Heroin, also known as smack and H, is a powerfully addictive opioid-based drug made from morphine that is extracted from the seed pod of the poppy plant.
Commonly sold as either a white or brown powder or a sticky black tar-like substance, heroin can be injected, snorted or smoked. It is illegal to use, possess or sell this Class A drug in the UK, with the maximum sentence for supplying heroin currently standing at up to life in prison.
Heroin is a highly addictive and extremely dangerous drug. 46% of drug misuse deaths in the UK are due to heroin, making it the most deadly illegal drug in the country. 
The detoxification and withdrawal process is usually more intense than with other opioid-based drugs, and for this reason, it is recommended that a heroin detox should only be attempted under the care of medical professionals who will be able to provide the care and support required.
How does heroin affect the body?
Unlike many other drugs, heroin is not usually ingested for recreational or social purposes – instead, it is used as a form of self-medication and an escape from negative thoughts, feelings or experiences.
Once heroin enters the brain, it is converted to morphine which then binds to opioid receptors. In turn the body’s nervous and digestive systems are slowed down while the brain experiences a surge of pleasure and euphoria, which is the sensation that so many heroin users are constantly chasing.
The intensity of this rush can vary depending on the method of ingestion and the amount of heroin taken. The individual may feel warm and safe during this time, and will likely stay in a state of drowsiness for several hours.  Many people also report feeling disconnected from others around them, suspended in a dream-like state.
However, many of heroin’s side effects are unpleasant and dangerous. Ingestion can often induce immediate vomiting while breathing slows and the ability to cough is suppressed. Heroin may also impede the ability to orgasm and reduce sex drive in both men and women, and the slowing of the digestive system can lead to constipation.
Is it possible to become addicted to heroin?
Heroin is one of the most powerfully addictive substances available. In 2018, 42% of all people in the UK entering treatment for drug addiction reported heroin as their primary substance. 
When heroin is used on a regular basis for a period of time, the body will build up a tolerance. It will begin to require higher doses in order to achieve the same effects, and this cycle can eventually led to a fatal overdose. The risk is even greater when the individual attempts to detox from heroin and ends up relapsing, as the body loses its tolerance as soon as the withdrawal period begins.
Heroin addiction is a complex issue. It causes both physical and psychological addiction, leading to unpleasant and sometimes dangerous symptoms when an addict attempts to withdraw from the substance. Many people find it difficult to stop using heroin as they find the withdrawal symptoms intolerable, particularly if they have attempted to detox in the past without the help of medical professionals.
What are the symptoms of heroin withdrawal?
As heroin is so powerfully addictive, people dependant on this substance can experience a range of withdrawal symptoms after just a short period of regular use. However, the symptoms can be more intense after a longer period of addiction and a higher dose.
Heroin withdrawal is not usually fatal, but there is a risk of danger or even death if the detoxification process is not properly managed. Many of the physical symptoms of withdrawal such as perspiration, diarrhoea and vomiting can lead to dehydration, which is why it is recommended that anyone undergoing a heroin detox should do so under the care of an experienced medical professional in a specialised rehabilitation centre.
Many symptoms of heroin withdrawal can appear similar to the flu, but the increased pain sensitivity and intense cravings for the drug can be very difficult for many people to deal with.
Physical symptoms of heroin withdrawal include:
- Sensitivity to pain
- Muscle aches, particularly in the back and legs
- Excessive perspiration
- Joint pain
- Changes in heart rate
- Runny nose
- Gastrointestinal issues
- Nausea and vomiting
Psychological symptoms of heroin withdrawal include:
- Intense cravings for heroin
If you are considering a heroin detox but are concerned about the potential withdrawal symptoms, speak to a doctor about your options. There are ways to reduce the severity of many of the most unpleasant side effects and you do not have to rely on willpower alone.
How to detox from heroin safely
It can take some time before someone who is addicted to heroin may feel comfortable with the idea of quitting. When the time is right, there are two main options that can be offered to them:
1. Maintenance therapy
Under a doctor’s supervision, the patient will switch to a less dangerous heroin substitute such as methadone. This provides a similar effect to heroin in order to avoid the unpleasant withdrawal symptoms but carries less danger due to the tight controls and monitoring undertaken by medical professionals. The patient will continue to receive a regular dose of the heroin substitute.
As above, the patient will begin a heroin substitute treatment programme. If their goal is to eventually become free from both substances, a doctor will work with them to gradually decrease the dose of the heroin substitute until their body is able to function normally without it.
Some studies show that high doses of vitamin C may have a significant impact on the severity of heroin withdrawal symptoms when administered orally, increasing endorphin levels and improving the overall detoxification process. However, further studies are needed to determine the extent of this impact. 
The safest and most effective way to detox from heroin is to enter a specialised treatment programme, either within a rehabilitation centre or with the use of outpatient facilities. Medical professionals are specifically trained on the process of withdrawal and will be able to provide support and guidance throughout the initial phase of treatment and beyond.
Many people will avoid seeking medical assistance for heroin detoxification out of a sense of shame or guilt and will attempt to go through the withdrawal process at home. However, this can be counterproductive if the withdrawal symptoms become too intense and painful for them to handle – in this situation, there is a higher chance of relapse, and the body’s decreased tolerance to the drug could lead to a fatal overdose.
What to expect when undergoing a heroin detox
Detoxing from heroin can be a difficult and unpleasant experience, no matter the length or extent of the addiction. Generally, the withdrawal symptoms will be more intense if the addiction has persisted for a long time or if the individual has ingested large amounts of heroin on a regular basis.
The first withdrawal symptoms can begin within a matter of hours due to the rapid metabolisation rate of this substance. They will generally peak between 36 and 72 hours and can last for around a week or up to 10 days.
In severe cases, withdrawal symptoms may continue for up to a month. It is highly recommended that medical advice and treatment is sought if symptoms continue to persist after the first two weeks of detoxification.
These symptoms can be managed and reduced if the individual chooses to switch to a heroin substitute such as methadone or buprenorphine, however, withdrawal is a necessary (although unpleasant) part of the detoxification and recovery process.
What happens after a heroin detox?
The treatment for heroin addiction does not end once the detoxification process is complete. Once the physical symptoms have been treated, the psychological aspect of recovery can begin.
To prevent relapse and increase the chances of a successful long-term recovery, it is recommended that individuals attend one-on-one and/or group therapy sessions in order to learn new ways of coping with negative emotions while challenging negative thought patterns and behaviours that may have played a role in the development of the heroin addiction.
Therapy can provide a toolkit of practical skills that can be carried throughout daily life including communication, stress reduction and the development of healthy behaviours. These new skills can boost self-confidence and increase resilience, both of which are essential to long-term recovery.