While you can quit heroin cold turkey, it's both ineffective and dangerous. Your brain cells change after long-term exposure to drugs, and when you stop suddenly, withdrawal symptoms can be so severe that they can become life-threatening.
If you're struggling with heroin use, you know what withdrawal feels like. Many people report using drugs like heroin repeatedly just to avoid feeling sick when they don't use them.[1]
Take those uncomfortable symptoms, multiply them and imagine living with them for weeks. That's what quitting cold turkey feels like.
If you choose to try quitting cold turkey, preparation can ensure you do so safely. But know you can opt for medical detox programs that use medications like Suboxone to help your brain adjust to a lack of heroin. Enrolling in these programs is a much safer and more effective way to stop using heroin for good.
After long-term heroin use, your cells become accustomed to constant drug access, and when heroin is present it feels like a new ‘normal’. When you quit using the drug abruptly, you'll notice your body struggling.
Early withdrawal symptoms include the following:[2]
People with a long heroin habit may feel these symptoms between doses. You may know that using heroin makes these symptoms go away. But if you don't use heroin, your symptoms can worsen and deepen.
Late withdrawal symptoms include the following:[2]
These symptoms can also get worse long before they get better. You may experience heroin cravings, especially if you’ve relapsed to drug use due to withdrawal symptoms in the past. Your body knows what has relieved withdrawal symptoms before and will prompt you to take that route again.
Most people experience withdrawal symptoms within about 12 hours of their last heroin dose.[2] If you've used heroin for long periods and high doses, your difficulties may start sooner.
Physical symptoms tend to peak within about two to four days, but they can be debilitating. People in the midst of withdrawal can't eat, drink or talk to friends. Most people struggle to stay warm, and they may sweat through their sheets and clothes multiple times.
In addition to physical problems, you may experience mental health challenges, including mood swings, anxiety and irritability. Your drug cravings will deepen the longer you stay in withdrawal, and your thoughts may be consumed with where you can get more heroin.
Some people feel better within a week or two, but others experience a protracted withdrawal with problems lasting for months. Relapse risks rise in these situations, as people may be willing to do anything to feel better. They may believe they can't survive without heroin.
Withdrawal is often described as a mild flu, but experts say it can be life-threatening.[3] Repeated episodes of vomiting, diarrhea and sweating can lead to intense dehydration. Any liquids you drink come right back out again, so you can't get better at home.
Some people last for a few days in withdrawal, and they relapse to drugs to feel better. While they were struggling to get sober, their brain cells were adapting. The result can be devastating. A dose that was once safe when your body had higher tolerance is now too large and can lead to an overdose.
Experts say overdose is common in people who relapse after getting sober quickly.[4] You may not feel any different, but your brain cells have changed. Relapse and overdose are very real risks for those who try quitting heroin cold turkey.
People who attempt a cold-turkey approach often need several tries to get sober.[5] Each one comes with risks of dehydration and overdose. If you’ve tried to get sober cold turkey and failed, it’s not safe for you to try this again.
It is much safer to withdraw from heroin under medical supervision, but if you do choose to try a cold-turkey heroin withdrawal, planning is crucial. These are the steps you should take before you quit taking heroin:
You will feel sick for several days, if not longer. Find a space that's cool, quiet and dark. You should have access to a sink and toilet. Ensure you're not near people who use heroin or will give you some if you ask.
You'll need several things to stay comfortable like these:
Find someone you trust to help you through this process. Don't work with someone who has used heroin, but find a close friend or family member who will encourage you and stay with you until you feel like yourself again.
Both you and your helper should stay in your safe place until you feel sober. Don't plan to work, see family or do anything outside of your home. You will be focused on getting well and need someone watching you around the clock.
Some people find cold-turkey withdrawal too excruciating to complete. Even if you think this won't happen to you, plan for it. Determine which hospital emergency room is closest to your withdrawal space, and create firm guidelines that your helper can use to determine if you need to go.
You're not required to put your body and mind through a difficult cold-turkey withdrawal. Many people use medications in a clinical setting (also called medical detox) to stop using heroin.
In a medical detox program, doctors use medications like buprenorphine or methadone to correct chemical imbalances caused by drugs. While you might feel mild withdrawal symptoms in these programs, you won't experience the full-blown misery associated with quitting heroin use cold turkey.
After medical detox, your doctor can use medications like Suboxone (a combination of buprenorphine and naloxone) to help you maintain your sobriety. Medication for Addiction Treatment (MAT) programs are very effective in treating heroin addiction, but just 18% of people with these issues get the medications they need.[6]
If you can't get sober alone or you can't maintain sobriety when you have quit using for a time, consider MAT. It is the first-line treatment for opioid use disorder, and it can help you to effectively and safely stop using heroin for good.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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