Imagine the worst flu you’ve ever. Now multiply it by 1000. That is how many a recovering addict describes the initial heroin withdrawal symptoms. Unfortunately, the fear of such a painful detoxification—or “detox” as it is commonly called—prevents many addicts from beginning the journey of recovery.
Luckily, there are medications and treatments available to help ease the discomfort associated with heroin withdrawal. From FDA approved medications or a more holistic approach, to counseling services and sober support groups, the resources are aplenty if the addict wants help.
Before taking a closer look at those resources, it is useful to take a closer examination of heroin withdrawal. What is heroin withdrawal in the first place? Why does it occur? And what are the symptoms?
What is Heroin Withdrawal?
Heroin withdrawal symptoms occur when there is a cessation or reduction of heavy and prolonged use. It causes clinically significant distress and impairment in social, occupational, or other important areas of functioning.[1]
Heroin withdrawal can last for days or weeks, depending on the individual. According to The Recovery Village website:
Different opioid drugs have different timelines for withdrawal, and it depends on how much and for how long the individual used heroin. For heroin, the withdrawal symptoms start within the first 24 hours (sometimes as soon as four hours) from the last use, peak within 36 to 72 hours, and last seven to 10 days for most people. People who use heroin chronically may experience some withdrawal for up to three or four weeks.
Heroin users account for the highest rate of relapse among all substance use disorders, with some studies suggesting it is as high as 90 percent.[2] According to a study from researchers for the Journal of Addiction, “Early relapse after inpatient detoxification has been found to be significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and failure to enter aftercare.”
Why Does Heroin Withdrawal Occur?
Heroin and other opioids cause physical dependence, meaning the user relies on the drug to simply feel normal. Over time, more of the drug is needed to achieve the same effect, thus creating drug tolerance.
Once physical dependence and drug tolerance enter the equation, withdrawal is a strong possibility.[3]
In other words, heroin users essentially alter their brain chemistry. According to the Addictions and Recovery website:
Withdrawal occurs because your brain works like a spring when it comes to addiction. Drugs and alcohol are brain depressants that push down the spring.
They suppress your brain’s production of neurotransmitters like noradrenaline. When you stop using drugs or alcohol it’s like taking the weight off the spring, and your brain rebounds by producing a surge of adrenaline that causes withdrawal symptoms.
What are the Heroin Withdrawal Symptoms?
- Increased sweating, rhinorrhea (severe runny nose), urinary frequency
- Diarrhoea, abdominal cramps, nausea, vomiting
- Muscle spasm leading to headaches, back aches, cramps, twitching, arthralgia (joint pain)
- Piloerection (goose bumps), pupillary dilatation, elevated blood pressure, tachycardia (elevated heart rate)
- Anxiety, irritability, dysphoria, disturbed sleep, increased cravings for opioids[4]
Help Resources
Although resources are available for those struggling with heroin withdrawal symptoms, it is merely the first step toward a long road to recovery. According to an article published on health.gov.au:
Withdrawal services should not be seen as a stand-alone treatment that is likely to result in prolonged periods of abstinence, but instead as a transitional step on the long road to abstinence. Indeed, research suggests that withdrawal treatment alone has little, if any, long-term impact on levels of drug use (Mattick & Hall 1996; Vaillant 1988). Unfortunately, many patients, families, friends, and health and welfare professionals hold unrealistic expectations regarding the outcomes of withdrawal services. Many are disappointed when people in these programs either cannot give up their heroin use in the first place, or recommence regular heroin use soon after a withdrawal attempt.
Nonetheless, there are more than 14,500 specialized substance abuse treatment facilities in the United States. Nearly all of them can offer some form of care, be It in the form of therapy, counseling or medication.
Withdrawal services generally seek to accomplish the following objectives:
- To alleviate distress.
- To prevent other severe problems associated with withdrawal.
- To provide linkages to and enable engagement in ongoing treatment.
- To break a pattern of heavy and regular drug use.
- To get help with any other problems.
Heroin withdrawal medications include methadone and buprenorphine (often in the form of Suboxone, which also blocks opioid receptor sites to prevent any attempts at abuse), the only two FDA-approved opioids for the treatment of heroin withdrawal symptoms.
Other medications, often in the form of sedatives like benzodiazepines or clonidine, are also commonly uses to treat specific symptoms.
A more holistic approach though the use of acupuncture or home remedies like herbal supplements or vitamins is not recommended. According to The Recovery Village, “There is very little scientific or clinical evidence to indicate that natural remedies for opiate withdrawal are effective. There are herbs that some people believe do help, such as ginseng or various blends that could help restore regular brain chemistry.”
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[1] health gov au
[2] ncbi nlm nih gov pmc articles
[3] medlineplus gov ency article
[4] health gov au
