Heroin Detox

Detoxification is the first and most painful step of heroin addiction treatment. People withdrawing from heroin may experience muscle cramps, anxiety or insomnia, which could last up to 10 days. But safely detoxing from heroin under medical supervision is an important step toward overcoming heroin abuse and entering recovery.

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Detoxification clears toxins from the body of someone dependent on or addicted to drugs or alcohol. The first stage of heroin treatment, detox aims to reduce the effects of withdrawal and help people transition to recovery.

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For a person battling heroin addiction, detox can cause painful withdrawal symptoms that start within a day of ceasing drug use. These symptoms can be mild, moderate or severe depending on the duration of heroin abuse. While heroin withdrawals are rarely life-threatening, detoxing alone without medical supervision can worsen symptoms.

However, many treatment centers in the United States offer comfortable settings for people to safely overcome heroin withdrawal. During detox, trained addiction specialists use medication-assisted therapy to treat heroin addiction. These medications can ease some withdrawal symptoms and reduce cravings.

Since the 1980s, public officials have increased funding for detox services. Supervised detoxification is an effective way to quit heroin use. People in recovery from heroin addiction must detox from the drug or begin medication-assisted treatment before they can begin counseling and therapy.

Woman speaking to medical professional

Heroin Withdrawal Symptoms

Heroin is a short-acting opioid. Most people experience heroin withdrawal symptoms between eight and 24 hours after last use. During the first day of withdrawal, symptoms are usually mild. They may include sweating and anxiety.

Symptoms usually peak in severity 48 to 72 hours after last use. Moderate and severe symptoms include insomnia, vomiting and diarrhea. Symptoms can last from four to 10 days, but they usually lessen in severity over time.

During heroin detox, other withdrawal symptoms may include:
  • Agitation
  • Muscle ache
  • Hot and cold flashes
  • Runny nose
  • Abdominal cramps
  • Dilated pupils

Clients can manage mild effects by drinking two to three liters of water each day during detox. This allows the body to replace fluids lost through sweating or diarrhea. Additionally, they should receive vitamin B and C supplements to make up for nutritional deficiencies.

“It is like the most severe flu you’ve ever had. Your skin’s crawling, you’re sweating. You’re sensitive to light and sounds. You’re irritable. Your bones hurt sometimes. It’s just very intense.”
Richard Molina, Head Therapist, The Recovery Village

Many people use heroin before entering rehab. This delays the detox process. Some medications can’t be used until a person has started withdrawal. People beginning treatment for heroin addiction should talk to their rehab provider about how heroin use prior to rehab will affect their treatment plan.

How Long It Takes to Detox from Heroin

Detoxing from heroin can take anywhere from a few days to more than a week. The duration of heroin detox depends on several factors, including how long a person has been using heroin, their tolerance level and their preferred method of use. People who shoot heroin may take longer to detox from the drug than people who snort heroin.

Other factors that affect the length of heroin detox include:
  • Age
  • Weight
  • Medical history
  • Mental health
  • Genetic profile
  • Alcohol or other drug use

The use of medications during detox can affect the length of time it takes to overcome heroin withdrawal. Although it varies from person to person, heroin withdrawal generally lasts between three and five days.

Evaluation Phase of Heroin Detox

Detox begins with an evaluation that includes a physical and psychological examination. Trained medical professionals generally ask clients questions to learn more about their medical history and substance abuse problems. Evaluation results help medical staff craft an effective treatment plan.

Exams may include X-rays, electrocardiograms and urine and blood tests. Treatment facilities may also test for diseases associated with opioid abuse — including hepatitis C, HIV or tuberculosis — and screen clients for mental illness.

A number of treatment centers simultaneously treat addiction and co-occurring mental health disorders such as depression or post-traumatic stress disorder. Like substance use disorders, mental illness can cause physical and psychological distress. Treating both disorders can reduce the risk of relapse and help individuals prosper during recovery.

Stabilization Phase of Heroin Detox

Once evaluation is complete, stabilization is the next step. During this phase, medical professionals assist clients with completely ridding heroin from the body and reaching a medically stable state, which may involve using medications.

The goal is to help clients through withdrawal safely. When appropriate, practitioners may also attempt to get the client’s family, loved ones or employers involved in the treatment process.

After evaluation and stabilization, medical professionals prepare clients to enter treatment. For individuals who show a pattern of not seeking further treatment after completing detox, a written contract may be incorporated to encourage further treatment.

Medications Used During Heroin Detox

For those experiencing moderate to severe withdrawal symptoms, treatment centers may provide medications that can stabilize the brain and ease distressing effects. Most health agencies recommend medication-assisted treatment as the most effective way to help a person recover from addiction. However, some detox methods do not use medications.

Drugs used during heroin detox include clonidine, buprenorphine, codeine phosphate, naltrexone and methadone.


Clonidine is a medication often used to treat high blood pressure. It also can be used to alleviate opioid withdrawal symptoms such as anxiety, cramping, muscle aches, agitation, runny nose and sweating. However, the drug does not reduce cravings.

The medication should not be used alongside opioid replacement therapy, which involves substituting heroin or another short-acting opioid with a longer-acting opioid such as methadone.


Buprenorphine treats severe heroin withdrawal symptoms and shortens the length of detox. The medication reduces the euphoric effects of heroin, lowers the potential for misuse, blocks the effects of other opioids and decreases cravings.

However, buprenorphine should be given only to someone who is in the process of withdrawal. The process generally starts eight hours after the last dose of heroin.

Seeking help for heroin addiction?We have detox programs that work.


Methadone can be safely taken at the start of recovery. This long-acting medication displaces heroin from opioid receptors in the brain to prevent withdrawal symptoms. Over time, clients slowly wean off the drug. Methadone is often used to detox from longer-acting opioids, but it can be used to treat heroin addiction.

The medication should be used with caution if someone has acute alcohol dependence, a head injury, a respiratory deficiency, severe liver impairment, Crohn’s disease or a condition being actively treated with monoamine oxidase inhibitors.

Codeine Phosphate

Codeine phosphate reduces withdrawal symptoms and drug cravings. However, codeine does not work for up to 10 percent of people, and it should be used with caution if someone has a respiratory deficiency or severe liver impairment.

Two people holding hands, offering support

Medical Support During Heroin Detox

Detoxing from heroin while alone can be dangerous. Individuals detoxing at home may not know how to properly overcome withdrawal symptoms and may not have access to medications that reduce these effects. Additionally, suffering through withdrawal symptoms has damaging health effects and can lower a person’s chances of recovering from heroin addiction.

Detox clears toxins from the body of someone dependent or addicted to drugs, alcohol - quote

Treatment centers are equipped with trained professionals who monitor clients throughout the day and help them deal with these effects. You can find a rehab facility that treats heroin addiction by calling a heroin hotline.

Recovering from heroin addiction involves gradually reducing opioid intake to avoid withdrawal. But potential health problems and strong cravings make this a difficult task. For these reasons, detoxing should always be done under the supervision of a medical professional.

Once detox is complete, counseling provides additional support and often motivates people to continue receiving treatment for heroin addiction. During counseling, trained mental health professionals help people learn more about addiction and how it has contributed to problems in their lives. It also teaches clients how to handle stress and make healthier life decisions.

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Matt Gonzales
Content Writer, DrugRehab.com
Matt Gonzales is a writer and researcher for DrugRehab.com. He graduated with a degree in journalism from East Carolina University and began his professional writing career in 2011. Matt covers the latest drug trends and shares inspirational stories of people who have overcome addiction. Certified by the Centers for Disease Control and Prevention in health literacy, Matt leverages his experience in addiction research to provide hope to those struggling with substance use disorders.

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