The school principal remembered her as a great kid, a former cheerleader with tons of energy. Then, in reflection, he said, there was a change. Little by little, the principal continued, until one day at school, the girl who had “the whole world ahead of her,” nodded off at her desk. Soon she collapsed. Her complexion turned gray. She had overdosed on heroin.

A certified EMS worker raced into the classroom to revive her, helped restore her breathing and an ambulance whisked her away to a local hospital where she survived a close call.

A guidance counselor later learned she had done heroin in the school bathroom before class that morning. Drug overdoses now kill far more people in the United States each year than automobile accidents, gun violence, or HIV/AIDS ever did. But fortunately for this girl and her family, not this time.

That’s not to dismiss the more than 72,000 people who died from overdoses in the United States last year – a new record driven by the deadly opioid epidemic, according to data from the U.S. Centers for Disease Control and Prevention. Opioids are to blame for a majority of the deaths – nearly 49,000. Heroin is not to be underestimated.

Although the U.S. government does not track death rates for every drug, experts in the substance abuse field believe it is safe to say that at least 10,000 deaths each year in the United States are due to heroin overdose.

No community is immune from a heroin overdose. The drug is both cheap and readily available in big cities and rural towns. In New York City, during 2017, 771 fatal overdoses were connected to heroin. And the demographics do not discriminate. Everybody – kids and adults of low- and high-income households – are using it.

Heroin is an opioid drug made from a derivative of morphine, a natural substance taken from the seed pod of various opium poppy plants.

From these flowers, local farmers squeeze out the opium gum, which is sold to drug cartels for transport to nearby labs.

Here, a cooking process transforms the gum into heroin, which is spiked with various types of acid including fentanyl, a powerful synthetic opioid, to boost potency.

Users inject, sniff or snort heroin in the form of a white or brown powder or a black sticky substance called “black tar heroin.” Because heroin enters the brain rapidly, people who use the drug report a “rush” or euphoria once the opioid receptors attach to cerebral matter that controls feelings of pain and pleasure.

Those same cells that reduce anxiety can influence heart rates, sleep and breathing. People who use heroin may also experience dry mouth, heavy feelings in the arms and legs, and clouded mental functioning. Continued abuse over longer periods may lead to collapsed veins, infection of the heart’s lining and valves, abscesses, and lung complications.

Research suggests that the misuse of prescription opioid pain medicine is a risk factor for starting heroin use. That means someone from any walk of life – mothers, fathers, students, lawyers, athletes, veterans, and musicians, white – and blue-collar workers – may soon find themselves addicted to heroin.

What are the Heroin Withdrawal Symptoms?

After the euphoric feeling that a dose of heroin can promise, a person addicted will likely experience withdrawal symptoms. The intensity level and symptoms from this “comedown” will vary depending on the average amount used, potency, frequency and prior attempts to reduce consumption or quit altogether.

Although Some Warning Signs are More Common Than Others, Typical Withdrawal Begins in the First Six to 12 Hours. This Discomfort May Include:

  • Cravings – a strong desire for more of the drug
  • Mood changes – dysphoric moods including depression, anxiety, and irritability
  • Aches and pains – muscle twitching, particularly, in the legs, back, and joints
  • Excessive bodily fluids – sweat, tears, and runny nose
  • Irregular heart rate
  • Dilated pupils
  • Diarrhea and stomach aches – loose, watery and frequent bowel movements, and pain due to spasms in the digestive system
  • Nausea and vomiting
  • Fever – raised body temperature
  • Restlessness and difficulty sleeping – anxiety, yawning, and insomnia

For those who are otherwise healthy, heroin withdrawal is usually not life-threatening, but the symptoms can be unpleasant enough to trigger a relapse and a return to dysfunctional living.

Symptoms from heroin withdrawal usually emerge about six to 24 hours after the last dose. More severe symptoms will surface after two to four days and begin to decrease after a week. However, psychological issues including anxiety, difficulty sleeping, and heightened cravings for heroin may persist for months.

Any withdrawal from heroin, no matter the frequency of use, will occur in stages. Here is what to expect.

Stage 1

Withdrawal begins during the first day of the last use. The first few days will be the most challenging. A typical withdrawal during this early period will include joint pain, nausea or diarrhea, irritability, and anxiety and depression. Fever and flu-like symptoms may continue for the next 10 days. Having a support system close by is a good idea to help with severe depression and possible suicidal thoughts.

Stage 2

Because the brain’s natural chemicals will begin to stabilize, this period should be more comfortable than what was endured in the first week of heroin withdrawal. After the first seven to 10 days, heroin withdrawal symptoms may include chills, goosebumps on the skin, muscle cramping, and continued aches and pains, anxiety, fever, and a loss of appetite. Some symptoms may be more intense than others.

Stage 3

Most people can confront this period of heroin withdrawal without much difficulty. As the hormones and chemicals in the brain stabilize, the body begins to regain many of its natural tendencies. Not all heroin users will experience this period of psychological discomfort, which may include anxiety and trouble sleeping.

Why Should I Detox?

Adjusting to life without heroin is not easy. But the good news is that you or a loved one wants to at least try. Because of the challenges associated with heroin withdrawal, a professionally managed detox facility is a good idea. By providing both the physical and emotional support needed to compromise withdrawal symptoms and tackle cravings, detox at a residential facility is a more comfortable and proven avenue for a return to good health. Here, licensed staff members can monitor potential complications from withdrawal and provide medications, such as methadone and buprenorphine, to temper symptoms and lower cravings.

Heroin addiction can be beaten. You’ve already expressed a willingness to take control of your life, and those desires no longer include heroin.

However, there is more to achieving sustained sobriety than you may have thought.

If you are serious and believe you have the resolve to commit to recovery, inpatient rehabilitation should be your next treatment step after detox.

Under the supervision of certified health and substance abuse professionals, addiction to heroin is combated through individualized treatment programs that include one-on-one counseling, group therapy, and educational workshops that can increase the chances of recovery.

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