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Withdrawing from Heroin at Home

Heroin is a highly addictive opioid, and withdrawal from this drug often takes place in a medical detox program to prevent unnecessary suffering and reduce the chance of relapse. Detoxing at home may be more difficult than detoxing under supervision, and though opioid withdrawal is seldom life-threatening, complications sometimes arise that require medical attention.

Detoxing from heroin at home can be an intense experience, and the Substance Abuse and Mental Health Services Administration advises against it.1 Continue reading to learn more about heroin withdrawal, the risks, and any tips for staying safe if you must detox at home.

What Can I Expect?

At home withdrawal is not recommended.Withdrawal symptoms may be more intense for one person than for another. Variables that may determine the severity of withdrawal include how long a person has used heroin, the amount regularly used, and any previous negative opioid withdrawal experiences.1

Though withdrawal experiences vary, speaking relatively, a person may experience:2

  • Mild withdrawal: If they used 1-2 bags of heroin daily or less.
  • Moderate withdrawal: If they used 3-6 bags of heroin daily.
  • Severe withdrawal: If they used more than 6 bags of heroin daily.

Those expected to experience moderate or severe heroin withdrawal might seriously consider some form of professional detox, such as partial hospitalization or inpatient treatment, where medications and other interventions may be used to mitigate suffering and manage any complications.

Acute heroin withdrawal symptoms can start within 8 to 12 hours of the last dose, peak in 24 to 48 hours, and resolve over the course of the next 3 to 5 days.1,2

Heroin withdrawal is often compared to an extremely intense flu since it produces many of the same symptoms, including:1,3

  • Insomnia.
  • Diarrhea.
  • Vomiting.
  • Cold flashes and goosebumps.
  • Muscle and bone pain.
  • Restlessness.
  • Uncontrollable leg movements.
  • Yawning.
  • Tearing of the eyes.
  • Rapid pulse.
  • Dilated pupils.
  • Anxiety.

Heroin is extremely addictive and, because it is associated with an intense withdrawal syndrome, it is important to understand the risks of attempting a home detox. When people experience an uncomfortable withdrawal, they may be inclined to use substances for relief. One study examined the experience of mothers living in Ireland who had children who were detoxing. The study found that it was common for the detoxing individuals to self-administer legal and illegal substances during the withdrawal period to help manage side effects. Among the study sample, relapses were common.4

How Do I know it's Time to Quit?

This quiz from U.S. Department of Health and Human Services may help you to uncover your motivation to stop using heroin:

Is the Process Safe?

Symptoms of withdrawing from a substance.Heroin withdrawal is rarely fatal; however, it is often extremely uncomfortable. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), detoxing without medical intervention can lead to unnecessary pain and suffering.1 The risk for relapse is high when you are at home, given your relative ease of access to heroin, other drugs, and alcohol.

Further, while it may not harm you physically to detox at home, treatment for addiction is necessary to address the underlying psychological issues that are fueling your addiction. Without professional care, you may be more prone to returning to heroin.5

If you've been abusing multiple substances (e.g., heroin and benzodiazepines), your likelihood of experiencing depression and suicidal thoughts during withdrawal is increased. Women, in particular, face an even greater risk of these issues. Without a supervised and supportive environment, these problems can put you in extreme peril. If you already struggle with depression, suicidal ideation, or other mental health concerns, detoxing at home may be too much of a risk.1

Other risks of detoxing at home include dehydration, electrolyte imbalances, and cardiac events.One surefire way to manage any withdrawal complications to arise is to enlist the help of a medical detox program.

How Can I Detox at Home?

Detoxing at home may not be a great option due to the dangers discussed above. However, for those who insist on detoxing at home, there are some steps you can take to protect yourself. To begin, find a comfortable and safe environment. Ask for assistance from family and friends while you detox; they can provide emotional support and help care for you physically. Also, if things go wrong at any point, you will have someone around who is monitoring your condition and can call for help.

Repercussions of quitting cold turkey.Heroin withdrawal often causes vomiting and diarrhea, which can deplete you and leave you feeling dehydrated, nauseated, and suffering from headaches. To combat dehydration, make sure to keep water and drinks with high levels of sodium and potassium (such as Gatorade or Pedialyte) nearby, and drink them, even if you experience nausea or vomiting. This is when you need to stay hydrated most. When you are very nauseated, it may help to take small sips often or even suck on ice cubes. If you are still unable to keep any water or beverages down and are showing signs of dehydration, you may need to go to the hospital where you can be administered IV fluids.6

Good nutrition is also essential during detox. Addiction often leads to unhealthy eating patterns and malnourishment, and a body in withdrawal needs energy and nutrients to recover. Improved nutrition can have many benefits for those in recovery from heroin addiction, including improvements to health and psychological well-being.7 Evidence suggests that poor nutrition can impede a person's ability to resist substance use.8

To regain your strength and best take care of your body, eat fresh, whole foods. Find a grocery store near you and pick up items that you love eating and that you can eat raw or that you know how to cook quickly. Likely, you won't be feeling up to preparing very involved meals, so keep it simple, unless you have someone who is willing to cook nutritious meals for you during this time. Avoid buying junk foods, and aim to fill up your kitchen with fresh foods that are in season.

Get enough sleep. During detox, you may be particularly vulnerable to using substances to help with sleep,9 so make sure you're taking steps to get better sleep naturally, such as by not using electronics before bed and keeping your bedroom cool.

Unproven Methods

Recently, there have been reports of people using kratom (a psychoactive plant) or ibogaine (a hallucinogenic plant alkaloid) to detox from heroin at home.

Kratom use dates back to 1836 in Southeast Asian countries. Today, it is used for recreational and medicinal purposes, but there is little scientific research on its efficacy and safety. Although it has been used by some to manage opioid withdrawal, its use may lead to vomiting, visual alterations, sedation, and mild dependence.10

Like kratom, ibogaine has a long history of use. However, there have been reports of the drug resulting in cardiac arrest and death.11 It is important to be aware of the risks of using kratom and ibogaine if you are thinking of using it to detox. These drugs are not approved for the use of heroin detox, unlike medications such as methadone or buprenorphine which can be administered in a safe, controlled medical detox environment.

When Should I Ask for Help?

Withdrawal can take an enormous toll on a person physically and may be too much to take on alone. Medical detox offers supportive care and medications to reduce withdrawal discomfort and prevent relapse. When you are detoxing alone, you may suffer to the extent that you relapse for relief, despite being incredibly driven to get sober at the start.

Having help around during detox can prove enormously beneficial at times that your willpower, or self-control, is at a low point. According to psychology, willpower is a finite resource.12 When you wake up in the morning, your amount of willpower may be filled to the brim. But as the day goes on, it begins to decrease. Having professional support and a substance-free environment can make all the difference during this time.

Seeking out help from a professional about substance abuse.You can expect to experience a wide range of emotions while you withdraw that may include irritability, anxiety, and depression.1 These feelings may be new or so powerful that you want to turn back to heroin to feel better. Asking for help takes tremendous courage. If you're detoxing at home and you're feeling emotionally vulnerable, reach out for support from a trusted friend or family member. And if you feel like you're on the verge of relapse, don't be ashamed to admit you need additional support from a detox program. If you're feeling too sick or anxious to look for a program yourself, enlist a loved one to call surrounding programs to inquire about their availability. You can search here for programs.

If you are helping someone who is going through heroin detox, watch out for the following physical or psychological warning signs. If they are experiencing any of these, it may be time to call for help or help them get to an emergency room:

  • Signs of dehydration: sunken eyes, extreme thirst, irritability, decreased urinary output, dry tongue, low blood pressure, slow rebound of skin when pinched, weak pulse, lethargy.13
  • Electrolyte imbalance: thirst, restlessness, confusion, agitation, edema, dry mucous membranes, seizures, coma.14
  • Signs of cardiac issues: shortness of breath, upper body pain, chest pain or discomfort.15
  • Overwhelming urges to relapse.
  • Thoughts of suicide or self-harm.

If you are detoxing at home, it is important to have treatment lined up for after you leave, either inpatient or outpatient therapy. Kicking your physical dependence is only the first step. Without further treatment, the issues that originally led you to abuse heroin will still be present, and you may return to heroin as a way to cope with them. The therapy offered in treatment can help you to uncover your motivation to stay sober, develop new and positive beliefs, and learn ways to manage your triggers and cravings.

References

  1. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and substance abuse treatment.
  2. Sigmon, S. C., Bisaga, A., Nunes, E. V., O’Connor, P. G., Kosten, T., & Woody, G. (2012). Opioid Detoxification and Naltrexone Induction Strategies: Recommendations for Clinical Practice. The American Journal of Drug and Alcohol Abuse38(3), 187–199.
  3. National Institute on Drug Abuse. (2018). What is Heroin?
  4. Van Hout, M. C., & Bingham, T. (2012). Mothers' experiences of their children's detoxification in the home: results from a pilot study. Community Practitioner85(7), 30.
  5. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
  6. U.S. National Library of Medicine. (2017). Dehydration.
  7. Neale, Nettleton, Pickering, & Fischer. (2011). Eating patterns among heroin users: a qualitative study with implications for nutritional interventions. Addiction, 107(3), 635-641.
  8. Jeynes & Gibson. (2017). The importance of nutrition in aiding recovery from substance use disorders: A review. Drug and Alcohol Dependence, 1(179), 229-239.
  9. Angarita, G. A., Emadi, N., Hodges, S., & Morgan, P. T. (2016). Sleep abnormalities associated with alcohol, cannabis, cocaine, and opiate use: a comprehensive reviewAddiction science & clinical practice11(1), 9.
  10. Swogger, M. T., Hart, E., Erowid, F., Erowid, E., Trabold, N., Yee, K., ... & Walsh, Z. (2015). Experiences of kratom users: a qualitative analysisJournal of psychoactive Drugs47(5), 360-367.
  11. Meisner, J. A., Wilcox, S. R., & Richards, J. B. (2016). Ibogaine-associated cardiac arrest and death: case report and review of the literature. Therapeutic advances in psychopharmacology6(2), 95-98.
  12. Bechara, A. (2005). Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nature neuroscience8(11), 1458.
  13. Centers for Disease Control and Prevention. (2018). Rehydration Therapy.
  14. Registerednursing.org. (n.d.). Fluid and Electrolyte Imbalances: NCLEX-RN.
  15.  Centers for Disease Control and Prevention. (2017). Heart Disease Facts.
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