Heroin Withdrawal Timeline

Published by Joseph, EditorCompiled from cited sources · not yet medically reviewedUpdated Oct 30, 20268 sources

Need help now? SAMHSA’s National Helpline is free, confidential and open 24/7 in English and Spanish: 1-800-662-4357. In a mental health crisis, call or text 988. In an emergency, call 911.

For information only, not medical advice. Talk to a doctor before stopping or changing any medication. Medical disclaimer

⚠ Medical warning

Don’t go through opioid withdrawal alone. It is very hard to get through, and the biggest danger comes afterward: once your tolerance drops, using your old amount can cause a fatal overdose. Get medical help to stop. Medicines such as buprenorphine and methadone work. Call SAMHSA at 1-800-662-4357, or 911 in an emergency. If the opioid is prescribed, don’t stop it suddenly: ask your prescriber about a taper.

Quick answer

Heroin is short-acting, so withdrawal usually starts 8 to 24 hours after last use, is worst around days 1 to 3, and acute symptoms usually ease in 7 to 10 days (SAMHSA TIP 63). Low mood, sleep problems and cravings can last for weeks or months. Withdrawal is rarely deadly by itself, but overdose after withdrawal is a major risk because tolerance drops. NIDA says fentanyl is often mixed into heroin. Medicines like buprenorphine and methadone make stopping safer.

Heroin withdrawal timeline at a glance

When did you last use or take it?

⚠ Medical warning (read before using this)

This places the typical ranges from this article's sources on your date. It is not a prediction or a diagnosis, and being past a phase does not mean symptoms or risks are over.

A rough guide from published sources, not medical advice. Everyone is different.

Phase	When	What you may feel	Severity	Red flags
Early withdrawal	8 to 24 hours after last use	Watery eyes, runny nose; Sweating, yawning; Restlessness, anxiety, insomnia; Muscle aches	Moderate	—
Fully developed withdrawal	1 to 3 days after last use	Dilated pupils, goosebumps; Stomach cramps, nausea, vomiting, diarrhea; Muscle twitching, joint and muscle pain; Fast heart rate, higher blood pressure	Severe	Vomiting or diarrhea you can’t keep up with, or signs of dehydration (dizziness, very little urine); Thoughts of suicide or self-harm: call or text 988 now
Easing	Day 4 to day 10 (total acute withdrawal often 7 to 10 days)	Physical symptoms gradually fade; Tiredness, poor sleep	Moderate	Signs of overdose (slow or stopped breathing, can’t wake up, blue lips): call 911 and use naloxone if you have it
Protracted phase	Weeks to months	Low mood (dysphoria); Cravings; Insomnia; Increased sensitivity to pain	Moderate	Signs of overdose (slow or stopped breathing, can’t wake up, blue lips): call 911 and use naloxone if you have it; Thoughts of suicide or self-harm: call or text 988 now

Print a daily symptom log for this timeline · My quit tracker

Symptoms, phase by phase

SAMHSA’s TIP 63 describes opioid withdrawal in stages. Early signs are watery eyes, runny nose, sweating, yawning, restlessness and insomnia, followed by dilated pupils, goosebumps, muscle twitching and aches. Fully developed withdrawal adds fast heart rate, high blood pressure, fever, nausea, vomiting, diarrhea and extreme restlessness. TIP 63 says it feels like gastroenteritis, severe flu, anxiety and dysphoria all at once. MedlinePlus calls the symptoms very uncomfortable but usually not life-threatening on their own. Complications such as dehydration and breathing vomit into the lungs can be serious, and the biggest risk is overdose after withdrawal, because tolerance drops. NIDA points people to medications for opioid withdrawal and addiction and to naloxone for overdose.

Early withdrawal: 8 to 24 hours after last use

Watery eyes, runny nose
Sweating, yawning
Restlessness, anxiety, insomnia
Muscle aches

Fully developed withdrawal: 1 to 3 days after last use

Dilated pupils, goosebumps
Stomach cramps, nausea, vomiting, diarrhea
Muscle twitching, joint and muscle pain
Fast heart rate, higher blood pressure

Easing: Day 4 to day 10 (total acute withdrawal often 7 to 10 days)

Physical symptoms gradually fade
Tiredness, poor sleep

Protracted phase: Weeks to months

Low mood (dysphoria)
Cravings
Insomnia
Increased sensitivity to pain

What makes withdrawal longer or shorter

Fentanyl in the supply. If your heroin contained fentanyl, timing may differ; see our fentanyl timeline.
How long and how much. SAMHSA’s TIP 63 says the severity of withdrawal reflects how physically dependent you are.
Short- vs long-acting. Short-acting opioids usually cause withdrawal sooner than extended-release forms or methadone.
Medication support. MedlinePlus says methadone and buprenorphine relieve withdrawal symptoms, and the FDA label for lofexidine (Lucemyra) says it is approved to ease opioid withdrawal symptoms in adults stopping opioids abruptly.

When to see a doctor or get help now

Before you stop: medicines (buprenorphine, methadone, and the non-opioid lofexidine for withdrawal symptoms) make withdrawal safer and more bearable.
Get urgent care for vomiting or diarrhea you can’t keep up with, or signs of dehydration.
Call 911 for any overdose signs. If you return to use after withdrawal, even a smaller amount than before can be fatal.
Call or text 988 for thoughts of suicide.

Not sure where to start? Call SAMHSA’s free, confidential helpline at 1-800-662-4357, 24/7. See Get Help.

Tapering

Medically supported withdrawal, ideally with buprenorphine or methadone, is safer than stopping cold turkey. We don’t publish dose-by-dose schedules. Your prescriber should set your plan, and adjust it if symptoms appear.

Tips for getting through it

Get medical help and ask about buprenorphine or methadone
Keep naloxone (Narcan) on hand and tell someone where it is
Drink enough fluids and eat several small meals, as NSW Health’s opioid withdrawal guidance advises; skip alcohol and go easy on caffeine
Never use alone, and know that tolerance drops fast after withdrawal
Find treatment at FindTreatment.gov or call SAMHSA at 1-800-662-4357

Frequently asked questions

How long does heroin withdrawal last?

Acute symptoms usually last 7 to 10 days; some symptoms can last for weeks to months.

What’s the most dangerous part of heroin withdrawal?

Overdose if you use again after your tolerance has dropped. Carry naloxone and never use alone.

Can I get medicine for heroin withdrawal?

Yes. Buprenorphine, methadone and lofexidine are used for opioid withdrawal and addiction. Call SAMHSA at 1-800-662-4357.

Next steps

Talk to others going through it. Share your experience or ask questions on the Opioids & Kratom board in our community forum. Planning to stop? See the Tapering & Talking to Your Doctor board, and talk to a doctor before you stop. Forum posts are personal experiences, not medical advice. Please read the community guidelines.

Sources

Last reviewed: October 25, 2026. Researched and written by Withdrawal Timelines from the cited sources. This article has not yet been reviewed by a medical professional. See How We Review and our Medical Disclaimer. This is general information, not medical advice.

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