How Long Does It Take to Detox from Heroin?

The timeline of heroin detox depends upon each individual and their drug use, but most people overcome withdrawal in between four and ten days. Professional medical detox supports you through this process, helping you to manage symptoms and paving the way for long-term recovery.

What Is Heroin?

Heroin is a potent opioid drug derived from the seeds of opium poppy plants. It comes as a white or brown power or in a black, sticky substance called black tar heroin. Heroin is a highly addictive, illicit drug, classified as a schedule I controlled substance by the Drug Enforcement Agency.

People smoke, sniff, snort, and inject heroin. Injecting heroin comes with additional risks associated with needle sharing, including blood-transmitted diseases like HIV and hepatitis.

What Is Heroin?

How Does Heroin Affect the Brain and Central Nervous System?

Opioid drugs like heroin work by binding to and activating opioid receptors in the brain, spinal cord, and other areas of the body. Our bodies’ opioid system regulates many important functions, including pain, pleasure, respiration, motivation, and reward. By activating opioid receptors, heroin can block pain signals and produce the feelings of euphoria that many heroin users seek.

How Does Heroin Affect the Brain and Central Nervous System?

How Addictive Is Heroin?

Heroin addiction is when you compulsively seek and use heroin, despite any negative consequences. Heroin is a highly addictive substance and addiction can develop after only a few uses.

Heroin addiction develops due to interactions with our bodies’ natural reward systems. Our reward systems are pathways in our brains designed to reinforce life-seeking behaviors such as eating or having sex. When we engage in these behaviors, our bodies release small amounts of neurotransmitters, including dopamine and endorphins (natural opioids), which signal to our brain to repeat the activity.

When you take heroin, your body metabolizes it to make morphine, which quickly travels across the blood-brain barrier, flooding your brain with opioids and dopamine. This alters neuronal connectivity networks, creating strong connections in the brain that produce intense urges to use the substance again. These urges are extremely difficult to resist without effective support.

Changes in neuronal connectivity can be long-lasting or even permanent, triggering urges to use a substance even after years of abstinence. However, addiction treatment programs can go some way to reversing these changes and provide individuals with the skills to manage them.

What Is Physical Dependence and How Does it Develop?

What Is Physical Dependence and How Does it Develop?

Physical dependence happens when you repeatedly use heroin over time. Your body gets used to the presence of the substance in the body and begins to adjust its own functions in response. You begin to need more heroin to feel the same effects (known as tolerance) and become dependent on the drug to feel normal.

If you then suddenly stop taking heroin, you experience withdrawal symptoms as your body readjusts. Heroin withdrawal symptoms can be uncomfortable and even dangerous, but with professional medical support, you can safely overcome withdrawal and pave the way for long-term recovery.

What Are Heroin Withdrawal Symptoms?

Heroin withdrawal can involve emotional, psychological, and physical symptoms. Symptoms can be mild to moderate, depending on several factors including:

  • your history of drug abuse, such as how long you have been using drugs and in what doses
  • your metabolism
  • any co-occurring mental health disorders
  • your physical health
  • whether you have undergone the withdrawal process before

Everyone’s experience of withdrawal is different, but there are some common symptoms that people typically experience. Physical symptoms are often flu-like, and may include:

  • Nausea and vomiting
  • Hot and cold flushes
  • Perspiration
  • Muscle cramps
  • Watery discharge from eyes and nose
  • Diarrhea

Common psychological and emotional withdrawal symptoms include:

  • Depression
  • Anxiety
  • Insomnia
  • Drug cravings

While opioid withdrawal is not normally life-threatening, some people can experience severe withdrawal symptoms that are extremely uncomfortable and require medical support. You should never try to quit heroin alone, and always seek the advice of a medical professional.

What Is the Heroin Withdrawal Timeline?

The timeline of opioid withdrawal depends on an individual’s drug use and mental and physical health. For short-acting opioids like heroin, the onset of withdrawal symptoms happens between 8-24 hours after the last use. Acute withdrawal symptoms typically persist for 4 – 10 days.

Some people experience psychological symptoms that persist for several months or even years after they quit the drug. These symptoms are known as post-acute withdrawal symptoms (PAWS). PAWS symptoms are usually mild and often resemble symptoms of mood disorders like anxiety or depression. While experiencing PAWS can be difficult, it is not uncommon, and a mental health professional can help you to manage PAWS and keep your recovery on track.

What Is Medically-Assisted Detox?

What Is Medically-Assisted Detox?

During medically-assisted heroin detox, medical professionals guide you through the withdrawal process, helping you to safely manage symptoms and cravings.

Medical detox can be inpatient or outpatient. During inpatient detox, you stay in a specialized detox facility for the duration of the withdrawal process. Medical professionals are by your side 24/7 to ensure you are as comfortable as possible and intervene in the case of any medical complications. They may prescribe you medications if necessary.

An outpatient detox involves close monitoring and regular check-ups by a trained professional, while you continue to live at home. Outpatient detox is suitable for milder cases of withdrawal. Because of the potential severity of heroin withdrawal, however, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends 24-hour medical supervision to ensure your safety at all times.

Both inpatient and outpatient detox include an individualized detox plan, requiring the gradual tapering of heroin dosage (as opposed to quitting heroin cold turkey). This helps to reduce withdrawal symptoms, making the process safer and easier.

How Can You Manage Heroin Withdrawal?

During heroin withdrawal, doctors will closely observe and monitor your progress, usually involving at least 3 or 4 check-ups a day. They may use the Short Opioid Withdrawal Scale to determine the appropriate management strategy.

The short opioid withdrawal scale lists several symptoms of heroin withdrawal, for which the doctor rates their severity from 0-3 (not present, mild, moderate, and severe).

  • A score of 0-10 indicates mild withdrawal, requiring symptomatic medication only
  • A score of 10-20 indicates moderate withdrawal, requiring symptomatic or opioid medication
  • A score of 20-30 indicates severe withdrawal, requiring opioid medication

Clients experiencing mild opioid withdrawal should drink 2-3 liters of water each day to avoid dehydration caused by excessive perspiration and diarrhea. They may also take vitamin B and C supplements and symptomatic treatment.

Treatment for moderate to severe symptoms is the same as with mild symptoms, plus clonidine or opioid medications such as buprenorphine and methadone.

What Medications Can Treat Opioid Withdrawal?

What Medications Can Treat Opioid Withdrawal?

During the withdrawal, doctors may administer both symptomatic and opioid medications.

  • Symptomatic Treatment – Symptomatic medications treat symptoms of heroin withdrawal individually. For example, doctors may prescribe paracetamol for headaches or quinine sulfate for muscle cramps.
  • Opioid Treatment – There are several types of addiction medicine approved by the Food and Drug Administration (FDA) to treat opioid withdrawal. Opioid medications interact with the opioid system in the brain, systematically affecting withdrawal symptoms, cravings, and the withdrawal process.

Some examples of opioid medications are listed below.

buprenorphine

Buprenorphine is a partial opiate agonist that binds to opioid receptors instead of heroin, helping to reduce withdrawal symptoms and cravings.

Doctors may start prescribing buprenorphine once withdrawal symptoms begin to show – usually around 8 hours after the last dose of heroin. The dosage should be tailored according to each person’s heroin use and reviewed daily, considering how well it controls symptoms and the presence of any side effects.

Because buprenorphine is only a partial opiate agonist, it has a “ceiling effect” whereby the opioid effects level off once an individual reaches a certain dosage. This reduces the potential for misuse and negative side effects.

Methadone

Methadone is an opiate agonist that works similarly to buprenorphine. However, as a full agonist, it lacks the “ceiling-effect”, increasing the risk of misuse. This makes it a less safe treatment for people with mild to moderate opioid disorder, but more effective for severe opioid addictions.

Codeine Phosphate

Codeine phosphate helps to alleviate heroin withdrawal symptoms and cravings. It is effective for 90-98% of people. Like other medications, people who have used higher doses of heroin typically need to take higher doses of codeine phosphate, but this should be adjusted according to each individual’s response throughout the process.

Clonidine

Clonidine is a non-opioid substance that blocks chemicals in the brain that trigger central nervous system activity, decreasing the length of the heroin detox. Clonidine should not be given at the same time as an opioid substitute.

Clonidine can help alleviate many opioid withdrawal symptoms, including:

  • sweating
  • vomiting
  • diarrhea
  • chills
  • anxiety
  • insomnia

What Can You Expect From an Inpatient Heroin Detox Program?

What Can You Expect From an Inpatient Heroin Detox Program?

Detox facilities are separated from other addiction treatment facilities, offering a quiet and calm atmosphere. You should be able to sleep, rest, meditate, or engage in moderate activities like walking, according to your wishes.

There is no evidence that physical exercise improves withdrawal; on the contrary, it may make symptoms worse and lengthen the heroin detox timeline. You shouldn’t be made to do physical exercise if you don’t want to.

It’s normal to feel anxious or scared during withdrawal. To help alleviate anxiety, staff members should offer accurate and realistic information about the withdrawal process.

You will not be asked to engage in counseling or other psychological therapy at this stage. People in withdrawal often feel vulnerable and confused and wouldn’t benefit from counseling. Instead, detox helps get your mind and body ready to engage in the treatment, giving you the time and energy you need to focus on introspection and positive change.

Heroin Addiction Treatment

Heroin Addiction Treatment

As explained by the National Institute on Drug Abuse in their “Principles of Effective Treatment”, detox alone is rarely sufficient to overcome heroin addiction and maintain lasting abstinence. Instead, detox from heroin paves the way for long-term addiction treatment approaches that address the underlying causes of addictive behavior and promote life-long recovery.

In recent decades, extensive scientific research has led to the development of several evidence-based treatment methods proven to help individuals overcome heroin abuse. These include:

  • Cognitive-behavioral therapy
  • Group programming
  • Support groups
  • Medication-assisted treatment
  • Experiential therapy
  • Complementary therapy
  • Dual diagnosis
  • Life skills development
  • Aftercare

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is an evidence-based substance abuse treatment proven to help individuals overcome addiction. CBT focuses on the interactions between our thoughts and behaviors, helping to identify negative patterns and change them into more positive ones.

During CBT sessions, you will learn skills and coping mechanisms, such as how to identify triggers and strategies to manage cravings. Research shows that the skills learned in CBT stay with clients after the end of the treatment process, promoting lasting recovery.

Support Groups

Support groups are self-organized meetings where people in recovery come together to share advice and inspiration, and find comfort in shared experiences. Having a strong support system of sober friends or family is an essential part of long-term recovery, and support groups often form an important part of this. Support groups are free and accessible online or in local groups, constituting a reliable source of ongoing support.

Many addiction treatment programs introduce clients to support groups early on in the treatment process to help familiarize them with the setting and fully benefit from the experience. They may also connect you with local groups once you have left the center to guide you through the rest of your recovery journey.

Dual Diagnosis

Over half of people living with a substance use disorder also struggle with a co-occurring mental health condition like anxiety or depression. These conditions can drive substance use, which may offer temporary relief from emotional distress. However, in the long run, it often makes symptoms even worse, leading to destructive cycles of poor mental health and substance abuse.

Dual diagnosis programs treat co-occurring disorders alongside addiction, addressing the root causes of drug use. They promote holistic and long-lasting healing that nurtures lasting overall well-being and helps individuals stay away from drugs in the long term.

Inpatient and Outpatient Care

As with heroin detox, heroin addiction programs offer varying levels of care. Some people stay in a residential treatment center for the duration of treatment, while others continue to live at home throughout the process. Many clients begin in inpatient care before transitioning to outpatient.

If you’re unsure what level of care is suitable for you, you can contact your practitioner, a treatment center, or other mental health professionals for expert advice.

Addiction Treatment at NP Addiction Clinic

The Neuro-Psychiatric Addiction Clinic (NPAC) offers the compassionate and comprehensive care you need to achieve long-term recovery. Our individualized programs support every client to reach their personal goals through a combination of evidence-based treatments and holistic therapies.

As one of the leading addiction treatment and detox centers in the United States, we are committed to offering the highest quality of care alongside state-of-the-art, pioneering treatments from the forefront of addiction science. We complement these methods with traditional therapy approaches and mind-body healing techniques to cater to each client’s every need.

Our modern and welcoming center offers 24-hour supervision from medical healthcare professionals, dedicated to your recovery journey.

If you or someone you know is struggling with heroin addiction or dependence, contact us today. We’ll guide you to a better future.

Begin the first day of the rest of your life

To find out more contact our team

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Samantha Kelly​

Director of National Business Development & Admissions Coordinator

I am a dedicated and passionate professional with extensive experience in business development Admissions and marketing. I have an incredible passion for showing others that there is a light at the end of this dark tunnel if someone truly wants it.
Being in recovery myself I understand the struggles of addiction and alcoholism. I Started this Career path in 2009. With multiple years of experience, I bring a multi-faceted approach and am always seeking new ways to make a difference in the lives of those I work with.

Kim L. Buckner

Facilitator

As a Substance Abuse Motivational Speaker, Pastor, Peer Advocate, and Facilitator. Kim helps clients avoid relapse by understanding their triggers. Those people, places and things that can cause craving, as well as internal triggers like feelings, thoughts, or emotions. Kim also clients with identifying and building healthy relationships now that they’re clean and sober.

Kim’s background includes extensive experience as a motivational speaker and work in faith-based organizations helping youth and adults alike. He says he is motivated by giving back to the community, understanding, and not judging who she comes into contact with. Kim’s favorite quote is by Dr. Raymond Johnson: “The respect given to others rebounds to the giver to deny the scared in the Other is to deny it in oneself.”

Caty Burns

Clinician

Caty graduated from Indiana University Bloomington in 2015 with a Bachelor of Arts in Psychology and minors in Counseling and History. Throughout her undergrad, she worked at the local CASA program, supporting volunteers advocating for children who had experienced abuse and neglect. Caty worked for seven years at a community mental health center (CMHC), partnering with children, adults, and families.

During those seven years, she taught life and coping skills as well as behavior management, provided case management and peer recovery services, and facilitated treatment teams that included the client, family, providers, and community members. I have also worked at an IOP providing group therapy services. She is currently working towards my Master of Social Work.

In her free time, Caty enjoys reading, especially historical fiction, spending time outdoors and having movie nights with her family. Disney World is her happy place, and she dreams of living among the elephants.

Madison Knowles

Mental Health Therapist

My name is Madison Knowles, I am a Mental health therapist at NPAC. I am a single-mother of two and I have a daughter who is globally delayed and has been diagnosed with autism. I have been in this industry since I was 16 years old, as I was fascinated with human behavior. I obtained my masters in applied behavioral analysis and started off working with people with disabilities. I then found my love for counseling when I worked with juveniles who had mental health and substance use issues. I then decided to go back for my mental health therapy license after that and working in a forensic treatment center. I went on to obtain my therapy credentials and since 2017, I have also been working on my PhD in forensic psychology in which I am currently working on my dissertation. I am inspired by change and how resilient people can be. My favorite inspirational quote is “Some will, Some won’t, So what, NEXT!!!” This quote has inspired me to try, try, and try again no matter how hard life gets, someone will give you a chance eventually. As a therapist at NPAC, I have been given the opportunity to work with diverse populations such as in substance use and mental health and I am known for my work with people on the schizophrenic spectrum as well as with other clients with other severe conditions including personality disorders.

Megan Carmona, LMHC

Lead Therapist

Our Lead Therapist, Megan, is a bilingual Licensed Mental Health Counselor who specializes in working with adults who struggle with addiction, anxiety, depression, and trauma. As Lead Therapist, she provides individual, family, and group therapy sessions to our clients.  Megan says “I am very passionate about therapy, especially about supporting my clients in exploring their strengths and identity. My goal is to provide individuals with the tools that can help them achieve independence in coping with their challenges and facilitating personal development.” In her free time, Megan enjoys watching docu-series and playing video games with her family. Her dream is to own acres of land so she can care for vulnerable animals, especially old dogs, cats, and horses. 

Kristen Bensley

Primary Clinician

As Primary Clinician, Kristen works with all aspects of our clinical team, from case management to primary therapy.  She has broad experience working in the mental health field. Prior to joining our team at the Neuro Psychiatric Addiction Clinic, Kristen was part of the team awarded the Evernorth Behavioral Health Center of Excellence Designation by Cigna. She says her motivation is to help people rediscover who they are and become excited about the future and all the possibilities life offers. Kristen’s favorite quote is: “You can’t go back and change the beginning, but you can start where you are and change the ending.”

Ronn Daigle, MSW

Therapist, Utilization Review Clinician

Ronn Daigle services as a Therapist and Utilization Review Clinician at the Neuro Psychiatric Addiction Clinic. He has been working in the field of substance use disorder treatment since 2011, with experience in all facility-based levels of care. Ronn earned, both an Associate of Arts in Psychology (2013) and Bachelor of Science in Human Services, with an Addiction Studies Concentration (2015) from Indian River State College. 

Ronn additionally earned a Master of Social Work degree in 2021 and is a current Registered Clinical Social Work Intern working toward licensure (LCSW). He describes himself as detail oriented, and solution focused.

Ronn says: “There is nothing more fulfilling than working with someone who doesn’t believe in himself or herself, and being there in the moment with them when the belief begins. We work with individuals who come to us at a point and time in their respective lives where they do not believe that change for others is possible; let alone for themselves…throughout the process they eventually come to a point where they realize that change is not only possible, but achievable.”

Erika Melecio, LMHC, MCAP, CEI

Assistant Clinical Director

Erika Melecio, LMHC, MCAP, CEI is the Assistant Clinical Director at Neuropsychiatric Addiction Clinic who specializes in the treatment of LGBTQ, addiction, as well as mental health disorders ranging from depression and anxiety, to Bipolar Disorder, trauma, personality disorders, psychotic disorders, and eating disorders. Erika utilizes a number of modalities including Cognitive Behavioral Therapy, Solution Focused Therapy, Motivational Interviewing, Dialectical Behavioral Therapy, and Mindfulness amongst others. Erika has been in practice for close to a decade and has earned her license in Mental Health Counseling, as well as being a Master’s Certified Addiction Professional. Erika has worked with many individuals including couples counseling and family therapy, and is fluent in Spanish.
 
Throughout my years of practice, one of the things I enjoy helping people find is inner peace. Whether you are in the deepest parts of depression, overrun by your anxiety, controlled by your addiction, or there are certain issues in your life that are negatively impacting your ability to function, and have a happy, healthy life, maybe now is the time to talk about it. I am a big believer in empowerment, working hard in therapy, and utilizing different techniques to help you regain that inner peace that may have been lost along the way. I want to work with you as a team because with two people, absolutely everything is possible. I want to be there as a therapist, to help build you up, support you, but also help you be honest with yourself and accountable. At the end of the day, when all is said and done, my biggest goal for you is going to be simple….for you to no longer need my services. Why? Because if you no longer need my services, it means that you have regained your peace, you have regained your strength, you have regained your confidence. It means that you now have the tools to address any issues that try to derail you, and best of all, you will have the insight to overcome and thrive. So let’s begin this journey together, and get you to the place you want to be, emotionally, mentally, psychologically, and in your sobriety.

Aurelio Ayuso, MSW, LCSW, CAP, ICADC

Clinical Director

Aurelio has worked with those that suffer from the disease of addiction in adults and juveniles alike for over 10 years, beginning in the United States Navy where he proudly served for 20 years, working with those that were succumbed by addiction due to trauma and continuing his passion for helping those in need locally in Central Florida.

He specializes in both Addictions and Trauma, he has worked first as a therapist then as the clinical supervisor to both the Juvenile and Adult Drug Court programs in Brevard County. Aurelio has been instrumental in developing substance abuse treatment programs directly tailored to help those that also suffer from complex trauma due to their addiction. He has been recognized by several organizations for his forward thinking and ability to tailor treatment to individuals in the most restrictive environments.

Mr. Ayuso received his Graduate Degree in Clinical Social Work from the University of Central Florida in Orlando. He is a Licensed Clinical Social Worker as well as Certified Addictions Professional in the State of Florida, and Internationally Certified Alcohol & Drug Counselor. Aurelio specializes in the treatment of Addiction, Trauma, and Abandonment using strength based strategies deeply rooted in Solution Focused, and Mindfulness Therapies. At the Neuropsychiatric Addiction Clinic he passionately develops holistic curriculums that foster the belief that through addressing the mind, body, and spirit together, the Disease of Addiction can be addressed successfully.

Robert Lehmann, MHSA

Chief Operating Officer

Bob Lehmann is the Chief Operating Officer at the Neuro Psychiatric Addiction Clinic. He has a Master’s Degree in Human Services Administration with a concentration in Mental Health Administration and over twenty-five years of experience as a senior executive at addiction and mental health treatment facilities.

One of the reasons for his commitment to excellence in addiction treatment was his experience related to family members who suffered from the disease of addiction. Bob has been actively involved in community organizations throughout his career. Recently he was one of the founders of the Florida Addiction Treatment Coalition (FATC) and is its present Vice President. FATC was designed to bring together treatment executives in Florida to advocate on behalf of treatment facilities and the clients they serve adhering to a foundation of integrity and service excellence.

Jose R. Toledo, M.D.

Medical Director

A well-rounded and accomplished individual, Jose R. Toledo, M.D., is the Medical Director of Neuro Psychiatric Addiction Clinic.

Dr. Toledo is a neurologist with 25 years of experience and has been in private practice since 1991 on the Treasure Coast of Florida. He completed his neurology training at the State University of New York and his Fellowship training at the University of Pittsburgh in Epilepsy and Clinical Neurophysiology.

He also completed 24 months of acute inpatient psychiatry at the Western Missouri Mental Health Center, University of Missouri in Kansas City. In 2008, Dr. Toledo participated in and was certified in the continuing medical education activity entitled “Buprenorphine and Office-Based Treatment of Opioid Dependence” from The Medical University of South Carolina during which began his quest to found and head Neuropsychiatric Addiction Clinic.

Dr. Toledo is a brain specialist with particular competence in addiction medicine and out-patient detoxification treatment and integrates the fields seamlessly. He is certified to prescribe Buprenorphine (Suboxone). He incorporates his background in neurology into the addiction field. Dr. Toledo is member/fellow of The American Medical Association, The Florida Medical Association and The American Society of Addiction Medicine