How Long Does Heroin Detox Take?

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Individuals experiencing opioid use disorder (OUD) generally require professional medical supervision during detox and withdrawal. Heroin and other opioids are incredibly dangerous and may cause severe withdrawal side effects if people go through detox without the aid of trained professionals. Studies have shown that "opioid withdrawal syndrome is a life-threatening condition resulting from opioid dependence." Pathways Recovery Center uses evidence-based treatments to support clients and safely guide them through heroin detox and withdrawal.  

Individuals with OUD benefit from attending detox programs that provide access to medical supervision and essential services. Heroin is a highly dangerous drug. Individuals going through withdrawal and detox frequently require a combination of prescription medication and psychological therapy to establish emotional and physical stability. Clinicians at Pathways Recovery Center educate clients and their families on the realities of overcoming heroin addiction. The care team ensures clients and their loved ones have the resources and tools they need to heal and achieve sobriety. 

Heroin Detox: Understanding Heroin and Its Effects on the Body

Under the Controlled Substances Act, heroin is considered a Schedule I substance. Schedule I drugs are known to be highly addictive and have no accepted medical use. According to the Drug Enforcement Administration (DEA), heroin is an "opiate (narcotic) drug processed from morphine and extracted from certain poppy plants." The effects of heroin vary depending on multiple factors. However, anyone chronically misusing the drug may experience physical and mental health issues. 

Short-Term and Long-Term Health Side Effects

Heroin abuse affects many systems in the body. The symptoms and side effects exist along a spectrum, and each person reacts to the drug differently depending on various factors, including genetics, age, general health, and how long they misused the drug. 

Some of the most common short-term side effects of heroin abuse include: 

  • Slowed breathing 
  • Decreased heart rate and blood pressure 
  • Emotion dysregulation
  • Reduced ability to feel pain 

Long-term symptoms and side effects of heroin abuse include: 

  • Hormonal imbalances 
  • Decreased in white and gray brain matter and other physical changes to brain structure
  • Difficulty making decisions
  • Memory issues 
  • Difficulty regulating behavior 
  • Decreased stress threshold
  • Severe withdrawal symptoms
  • Increased risk of accident or injury
  • Severe illness 

Overdose and death are two potential long-term effects of OUD. According to the National Institute on Drug Abuse (NIDA), in 2020, heroin overdose was responsible for approximately "13,165 deaths" in the United States. Chronic heroin abuse also affects relationships and quality of life. Often, people with OUD self-isolate or develop maladaptive relationships to support their addictive behaviors, leading to additional mental health disorders. 

Heroin Detox and the Importance of Detoxification in the Recovery Process

Recovering from heroin abuse starts with accepting the need for help and participating in treatment. In most cases, the first stage of treatment involves detox. The process of detoxification and withdrawal takes anywhere from several days to over a week, depending on the severity of symptoms and treatment methods. Individuals in detox experience acute withdrawal symptoms followed by a period of protracted withdrawal or post-acute withdrawal syndrome (PAWS). 

After a person stops taking heroin, the body begins to detox and naturally rid itself of the substance. However, physical changes caused by chronic heroin abuse may impact detox and brain function. According to Addiction Science and Clinical Practice, "Repeated exposure to escalating dosages of opioids alters the brain so that it functions more or less normally when the drugs are present and abnormally when they are not." Addiction recovery experts at Pathways Recovery Center use evidence-based methods to help clients safely detox off heroin. 

Detox and withdrawal programs are the first step in rehabilitation and set the stage for long-term treatment and recovery. During the initial three to ten days of detox, clients are introduced to their care team and provided with essential support services. After withdrawal symptoms resolve, clients transition to the next level of care—many people with OUD transition to residential treatment after detox. Outpatient treatment programs are also available for individuals with more mild symptoms.  

Factors Influencing the Duration of Heroin Detox

How long it takes someone to fully detox depends on factors such as metabolism and overall health. Open-Access Impact Journal on Aging states, "Studies have shown that drug addiction can be considered a metabolic disease; it is triggered by the destruction of the body's metabolism and thereafter leads to persistent neurochemical disorders." In addition, "During acute heroin withdrawal, oxoglutaric acid and isocitric acid are significantly reduced," affecting energy levels and removal of toxic ammonia. 

The duration and frequency of heroin misuse affect how long it takes to detox. Individuals who frequently abuse high doses of heroin over a long period will take longer to detox and experience more severe symptoms fully. In some cases, chronic heroin abuse causes PAWS or other lingering health issues. 

Personal tolerance of heroin and other substances plays a role in the duration of detox and potential side effects. Some people have an easier time tolerating detox and withdrawal. Pharmacological treatments are available to help individuals who have difficulty coping during detox. Clients with a decreased ability to tolerate detox symptoms may require additional treatment and medical supervision to ensure they safely taper off the drug.

The Impact of Co-Occurring Disorders on Heroin Detox

Many people diagnosed with OUD also have co-occurring mental health disorders or additional disorders related to substance abuse. For example, someone with OUD may also have alcohol use disorder (AUD). 

Some of the most common co-occurring disorders include: 

  • Anxiety 
  • Major depressive disorder (MDD) 
  • Post-traumatic stress disorder (PTSD)
  • Personality disorders 
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Bipolar disorder (BD)
  • Schizophrenia 
  • Substance use disorder (SUD)

Heroin reduces sensations of pain. Some people misuse heroin to cope with chronic pain, injuries, or illnesses. Treatment must address any co-occurring physical health issues affecting recovery.

A General Timeline of Heroin Detox

According to research by the World Health Organization (WHO), "Withdrawal management (WM) refers to the medical and psychological care of patients who are experiencing withdrawal symptoms as a result of ceasing or reducing use of their drug of dependence." Pathways Recovery Center manages withdrawal by providing essential services, including medication-assisted treatment (MAT). Personalized withdrawal management provides clients high-quality treatment and additional support during early recovery. The clinical team uses individualized care to improve the effectiveness of medically assisted detox. 

Initial Withdrawal Symptoms

The initial withdrawal symptoms are acute and begin manifesting within eight to 24 hours after the last dose of heroin. Medical detox reduces the severity of symptoms and helps clients achieve emotional and physical stability during withdrawal. 

Acute withdrawal symptoms include: 

  • High blood pressure 
  • Increased heart rate
  • High body temperature
  • Sensitive reflex responses
  • Dilated pupils 
  • Sleep disturbances
  • Excessive sweating
  • Muscle aches, spasms, or cramps 
  • Bone pain 
  • Nausea or vomiting 
  • Diarrhea
  • Clear discharge from eyes or nose

Acute withdrawal generally lasts between three to ten days. Some symptoms may continue for much longer. After acute symptoms begin to resolve, some people continue to experience mild discomfort and emotional distress. The clinical team uses comprehensive treatments to address lingering symptoms or side effects. 

Post-Acute Withdrawal Syndrome (PAWS)

In rare cases, people experience post-acute withdrawal syndrome. The Yale Journal of Biology and Medicine states, "Post-acute withdrawal begins shortly after the acute phase of withdrawal and is a common cause of relapse." Relapse prevention education and ongoing psychological support reduce the risk of relapse. Some clients may require additional support services to improve their quality of life while experiencing PAWS. 

A few common symptoms of PAWS include: 

  • Anxiety 
  • Fluctuation in energy levels
  • Unusual irritability
  • Decreased enthusiasm for everyday activities
  • Difficulty concentrating
  • Sleep disturbances 

PAWS can last up to two years and shares similar side effects with major depressive disorder (MDD). Psychotherapy and prescription medications are the most common treatment for PAWS. 

Heroin Detox at Pathways Recovery Center

Detox treatment at Pathways Recovery Center occurs in a controlled environment where medical professionals and support staff monitor clients. Clients have private sleeping quarters. However, phones and other methods of communication are often controlled to ensure clients focus entirely on their healing and to reduce the risk of relapse. The clinical team ensures each client has access to trained recovery experts 24/7. 

Medical supervision is critical during detox and allows the clinical team to track progress and symptoms. Some people may experience sudden changes in their physical or mental health. On-site clinicians can alter treatment immediately to address any new concerns or complications. 

Benefits of Personalized Treatment Plans

Pathways Recovery Center uses personalized care plans to tailor treatment programs. Every client has unique needs and preferences. The care team takes them into account when presenting treatment options.

Clinicians collaborate closely with clients and their families to ensure the following:

  • Clients receive the level of care they need 
  • The treatment provided is appropriate and effective 
  • Clients have all the information they need to make educated decisions 

Personalized detox provides clients with structure and access to essential support services. Many people going through detox benefit from participating in customized treatment. 

Addressing Co-Occurring Mental Health Disorders During Heroin Detox

Most individuals who misuse heroin have co-occurring physical or mental health disorders. During the detox stage of treatment, co-occurring disorders may cause more severe symptoms and side effects. The care team at Pathways Recovery Center uses comprehensive assessments and screening tools to make an accurate diagnosis and ensure clients receive relevant treatment for co-occurring conditions.

Some of the most common co-occurring mental health disorders include: 

  • Anxiety disorders 
  • Depressive disorders 
  • Personality disorders 
  • Post-traumatic stress disorder (PTSD)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Schizophrenia
  • Bipolar disorder

Individuals who misuse heroin may also struggle with mental health issues related to chronic pain.

Potential Complications and How They Are Managed During Heroin Detox

Dehydration and nutritional deficiencies are some common health complications for individuals with OUD. Treatment involves introducing nourishing meals with essential vitamins and minerals. Clients are also educated on proper hydration. According to the National Hearts Lung and Blood Institute (NHLBI), "Adults who stay well-hydrated appear to be healthier, develop fewer chronic conditions, such as heart and lung disease, and live longer than those who may not get sufficient fluids." 

Women should consume about eight cups of water daily, and men should consume ten. However, individuals who misuse heroin may struggle with issues related to chronic dehydration. Dehydration causes severe and sometimes life-threatening health conditions and should be avoided during detox and treatment for OUD. The care team carefully monitors nutritional intake to ensure clients improve overall health during treatment. 

Some clients experience psychological complications, including anxiety, depression, and ambivalence about treatment. Pathways Recovery Center treats physical and psychological issues by providing psychoeducation, nutritional counseling, psychotherapy, and alternative holistic therapies. Continuous monitoring by clinicians and support staff ensures the safety and comfort of clients going through detox treatment. 

After Heroin Detox: Transitioning to Residential Treatment

Clients with OUD benefit from continuing treatment after detox. According to the Department of Health and Human Services (HHS), "Although there are effective treatments for opioid use disorder, only about one in four people with this disorder receive any type of specialty treatment." 

Detox on its own is generally not enough to sustain long-term sobriety, and it doesn't address underlying issues or co-occurring conditions contributing to substance abuse. Without addressing the root cause of addiction, clients have difficulty maintaining recovery. Professional mental health and addiction recovery services provide the best outcomes by ensuring clients have the tools and skills they need to maintain sobriety long-term. 

Transitioning directly from detox into a residential treatment program provides clients with continued structure, accountability, and support while removing distractions. Residential programs at Pathways Recovery Center use a holistic approach to address the root cause of issues related to substance misuse. The care team collaborates with clients to identify and resolve potential problems using evidence-based and alternative holistic therapies. 

Preparing for the Journey: What Loved Ones Should Know About Heroin Detox

Families can support loved ones by preparing them for detox and rehabilitation. Many families host interventions to encourage loved ones to get treatment and educate them on the benefits of rehabilitation programs. 

Families can also offer support by doing the following: 

  • Collaborating with the care team to ensure their loved ones receive the most effective treatments 
  • Providing emotional support
  • Holding loved ones accountable for their recovery
  • Providing practical support
  • Participating in family therapy 

Families should set realistic expectations to avoid pressuring loved ones during detox and early treatment. The care team educates families on potential challenges clients may face during treatment to ensure they understand their loved one's condition.

Early stages of recovery, including detox, generally focus solely on the client and their health. After completing detox, clients may be encouraged to engage more directly with family members through facilitated meetings or family therapy sessions. Later stages of treatment benefit from heavy family involvement. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), "While there is no one-size-fits-all solution for helping a family member who is drinking too much, using drugs, or dealing with a mental illness, research shows that family support can play a major role in helping a loved one with mental and substance use disorders." Transitioning to aftercare and independent sobriety is more manageable when families continue to support their loved one's recovery. 

The Path Ahead With Pathways Recovery Center

Detox is a vulnerable time for many people. Participating in medically assisted detox reduces the risk of relapse and makes it easier for clients to manage their symptoms. Pathways Recovery Center is committed to ensuring a safe and effective detox experience. Clinicians go above and beyond to provide high-quality services and treatments to clients struggling with heroin addiction. 

Early treatment reduces the risk of severe illness, injury, overdose, or death. Clinicians and peers uplift clients and help them find healthy ways to manage their condition during detox and early recovery. Individuals and families trust Pathways Recovery Center to help them take the first steps toward a healthier future.

Heroin is a highly addictive substance with the potential to cause severe physical and mental health issues. Medically assisted detox helps clients successfully recover from heroin misuse. Many people who misuse heroin have underlying health issues, including chronic pain or mental health disorders. Programs must address all active and underlying issues to fully treat SUD. Pathways Recovery Center uses evidence-based and alternative holistic therapies to help clients and their families heal from the damage of heroin misuse. Detox is only the first step. Pathways Recovery Center offers a full continuum of care to ensure clients receive the level of support they need to heal. Learn more about our programs and services by calling our office at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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