Heroin is a highly addictive substance. For those suffering from heroin addiction, life becomes a constant struggle and for those that decide to quit, the withdrawal symptoms can be tremendously uncomfortable, life-threatening and extremely painful. While some people choose to go through detox and withdrawal on their own, it is highly recommended that it takes place under the strict supervision of drug treatment experts.
One of the main reasons most people relapse during withdrawal is because of the adverse symptoms they experience. Understanding the withdrawal symptoms and what to expect can help with the recovery process.
What Causes Heroin Withdrawal Symptoms?
Our bodies are designed to produce opioids naturally. These opioids attach to receptors found in the brain called neurotransmitters, which help the body in regulating stress and pain.
When you ingest heroin, which is a chemical opioid, it attaches to the same brain receptors thus producing euphoria. Chemical opioids such as heroin are much stronger than the natural ones produced by our bodies and they eventually hamper the body’s ability to produce natural opioids. This is mainly why withdrawal occurs because when you quit heroin, you now lack both the chemical and natural opioids and your body needs time to go back to homeostasis.
Short-Term Heroin Withdrawal Effects
Heroin addicts begin experiencing withdrawal symptoms 8 to 12 hours from their last use. How fast one experiences the withdrawal symptoms are influenced by their frequency in using the drug.
At the onset, withdrawal symptoms may include dehydration, runny nose, insomnia, and restlessness. Most addicts have also reported experiencing spasms, muscle aches, irritability, extreme mood swings, and aggression.
Short-term symptoms are physical and can be very frustrating because recovering addicts lose control of their bodies. Feeling ill for prolonged hours or even days can be unbearable to many. This is why addicts are advised to seek medication-assisted rehabilitation from the very beginning, to help make the withdrawal symptoms bearable.
Long-Term Heroin Withdrawal Effects
Once the short-term withdrawal symptoms pass, an addict begins experiencing longer lasting and more intense symptoms. The long-term symptoms can last anywhere between 5 and 7 days. Long-term effects usually include psychological effects such as anxiety and depression.
Some addicts also experience phases of hyperactivity behavior, extreme drug cravings, and paranoia. Surviving the long-term withdrawal symptoms is usually the most difficult part of recovery but with the right medical support, it is attainable.
Post-Acute Withdrawal Syndrome (PAWS)
After a few weeks of detox, the psychological and physical symptoms of withdrawal subside. A newly recovered addict might start feeling better and some make the mistake of discontinuing treatment at this point. What many addicts don’t realize is that more often than not, the withdrawal symptoms do return aggressively. This condition is referred to as post-acute withdrawal syndrome or PAWS.
Some experts consider PAWS to be a form of second stage withdrawal. PAWS is characterized by physiological and emotional withdrawal symptoms, which can last for weeks or months. Symptoms in the PAW’s stage include emotional numbness, anxiety, outbursts, inability to handle stress, low energy levels, sleep disruption, dizzy spells, poor coordination and balance, and memory loss. Research in this area is ongoing and more symptoms are expected.
Because symptoms experienced in PAWS can last a very long time, they can be overwhelming not just to the addict but loved ones. At this stage, an addict’s should be under strict supervision because the emotional instability can drive them to suicide or causing harm to others.
Heroin Withdrawal Symptoms
So far, we have looked at Heroine withdrawal symptoms in general but in this section, we are doing to look at some of the common symptoms. It is important to note that everyone has a different experience with heroin withdrawal but some symptoms cut across the board.
- Heroin cravings
After withdrawal, an addict is likely to crave heroin more than ever before. One of the obvious symptoms of craving is the desire to acquire and use the substance. Other signs include inattentiveness, sweaty or clammy skin, and memory problems.
It is key for addicts to keep away from situations that would cause them to give in to their cravings. Hanging around people and places where one got access to the drug is a recipe for disaster. Cravings are not an indication that you want to start using heroin again, it’s just your body’s way of recollecting the high it was accustomed to.
- Mood changes
Irritability, feelings of depression and anxiety also referred to as a dysphoric mood is normal during heroin withdrawal. During heroin use, the body produces an abnormally high amount of dopamine, which gives an addict the heroin high. During withdrawal, the levels of dopamine are significantly less and the body is still regulating itself to go back to its homeostatic state.
Addicts going through heroin withdrawal tend to get in touch with repressed feelings linked to past trauma and coupled with the other symptoms experienced during withdrawal, this can easily push a recovering addict to the edge. Finding the right emotional support is therefore key during the withdrawal phase.
- Aches and Pains
During a heroin high, a user’s body pain conduits are blocked. This means when someone is high on heroin, they don’t feel pain as a normal person would. During withdrawal, however, the opposite effect occurs. Addicts become extremely sensitive to pain and they experience pain and aches all over their bodies.
This pain is real and can be managed with medication administered and monitored by a recovery specialist. Addicts should never make the mistake of self-medicating when these pains and aches occur.
- Excessive Biological Fluids
Our bodies produce all kinds of fluids from urine to sweat, mucus, and tears. During withdrawal, addicts experience an overproduction of these bodily fluids. Many wake up soaked in pools of sweat, others experience a profusely running nose, while others pass urine uncontrollably. This occurs as the body attempts to find back its balance as the heroine is eliminated from the system.
- Diarrhea and Stomach Pain
Stomach spasms in the digestive tract during withdrawal cause stomach pain and watery, loose, recurrent bowel movements. This is a normal reaction to quitting heroin but that doesn’t make it easy for the recovering addict. Fear of accidents and the pain from stomach cramps can inhibit one from carrying on with their regular routine.
- Nausea and vomiting
When a heroin addict stops using the drug, they feel sick. This is because their body is trying to adjust to carrying out functions without the presence of heroin in the system. Because the body has already developed a tolerance for the heroin, it starts demanding more during withdrawal and this is what causes nausea and vomiting.
Eventually, nausea and vomiting subsides but it is key to stay hydrated during this phase.
Fever is common during heroin withdrawal. In adults, a temperature of 99F and above is considered a fever. A fever is an indication that your body is fighting infections or illnesses. However, in heroin withdrawal, this is not the case because there is no infection in the body and there is, therefore, no need to address the fever.
More often than not, the fever resolves itself or can be managed through simple home remedies. It becomes imperative to seek medical attention if:
- the fever goes above 103F
- home remedies and other treatments fail to bring it down
- you have a pre-existing heart problem
- you suffer from sickle cell anemia, HIV, diabetes or cystic fibrosis
- If you suffer a seizure
- Restlessness and Sleep Problems
During heroin withdrawal, the body is still trying to find a balance and carry out its functions without heroin. This affects the physiological, biological, emotional and psychological aspects of one’s body. Sleep patterns are also affected and addicts may have trouble sleeping or staying awake.
How To Cope With Withdrawal Symptoms
Peoples’ reactions to cravings differ and not all suggestions for managing cravings work for everyone. It is important to try different coping methods before you find what works for you.
- Identify your triggers. The best way to identify triggers is by keeping a journal and noting down things or situations that make you feel like you need a hit. Once you know your triggers, you can anticipate and plan how to manage the cravings in advance.
- The reality is that you cannot avoid people or situations that trigger cravings forever. To help keep you on course during withdrawal, come up with possible solutions to manage your feelings should you find yourself in a place or surrounded by people that trigger your heroin craving. For instance, plan in advance what you will drink or eat, and if need be have someone with you to help keep you in check until you return to your safe space.
- Keep busy. One way to tackle cravings is by keeping busy. Look for activities of work to engage in so that you can keep your mind off the heroin cravings. You’ll find that with time, you’ll go for hours without thinking about wanting some heroin.
- We are not all good at sharing our feelings but one effective way of managing cravings is by talking about them to someone trusted. That is why support groups, counseling and having healthy relationships with friends and loved ones come in handy.
- Surfing. This is a term that refers to revisiting the negative effects of heroin use. Sometimes all you need is a reality check that will help you get back the determination and zeal to stay clean.
- Music therapy. Many recovering heroin addicts attest to the power of music therapy in handling withdrawal symptoms. Music can be soothing, it can also create a great distraction that keeps your mind off the physical, psychological and emotional turmoil one experiences during withdrawal. There is no specific music recommended. Find what works for you and listen to it or dance to it and you will feel better.
- Exercise is one of the most effective ways of managing cravings. This is because working out releases endorphins that elevate your mood, enhance sensations and keeps your mind off the negative effects of the heroin withdrawal. When you first start working out, engage is lighter activities especially if the withdrawal is causing pain, aches and muscle weakness, and intensify your workout as your body regulates back to normal.
- Diarrhea, Vomiting and Stomach Pain
Most addicts experience all the above during withdrawal and you cannot prevent it from happening but you can use the following tips to manage it. Diarrhea and vomiting can cause severe dehydration that can cause one’s body to go into shock. Drinking plenty of water is key in replacing the lost fluids. However, most addicts have difficulty keeping anything down; including water. If going through withdrawal from a medical/ recovery center, they may choose to administer the fluids intravenously using an IV.
There are also rehydration fluids that can be bought over the counter from drug stores. They help manage the vomiting and diarrhea, replace the lost electrolytes and keep you hydrated.
Yogurt that contains live cultures has bacteria that help reduce the length and brutality of diarrhea during withdrawal. Addicts are advised to stay clear of hot beverages, spicy foods, and acidic fruits during this period, as these foods aggravate spasms that make the stomach pains and diarrhea worse. Instead, opt for bland foods like white rice, white bread, and bananas.
To manage nausea and vomiting, you might be forced to keep off food until the initial stage of acute withdrawal passes.
There are also medications that can help manage diarrhea. These include Pepto-Bismol, Kaopectate, and Imodium. Although these drugs are available over the counter, it is best to consult a medical professional before buying.
- Withdrawal Fever
As earlier discussed, most withdrawal fevers resolve themselves without needing medical attention. Withdrawal fevers rarely indicate an infection or illnesses. However, they should be keenly investigated to ensure that there is no underlying infection. To treat and monitor a heroin withdrawal fever, do the following:
- Keep a record of the temperature every hour or two and abstain from consuming hot fluids or smoking 15 to 30 minutes before your next reading. This is because hot fluids and smoking normally elevate the body’s temperature and so you are likely to get an inaccurate reading.
- Undressing despite the shivering and chills one experiences during a withdrawal fever helps to lower temperature.
- Taking a sponge bath or tepid bath can help in lowering the temperature if the reading is below 101.3F. Iced or Cold water should never be used during a withdrawal fever as the shivering cause the body temperature to increase internally.
- Should the temperature rise above 101.3F, take a dose of ibuprofen or acetaminophen as prescribed. Heroin addicts suffering withdrawal fever should never take painkillers that contain codeine, opioid or opiate.
- Taking plenty of fluids not only helps manage withdrawal fevers but keep them at bay as well. Drink lots of water and if you’re having difficulty doing that, popsicles or some clear soup can be taken as well.
When do you know it is time to seek medical attention when experiencing a withdrawal fever?
If your fever persists for more than 24 hours or doesn’t respond to treatment within an hour, consider getting medical attention.
- Withdrawal Insomnia
Withdrawal insomnia is temporary. It only occurs because one’s body is cleaning out the heroin from the system and attempting to go back to its normal state. Observing good sleep asepticism can help you beat withdrawal insomnia fast. As your body rids of the heroine, you find that your sleep pattern tremendously improves. So how do you deal with withdrawal insomnia?
- Create a sleeping ritual. Part of recovery involves replacing bad lifestyles with good ones. During addiction, most heroin addicts do not get adequate sleep or they sleep too much when in euphoria. They do not have set times for sleeping and waking up since all their activities are managed by the drug. During withdrawal, set times for sleeping and waking up. Secondly, do things that will help you go to sleep when you’re supposed to such as listening to calming music, reading, switching off lights, or taking a warm glass of milk. Whatever works for you, do it and in time you’ll find that is it easy to stick with the sleeping routine.
- Re-establish the circadian rhythms. A circadian rhythm is a 24-hour phase in the physiological procedures of all living things. Circadian rhythms are internally generated but can be moderated by external signals such as temperature and sunlight. Circadian rhythms are key in determining our feeding and sleeping patterns. Most heroin addicts stay up all night or at least most of the night and spend the days blacked out or in a daze. One of the most effective ways of restoring the circadian rhythm during withdrawal is by exposing one’s eyes to daylight without looking directly into the sun.
- Go for natural approaches first. While there are many treatments available for withdrawal insomnia, it is not advised that an addict dives straight into taking medicine. Try natural remedies to tackle withdrawal insomnia such as taking warm tea free of caffeine before bed, meditation and keeping active in the daytime so that you’re tired and ready to sleep at night. Some people choose music, cinnamon or other herbal teas are known to help with sleep among other natural remedies. A quick google such will provide hundreds of tips on how to deal with withdrawal insomnia. Try these natural remedies out before turning to medication. You are also allowed to combine different methods until you find what works best for you.
- Sleep medications. While there is an option of taking medications to deal with insomnia, addicts ought to take caution because it is easy to replace one addiction with another during withdrawal. Avoid self-medicating at all cost and not just self-medicating on over the counter medicines but marijuana, sleep aids and alcohol as well. If you must take sleep medications, ensure it is prescribed by your physician and the use should be short-term to help you sleep as you explore other natural remedies to insomnia. Remember withdrawal insomnia is primarily caused by the imbalance your body experiences during withdrawal so as soon as your body goes back to its normal state, your sleep patterns should improve on their own. It is important to also do research and find out if there are any adverse effects to the sleeping medication prescribed so that you can make an informed decision before deciding to take the medicine.
Ultimately, good sleep is important for recovery while sleep insomnia and other sleep abnormalities impede the recovery process and often cause a relapse. There are sleep based therapies that have also proven very useful to heroin addicts experiencing withdrawal.
Managing Heroin Withdrawal With Therapy
Heroin addiction is mainly influenced by lifestyle and personality. In order to successfully manage withdrawal symptoms as well as their aftermath, it is key for a recovering addict to engage in therapies that include:
- Group therapy. Although it’s difficult to open up to strangers about your problems, group therapy puts you in the same space with others who have experienced heroine withdrawal. Having that in common can significantly help in managing the withdrawal.
- Individual counseling.
- Cognitive behavioral therapy. This involves helping a heroin addict change their thinking patterns, and by doing so change how they feel and ultimately how they behave.
- EMDR (Eye Movement Desensitization and Reprocessing). This form of therapy is crucial for individuals who are undergoing withdrawal and facing emotional distress resulting from past traumatic experiences. Some people turn to drugs such as heroin to escape the pain from traumatic events. Detoxing forces many to deal with those bottled up issues thus making the withdrawal symptoms more aggressive.
- Family therapy. Heroin addiction often puts a strain on relationships with family members. Family therapy helps repair and rebuild these relationships. This is key because family members often play a key role in helping you survive withdrawal and avoid relapse.