if left untreated, severe dehydration, hypernatremia (elevated blood sodium level), and heart failure.
Also, in the event of an overdose or in settings of ultra-rapid detox where antagonistic drugs such as naloxone are used to reverse the effects of heroin, some of the body’s systems may not be able to handle the sudden chemical changes that occur.
While these medications tend to have a low incidence of harmful effects, careful administration and cardiorespiratory monitoring are warranted. Catecholamines, such as dopamine and adrenaline, are hormones generated by the adrenal glands and can be released from large or rapid doses of naloxone. This can result in cardiac arrhythmia (irregular heartbeat) and pulmonary edema.
Medications more commonly used in non-emergency settings, such as methadone or buprenorphine, do not carry this same risk, however. These drugs are opioid “agonists” that moderately mimic – but not reverse – the effects of heroin.
What is Withdrawal?
Withdrawal from a substance is characterized by the onset of psychological and physiological symptoms if a person sharply reduces their dose or discontinues use of the substance.
For a withdrawal to transpire, the individual must have used the substance repeatedly and have developed a physical/chemical dependence on the substance. Physical dependence has developed when a person’s system is no longer able to function correctly without the drug’s presence.
In almost all cases of physical dependence, the substance has been used over a prolonged period and in large doses. When the body no longer receives these regular doses to which it has become accustomed, it will no longer function normally, and a number of uncomfortable or painful symptoms will ensue.
Most Common Heroin Withdrawal Symptoms
Heroin withdrawal typically involves three stages of symptoms that manifest over hours to days since the last occurrence of drug use, generally.
First-stage symptoms usually appear up to 6-12 hours after the last dose. Second-stage of symptoms usually onset 8-24 hours after the last dose. Third-stage symptoms may occur up to 3 days after the last dose.
Symptoms usually peak between 24-48 hours after first developing but may continue for several days. Each person will likely encounter a unique set of symptoms while undergoing heroin withdrawal. Nonetheless, there are several withdrawal symptoms, both physiological and psychological, that tend to occur in each stage.
During the first stage, drug cravings begin. Heroin-dependent people have acclimated to the continual presence of the drug in their system. As such, those in the throes of an acute withdrawal may feel intense, nearly irresistible cravings for heroin.
Along with these cravings, individuals in this first stage may suffer extreme mood swings, feelings of anxiety, irritability, depression, and even suicidal ideations.
During the second stage, people often experience stomach cramps and flu-like symptoms, including runny nose, sweating, and tearing. Restlessness, insomnia, anxiety, and body aches are also common.
During the third stage, individuals may suffer from diarrhea, nausea, and vomiting, and flu-like symptoms such as fever and chills persist. Muscle spasms, joint pain, and tremors are typical. Heart rate and blood pressure may also increase.
The psychological symptoms of heroin withdrawal tend to be longer-lasting than physiological symptoms. As such, they may or may not occur within this three-stage timeline. Some psychological symptoms can persist for a long time after detox, and some of them may have been pre-existing conditions that were only exacerbated by the withdrawal.
Symptoms of anxiety during heroin withdrawal are likely associated with feelings of withdrawal stress. Moreover, individuals may feel anxiety about life without heroin and may feel increasingly anxious or nervous while considering the prospect of long-term abstinence.
In addition to anxiety, irritability is a normal and common occurrence. Due to the stress of enduring heroin withdrawal, individuals are easily triggered and frequently rude, cold, or downright mean to those around them.
Depression and Suicidal Thoughts
Depression occurs because a person’s body is no longer able to produce its own pleasurable sensations without the assistance of heroin. Some symptoms can include negative or low mood, a lack of motivation, social isolation and withdrawal, helplessness, and hopelessness.
In extreme cases, the individual may be suffering so much that depressive thoughts lead to suicidal ideations or behaviors.
Treatment for Heroin Withdrawal and Addiction
While withdrawal from heroin is rarely fatal, it can and does frequently result in highly unpleasant and sometimes painful effects. Those seeking treatment are urged first to undergo medical detox where patients are monitored by medical staff around-the-clock for several days during the withdrawal process.
After detox, patients are encouraged to participate in long-term inpatient or intensive outpatient treatment. Our center offers services in both formats, which include integrated, evidence-based modalities such as psychotherapy, psychoeducation, group support, and individual and family counseling.
We can help you restore sanity to your life and achieve the long-lasting sobriety and wellness you deserve! Contact us today to find out how!
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