If you had only known what you were dealing with in the very beginning. If you are a parent, you are probably saying, “If I had only noticed the signs sooner.” You are not alone. It’s not because you’re weak or don’t have enough willpower to kick the habit. Heroin is not a drug to take lightly. It is almost guaranteed that most heroin abusers will form an addiction to the drug while finding it nearly impossible to get off. Heroin tricks your mind into believing you need it much more than any other drug. And you don’t just want it every other week or day, you may need it every hour.
Heroin withdrawal is not an easy process. Symptoms of withdrawal include muscle aches, anxiety, and sleeplessness. However, the right treatment can help make the detox and withdrawal processes manageable. Keep reading to learn more about heroin withdrawal and treatment.
Let’s explore the gritty truths about this highly addictive and destructive drug as we start you on your path to recovery.
- What is Heroin?
- Heroin Effects & Side Effects
- Heroin Addiction
- Long-term Effects of Usage & Addiction
- Heroin Abuse Statistics in the US
- Heroin Overdose Statistics in the US
- Heroin Withdrawal
- Heroin Withdrawal Timeline
- Getting Help to End Heroin Addiction
- References & Resources
What is Heroin?
Heroin is an illegal substance processed from morphine. The drug is highly addictive occurs naturally from the seed pod of certain poppy plants. The solid white or slightly brown powder is typically added to sugars or starch.
Pure heroin is snorted or smoked and does not have to be injected. Heroin that is not highly pure is typically dissolved and diluted before being injected into the veins or muscles. Heroin is a Schedule I drug, and it cannot be prescribed by medical professionals.
As a Schedule I drug, heroin has no medical uses and is completely illegal in the US. Because of this, heroin dealers often come up with different names to avoid detection by the police.
Common street names
- Big H
- China white
Heroin is often cut with other substances and goes by many different names depending on the combination.
Common heroin combination names
- Dynamite: heroin and cocaine
- Primo or dragon rock: heroin and crack
- Screwball: heroin and meth
- H-bomb: heroin and ecstasy
- Neon nod: heroin and LSD (acid)
- Chocolate bars: heroin and Xanax
- Atom bomb or A-bomb: heroin and marijuana
- El diablo: heroin, cocaine, and marijuana
- LBJ: heroin, LSD, and PCP
One of the most lethal mixes is the combination of heroin and fentanyl. Typically, users don’t even know that fentanyl has been added to their bag of heroin until they experience extreme effects, such as overdose and death.
Common ways heroin is used
As previously mentioned, heroin is ingested in a number of ways. The white powder is snorted or smoked. The black tar is dissolved, diluted and injected into the veins or under the skin.
How heroin works
Heroin attaches to specific receptors in the brain that control our pain and reward sensors. The activation of these receptors causes one of our body’s messengers, dopamine, to flood the brain and produce intense feelings of pleasure.
Heroin Effects & Side Effects
Heroin impacts the brain by binding to mu-opioid receptors (MORs). By activating these receptors, heroin can stimulate the release of neurotransmitter dopamine. MORs active in the brain’s reward center can regulate pain and produce feelings of well-being. These effects can reinforce the behavior of taking heroin.
The immediate effects of heroin can include a pleasurable sensation or a rush. How much of the drug is taken and how rapidly it binds to the opioid receptors can impact the intensity of the rush.
Effects of heroin usage
- warm flushing of the skin
- dry mouth
- heavy feeling in limbs
- nausea and vomiting
- intense itching
- cloudy or foggy mental function
- slow heart beat
- slow breathing or shortness of breath
- chest pain
When the immediate effects of heroin wear off, users can feel drowsy for several hours. Mental function is slowed or clouded and the heart slows down. Breathing is slowed, which can lead to coma, brain damage, or even death.
Long-term heroin use can cause the white matter in the brain to deteriorate. Over time, the drug can impact a person’s ability to make decisions, regulate their behavior, and respond to stress. Regularly using heroin can also lead to tolerance or a physical dependence. If a dependence on heroin is developed, withdrawal symptoms can occur if someone stops using the drug.
How long does heroin stay in your system?
The immediate effects of heroin can last for up to 30 minutes. Heroin is a fast-acting drug with a short half-life. Effects can begin almost immediately and wear off completely within a few hours. Heroin metabolizes to 6-acetyl morphine and morphine with a half-life of two to six minutes.
For urine tests, heroin can be detected for one to four days after usage. A blood test can detect heroin for up to six hours, and a saliva test can detect the drug for up to 24 hours. Hair tests, while less common, can detect heroin for up to 90 days.
It is possible for poppy seeds to produce a false positive test for heroin. There are trace amounts of morphine and codeine in poppy seeds, which could read positive for heroin. If you have an upcoming drug test, it is best to avoid food or medications that could trigger a false positive test result.
To get heroin out of your system, you have to stop taking the drug. Then, you have to allow time for the drug to metabolize and be eliminated from your body. However, be aware that stopping heroin use cold turkey can lead to withdrawal and potentially dangerous side effects.
Many users attempt to hide the signs and symptoms of heroin use and may try to write them off as a one-time occurrence. However, heroin is rarely used one time. So, what do you look for to determine if a loved on is intoxicated or addicted to heroin?
Signs of heroin intoxication
- changes in size of pupils
- bad mood or dysphoria
- discolored tongue
- depressed feelings
- irritability or restlessness
- runny nose
- track marks
- missing family or work obligations
Frankly, the life of an addict revolves around the drug. Additional signs of heroin abuse include clouded judgement and unexplained flu-like symptoms.
Long-term Effects of Usage & Addiction
Frequent and long-term use of heroin can have irreversible effects on the chemistry of the brain. An abuser can become addicted to heroin after just the first or second use regardless of the method of ingestion. Users often believe that smoking heroine is less addictive than injection via a needle, but this is not true.
- impaired decision making
- inability to regulate behavior
- Abuse of heroin can also lead to serious neuropsychological complications and a lifelong addiction to drugs.
- insomnia and constipation
- lung complications (including various types of pneumonia and tuberculosis)
- mental disorders, such as depression and personality disorders
- sexual dysfunction
- nose tissue damage
- scarred and collapsed veins
- clogged blood vessels
- problems in the cells of vital organs leading to arthritis
- Hepatitis B, C, and HIV
According to Oxford University’s Dictionary of Psychology, addiction is defined as “a state of dependency on a chemical substance, especially on a drug such as alcohol … Or narcotic such as morphine or heroin, characterized by strong physiological and/or psychological need and a compulsive inability to resist taking the drug despite anticipation of probable adverse consequences.” Simply put, an addiction causes you to intensely crave and continue seeking a substance in spite of how bad it makes your life or how much it damages your body.
Since heroin increases the dopamine in the reward center of the brain, it causes the brain to adapt to this high amount of dopamine and become less sensitive to the chemical response. The brain builds a physical dependence on this feeling of pleasure, which leads users to consume stronger doses in order to obtain the same high and to prevent heroin withdrawal symptoms. Heroin addiction certainly is one drug that destroys lives and ruins the body’s organs—heroin can also damage the reproductive, digestive, and cardiovascular systems and lead to heart, lung and liver disease.
Heroin Abuse Statistics in the US
Over 500,000 people in the US suffer from a heroin use disorder with a steady increase in the numbers of first-time abusers each year. The youngest reported age group is between 12 and 16 years old, while the highest percentage of users are 18 to 25.
In the past, heroin use predominated urban areas, but has increasingly began to impact rural and suburban regions as the progression from opioids to cheaper and easier access drugs has increased. At one point, heroin use was also highest among non-Hispanic white males, but has increased among new groups including women, those using prescription opioids and people with higher incomes.
Heroin Overdose Statistics in the US
Almost one third of opioid deaths involve heroin use. Over 15,000 people died from heroin overdose in 2018, increasing the numbers of overdoses by 5 times compared to 2010. This means heroin deaths have surpassed the number of deaths due to fatal car accidents.
A heroin overdose can be life-threatening, and many people have overdosed on their first time using the drug. For those who manage to live through an overdose, there can be detrimental lifelong effects, including paralysis. It is important to seek help immediately if you or someone you know show the following signs of an overdose.
- bluish lips, nails or fingers
- slow and shallow breathing
- weak pulse
- extreme drowsiness
- delirium or confusion
- loss of consciousness
Quitting heroin can be extremely painful and requires complete detox from the drug. Withdrawal symptoms can begin a few hours after the drug was last taken.
If someone with a heroin addiction or dependence stops taking the drug, they may experience withdrawal symptoms. The painful symptoms of heroin withdrawal sometimes cause heroin addicts to continue using the drug, which is why medically supervised detox is the best option for getting clean. Withdrawal symptoms can begin within six to 12 hours after the last dose of heroin.
Heroin withdrawal symptoms have been compared to a bad case of the flu. Symptoms can peak after a couple of days, but they may last for a week or more.
Signs of Heroin Withdrawal
Signs of heroin withdrawal typically include the symptoms listed above. Users who are experiencing heroin withdrawal may also suffer from muscle spasms, sweating, shaking, nervousness, and agitation. They will like have cravings for drugs during this time as well.
List of common withdrawal symptoms
- Abdominal cramping
- Dilated pupils
- Muscle aches
- Difficulty breathing
- Rapid heart rate
- Goose bumps
- Difficulty concentrating
Can you die from heroin withdrawal?
Withdrawal from heroin can be deadly if not properly overseen by a medical professional. Inaccurate information available online or from unreliable sources can cause people struggling with drug addiction to avoid getting help. However, a medical professional can provide the guidance and oversight needed to ensure withdrawal is handled safely.
In the proper medical facility, heroin withdrawal is not likely to cause death. Trained doctors and nurses on staff can provide medical attention if a person suffers dangerous symptoms of withdrawal. The staff can also provide the proper nutrition, environment, and medication to help mitigate the effects of withdrawal.
How long does heroin withdrawal last?
It is difficult to determine exactly how long heroin withdrawal will last because the process is different for everyone. A variety of factors can impact the duration of heroin withdrawal, including:
- How long someone has abused heroin
- How much heroin someone took each time they used the drug
- How frequently an individual used heroin
- The method used to take heroin
- Any existing or underlying health issues
It is also possible to experience Post-Acute Withdrawal Syndrome (PAWS) depending on how much and how long the individual used heroin. PAWS symptoms can last for one to two years, even after initial withdrawal symptoms subside.
Opiate PAWS symptoms
- Panic attacks
- Poor sleep
- Mood swings
- Poor concentration
- Memory loss
Heroin Withdrawal Timeline
While heroin withdrawal affects each user differently, there are some similarities among withdrawal timelines. For many users, withdrawal symptoms can begin within just six hours of the last dose. Throughout the first day of withdrawal, individuals may experience pain and muscle aches which intensify over the next 48 hours. The first couple of days can also include symptoms like anxiety and panic attacks, insomnia, and diarrhea.
Days three through five are typically the peak of withdrawal symptoms. A person may experience abdominal cramps, sweating, shivers, nausea, and vomiting. By the end of the week, symptoms tend to taper off. Muscle aches and nausea can lessen significantly, signifying the end of acute withdrawal. Heroin users may begin to feel more normal within a week, but they will still likely experience fatigue.
Getting Help to End Heroin Addiction
Heroin is one of the most dangerous drugs available and is highly addictive. It is critical that you get help as soon as possible if you or a loved one suffer from this addiction.
Though withdrawal related deaths are rare, detoxing from heroin should be monitored by a doctor or treatment center. Withdrawal symptoms begin within 6-12 hours of the last dose. Withdrawal symptoms peak within 2-3 days and last 5-10 days in total. Medical heroin detox typically incorporates medicines that help with the withdrawal symptoms. Blood pressure, heart rate, and breathing must be monitored closely during this detox process.
Heroin Withdrawal Treatment & Help
Medical detox is the best route when it comes to heroin withdrawal. The drug is highly addictive and withdrawal symptoms can be very powerful. Attempting to quit cold turkey or detox from heroin unsupervised can be extremely dangerous. Severe withdrawal symptoms can cause permanent health damage and even death if left untreated by trained medical professionals.
For heroin users, there may be fear associated with seeking treatment because the drug is illegal. While using, manufacturing, and selling heroin are all illegal acts, seeking addiction treatment or medical detox is completely legal. Those who want to stop using heroin should not hesitate to ask for help or seek treatment from a legitimate medical facility.
If you or someone you know struggles with addiction to Heroin or have begun using heroin in any of the described forms, you can seek help by calling Heroin Anonymous (HA). You can also contact a local addiction clinic or the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357.
Why is medical detox the best option for heroin withdrawal?
At a medical detox facility, treatment can begin before a person even experiences withdrawal symptoms. A doctor can evaluate your current situation, including the duration of heroin use, frequency of use, and how much heroin was used. With this information, they can create a customized treatment plan that works best for your needs.
Medical detox typically lasts between five days and a week, but it may last longer depending on a person’s heroin dependence. Under the care and supervision of a doctor and trained medical staff, users receive treatment for heroin withdrawal symptoms. Several medications have been approved to treat heroin dependency and withdrawal, and a doctor can ensure you safely receive the proper care.
Medical facilities are also more comfortable than detoxing on your own. The pain and discomfort that comes with heroin withdrawal often causes people to start using again. By managing withdrawal symptoms and lessening the pain, you can make the detox process more bearable.
When treated at a medical detox facility, you also have access to mental health professionals who can help you continue to stay clean. One on one counseling sessions, group therapy, and proper medication can reduce cravings and assist with substance abuse recovery. Heroin withdrawal is a difficult process, but it is more manageable with the right resources and a team of professionals.
Heroin is not safe. It is one of the most dangerous drugs abused and is extremely addictive. Heroin can lead to the failure of different systems within the body, respiratory failure and death.
Heroin can be found in two forms. It is either a white or brownish powder, or a black tar-like substance.
Heroin is smoked, sniffed, snorted or injected into the body using a needle.
Yes, heroin creates an immediate high called a rush.
Yes, heroin is a narcotic. Other narcotics include Vicodin, codeine, morphine and fentanyl.
Heroin is a Schedule I drug. According to the DEA, Schedule I drugs are defined as drugs with no legitimate medical use, which carry a significantly high potential for abuse, leading to severe psychological or physical dependence.
No, heroin is not a stimulant. It is a narcotic which affects the opiate transmitters in the brain.
No, heroin is not an amphetamine. It is a narcotic which affects the opiate transmitters in the brain.
Yes, heroin is an opiate. Opiates are made from the opium poppy plant and interact with the opioid receptors in the brain.
Heroin creates an intense feeling of pleasure called a rush. It also causes sedation followed by alertness.
Heroin causes nausea, flushing of the skin, dry mouth, and slow breathing. If overdose occurs, additional side effects can include blue lips and fingers, convulsions, clammy skin and coma.
Heroin causes an intense feeling of euphoria or flooding sensation of pleasure.
Heroin is highly addictive, causing some users to become physically dependent after the first or second try.
Heroin is highly addictive because of the effect it has on the brain. It causes endorphins to bind to receptors in the brain that create intense feelings of pleasure and lead to a craving for the drug. Increased usage causes the body to develop a tolerance to the drug, which means more must be ingested to obtain the same effect.
Heroin is cut with many different substances in order to increase profits. Due to its powdery look, many of these cutting agents include baking soda, sugar, starch, painkillers, talcum powder, powdered milk, laundry detergent and rat poison.
Heroin is derived from the opium poppy plant, which grows in South America, Asia and Mexico.
The euphoric effects of heroin can be felt immediately and are short-lived.
The high of heroin can last up to three to five hours depending on the dose.
Heroin is typically sold in small bags when it’s sold to the end user.
Heroin addiction can cost a user nearly $200 a day, with a bag costing $5-$20. This is equivalent to over $50,000 a year.
According to Very Well Mind, heroin can stay in the body for up to 3 months and can be detected for a varied number of days depending on the screening method.
-Blood: Up to six hours
-Urine: Up to three days
-Saliva: Up to 24 hours
-Hair: Up to 90 days
Yes, heroin is lethal and can lead to death. It causes slowed breathing and can put users into a coma-like state after even the first use.
Yes, heroin is illegal in the US. There are no medical uses for the drug.
There are a number of observable signs associated with heroin use and abuse. Signs of use include shrunken pupil size, runny-nose, burned fingertips or lips, slow heartbeat, low pulse, convulsions and sedation.
Signs of heroin abuse or addiction include needle tracks on the body, drug cravings, mood swings, sudden financial troubles, not being able to maintain a job or take care of their family, problems in relationships, or selling personal property. Environmental signs of heroin usage in someone’s home, vehicle, or other place of use include small glass or metal pipes and powdery residue on flat surfaces, as well as syringes, spoons, and lighters lying around together. Signs of overdose include blueish-colored lips or nails, delirium, or loss of consciousness.
In order to get off of heroin, an abuser must typically participate in a heroin detox program that combines prescription medication with rehabilitation to help break the physical dependency on the drug.
It can take 5 to 10 days to detox from heroin.
The most severe symptoms of heroin withdrawal lasts 5 to 10 days.
Death from heroine withdrawal is unlikely, but can occur due to dehydration or loss of electrolytes. This is why it is important to enter a medical detox program where you will be monitored by doctors and specialists in drug detox.
Yes. Heroin abusers can seek help confidentially at local addiction clinics or by contacting the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357. Abusers can also contact Heroin Anonymous (HA). Treatment usually begins with inpatient detox, inpatient treatment and then outpatient services.
References & Resources
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“Street Slang & Nicknames for Heroin.” American Addiction Centers, americanaddictioncenters.org/heroin-treatment/slang-names. Accessed 10 July 2020.
“Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013.” PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC4584844.
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