How Good of an Idea Is Quitting Heroin Cold Turkey or Quitting Heroin on My Own?
Last Updated Dec 2, 2021
The “cold turkey” approach to quitting heroin isn’t usually the best approach to stopping use. It is better to talk with an addiction treatment professional and build an evidence-based treatment plan together.
Medication-assisted treatment (MAT) is considered the gold standard treatment for opioid use disorder (OUD). This involves the use of medication to keep opioid withdrawal and cravings at bay while the person undergoes therapy to address the addiction.
Is Quitting Heroin Cold Turkey Safe?
Quitting heroin cold turkey is typically going to result in withdrawal if physical dependence has formed. Heroin withdrawal is not generally life-threatening, although it can be uncomfortable. It is difficult to get through it on your own without the assistance of treatment professionals.
While the specifics will be discussed more throughout this article, quitting cold turkey on your own isn’t recommended. It isn’t necessarily “unsafe.” The risks associated with this approach have more to do with its high risk of failure and the increased chance of a potentially dangerous relapse if you take this approach for a few weeks and then return to drug use.
MAT greatly increases the likelihood of successfully making it through early recovery. If you relapse after a cold-turkey attempt, overdose is more likely, and this could be deadly.
What Happens When You Quit Heroin Cold Turkey?
Quitting “cold turkey” means to suddenly stop taking a drug, going from regular use to complete drug abstinence. It is generally meant in the context of quitting without any expert assistance, which is how we use the term in this article.
How this affects a person is going to depend on their level of drug use before quitting and, more specifically, the level of physical and psychological dependence they have formed to opioids, the class of drug that heroin is in.
Most people who have regularly used heroin, especially if they consider themselves to have a heroin addiction or otherwise view quitting as challenging, have brains that have adapted to repeated drug use. This is what is meant by physical dependence, with the body essentially becoming rewired by drug use and causing the person to experience unwanted withdrawal symptoms if they stop taking it.
Quitting cold turkey, with no support, is generally what causes the most intense, uncomfortable withdrawal symptoms that are most difficult to handle. This is in addition to any psychological dependence a person has, which refers to the feeling that one needs a drug to function and a compulsion to keep using that drug, even if that drug is logically doing them harm.
The Risks & Dangers of Quitting Heroin Suddenly
The core issue with the cold turkey approach is that it is associated with some of the most intense withdrawal symptoms and gives a person access to the fewest tools to deal with those symptoms.
Additionally, it works on the flawed assumption that detoxing from a drug, where the body is given time to readjust to drug abstinence, is all that is needed to overcome addiction. The reality is that recovery is generally a long-term process that should involve working with a mental health professional to identify what drove you to use drugs in the first place. In therapy, you’ll also learn how to avoid using drugs if you experience drug cravings in the future.
Some notable risks and dangers of the cold turkey approach include the following:
- Significantly reduced ability to develop important skills to maintain heroin abstinence long term
- Minimal development of the important support systems that make addiction recovery and abstinence maintenance easier
- A higher risk of relapsing into heavy drug use after a period of abstinence, which can be dangerous due to a lowered tolerance for drugs caused by that abstinence
- No access to evidence-based medications, which can make the recovery process easier and more likely to succeed
Heroin Withdrawal Timeline
Heroin is a short-acting opioid. These drugs are typically associated with more intense withdrawal symptoms over a shorter amount of time compared to long-acting opioids, such as methadone.
Typically, heroin withdrawal will begin between 8 and 24 hours after a person’s last use of an opioid, assuming their body has become dependent on opioids. As stated earlier, not everyone who has used heroin necessarily develops dependence, but repeated, heavy use makes developing dependence much more likely.
After their body has had time to process most of the opioids already in its system, a person will begin experiencing withdrawal symptoms, including these:
- Hot and cold flushes
- Muscle cramps
- Nausea and vomiting
- Watery discharge from eyes and nose
This stage is called acute withdrawal and symptoms will typically worsen, hit a peak, and then slowly lessen over the course of 4 to 10 days. When undergoing this process, especially on your own, it is important to keep hydrated, as the body can lose a significant amount of fluid through vomiting, diarrhea, and sweating.
After this, a person will go through what is called protracted withdrawal, which can last up to six months. This is a longer, less intense type of withdrawal where a person will feel generally unwell and experience strong cravings for opioids.
It’s this phase that many people who take the cold-turkey approach underestimate, as it is often very difficult to get through for people with even moderate addiction symptoms without any kind of expert psychosocial support (such as regularly talking to an addiction treatment expert). If you are in an addiction treatment program, you’ll receive psychological and emotional support during this time, making it much less likely that you’ll relapse.
How Long Does It Take to Detox From Heroin?
Detoxing from heroin refers to giving your body time to fully process all the heroin already in your system, allowing yourself to go through acute withdrawal and adapt to the absence of heroin. As mentioned in more detail above, this typically takes 4 to 10 days for heroin and similar short-acting opioids.
Note, however, that you will still likely then experience a protracted withdrawal phase, where you will still feel unwell and have strong drug cravings.
Tips to Help You Quit Heroin
Some useful tips that can help you quit heroin include the following:
- Whatever your plan for overcoming addiction, talk to an addiction treatment expert about what you’re going through and what they recommend, so you can fully understand your options and get the support you need.
- Even if you intend to quit heroin on your own, read government resources on opioid withdrawal like this one, so you can fully understand what to expect.
- The World Health Organization recommends people going through acute opioid withdrawal drink a minimum of two liters of water daily to replace lost fluids and take vitamin B and vitamin C supplements.
- While many people consider various medication-assisted treatments for opioid addiction to be “trading one addiction for another,” this isn’t supported by the evidence. Treatments like Suboxone and methadone have been shown to help people regain control over their lives and avoid engaging in drug abuse, especially when combined with a comprehensive therapy plan.
Alternatives to the Cold-Turkey Approach
The following are some ways to quit heroin that may be better alternatives to the cold-turkey approach:
Tapering is a process by which a person slowly reduces the amount of drugs they take over time rather than stopping use all at once. This can help make withdrawal less intense and easier to get through, improving the chance of successfully getting through the process.
While it’s theoretically possible to taper your own drug use, it’s better to talk to a doctor about the best way to do this. A doctor can schedule a taper, ensuring you lower your dose at appropriate intervals and that the process is safe.
Medication-assisted treatment uses medications to reduce a person’s risk of engaging in drug abuse. Two common MATs recommended for opioid use disorder include methadone and buprenorphine-naloxone combination drugs (such as Suboxone).
Methadone is a long-acting opioid that allows a person to avoid withdrawal and sharply reduce their drive to misuse opioids when taken on at a carefully controlled prescribed rate. Drugs like Suboxone are similar, with buprenorphine acting as a partial opioid agonist, although these drugs have less abuse potential than methadone and are generally easier to access.
Whatever treatment path is chosen, a person seeking recovery from heroin addiction should receive some form of addiction therapy or counseling.
One of the most common types of therapies used is cognitive behavioral therapy (CBT), where you work with a mental health professional to identify how you think about drugs and what drives you to use them. Then, you work with the therapist to reshape your thought process surrounding drugs, learning to avoid thinking about drug use when possible and better control those thoughts when they do occur.
Family therapy can be helpful. This is a type of group therapy where both you and your family members talk with a mental health professional together. The mental health professional helps you discuss your addiction with your family, allowing them to better understand your struggles and needs. They will also have an opportunity to discuss some of their own personal difficulties.
This type of therapy can be good for families that want to be supportive but don’t know the best way to do so or who may have been hurt by some of your past behavior related to your drug use. A lot of work in family therapy goes toward repairing relationship damage.
Various other forms of therapy may be used in addiction treatment, such as art therapy, music therapy, adventure therapy, and more. Talk to your primary therapy about approaches that may work well for you.
Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. (2009). World Health Organization.
Opiate and Opioid Withdrawal. (April 2022). National Library of Medicine.
Opioid Addiction Treatment. (2016). American Society of Addiction Medicine.
Heroin DrugFacts. (December 2022). National Institute on Drug Abuse.
In Animal Study, “Cold Turkey” Withdrawal From Drugs Triggers Mental Decline. Georgetown University Medical Center.
Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice. (June 2020). Journal of Primary Care & Community Health.
Effects of Medication Assisted Treatment (MAT) for Opioid Use Disorder on Functional Outcomes: A Systematic Review. (March 2018). Journal of Substance Abuse Treatment.
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