By David Heitz
Heroin withdrawals can be dangerous and fatal, particularly to a heroin addict who already may be in poor health due to prolonged drug use.
For even a healthy pregnant woman, however, heroin withdrawals can result in loss of the fetus.
Withdrawal symptoms peak about a day or two after a person last uses heroin. A week later, they usually subside.
“Heroin withdrawal is never fatal to otherwise healthy adults, but it can cause death to the fetus of a pregnant addict,” the renowned Cleveland Clinic reports. (1)
According to the Cleveland Clinic:
“Physical dependence and the emergence of withdrawal symptoms were once believed to be the key features of heroin addiction. We now know this may not be the case entirely, since craving and relapse can occur weeks and months after withdrawal symptoms are long gone.
“We also know that patients with chronic pain who need opiates to function (sometimes over extended periods) have few if any problems leaving opiates after their pain is resolved by other means. This may be because the patient in pain is simply seeking relief of pain and not the rush sought by the addict.”
What it’s like to go through heroin withdrawals: In the words of an addict
The non-profit, non-partisan journalism website MinnPost.com has a compelling story that includes first-person accounts of heroin withdrawal.
Writes Ian McLoone, a University of Minnesota graduate student when the piece was written in 2014:
“In the moment, when you are experiencing the first few stages of withdrawal, even though you know that the worst that’s going to happen is that you will feel like you have the flu, there’s a psychological piece that is so terrifying and so disconcerting.
“You know that there’s a cure, and you know that it’s out there, and that’s why people will go to such lengths to quell those withdrawal symptoms. Even though it’s ridiculous and it’s weak and it’s pitiful, in the moment, it really seems like it’s the worst thing that can ever possibly happen. Isn’t that weird?” (2)
Why some people detox and get past heroin more easily than others
Many, if not most, people who suffer from any kind of addition do so because they have a co-occurring mental disorder. To back up and destigmatize: A mental disorder can result from being a victim. For example, PTSD is a common mental disorder that often results in the victim trying to medicate anxiety, anger and angst.
Many turn to booze; some turn to opioids.
Those who turn to both often don’t come out alive.
Scientists have known about the effects of opioids on the brain for about 15 years now. In one 2002 study, the authors explained it this way.
“The abnormalities that produce dependence, well understood by science, appear to resolve after detoxification, within days or weeks after opioid use stops. The abnormalities that produce addiction, however, are more wide-ranging, complex, and long-lasting.
“They may involve an interaction of environmental effects—for example, stress, the social context of initial opiate use, and psychological conditioning—and a genetic predisposition in the form of brain pathways that were abnormal even before the first dose of opioid was taken. Such abnormalities can produce craving that leads to relapse months or years after the individual is no longer opioid dependent. (3)”
It’s important that treatment also address the underlying psychological problems causing most patients to use. A good treatment center also helps people addicted to drugs or alcohol find fun, new habits that will replace those that brought them to treatment in the first place.
Besides withdrawals, which can be fatal in already unhealthy people (as most long-term heroin addicts reach the point of injecting), heroin use has many other dangerous consequences, according to Cleveland Clinic.
“Many of the additives in street heroin may include substances that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Immune reactions to these or other contaminants can cause arthritis or other rheumatologic problems.”
How to manage heroin withdrawals
Over-the counter medications for diarrhea, motion sickness and allergies (Benadryl) can help manage opioid withdrawals at home, Healthline.com reports. Chinese medicine such as acupuncture also can be helpful.
Still, quitting a drug “cold turkey’ should be done under the supervision of a doctor, even if you try to do it at home. Tell your doctor of your intent to stop using and make sure they are available to help you if you need it. (4)
Managing withdrawals with medication
While nobody looking to get sober likes taking medication that is a derivative of what they’re addicted to, it does make withdrawals easier and safer for the short term.
Many treatments known as “opioid maintenance therapy” are available, including:
Methadone. With the advent of buprenorphine, methadone isn’t used as often as it once was, at least in terms of which medication to choose when it comes to opioid maintenance therapy.
“Methadone, a long-acting synthetic opioid agonist, can be dosed once daily and replaces the necessity for multiple daily heroin doses. As such, it stabilizes the drug-abusing lifestyle, reducing criminal behaviors, and also reducing needle sharing and promiscuous behaviors leading to transmission of HIV and other diseases.
“Methadone is a highly regulated Schedule II medication, only available at specialized methadone maintenance clinics. It is estimated that established methadone clinics can accommodate only 15 to 20 percent of U.S. heroin addicts.
“Methadone clinics often generate controversy in communities fearful of addicts in various stages of recovery. In addition, some patients are unable to travel to clinics, and others will not enter methadone maintenance therapy because of fear of stigmatization. Clearly other options would be beneficial for treatment of chronic opioid abuse.”(5)
Buprenorphine. Buprenorphine is usually considered a better choice than methadone because it’s formulated differently. Buprenorphine will not produce the euphoria that comes along with methadone, yet it still will help quell the symptoms of withdrawals. (6)
Today, there even is a long-lasting buprenorphine implants. Studies have shown it has been helpful in some people in terms of easing withdrawals when opioid maintenance therapy also stops.
Naltrexone. According to SAMSHA:
“Naltrexone blocks the euphoric and sedative effects of drugs such as heroin, morphine, and codeine. It works differently in the body than buprenorphine and methadone, which activate opioid receptors in the body that suppress cravings. Naltrexone binds and blocks opioid receptors, and is reported to reduce opioid cravings. There is no abuse and diversion potential with naltrexone.” (7)
While heroin withdrawals are extremely uncomfortable and can be dangerous, horror stories make it sounds worse than it actually is – even as bad as it is.
Treatment in a comfortable environment with a supportive treatment team makes heroin withdrawals and even lasting recovery very manageable.
The addicted owe it to themselves to reclaim their lives, and those who love them should support them every step of the way.
- Heroin: Abuse and Addiction. Undated. Cleveland Clinic. Retrieved Sept. 24, 2017, from http://www.clevelandclinic.org/health/health-info/docs/0900/0915.asp
- Williams, S. (2014, Feb. 14). What’s it really like to withdrawal from heroin and painkillers? MinnPost. Retrieved Sept. 24, 2017, from https://www.minnpost.com/mental-health-addiction/2014/02/whats-it-really-withdraw-heroin-and-painkillers
- Kosten, T. et al. (2002, July). The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science Clinical Practice. Retrieved Sept. 24, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
- Home remedies to ease opioid withdrawal symptoms. Undated. Healthline. Retrieved Sept. 24, 2017, from https://www.healthline.com/health/home-remedies-opiate-withdrawal#support5
- Opioid Abuse: Treatment and management. (2017, July 13). Medscape. Retrieved Sept. 24, 2017, from http://emedicine.medscape.com/article/287790-treatment
- Whelan, P. et al. (2012, Jan-April). Buprenorphine v. methadone treatment: A review of evidence in both developing and developed world. Journal of Neuroscience Rural Practice. Retrieved Sept. 24, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271614/
- (2016, Sept. 12). Substance Abuse and Mental Health Services Administration (SAMSHA). Retrieved Sept. 24, 2017, from https://www.samhsa.gov/medication-assisted-treatment/treatment/naltrexone