Can You Quit Heroin Cold Turkey?: How to Quit Heroin Safely

Although you technically can quit heroin cold turkey, it’s not recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA) due to safety concerns. SAMHSA recommends 24-hour medical detox in a hospital or other inpatient setting for withdrawal from heroin and other opioids like prescription painkillers and fentanyl. [1]

Medical detox is the safest way to undergo heroin withdrawal, and 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 heroin addiction.

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:[2],[3],[4]

• Vomiting
• Nausea
• Diarrhea
• Fever
• Sweating
• Muscle cramping
• Joint pain

Heroin withdrawal is not generally life-threatening, although it can be uncomfortable and severely painful. 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 vomiting

Dangers of Quitting Heroin on Your Own

The most dangerous complication of quitting heroin cold turkey is the risk of possible overdose. Because heroin withdrawal can be so difficult to deal with, many people may relapse on heroin or other opioids to alleviate these symptoms. This can be especially risky because 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.

Not to mention, heroin and other street drugs are often, unknowing to the user, cut with potent opioids like fentanyl, which greatly increases the likelihood of overdose and death. [3]

Because of these potentially fatal complications, heroin withdrawal is best managed in an inpatient, medical detox facility or hospital, where individuals can receive medical treatment, monitoring, and supervision.

Other Risks of Quitting Heroin Cold Turkey 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 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.

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 Symptoms

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.

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

Medical detox involves 24-hour medical care, supervision, and management in an intensive treatment setting, such as: [1]

• Medical hospital
• Psychiatric hospital
• Free-standing inpatient detox facility
• Detox facility within an addiction treatment program

In these settings, doctors and nurses are available around-the-clock to ensure your safety and comfort while you detox from heroin. You’ll receive many evidence-based treatment modalities, such as: [1]

• Opioid withdrawal medications like methadone or buprenorphine
• Supportive care, such as IV fluids
• Symptomatic medications, such as anti-nausea medications
• Psychological and emotional support
• Case management services
• Referral and transition to a heroin addiction treatment program

Under the guidance of a medical team, you’ll be able to go through heroin detox in a safe and monitored setting 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 wit ha mild heroin addiction or someone who has already attended a higher level fo 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 Safely

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.