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  • Heroin Withdrawal and Detox: How to Get Clean Again

    According to the Centers for Disease Control and Prevention (CDC), the incidence of heroin abuse has increased to epidemic proportions in the United States in the last decade.

    Heroin Withdrawal and Detox

    Heroin is a highly addictive drug with potentially fatal side effects. Many who are aware of the dangers of heroin addiction want to quit the drug or try to motivate a loved one to give it up. But going cold turkey is a dangerous option.

    According to the National Institute on Drug Abuse (NIDA), heroin withdrawal symptoms are rarely fatal. But this ABC News report about deaths after jail heroin withdrawal confirms that in certain cases, complications can be deadly. A chronic user of heroin or an addict should undergo detoxification at a medical facility where his withdrawal symptoms will be closely monitored and promptly managed. Successful detoxification is essential for continued abstinence and to prevent relapse.

    How to detox from heroin at home?

    Heroin detox can be carried out at home with the following methods:

    • Drinking lots of water
    • Exercising to boost metabolism and blood flow
    • Exercising to burn fat cells that store heroin
    • Eating nutrient- and antioxidant-rich foods

    Learning about heroin withdrawal symptoms and what to expect during the detox period will assure you and keep away doubts and fears.

    Heroin Withdrawal Symptoms: The Physical Signs

    Chronic heroin use or abuse usually makes a person physically dependent on the drug. The person becomes accustomed to having the drug in his system. So withdrawal symptoms manifest when he stops taking it.

    The physical symptoms of heroin withdrawal are:

    • Restlessness
    • Abdominal cramps
    • Diarrhea
    • Nausea and vomiting
    • Bone and muscle ache
    • Uncontrollable kicking movements
    • Cold flashes or chills
    • Goosebumps
    • Runny nose
    • Fatigue
    • Incessant yawning

    These symptoms are usually mild or moderate in severity. More severe withdrawal symptoms may manifest in people who have been abusing heroin for prolonged periods. The serious physical symptoms of heroin withdrawal are:

    • Insomnia
    • High blood pressure
    • Rapid heart beat
    • Difficulty breathing
    • Muscle spasms

    Some of these symptoms can worsen and lead to fatal consequences if left untreated.

    Heroin Withdrawal Symptoms: The Psychological and Emotional Signs

    Heroin binds to specific opioid receptors in the brain. Chronic abuse is known to affect the structure and functionality of neural cells and neurotransmitters. The brain needs time to reverse these changes. So psychological and emotional withdrawal symptoms manifest just after a person stops taking the drug.

    The psychological and emotional symptoms of heroin withdrawal are:

    • Anxiety
    • Depression
    • Not being able to feel pleasure
    • Insatiable craving for heroin
    • Foggy thinking
    • Problems with memory
    • Problem concentrating for prolonged periods
    • Difficulty in dealing with stress

    These symptoms are seemingly harmless, but sometimes complications arise. For instance, interpersonal relationships take a toll when withdrawal symptoms make it difficult for a person to interact or deal with people in social settings.

    On the other hand, unmanaged depression can make someone contemplate suicide. It is best to seek the help of mental health professionals to combat some psychological symptoms.

    What are the stages of heroin withdrawal?

    The stages of heroin withdrawal are:

    • Symptoms begin: Symptoms manifest after quitting the drug
    • Symptoms peak: Symptoms peak between day 1 and 3
    • Symptoms subside: Withdrawal symptoms begin to subside after a week
    • Post-Acute Withdrawal Symptoms: Some psychological and emotional withdrawal symptoms may continue for weeks, and can last for years

    Stages of Heroin Withdrawal

    Not all physical and psychological symptoms of heroin manifest at once. A person usually goes through several stages during the withdrawal phase.

    The stages of heroin withdrawal are:

    • Start of Symptoms: Withdrawal symptoms start to manifest between 6 and 12 hours of stopping the drug.
    • Peaking of Symptoms: The symptoms intensify and peak between 1-3 days of stopping the drug.
    • Subsiding of Symptoms: Withdrawal symptoms start to subside after a week.
    • Post-Acute Withdrawal Symptoms: Some psychological and emotional withdrawal symptoms may continue for weeks, months, and even years after quitting heroin.

    Withdrawal symptoms usually persist for months and years in people who had abused the drug for prolonged periods, usually for many years.

    Why is home heroin detox dangerous?

    Home heroin detox is dangerous for the following reasons:

    • Severe withdrawal due to prolonged drug abuse
    • Co-occurring mental and physical disorders may intensify withdrawal symptoms
    • No medical assistance in cases of emergency
    • Exposure to triggers may cause a relapse

    How Long Does Heroin Stay in the Body?

    Some heroin users believe that the drug clears from their system when their “high” ends. But just about half of the drug clears from their systems when the “high” ends, which is approximately within 10-30 minutes of taking it. However, heroin is broken down into morphine that stays in the system for up to 2 days.

    Heroin is also broken down into several other metabolites that remain in the body in trace amounts for longer durations. Tests on blood, urine, saliva, and hair follicle can detect the presence of heroin even months after the person has stopped taking the drug.

    The window for detecting the presence of heroin differs depends on the biological sample collected:

    • In Blood: Heroin can be detected in blood samples for up to a day after consumption.
    • In Urine: Heroin can be detected in urine samples for 1-4 days. However, it can remain in the system of chronic or heavy users and be detected in their urine samples for up to a week.
    • In Saliva: Heroin can be detected in saliva for up to 5 hours after consumption.
    • In Hair Follicle: The hair follicle test for detecting the presence of heroin is regarded as the most sensitive of all tests. The presence of heroin can be detected in hair follicles for up to 3 months.

    However, these durations vary across individuals. How long heroin stays in the system depends on the following factors:

    • Dosage: The more the amount of heroin taken, the longer is the time it stays in the body.
    • The Frequency of Use: Heroin stays longer in the body of habitual users than those who take the drug recreationally. Frequent users generally develop tolerance to the drug and take larger and larger doses to produce the same degree of “high” they had experienced before on a smaller dose.
    • The Purity of Heroin: The greater the purity of heroin, the longer it stays in the system. Heroin is classified on a scale of 1-4 based on its purity, with 1 being the least pure and 4, the purest form of the drug. The highest grade of heroin will stay longer in the body even if it is taken in smaller doses than grade 1 heroin.
    • Body Mass Index of the User: The more the body mass index (calculated on the basis of height and weight) of the person, the less is the time heroin stays in his system. Heroin stays longer in the systems of people with smaller frames and/or low body weight.
    • Metabolism Rate of the User: The faster the rate of metabolism, the quicker heroin is eliminated from the system.
    • Liver and Kidney Functionality of the User: Heroin stays longer in the systems of people with impaired liver and/or kidney dysfunction because the drug cannot be metabolized by the liver and excreted by the kidneys effectively.
    • Route of Administration: Not many users know this but how heroin is ingested determines how fast it is cleared from the body. For instance, heroin stays longer in the body when it is smoked and injected than when it is taken orally as a pill. Users who smoke or inject heroin generally use a purer form of the drug. Also injecting delivers the drug directly into the bloodstream of the user while the lungs absorb heroin directly when it is smoked. In both these cases, the heroin does not reach the liver first, so it is not broken down fast.
    • Age of the User: Young people tend to have higher metabolism rates than the elderly. They are also less likely to suffer from liver and kidney dysfunction. So they are generally able to metabolize and excrete heroin faster than the elderly.

    Heroin Detox Guide

    Detoxification is the first step of healing from the effects of drugs.

    Of course, detoxification has to start with abstinence. But abstinence causes a host of withdrawal symptoms especially in frequent or heavy users whose bodies have become dependent on the drug. The pain and anguish of actually going through the symptoms of withdrawal make many users succumb to their cravings during the abstinence period.

    To prolong the abstinence period and prevent relapse, it is critical that the withdrawal symptoms are managed during the detoxification period.

    A heroin detoxification program generally consists of the following approaches:

    • Drug therapy to manage the symptoms of withdrawal
    • Drug therapy to reduce the use of heroin
    • Behavioral therapy to manage psychological and emotional withdrawal symptoms
    • A combination of therapies based on individual needs

    Drug Therapies for Heroin Dependence During Detoxification

    The following types of drugs are used during heroin detoxification:

    • Drugs to Manage Withdrawal Symptoms: Drugs like Clonidine, an alpha-2 agonist, is used to treat high blood pressure. In heroin users undergoing detox, it also helps to lessen the severity of many unpleasant withdrawal symptoms, like anxiety, agitation, stomach cramps, muscle pain, sweating, and runny nose.
    • Drugs as Alternatives to Heroin: Opioid agonists like methadone and buprenorphine simulate the effects of heroin but to a lesser degree. Suboxone produces similar effects like buprenorphine. According to a report published by the Harvard University, methadone maintenance therapy is, by far, the most effective pharmacological approach to treat heroin addiction.
    • Drugs to Block the Effects of Heroin: Drugs like naloxone and naltrexone reduce drug-seeking behavior by blocking the effects of heroin. This reduces the chances of an overdose or a relapse.

    Behavioral Therapy During Heroin Detox

    The following are the goals of behavioral therapy during heroin detox:

    • Help users deal with and manage the psychological and emotional symptoms of withdrawal without resorting to heroin
    • Help users identify and deal with addiction triggers, like stress, in a healthy way
    • Help users alter mindset and thought patterns to recognize the harmful effects of heroin
    • Help manage and/or treat the symptoms of any co-occurring mental disorder
    • Help family members help their loved ones battle heroin use, with understanding and compassion

    How Long does Heroin Detox Last?

    Generally, a detox lasts for about 7 days, which is the time from when withdrawal symptoms begin to subside. However, the length of heroin detox may vary depending on the following factors:

    • The frequency of Use and Dosage: A habitual heroin user usually exhibits more severe withdrawal symptoms than a recreational user. The drug also takes longer to be cleared from the body of the chronic user. Someone who has taken a large amount of heroin or has overdosed on it will also exhibit more intense symptoms.
    • Severity and Duration of the Withdrawal Symptoms: The more severe the withdrawal symptoms and the longer they last, the lengthier is the detox period.
    • Presence of Co-Occurring Mental and/or Physical Disorders: The presence of co-occurring mental disorders may necessitate behavioral therapy. The presence of physical disorders can complicate the pharmacological therapy. For instance, chronic users who also suffer from severe liver and/or kidney diseases cannot be prescribed some addiction-treatment or relapse-prevention drugs.
    • History of Abusing Other Substances: Some heroin users may also abuse other substances. Managing their withdrawal symptoms thus becomes complicated. Furthermore, they have to be detoxed from these substances as well.

    Heroin Detox at Home

    Medically-assisted heroin detox should ideally be carried out under the supervision of specialists at an inpatient or outpatient facility. Only addiction professionals can decide what addiction-treatment and relapse-prevention medicine will work for an individual.

    Heroin detox can also be carried out at home using the following methods to flush out heroin from the body:

    • Drinking lots of water
    • Exercising to boost metabolism and blood flow
    • Exercising to burn fat cells that store heroin
    • Eating a nutrient- and antioxidants-rich diet to boost the body’s capability to clear toxins
    • Taking supplements that are known to boost liver and kidney function or those that increase metabolism

    These methods work only when a person has taken a small amount of heroin or is not a chronic user of the drug.

    But heroin detox at home is dangerous in the following circumstances:

    • When the user has been abusing the drug for long periods, which makes him vulnerable to severe withdrawal symptoms
    • The presence of severe withdrawal symptoms
    • The presence of co-occurring mental and/or physical disorders that may intensify the withdrawal symptoms or aggravate themselves
    • If there would be no one at home to monitor the user and rush him to the ER, if symptoms intensify
    • The presence of addiction triggers at home that makes the user vulnerable to a relapse

    Heroin withdrawal and detox are safe when undertaken under the supervision and according to recommendations. When you go through these processes successfully, you are a step closer to reclaiming your life.

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