Syringes to Sobriety

Stories and Advice from a Real Heroin Addict

Heroin Withdrawal Symptoms-Timeline

Heroin Withdrawal Symptoms- Heroin Hell

heroin withdrawal symptoms are hellMany people have a hard time understanding the fear associated with imminent withdrawal after the abuse of heroin.  Making matters worse, Hollywood rarely portrays heroin withdrawal symptoms accurately.

I am sure this is not intentional. Even if actors portrayed the physical heroin withdrawal symptoms accurately, there is no way to show the actual length of time these symptoms persist. It is simply impossible to fit even the first 3 days, of the seemingly endless first month of withdrawal, into a 2-hour movie. Plus, heroin withdrawal is far from glamorous!

In Neil Armfield’s film Candy, starring Heath Ledger (Dan) (RIP :() and Abbie Cornish (Candy), you see one of the most accurate portrayals of heroin withdrawal ever filmed.

The Irony of Ledger’s Portrayal

Tragically, Heath Ledger died, two years after the release of Candy, from a prescription drug overdose. The toxicology report, obtained during autopsy, confirmed the presence of hydrocodone, oxycodone, diazepam, temazepam, alprazolam, and doxylamine, in Ledger’s blood.

(Mixing opiates and benzodiazepines is often a death sentence and most doctors will not prescribe these medications in tandem. It is one of the most dangerous drug combinations possible, as both drugs suppress your breathing.)

I wonder whether Ledger’s opiate addiction made him the perfect actor for this part, allowing him to recreate the actual symptoms he had during his own withdrawals. Maybe personal experience gave Ledger the edge needed to play the role of a heroin addict so realistically.

Without further ado, here is the clip:

If you have personal experience with heroin or opiate withdrawal symptoms, I would like to hear your feedback on this video clip. Do you think they have left anything out as far as symptoms go? If you were directing this film, what else would you add to this scene? Leave your answers in the comments below.

Heroin Withdrawal Symptoms Timeline

heroin withdrawal symptom timelineThe symptoms described in this article apply to withdrawal from heroin, as well as OxyContin, Percocet, and other oxycodone, hydrocodone, opiate-based pain pills. (Every person responds differently, but a physical addiction can develop in as little as ten days of opiate use.)

For those of you with no experience on the subject, here is a non-exhaustive list of symptoms experienced during the first 1-5 days of heroin withdrawal:

Stage 1: Physical Withdrawal Symptoms (Days 1-4 or 5)

  • sweating profusely
  • chills
  • fever
  • vomiting uncontrollably, mostly stomach acid and bile
  • diarrhea
  • shakes
  • constant yawning
  • extreme watery eyes
  • constant runny nose
  • muscle and full-body aches
    • (Note: Females seem to experience this symptom with much greater intensity. It has something to do with hormones, but the body aches experienced by females in opiate withdrawal are equated to the pain felt by late-stage bone cancer patients.)
  • restless legs
  • extreme drowsiness
    • (As a user passes the 24-hour mark of withdrawal, extreme drowsiness kicks in. This is not a blessing however, as it is accompanied by extreme insomnia. The other symptoms a user is experiencing during this time makes it hard to get any rest.)

Without 8 hours of sleep per night, 3-4 days of tossing and turning in bed with these symptoms, feels like an eternity.

Stage 2: Emotional Withdrawal Symptoms

After the initial 3-5-day period of extreme physical withdrawal symptoms, the battle continues. Stage 2 starts between days 3 and 5 and lasts anywhere from 6 months to 3 years, depending on the person.

A Glimmer of Hope

Between days 3 and 5 of heroin withdrawal, loved ones start to recognize a change in a user’s eyes, as if a light switch suddenly switched back on. This gives loved ones’ hope because they have lived in constant fear that this light had been extinguished forever. This change is especially jarring and hope-provoking when witnesses in the eyes of a long-term heroin user.

I remember, on a few occasions, being told how much better I looked around Day 5. My parents would start to smile and tell me how much they had missed the ‘real’ me. This was hard to hear at this stage because, even though I may have started to look like my old sober self, I felt worse than ever inside. I remember thinking, if this is what sober feels like, I don’t want any part of it!

During the first week of Stage 2, a user starts to develop an appetite for heroin withdrawal nutrition

healthy meals again. It is extremely important to eat healthily when this happens because most users have failed to take good care of themselves while using, leaving their bodies under- and malnourished.

Don’t be a Fool!

Do not mistake a glimmer in the eye and a return of appetite for the end of withdrawal. It will take many healthy meals to replenish all the vitamins and minerals a user has been lacking. Replenishing nutrients, while the user’s body detoxifies, helps heal the body and mind, so the user has the best chance of giving his all to recovery.

!!Warning!!

heroin withdrawal emotional symptomsDays 4-6 are the most dangerous, delicate time of withdrawal. It is nearly impossible for a user, on days 4-6 of withdrawal, to abstain from looking for a fix. I know, from personal experience, a user will do almost anything to get ‘one last high.’ The extreme guilt of letting his family down coupled with, what the user perceives as, unavoidable failure, causes the brain to ‘double down’ to find relief from the physical and emotional pain. Chemicals in the brain go haywire, intensifying urges until a user gives in and does what users in pain do best, get their fix.

As discussed in “What is the Cause of Drug Addiction,” this urge is triggered in the brain. Constant use carves deep neuropathways into a user’s brain and after few days of feeling sick, the brain resorts to what it has grown accustomed to, using heroin to feel better. This urge is completely chemical and will not go away until new neuropathways are formed over time. This can only happen if the user forces himself to make healthy choices, new habits, for a lengthy period.

Feeling the Feels

Muscle aches can continue during this stage, most commonly in the back or shoulder area. A user will find it difficult to sleep for more than a few hours at a time. For many, regular sleep patterns do not start to return for years.

Although the user seems coherent and clear-headed, he is not out of the woods yet. Emotional symptoms peak during this stage of withdrawal. These emotional symptoms are present deep inside the user’s psyche.  They are difficult to identify through physical observation. A user experiences extreme emotion, from anger to depression, to anxiety, in quick succession. Extreme anxiety followed by extreme depression followed by extreme emptiness and so on.

A skilled mental health professional can help the user identify these symptoms (emotional trauma, depression disorder, insomnia, general anxiety disorder, and so on) and develop healthy ways to cope with them. Without proper symptom management, a relapse becomes much more likely.

Factors influencing how long a person remains in Stage 2 include, length of time on heroin, the quantity of heroin used (tolerance), whether heroin was used as a way to self-medicate, what type of treatment program attended, how much effort is put into recovery and whether the user has a support system to help get his life back together.

Recovery: A Family Affair

Often overlooked, yet incredibly significant to preventing relapse, is the recovery of a user’s loved ones. It is less common for family members and friends to seek psychological help during a loved one’s recovery process. However, it is extremely important. Although unintentionally, loved ones may be enabling the user or triggering urges.  An experienced professional can identify and stop any enabling behavior while addressing family dynamic issues that increase the recovering user’s risk of relapse if not dealt with.

Post-Acute Withdrawal Syndrome

After intense physical withdrawals, Stage 2 is accompanied by the seemingly never-ending symptoms of Post-Acute Withdrawal Syndrome. (PAWS) PAWS is defined by the lingering symptoms experienced after getting off drugs.

For a heroin user, symptoms include insomnia, nausea, fatigue, depression, anxiety, irritability, mood swings, and more. Then there are the less painful, but sure to drive a person nuts, symptoms of PAWS, including excessive yawning, watery eyes, and sneezing.

The latter is the symptom I remember the most. I completed a three-day suboxone taper at a detox center. Upon discharge, I was given Seroquel to help with my insomnia, but other than that, I was on my own. Two weeks out of detox, I started having sneezing fits. Literally, I would sneeze 9 times in a row. This would happen up to 4 times a day! I know, it does not even sound possible, but trust me it is. Another month or so and the fits decreased to six sneezes in a row. A few more weeks and a decrease to four sneezes, and so on, and so on for the next six months! I almost considered seeing a doctor until I was reassured by others in recovery that this was to be expected.

Anyway, enough about me. Reader, I hope you are starting to understand how scary it is for a user to go into cold-turkey withdrawal. Even considering medical detox, where symptoms can be managed, is frightening. If we genuinely want to help stop the opioid epidemic in its tracks, we need to start understanding the fear of withdrawal. We must focus on making the experience as comfortable as possible for the user.

heroin withdrawal symptom kindlingKindling

I recently read an article about the kindling effect. The study proposing the Kindling theory was based on alcohol withdrawal, but many have theorized it also applies to drug withdrawal. The kindling theory purports that withdrawal symptoms get worse with each relapse. Relapse serves as kindling and withdrawal is the fire. The intensity of heroin withdrawal symptoms increases with each relapse, as a fire grown more intense with added kindling. If interested in reading more about this theory, I suggest this article: The Kindling Effect

Can You Die from Heroin Withdrawal?

Many believe it is not possible to die from heroin withdrawal.  Nurses, especially those in jail, frequently told me I could not die from heroin withdrawal.  Somewhere along the line, the medical community was led to believe that a user can only die during withdrawal from alcohol and benzodiazepines (Xanax, lorazepam, etc.) When a user gets arrested and tells a nurse he is a heroin user, the nurse does not prescribe any medication. Therefore, the user is left to suffer cold turkey withdrawal in a cold, dirty jail. However, when an alcoholic or benzo user gets arrested, they are given medication to ease the side effects of heroin_withdrawal_symptoms_lead_to_deathwithdrawal, prevent insomnia, and avoid seizures.

I used to say, “Detox off alcohol and benzos may be the only life-threatening withdrawal, but detox off heroin is the only withdrawal that makes you feel like you wish you were dead.” This was not an exaggeration. However, it was based on incorrect information.

Recently, I discovered it is VERY possible to die from heroin withdrawal. Heroin withdrawal symptoms include vomiting and diarrhea. Untreated, these symptoms lead to dehydration, hypernatremia (elevated blood sodium level), and resultant heart failure. Someone attempting detox on their own needs to be aware of this possibility.  Without awareness, we will continue to lose loved ones. Hopefully, people will stop belittling the dangers associated with heroin withdrawal so more lives can be saved.  Detox should be a time to give extra love.  It is wholly unproductive to let resentment toward substance abusers affect treatment during heroin withdrawal.

If you have any questions about heroin withdrawal, or need any advice, please feel free to leave a comment below. Thank you for reading and remember to hug your loved ones.

ANA

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42 comments on “Heroin Withdrawal Symptoms-Timeline

  1. I know it sounds stupid but two questions, do you think that something like mushrooms could possibly help someone quit cold turkey? I’ve always been a “mind over matter” person until i wrestled this demon. I don’t have any family but i want to get off of this so badly. I am scared to go to rehab because I don’t want to lose custody of my sister. My boyfriend also is scared of the same thing as before this vice entered our life he was working to get custody of his son. Its a dark secret and no one knows. I am going to be 23 this year. I am trying so hard to get over this shit. This is not a proud boast, I had taken so many drugs in my youth notorious for being “addictive” and never really had the urge to do it again. Except cigarettes. As my boyfriend reintroduced Percs into my life I didn’t see the claws sinking in, I like to think he didn’t either. His was to suppress pain, I subconsciously was too but consciously I just liked to snort stuff sometimes. To spare details one bad choice lead to another now here I am a year addicted to heroin trying to remain functional but slowly losing ambition for everything. Now I am really trying to make myself “sober” and of course all research you find on the internet points to “Get a medical professionals help, go to rehab, get medicine to get off medicine. ” I wonder if I were to go get on suboxones would I just be trading one for another, forced to live the rest of my life to get a pill or shot to stop “addiction”? Because that just sounds like addiction to me but one that fills that pharma’s pockets instead of the dealers… Acid and mushrooms changed my whole perspective of life once upon a time but I haven’t done either in years. I don’t see myself using acid to get off… To much analytical thinking I’d probably think myself into a heart attack…. Shrooms however seem to have less control and still seem to achieve the goal of “rewiring” the brain… So my question is do you think shrooms could work to rewire the brain and basically help me kick the habit? Also, I know my boyfriend wants off of it too. Sometimes I feel like he’s the reason I go out and get money and go and grab the stuff. (It’s not just him it is me too, but sometimes I feel like if I was alone and didn’t have someone enabling me and coercing me to get money that maybe it would be easier to kick the habit) My second question is, did you and your boyfriend work together to quit? Or did you have to part ways and meet again on the other side of the fence? I know everyone is different. I just have that guilty feeling if I leave him behind to fend for himself that he will end up dead, in jail, or on the streets..

    1. First of all, I want you to know that you are incredibly brave to be so honest about your issues and how you are working to overcome them. That very honesty will be the reason you SUCCEED in having the future you have envisioned for yourself. I hope to be just as honest and transparent in my response to your question, so here goes.

      With regard to mushrooms…oddly enough, I have only tried mushrooms twice in my life and both times I did not trip because I took such an insignificant amount. The reason I never got that into shrooms was simply because I was a wimp. I felt as though tripping would take me out of control of my high and that was the last thing I wanted. (Control issues, anyone? ha)

      However, I am not against the idea of using drugs that cause introspection and reflection to help kick a habit. (Disclaimer: I am not a medical doctor and I am never suggesting you do this without medical supervision…sorry, I don’t need to get into legal trouble for any of this!)

      Your post actually got me thinking about some studies I have read about Ibogaine, a psychedelic drug, being used to treat opiate addiction. It seems scientist were hopeful at the beginning but that the positive results in patients were ultimately short-lived. However, the size and number of these studies has been pathetic, to say the least, so, hopefully, in the future, we hear more about the potential correlation between psychedelics and helping people heal from opiate use disorder. For now, check out this article

      Another thing that came to mind as I read your comment was Ayahuasca treatment for different substance use disorders. Unfortunately, a study, notably with a very small sample size of participants, found that ayahuasca had no effect on opiate use, although it was very effective in treating other substance abuse disorders, like cocaine and tobacco. Ayahuasca is a psychotropic and causes severe hallucinations, incase readers are not familiar. This article talks about the reasons that this treatment has been effective.
      The author lists the following reasons:
      1. It doesn’t require “talking.”

      For people who don’t like “talk therapy” or who aren’t strong in expressing their thoughts and feelings verbally, then ayahuasca offers a non-verbal experience that draws on your other senses to facilitate psychological and spiritual.

      2. It can improve mental health.

      Not only has ayahuasca therapy been linked to a reduction in symptoms related to depression and anxiety, but it may also induce a biological effect on specific brain areas that impact these conditions (like the insula and amygdala).

      3. It has healing powers.

      People who have participated in ayahuasca ceremonies sometimes report psychological healing from childhood trauma and unconscious psychological distress, through increased insight and reflective capacity on past experiences. It can open people up to engage in traditional psychotherapies with greater success.

      4. It can help to provide a different mindset.

      A commonly reported side-effect of ayahuasca treatment (and hallucinogenic experiences broadly) is a change in mindset. It can induce a sense of hope, confidence, and feelings of empowerment. It can also make you more mindful and connected to self, other people and the environment.

      5. It can help regulate biology.
      Ayahuasca therapy can improve serotonin activity, which regulates mood and is a critical player in the pleasure-seeking urges related to substance addictions.

      In particular, alcohol and cocaine addictions have been treated with Ayahuasca, while in the case of opiate addictions, people are advised to first use Ibogaine under close expert supervision.

      I found this analysis especially useful with regard to your question, because some of these reasons may be relatable to you. Unfortunately, this treatment is not available in the states, but I do believe you can still find practicing centers in Canada.

      Unfortunately, because I have not tried shrooms I cannot provide insight into whether they would help you, but I do know many people who have had tremendous success using marijuana to get over heroin abuse issues and my mind is open to any new therapies out there.

      With regard to replacing one drug for another, I want you to ignore that criticism. Have you ever noticed it is people who have never touched a Percocet or heroin in their entire lives who are critiquing others for replacing one drug for another? Ugh it drives me nuts.

      I am on methadone maintenance and it saved my damn life. I am able to function like a normal person again and I am not in prison, which is where I would be had I not ignored those who told me I would be replacing one drug with another. I also feel very confident that I could taper down off my methadone slowly at any point I feel I would like to.

      Everyone is different. All that matters is that you do something to get to a point in your life where you feel happy. For some that is methadone, for others it is complete abstinence, and for a few it is using in moderation. I have seen all done successfully. The trick is finding what works best for you.

      I will try to keep the answer to your second question short. If you have any further questions please feel free to reply.

      My boyfriend and I have difference recovery styles, although we are both on methadone maintenance at the current time. It is important to keep in mind that what is good for you, may not be good for him, and vice versa. Most importantly, be supportive of each other, do not discourage positive decisions, and be understanding that recovery is a learning process. You will learn new things about each other, about yourselves, and ultimately about whether or not you want to be with each other. If you find out you are not the right fit anymore, you separate with love and understanding. If you figure out you want to be together, you stay together with love and understanding.
      I hope this helps!!

  2. Hey there, thank you so much for this touching article, i felt it differently because I know a friend that has been struggling with drugs, he fell into depression, became a drug addict and  is now trying to withdraw, this article was perfect as it explained the stages very correctly, seeing your loved one go through these things can be very emotional 

  3. Hello again! This article is actually an eye opener and I’m going to share it to friends and family around me. It would expose them to these things and would push them to stop some acts they get involved in. I have witnessed a lot of cases where heroine addicts die from withdrawal process. Its not really an easy process because their system is already very used to it and these people need real help to overcome it, I pray they get all the help they need. Thank you. 

  4. The abuse of any substance is really a bad idea and heroine is certainly not one that is easy to just drop and get on with your daily life like it never happened to you. I feel happy learning some vital things here and the emotional withdrawal from to be very difficult because it’s not just something to touch and all. You’ll be dealing with the mind. Thanks for the knowledge 

  5. Well! I am particular about the heroin withdrawal and the various issues that might actually ho wrong if the proper steps us not taken to mitigate the withdrawal effects. I am writing a final year thesis on a topic related to this and the things you have shared here are really enlightening and also very elaborating. Surely a good post here. Thank you for this