Syringes to Sobriety

Stories and Advice from a Real Heroin Addict

Heroin Withdrawal Symptoms and Timeline- Slaying the Dragon

Heroin Withdrawal- Heroin Hell

Many people, especially those without substance abuse issues, have a hard time understanding the feelings a heroin user experiences when faced with imminent withdrawal. Making matters worse, Hollywood rarely portrays opiate withdrawal accurately. I am sure this is not intentional. After all, even if the actors portrayed the physical 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 Armfeld’s film Candy, starring Heath Ledger (Dan) (RIP :() and Abbie Cornish (Candy), you will see one of the most accurate portrayals of heroin withdrawal ever filmed.

Tragically, Heath Ledger died, two years after the release of Candy, from 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 benzodiazapines is often a death sentence and most doctor’s will not prescribe these medications in tandem. It is one of the most dangerous drug combinations possible, as both drugs suppress your breathing.)

I can not help but 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. This personal experience may have given 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, 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

The symptoms described in this article apply to withdrawal from heroin, as well as OxyContin, Percocet, and other oxycodone, hydrocodone, opiate-based pain pills. When a user abuses opiates for a long enough period, they risk dealing with many of the following symptoms during withdrawal. 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 may have to do with our hormones, but the body aches experienced by females in opiate withdrawal have been 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 can last 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 will start to recognize a change in a user’s eyes, almost as if a light has been switched back on. This will give loved ones hope, especially when the user has been on a lengthy binge, because they have lived in constant fear that this light had been extinguished forever.

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 I have to feel like to stay sober and keep everyone off my back, I don’t want any part of it!

During the first week of Stage 2, a user starts to develop an appetite for healthy meals again. It is extremely important to eat healthy 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!!

Days 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’ in an effort 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 so they are not easy to identify through physical observation of the user alone. A user will experience emotional extremes, in quick succession. Extreme anxiety followed by extreme depression followed by extreme emptiness and so on.

A skilled mental health professional will be able to 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, 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 of 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 seroquil 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 doesn’t 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 truly want to help stop the opioid epidemic in its tracks, we need to start understanding this fear of going into withdrawal and focus on making the experience as comfortable as possible for the user.

Kindling

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. Intensity of withdrawal symptoms increase 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. I was frequently told, even by nurses in jail, that a user can only die during withdrawal from alcohol and bezodiazepines (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 get arrested, they are given medication to ease the side effects of withdrawal, 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. As noted above, heroin withdrawal symptoms include vomiting and diarrhea which, if left untreated, can result in dehydration, hypernatraemia (elevated blood sodium level) and resultant heart failure. This is very important information. Hopefully people will stop belittling the dangers associated with heroin withdrawal so more lives can be saved.

 

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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16 comments on “Heroin Withdrawal Symptoms and Timeline- Slaying the Dragon

  1. Hello Ana,
    This is a very informative article for those facing heroin withdrawal’s. I can’t imagine going through anything like this but it’s good to know there are sources, such as your website that people can reach out too when facing hard times such as this.
    I would’ve never even thought that one could die from having heroin withdrawals. That’s awful! I’m so glad you are reaching out and trying to help people in need. It’s bad enough for someone to have an addiction, but when they are trying to quit using and having to face these withdrawals, they need to know how to cope with it.
    Congratulations on conquering such a horrible addiction! You must be one very strong person to get through it!
    I have a lot of respect for you, sharing what you’ve been through and providing helpful information for other’s.
    Keep up the good work. I’m sure you are making a difference in so many lives!

    Best wishes,
    Devara

    1. Thank you for reading and commenting Devara. You are fortunate to have not had personal experience with heroin addiction. I think it is important for everyone, personally effected or not, to at least understand what a user is up against. Hopefully more people will have more compassion for those suffering. Hope you have a wonderful weekend.

  2. Unfortunately, not everyone is aware of the dangers associated with heroin withdrawal, and the tendency to minimize the suffering of heroin users is still very present.

    A friend of mine is currently trying to recover; however, it is not always easy to find the right way to help her. I feel very ignorant, so I am trying to read as much as possible about the subject.

    Your article is very informative -thank you!!

    1. I am soooo happy to hear my experiences are helping you help your friend. PLEASE do not hesitate to contact me with ANY questions, no matter how silly you think they may be. I will do my best to help and, if for some reason I do not have an answer for you, I will reach out to someone else who will. Remember, the best thing you can do fro your friend is show compassion. The majority of users who ‘recover’ have slipped up on more than one occasion.. This is okay, as long as your friend learns from her mistakes and does her best to make a better decision the next time.

      Again, let me know if you need anything.
      ANA

  3. Wow this was a really good read and hit close to home as I had a cousin who was addicted to heroin managed to beat it and for a significant amount oftime was doing really well. However a couple years ago out of the blue passed to an overdose.
    Thankyou for such an insightful read.
    Michael

    1. I am very sorry to hear about your cousin. It is never easy when someone is taken from us, especially when it may have been prevented.

      I always tell newly sober heroin users to remember one thing: When a person gets clean. their tolerance drastically drops. Relapse is a part of recovery, for some more than others, so it is important to take tolerance levels into account when relapse if imminent. Some users think, after being clean for a while, they can handle the same amount of heroin they were doing right before they got clean. This is how people overdose and it could have been prevented very easily.

      I used to go to NA and AA meetings and tell this to the newcomers who made conversation with me. Most of the other group members looked at me like I was nuts for even talking about relapsing, but I did not care. It is reality and I believe we have a duty to help users stay safe.

      Thank you for sharing something so personal Michael.
      Have a great weekend
      ANA

  4. I have been through opiate withdrawal. The film was very mild compared to the reality of it. I mean VERY mild. I was also bothered by the fact that they showed a pregnant woman going cold turkey on her own. That is not safe for the baby!

    Just reading about this has brought back horrible memories of withdrawal. Those days were with a doubt the worst days of my life. I done cold turkey withdrawal and medically supervised withdrawal. I would never recommend cold turkey but even medically supervised really can’t help the emotional part completely.

    1. Completely agree with you Shiloh. Cold turkey withdrawal is a different kind of hell of Earth. I would not wish it upon my worst enemy. Also, very good point about withdrawing during pregnancy. Thank you for reminding me to address this VERY IMPORTANT issue. If any readers are pregnant, SEE A DOCTOR before trying to quit using opiates. It is very common for pregnant women to lose the baby if they attempt detox. Usually, a doctor will put a pregnant women on methadone during pregnancy and throughout the time she is breastfeeding. This allows the baby, through the mothers breast milk, to slowly wean off the methadone. The last thing you want is to lose your baby or watch a baby suffer through the pain of detox.

  5. I do agree with you, from looking at the symptoms that it is possible to die from a heroin withdrawal. I will continue to pray a special blessing over your life and also that this website will continue to bless others. I pray that God will open financial doors so that you will have money to continue writing and fulfilling your purpose for which you were created. Be blessed.

    1. Thanks so much for the well wishes Josephine! As long as this site helps at least one person who is struggling, I have fulfilled my purpose. 🙂 Hope you have a wonderful week!

  6. Wow. Just wow. This is a very powerful post with great, detailed information of actual withdrawal symptoms. I haven’t seen that movie but the clip itself is such an eye-opener! Thanks for this post.

    1. The movie barely scratches the surface, but it is the most accurate clip I have been able to find so I hope it helps gets my message out there. Thanks for commenting!

    1. ..and please do! This discussion needs to be had! Our country is in crisis and the only way to fix it is to take an active role in discussions, while implementing potential solutions. Thanks!

  7. Thanks for writing such a thorough and unbiased article. I haven’t had any personal experience with heroin withdrawal but it sounds like a really horrible experience. I have to ask why do they offer medications to help with withdrawal from alcohol or benzo users but not for heroin users? That seems very unfair.

    1. Benzos are basically alcohol in pill form. If you have ever taken a Xanax and not remembered what happened while you were on it, you were basically experiencing the same thing a black out drunk experiences when he can not remember what happened after his 6th beer the previous evening.

      Supposedly, it is easier to die from alcohol and benzo withdrawal because a user can have life-threatening seizures as the substances leave their body. Although it is not as likely to die from heroin withdrawal, it is just as painful as alcohol and benzo withdrawal…and, as discussed above, more and more people are dying from the complications related to excessive vomiting and diarrhea while coming off opiates.

      In jail, they are not concerned about how crappy one feels, because they have a ‘consequences of your actions’ mentality. They hand out meds to those coming off benzos and alcohol only to cover their asses becuase if an inmate dies, under their supervision, during withdrawal, they can expect a lawsuit. Unfortunately, in the jails it is all about liability and spending as little money as possible.

      Great question Helen!

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