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Can You Quit Heroin Cold Turkey?

Can you quit heroin cold turkey? Experts like the Substance Abuse and Mental Health Services Administration (SAMHSA) don’t recommend it.[1] Abrupt heroin withdrawal can lead to severe gastrointestinal symptoms (like relentless diarrhea) that can lead to dehydration.

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In a supervised detox program, doctors can use medications like methadone or buprenorphine to reduce severe withdrawal symptoms and ease your cravings. Your team can monitor your progress and change your medication regimen if severe symptoms appear.

Success rates are also important to consider. Researchers say opioid withdrawal symptoms can be so strong and so frightening that they keep people trapped in a cycle of using drugs—even when they don’t want to do so.[10] By easing severe withdrawal symptoms, doctors can help you get sober safely and successfully. Then, you can enroll in rehab programs to build up your sober skills for a healthier future.

Is It Safe to Quit Heroin Cold Turkey?

If you are dependent on or addicted to heroin, quitting cold turkey will cause distressing withdrawal symptoms, such as vomiting, diarrhea, fever, sweating, muscle cramping, and more. [2], [3], [4]

The risks associated with quitting heroin cold turkey involve complications caused by various symptoms, such as: [3], [4]

  • Electrolyte imbalance due to vomiting and diarrhea
  • Severe dehydration caused by loss of fluids and sweating
  • Lung infection due to aspirating vomit

Doctors are encouraged to monitor their patients closely for these complications and provide medications when they appear.[1] Quitting cold turkey means cutting yourself off from that help, which can lead to life-threatening problems.

Quitting heroin cold turkey can also lead to relapse, as people look to heroin to ease their symptoms. This can be risky, as any period of abstinence—such as withdrawal—can lower a person’s tolerance. And if they return to the previous dose they were using prior to withdrawal, they run the risk of a heroin overdose. 

Also, heroin and other street drugs are often, unknowing to the user, cut with potent opioids like fentanyl. This greatly increases the likelihood of overdose and death. [3]

Because of these potentially fatal complications, heroin withdrawal should involve medical treatment, monitoring, and supervision.

Other Risks of Quitting Heroin On Your Own Without Support

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 like heroin, 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 attending heroin addiction treatment to identify what drove you to use heroin in the first place. In therapy, you’ll also learn how to avoid using heroin and opioids if you experience drug cravings in the future. 

Some notable risks and dangers of the cold turkey approach to heroin detox include:

  • 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
  • No access to opioid withdrawal medications, which can make the recovery process easier and more likely to succeed
  • No medical treatment or support in case of a complication or emergency
  • No psychological support from professionals
  • Lack of guidance in transitioning into heroin rehab

What Happens When You Quit Heroin Cold Turkey?

Quitting heroin cold turkey means you suddenly stop taking this opioid after you’ve developed a dependence or addiction to it. 

It is generally meant in the context of quitting without any professional assistance or detox treatment. 

Abruptly stopping heroin use tends to result in painful withdrawal symptoms, such as: [1], [2], [3], [4]

  • Nausea, vomiting, and diarrhea
  • Fever and sweating
  • Anxiety and agitation
  • Depressed mood
  • Achy joints and muscle cramps
  • Runny nose and tearing of the eyes
  • Insomnia
  • Stomach cramping
  • Goosebumps
  • Excessive yawning
  • Rapid pulse and high blood pressure
  • Increased sensitivity to pain
  • Enlarged pupils

Heroin withdrawal can range considerably from mildly unpleasant to unbearable. How quitting cold turkey affects a person will depend on many factors, such as:

  • Individual physiology
  • Physical and mental health
  • Duration of heroin use
  • Amount of heroin regularly used
  • Severity of dependence
  • Previous withdrawal experiences

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 severe and overwhelming heroin cravings that can be challenging to manage, especially while feeling so sick.

If you asked yourself “Can you quit heroin cold turkey?” and then tried it, you may already be feeling sick and uncomfortable. It’s not too late to get help. If you experience the symptoms we’ve listed above after quitting, visit the hospital or an urgent care center. Explain that you tried to quit and now feel sick. You could get the medications you need to get better.

Heroin Withdrawal Timeline

Heroin is a short-acting opioid, which means that its effects come on fast and are relatively short-lived. These drugs are typically associated with more intense withdrawal symptoms over a shorter amount of time compared to long-acting opioids, such as methadone.

Acute Withdrawal

Typically, acute heroin withdrawal will begin between six and 12 hours after the last dose, assuming their body has become dependent on opioids. 

Steadily, withdrawal symptoms will intensify, peaking between one and three days before dissipating over five to seven days. [4] 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.

TimeSymptomsIntensity
6-12 hoursAnxiety, insomnia, runny nose, sweating, muscle achesSymptoms emerge: mild/moderate
1-3 daysVomiting, diarrhea, stomach cramping, goosebumpsSymptoms peak: most severe
5-7 daysAnxiety, depressed mood, insomniaSymptoms subside: moderate/mild

Protracted Withdrawal

After this, a person will go through what is called protracted withdrawal, which can last for weeks or even months. This is a longer, less intense type of withdrawal where a person will feel generally unwell and experience strong cravings for opioids as well as depression, anxiety, and an inability to feel pleasure. [4]

It’s often the protracted withdrawal phase that many people who take the cold-turkey approach underestimate, as cravings and mental health symptoms can be difficult to deal with. 

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.

Alternatives to Detoxing from Heroin Cold-Turkey

Although it can be tempting to try to quit heroin at home on your own, there is no need to when you have plenty of options available—options that prioritize your safety, comfort, and well-being.

Medical Detox for Heroin Withdrawal Management

Managed opioid withdrawal (also called detoxification or just detox) begins with an assessment. The team learns more about how much heroin you use, when you took your last dose, and how many times you’ve tried to detox before. Your team will also look for signs of opioid withdrawal and measure their severity.[1]

When the assessment is complete, your care team will provide medications like methadone or buprenorphine to ease your withdrawal symptoms.[1] Other therapies, either prescription or over the counter, might be helpful for cardiac symptoms or insomnia. Your team will also ensure that you’re hydrated and not struggling with gastrointestinal problems.

It can take time to find the right medication dose, and your treatment team will use your symptoms as a guide. If you’re experiencing significant withdrawal symptoms, your dose may be too low. If you’re overly sedated, your dose might be too large.

Once you’re feeling stable medically and psychologically, the dose can be tapered (over several days or weeks). That medication could also be continued as part of long-term maintenance treatment, which we’ll discuss below.[11]

With the guidance of a medical team, you’ll go through heroin safely and experience relief from your intense withdrawal symptoms and cravings. And once you are medically stabilized, they will work with you to create a post-detox treatment plan to help you overcome your addiction.

Post-Detox Addiction Treatment

Treatment doesn’t end once you complete heroin withdrawal—detox only helps stabilize you while the opioid leaves your system. You’re going to need comprehensive and integrated addiction treatment services to help understand the underlying factors that caused your heroin use, create lasting behavioral change, and develop healthy coping and relapse prevention skills.

There are several levels of care for heroin addiction treatment, including:

  • Inpatient: You live at the treatment facility and receive around-the-clock care and support away from your everyday triggering environment.
  • Partial hospitalization: The most intensive outpatient option in which you live at home and attend treatment for up to 30 hours each week.
  • Intensive outpatient: A step down from partial hospitalization, you live at home during non-treatment hours and attend therapy for between 9 and 20 hours per week.
  • Standard outpatient: The least intensive option in which you live at home and attend counseling and therapy for a few hours each week. This may be best for someone with a mild heroin addiction or someone who has already attended a higher level of care.

Treatment is highly individualized to each person; however, most inpatient treatment programs last anywhere from one to three months, while outpatient options may be longer. And many people attend continuing care on an outpatient basis for years after completing their initial program so they can continue to build the necessary skills to maintain recovery.

Medication-Assisted Treatment for Heroin Addiction

Medication-assisted treatment (MAT) for heroin addiction refers to the use of medications and counseling to help people overcome their addiction. These medications for opioid use disorder include: [5]

  • Methadone: A long-acting opioid agonist that reduces withdrawal symptoms and cravings and decreases the risk of relapse.
  • Buprenorphine: A partial opioid agonist that mitigates cravings and withdrawal symptoms.
  • Suboxone: A combination medication containing buprenorphine and naloxone (opioid antagonist), which manages withdrawal and cravings and decreases the risk of misuse of the medication.
  • Naltrexone: An opioid antagonist that blocks the desirable effects of opioids like heroin and can reduce cravings.

Typically, people take methadone for at least a year while they stabilize and begin the early stages of heroin recovery, although many people take it indefinitely. The same can be said for medications like Suboxone—there is no limit to how long you can take this life-saving drug.

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, so you can fully understand what to expect.
  • If you are determined to quit on your own, you might want to try tapering the amount of heroin you take over time as opposed to stopping all at once—this can minimize withdrawal symptoms and cravings. Just make sure you have fentanyl test strips and Narcan on you because heroin is often cut with this deadly opioid.
  • 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. [2]
  • 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.
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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated February 14, 2024
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