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What’s it really like to withdraw from heroin and painkillers?

REUTERS/Diana Markosian
Movie depictions of heroin withdrawal — from frenzied and frothing to debased and pleading — both exaggerated and fell short of conveying the real agonies that opioid addicts face, say those who’ve been through it.

Frank Sinatra didn’t get it quite right in “The Man With the Golden Arm” (1955), and neither did Leonardo DiCaprio in “The Basketball Diaries” (1995). Their depictions of heroin withdrawal — from frenzied and frothing to debased and pleading — both exaggerated and fell short of conveying the real agonies that opioid addicts face, say those who’ve been through it. Not to mention the prolonged and concentrated effort it requires to gain a foothold in recovery.

“I think one of the most difficult parts is the mental withdrawal,” said Dr. Marc Myer, director of the Health Care Professionals Program at Hazelden Betty Ford Foundation in Center City, Minn. It’s a combination of “a severe depression and feeling that you’re never going to pull out of that state. It’s pretty well known among [treatment] providers that, because of that feeling of hopelessness, the anticipation of the withdrawal is oftentimes worse than the actual thing.”

Here are excerpts from interviews with four people who live and work among us, who became addicted to opioids (prescription painkillers or heroin), who went through withdrawal, stopped using for a while, then relapsed and went through it again and again until they began to achieve some peace in their lives.

Maybe it’s not movie material, but it’s material for serious reflection as we process the tragic and lonely death of Philip Seymour Hoffman — and the deaths of one too many like him these days.

Dan Cain, longtime president of RS Eden

I’ve withdrawn from heroin, albeit 41 years ago, on several different occasions. The experience hasn’t changed much in the course of 41 years.

It’s important to remember that withdrawal with heroin, as with many of the other substances, is both physical and psychological. The actual physical withdrawal from heroin, first off, is unlike what people are led to believe — no one has ever died from withdrawal from heroin to my knowledge and in my experience. People have died from withdrawal from alcohol, people have died from withdrawal from barbiturates and benzodiazepines, but no one has ever died from withdrawal from heroin.

And, in fact, it’s like a sustained case of the flu that can go on for a while, with minor chills and sweats and diarrhea. But the actual physical part is less the issue than the psychological part.

I have seen people who, when they were out on the street and there were no drugs available, go through extreme machinations of withdrawal. Their drive to make this pain go away was extreme. I’ve seen the same people with the same habit go to jail. Interestingly enough, in jail you grab yourself … a bucket [to sit on]. You bring it into the shower, you turn the water on hot, and you just sit there. It’s not nearly as extreme or as painful. That’s a reflection of when you’re out on the streets, you have a chance or an opportunity to go and get some more drugs, so the drive is a lot stronger and the psychosomatic symptoms are a lot stronger. When you take people out of that environment … there’s a certain amount of discomfort. But it’s far from unbearable.

People use drugs to change the way that they feel. Some drugs produce tissue tolerance — that’s a byproduct. But you’ll often find people, if they’re addicted to heroin, if they can’t take heroin, they’ll go take benzodiazepines, or they’ll take Seroquel or they’ll take Sinequon or they’ll take other drugs to try and lessen the symptoms because they’re afraid of what they don’t know. A lot of people quite frankly have never been in full heroin withdrawal. Even the addiction piece for some people can be psychosomatic. They believe they are addicted before they are addicted, they start to feel things that may be a little bit odd, and they equate that with withdrawal, and immediately go out and do something to address it and have never been through a full withdrawal cycle. People who have been through a full withdrawal cycle  — be it from heroin or other narcotics or methadone or Suboxone or whatever — that’s not medically managed find out that it’s a pain, it really is, don’t get me wrong, it’s not anything that anybody would willingly go through. But it’s also not the end of the world.

There is this constant tug-of-war that goes on in the addiction world. Part of the problem is that addiction is not easily categorized. It has biological, psychological, social, behavioral and even spiritual implications caused by people feeling deficient in one area or another. But those of us who treat addiction and probably, just as importantly, those of us who do research who wouldn’t know an addict if one came and tapped them on the shoulder, will try and pigeonhole it into one of those particular areas. So consequently you have the medical profession trying to identify it as a brain disease, treatable with normal medical interventions. The social workers identifying it as a social disease and trying to treat it with social interventions. The faith healers or the faith-based programs identifying it as a spiritual deficiency and trying to treat it with spiritual things. The corrections system identifying it as a behavioral issue, trying to treat it with incarceration. And so on, and so on, and so on.

Unfortunately, no one seems to recognize that it’s not one or the other — it’s all of the above. There are many paths to addiction. And I think we do our clients a disservice when we try and pigeonhole it into one area or another and give them the false hope that by addressing this and this alone, it’s going to solve the problem. George Carlin had the quote, “Just because the monkey’s off your back doesn’t mean the circus has left town.”

Hoffman had 23 years of sobriety. And he did some incredible things during that time, including putting together a family and all of his success in the acting world. I think as a society we tend to view recovery as lifelong abstinence and discount things that ultimately turn out bad. I think it’s tragic that Philip Seymour Hoffman died. I understand it. But I’m not one to say that his recovery wasn’t successful, because 23 years, with the kind of success that he had, is something that a lot of people would trade for.

Dr. Marc Myer, treatment provider

One of the real struggles for opioid-dependent people is that the acute symptoms can go on for weeks, depending on the substance being used. And then the prolonged symptoms, which are a kind of general malaise or mild to moderate depression, can go on for months and months. Sometimes patients will ask, “Doc, when am I going to feel better?” And I sometimes don’t want to tell them that it’s going to be awhile. It’s hard to ride that line between being realistic and not removing hope.

One time I [went] on a continuing medical education conference to Mexico [in 2003]. One of the reasons why I chose to go was in the hope that I could remove myself from access [to painkillers] and have time away from work to detoxify, thinking that I could get back on track. I had planned to wean myself, to do a kind of a scheduled taper. But, of course, because I was so active in the disease, I used up that supply within the first 24 to 48 hours and then started going into immediate withdrawal. And it was awful.

I felt lonely and hopeless, just in the disease. But then going through withdrawal by myself in a motel room in Mexico was just a feeling of emptiness and despair. I had … runny eyes, runny nose, diarrhea, dehydration, complete lack of appetite, overwhelming nausea, pain in every part of my body.

The other punishment involved with opioid withdrawal is that you can’t sleep. So there’s no respite. There’s anxiety and panic and feelings of dread and thoughts of this never getting better. And the depression, the inability to function at all. I didn’t leave my room for five or six days until I had to [in order] to fly home. I felt so awful, so dehydrated, overwhelmed with feelings of cravings to use again just to feel better. I got off the airplane, immediately went to an emergency room and complained of headache and other pain symptoms so that I could get opioids.

It took repetitive attempts to cease my opioid use. And [it took] the intervention of co-workers who finally recognized that I had a problem and needed help. Once my career was threatened, I found a willingness to self-report and seek the help I needed. I went to treatment, relapsed, came back, relapsed. My license ended up being restricted and then suspended. I finally entered long-term recovery starting in August of 2008.

In early recovery from any illness, there are days when it requires simply putting one foot in front of the other. Recovery may not happen immediately. A person may not feel all the way better immediately or on their timeline, but it does happen. It always happens. And with the Twelve Step program of recovery, the relief that we seek can be hastened by doing the work of the steps of recovery.

I feel for anyone with opioid addiction or anyone with the disease of chemical dependency, but especially for those celebrities and other political figures, people in the public eye. Because it’s difficult to reach out for help when you’re driven by fear of people’s judgment. We live in a society that minimizes success and magnifies mistakes. It’s just the way things are.

Emily Carter Roiphe, writer and books critic

You’re ill and you’re in pain, your joints ache. You lie down, and then you get up, but you can’t get comfortable. In the beginning, there’s a lot of nausea. But mainly the worst thing is the joint pain and restlessness combined with weakness and sleeplessness. It tends to last for 72 hours, so people often call it the Asian flu.

Some people say that it doesn’t matter whether you’re stopping a $30- or $300-a-day habit. What’s horrible is how badly you miss your drug, because you know it will give you relief. It’s very unpleasant, there’s no doubt about it. In movies, it’s much more dramatic, people are crawling around and screaming — they’ll do anything for another fix. That’s just nonsense. Basically, you just feel like crap. That’s the worst part of it.

Some people feel so good that they feel well enough to go out and start using immediately again. For some people, it’s very scary because they’re used to being somewhat tranquilized all the time. And then all the emotions come back. It’s very common to see people weeping over dog-food commercials and such. People are very raw, extremely raw.

It’s very good for an addict to be in a treatment setting when they’re withdrawing, because as soon as you feel physically better, the disease gets into your mind. You think: I could go for a walk and use once without all this happening again. The withdrawal doesn’t do anything to remove the addiction. The addiction is still there. I don’t know of anyone who all of a sudden just stopped and never went back to it.

A great many people use to self-medicate. And it’s very dangerous because not only will it remove your depression, it will replace it with euphoria. That’s a powerful incentive.

After the immediate withdrawal, the horror can be that you’re facing feeling how you feel with no relief — ever again. That’s why in AA they say, “One day at a time.” If you start thinking about living the rest of your life without a drug or a drink, it’s horrifying to an addict. It’s like saying that you’ll never, ever, ever have a moment of happiness again. You’ll never, ever not be sad, anxious, lonely.

I can’t emphasize enough how important it was to hear that “One day at a time” thing. That for me was everything. If I thought that I could actually achieve something by staying sober for 24 hours, and that people would give me props for that, that was everything. The idea of facing a life without my drug of choice, which was at the time the only thing that provided me any pleasure whatsoever, would cause me to despair. So hearing that if you can get through one day, you’ve done well — that meant everything to me.

Ian McLoone, LACD counselor, U of M grad student

Because we’re dependent on our endogenous opioid systems for so much of our daily experience, when you tinker with it or stop producing your own endorphins, it affects the whole range of your daily experience.

You hear a lot about people who never quite feel totally normal again — even folks who are abstinent for 10 years. I’m on methadone maintenance, so I feel [relatively] normal. I continue to taper down on my medication. I’ll notice that my body kind of catches up. After I lower my dose, I notice it for a couple days, then my body makes up the difference and finds the homeostasis. So I’m hoping it continues to do that as I continue to taper all the way down.

I’m taking it one day at a time, as they say.

In the moment, when you are experiencing the first few stages of withdrawal, even though you know that the worst that’s going to happen is that you will feel like you have the flu, there’s a psychological piece that is so terrifying and so disconcerting. You know that there’s a cure, and you know that it’s out there, and that’s why people will go to such lengths to quell those withdrawal symptoms. Even though it’s ridiculous and it’s weak and it’s pitiful, in the moment, it really seems like it’s the worst thing that can ever possibly happen. Isn’t that weird?

With the flu, you kind of know that there’s no immediate fix. You’re just going to buckle down and hope that you don’t end up in the hospital. But you spend so much time using just to feel normal, and to avoid that sickness that when the sickness comes on — and you know that if you had just saved that last little bit a little bit longer, not spent that money on this other thing, or if you could just get your hands on something you could sell — that you could fix it. Right? It’s that sense that there’s a cure but it’s just out of reach. So you’ll do whatever it takes to “fix” that horrible feeling. I can fix this. It’s just a real psychological component in there. It’s really hard to convey sufficiently what that feels like.

I was facing losing my spouse, my marriage, my child, my home, any semblance of the life I had. And I was thinking that I should get off my medication and just be totally clean. And somebody said, “Ian, you’ve got one chance to get this right, you should use every tool at your disposal to increase your odds of success.” It just helped me not to feel ashamed about using a medication.

People recover. Most opiate addicts who come into treatment know the true despair of that day-to-day grind of just feeding your habit. [As a provider, I can help them by] just offering some hope that there’s another way to live, empathizing with where they’re at, and offering encouragement to try things differently.

Comments (27)

  1. Submitted by Paul Brandon on 02/14/2014 - 11:02 am.

    Behavioral Pharmacology

    The University of Minnesota has a very highly regarded psychopharmacology program. You might have talked to someone there; I suspect that they’d tell you that this is old news.

  2. Submitted by THOMAS REYNOLDS on 02/14/2014 - 11:34 am.


    Often the lines are blurred between physical addiction and mental illness. Addictive behavior are also or can be reflective of deep seeded underlying causes that individuals mask through self medication. A means of coping… it never is healed and the hole is always present. The only thing a friend or family can do is support the individual by helping them by offering some hope that there’s another way to live, empathizing with where they’re at, and offering encouragement to try things differently.

  3. Submitted by Dennis Tester on 02/14/2014 - 01:37 pm.

    I quit cigarettes

    cold turkey nine years ago. I heard people say at the time that my 30-year, 2-pack a day habit would be tougher to quit than heroin. I don’t know if that’s true or not or whether people just said that to “encourage” me. Regardless, I didn’t think it was so bad.

    • Submitted by Tiger World on 02/12/2017 - 06:37 am.

      Not really true

      I don’t know why people compare the withdrawel from cigarettes and heroin as they are more dissimilar than you can imagine. Just to clear up any misunderstanding, the withdrawel from cigarettes is very, very mild compared to opiates. As I’m sure you experienced yourself, it is really just some irritation and maybe mild gastrointestinal problems. Giving up opiates on the other hand is the most torturous experience you can possibly image – the most violent flu combined with an all over skin-crawling sensation and zero sleep for up to a week’s duration. I think that the only reason people claim that giving up cigarettes is harder is that they are referring to the actual physical cravings as opposed to the withdrawel symptoms which are two entirely different things. I suppose because cigarettes are more socialy acceptable and so easier to incorporate into everyday life – they might in theory be harder to refrain from after the withdrawel period has passed, though even this I would debate!

  4. Submitted by Mark Rose on 02/15/2014 - 05:10 pm.


    As an addiction researcher and psychologist in long-term recovery from addiction, I cannot overstate the value of the information in this article. Even among professionals in the medical and behavior health fields, I am often appalled by the lack of basic understanding of addiction. Dan Cain totally nailed it when he discussed how different providers are locked into their paradigm (I would add to the point of dogma) and unable to see the multiple dimensions to the causation and recovery of addiction. Marc Myer gave a compelling narrative of his own withdrawal, and provided an important piece, the intense agitation and anxiety that comes with acute opioid withdrawal. Emily Carter Roiphe added the vitally important concept that nobody with addiction has ever been cured by successful detoxification, because withdrawal only removes the drug without addressing the underlying addiction and other contributing factors (trauma, depression, etc.). And Ian Mcloone did a great job explaining how the drive to attain momentary relief eclipses all other potential competing motivations. A superb article that should be required reading for anyone working with addicted clients.

    • Submitted by Dan Cain on 02/18/2014 - 11:27 am.

      Hi Mark,I’m glad to be

      Hi Mark,

      I’m glad to be validated by your comment, and urge you, and others that are concerned with the dogma and direction that is taking over the field to speak out.

  5. Submitted by daniel harvey on 03/12/2015 - 07:25 am.

    excellent article .. however…

    The author is on point in many ways and I agree with much of what I read. I also appreciate that this person has direct experience. However, the description of the physical part of withdrawal as a flu with mild chills, sweats, and diarrhea is far, far frorm the truth for everyone. Yes, withdrawing from a mild to moderate percocet addiction is just like that, plus depression, restlessness, anxiety, and insomnia of course. On the other hand, someone withdrawing from a longterm, severe IV habit is going to exprience all of this x10, not to mention severe body pains. Pains equivalent to being in a nasty car accident, having a battered body, possibly with some mild fractures. Combine this with the other symptoms plus the psychological part and you have a human who feels like they have been plunged into the bowels of hell. It is important to remember that the severity of withdrawal is generally directly related to the severity of the addiction and habit. Yes, I do agree that the psychological struggle is far tougher in the long run, but it is not necessary to diminish the physical symptoms so greatly to get your point across. I speak from experience in all I mentioned. Thank you for the article.

  6. Submitted by josh stanger on 05/09/2015 - 10:06 am.

    very nice…

    I liked this article and some fantastic points were made. However, comparing methadone and long term heroin withdrawal symptoms as like “having the flu” is like comparing a bath that is a little overheated to being boiled alive. These symptoms are not “mild” and among the most painful things any human can go through. The term “kicking the habit” was derived from addicts in WD who literally kick and flail there arms and legs from the intense pain and anxiety. I feel this article minimized the physical pain of WD’s. Overall though it was very well done and accurate to my experience.

    • Submitted by Denny Smith on 01/10/2016 - 01:19 am.

      Not just the “flu”

      Totally agree, Josh. Boiled alive is not much of an exaggeration. But possibly you and I have worse WDs than many other folks? I think it varies across people and their particular profiles.

    • Submitted by Derek Davis on 06/12/2016 - 08:02 pm.

      I agree

      I’ve been in a pain management program for 5 yrs 300 mg MScotin and 60 mg oxy daily! Keep in mind I’m a 26 yr old male only weighing 86lbs I was diagnosed with a hyper metabolism not due to meds. I have been through the suffering of WDs. Reading this article made me quite upset with their aspect of WDs. The physical part is far worse then anyone that hasn’t experienced could possibly even imagine. I have muscle degeneration in my right leg due to a femaur fracture with hardware. I didn’t choose to be on them for fun but as a blue collar man I need to work and it makes the pain tolerable to do so. But during the 1st minutes of WDs my insides start to boil I drenched in sweat making me cold and hot at the same time and every single little skin pore feels like I have sewing needles stabing me in every single pore at the same time. My leg feels like a butter knife is carving at me from the inside out. My energy is drained all I want to do is sleep but can’t due to the tremendous pain as well as increased heart rate due to dehydration. Can’t eat and if you can manage to don’t plan on it staying down forget it. You want to lay there and just stay completely still and hope if there is a God he put me out please. This is why opiate addicts relapse if there’s something you know that will take this pain away you’d be crazy not to. Keep in mind this is only in the 1st 24hrs! There is NOTHING MINOR about this feeling. I know some of you can relate those that can’t there you have it from someone who has actually experienced it. The worse part is once you manage to go through it all nothing is the same anymore things that gave you dopamine sex food sleep accomplishing a great thing for the rest of your life this all supposed to make you happy and high on life after a year of opiate dependency you feel absolutely nothing. Your pretty much an emotionless robot going through life feeling hollow until you use again. Then you ask yourself which is better living a healthy empty life or a short happy one? We all die at some point it really boils down to living longer with no feeling of happiness for sake of family and friends but never enjoying a moment or going back and using it as a tool to help you live and enjoy your life and spend as much with loved ones and getting the feeling of satisfaction. Don’t get me wrong SOME peoples brains recover the receptors but MOST will be stuck like that for the rest of their lives. Just remember that when you want to call someone a junkie or throw away a relative who is using opiates. They just want to feel like all the normal people that are sober they just want to feel human again. We just have to jump through the firey rings of hell to do so.

      • Submitted by Alena Chester on 01/12/2017 - 08:08 am.


        I must say, I can relate to your response the most in this area. I find that the detox phase and stages to very from person to person. I personally am a very strong minded individual and can fight thru the detox easily, it is the after affects that get the best of me. I’ve had back surgery in 2003 and have been on and off of pain meds thru out my life ever since. My pain is real and so unbearable that I can not live on a daily basis without some relief. This is where I stand today. I am looking for some hope to help me thru the era of my existence. Cause I find that I am not living, just existing and coexisting.

      • Submitted by Angie Mallory on 05/26/2018 - 05:59 am.

        Opiate addiction and withdrawal

        I couldn’t have said it better. I know this post is long ago but was so glad to see someone who can relate to my pain. I have been using opiates (vicodin, Percocet, fentanyl, oxycontin , methadone) for seventeen years , I have to say that withdrawal from the fentanyl suckers was the complete and utter hell that you described. I detoxed from them, spent a week in rehab and went straight back home and got into my stash of three hundred, 10mg Percocet. And so began the process again. I won’t describe the pain and suffering I put my self and my family through. Because you know. I had three and a half years clean. I am so ashamed of myself but my mom was diagnosed with brain cancer and I took care of her with the help of hospice for a year and a half. And so began my endless supply of long acting morphine, liquid morphine, oxycodone, fentanyl patches and Percocet. My mom died ten days ago. The physical and mental pain I am going through is just more than I think I can handle. The leg and back pain I’m in is almost unbearable. I have a fourteen year old that is high functioning autistic with a learning disability. I have a nineteen year old daughter that is helping support us. She said she would leave if I got another prescription of pain killers. I just can’t believe I’m in this position I’m in. Please try not to judge me to harshly.

        • Submitted by tyler william on 01/14/2020 - 07:05 pm.

          I know this is pretty damn late. We’re in 2020 already. And I really do hope you’re doing okay. There’s nothing I can say that could make you and other opiate addicts feel better. But what I will say is that you’re a lucky man to have family that cares and is willing to help you. Don’t focus on how your life has turned out because of opiates. Focus on how your life can be, how tomorrow can be without them. Err…the good stuff of course not the withdrawals and whatnot. I’ve had to deal with opiate addiction for a very long time. I started using heroin and alcohol after witnessing the death of my girlfriend. It messed me up for the majority of my life. And during the withdrawals I had relive that scenario over and over and over again. But there is a light at the end of the tunnel. After a while things just start to kind of “fall into place”. You start getting a grasp over your emotions, over your feelings of despair and emptiness. You start to feel the opposite of when you went into opiates. You start to feel like you can take on the world. You’re genuinely happy again. And of course there’ll be some shit days. Some bad days where grabbing the needle or the pill and “just using a little bit” or “just take one pill it won’t hurt” can cure the blues. I guess what I’m trying to say is that we as human beings are capable of absolutely remarkable things. I mean we invented twitter for Christ sakes! Lol. But In all seriousness we are capable of overcoming anything that is thrown at us. And as hard as it may be to hear it or do it, only YOU can find that determination and courage in stepping further and saying enough is enough. My phrase throughout my withdrawals whenever I got the craving was “fuck this shit, lets just make it to tomorrow”. I guess I’m replying to you to tell you that everything will be okay. And don’t feel bad or ashamed because watching a loved on die in front of you for days, weeks, months on Is hard for anyone. We find solace in things during that time and unfortunately opiates just happened to be our vice. I had to take care of my grams for 9 months with help from hospice so I understand to a degree. Anyways I hope you’re doing well. I really do. This story just kinda stuck out to me.

  7. Submitted by Christopher Louthan on 08/24/2015 - 09:49 am.


    Love the article, good information from people who have been through opioid withdrawal. I wish I had knowledgeable people such as this around when seeking help. I found the doctors, counselors, and shrinks in my area very ignorant when it comes to withdrawal. Experience matters.

    As an addict in recovery, I’ve successfully detox’d from many different variations of opiates. All of them were somewhat bad to kick, with the exception of methadone, which made me pray for death.

    Thanks for the article.

  8. Submitted by Diana Fields on 09/04/2015 - 12:57 am.

    Heroine addiction

    Hello, after reading all these articles I have a better understanding of the withdrawal stage with heroine. My question is how do you get someone to get help? I have someone that I care deeply for that has been abusing drugs for awhile and for the past year or so has been using heroine…..this scares me because I have already buried 8 different people I knew in the past 10 years from this drug and I do not want to bury the cater of my children now too. Please help me so I can help him

  9. Submitted by Denny Smith on 01/10/2016 - 01:15 am.

    Mostly correct, but . . .

    I think the descriptions of both dependence and withdrawals could use some tweeking (pardon the synonym!). Not all of us are on opiates for fun–I started because of serious neuropathy that only responded to opiates. And when I’ve tried to stop, my withdrawals have been worse than almost anyone else’s descriptions–just unremitting, utterly global, all-organ system, constitutional pain from the inside out, lasting longer than “72” hours, that’s for sure. Frankly, I think all opiate-dependent folks deserve a no-cost, compassionate, medicated stay in a professional detox institution. Because of advanced medical technology, there’s no acceptable reason any human being should experience opiate WDs alone or without a medicated “parachute” landing. Period!

  10. Submitted by Kathy Murphy on 02/19/2016 - 12:01 pm.

    Good info, but minimizes the physical pain

    I feel as though most movie depictions of withdrawal hit closer to home than what you imply. Every cell in my body feels as though they are screaming and tortured. Every cell, every single cell. I am very thin with a fast metabolism, I wonder if that matters in any way. I kick and hit the back of my calves in desperate attempt to release the itchy and overwhelming restlessness. My body dramatically contorts during different phases, trying to stretch away the restlessness. It’s like trying to stretch, but no amount of stretching gives the release that it should – like needing to sneeze, but the actual sneeze doesn’t come (the relief of sneezing, like the relief of stretching isn’t there). I shake, contort and stretch in search of relief from the searing restlessness, panic, pain and hell. I have been on suboxone for four years prior to a single year heroin obsession. I no longer feel mentally addicted, it is just the physical torture that is keeping me from jumping off suboxone. I went from 8mg for 3 1/2 years down to .25mg morning and night. I can’t handle a single day without it, kicking and twitching in response to the electric current feeling that courses through me. Bone pain, muscle pain, skin pain, mental pain. Sub withdrawing, for me, is worse in a way and much longer lasting than heroin withdrawing. Well, heroin withdrawing actually was just as severe if not more than sub, but it is only 3 days or a bit more compared to the power of methadone or suboxone. I cannot fathom how people could handle this easily without coming close to a true mental break. I am down to such a low sub dose and I am desperate to jump off. The .25mg of sub feels the same as 8mg now that I am stable on it. How does that make sense! That must mean it is not too much different than just jumping off at 8mg! I can’t get much lower than .25. Sorry for the long post, I just can’t wait for the day that I am strong enough to finally kick it for good. To face the physical torture and come out on the other side.

  11. Submitted by Lindsay Faith on 12/09/2016 - 11:53 am.

    probably the farthest thing from the truth ive ever read

    I think this is one of the most unfounded and dishonest representations of heroin/opiate withdrawal I have ever read in my entire life. I suffered from and struggled with opiate addiction for 5 years, starting with pain killers, leading to heroin and fentanyl, and finally ended up on the methadone program and have been for the past 2 years, where I am finally recovering and clean, and on the way to a normal life and mind state.

    First of all, coming from someone who has experienced withdrawal in many different levels of severity, in many different stages, from many different opiates… I can say… no opiate withdrawal I have ever experienced, whether from pills, heroin, fentanyl or even methadone, was 72 hours. That is a massive understatement. Sometimes the withdrawal, in its full effect, can last for a month or more. I’d say, if I was to correct that statement, that the WORST parts of it are in the first 72 hours. And even after that, it still doesn’t get “better”. I would say it levels out, and plateaus for awhile, but it is a long, torturous time before anything is better. There is also no way that anybody who has ever truly experienced full fledged opiate withdrawal, would say that the worst part is the psychological part. While I understand that the mental part of it isn’t pleasant, lets just say, if you only had to face the mental portion, it would be a walk in the park compared to the physical. In my personal opinion, the psychological symptoms only even feel as bad as they do, because of the underlying physical trauma you experience.

    Craving the drug, is also most definitely, NOT an overpowering feeling. Not in my experience, or in a majority of addicts I have questioned regarding this, anyway. I am sure for some people who aren’t ready to quit yet, they may experience intense cravings, but for the most part, I think it’s misunderstandings and misinterpretations of withdrawal such as statements like these, that attach that specific stigma to it all. People always think that an opiate addict is suffering during withdrawal because they are just “so badly” craving the drug and want to get high. So many people make it out to seem like people need to just “toughen up” and get some willpower, and stay away from people who use it, and change their living patterns etc. But that is NOT how it should be viewed, how it should be understood, or how an opiate addict should be looked at.

    An opiate addict is not anything the same as addicts of other substances, such as stimulants, like cocaine or methamphetamine. Stimulants, while providing minor physical withdrawal symptoms, are mostly a psychological form of withdrawal, and for the most part, can be battled by practicing strong will power, or changing your schedules, group of friends or routines.

    An opiate addict doesn’t break down during withdrawal and give into drug use because they are overcome with the desire or urge to get high. They don’t suffer to the point of break because of unhinged cravings for the drug. In my experience, and a majority of other addicts I have spoken to on the matter, the reason, in the end, that you keep using heroin, is out of an intense fear of the withdrawal itself. The pain, the sickness, and the overall destruction of the withdrawal symptoms is enough for you to keep using, at any cost, in order to not have to suffer.

    And oh, you do you ever suffer. Its not MILD or MINOR aches and pains, it isn’t a simple or even advanced flu, and I have never once heard anybody call it the avian flu.
    To put it into grand perspective, during the period of time where I struggled with addiction and endured withdrawal, I also contracted E.coli from bad meat, and nearly died during the ordeal.
    I would much rather, anyday, go through my near death experience with E.coli again, and again, than ever have to face even 24 hours of opiate withdrawal.

    Why, logically, would nobody ever faced with it, be ready and willing to undergo it cold turkey without any opiate substitution treatment, if it was tolerable?
    Often during the most severe withdrawal I experienced, I had been completely done and fed up with the drug itself, I no longer even felt high when using it, so there was no fun in the experience, and as a result, was not driven by any craving or desire to do the drug. Infact, during most withdrawal, I didn’t want to do it at all, and only resorted to doing so because the withdrawal was so literally tormenting that I couldn’t go through with it.

    I have seen some of the most fearless and strong willed of people break in mere hours of withdrawal. You are no longer using the drug to experience any high at all, as your tolerance level rapidly rises and prevents any high from developing. You use to avoid sickness, and pain, and the other horrific things that come with withdrawal once addicted.

    I think there needs to be more realism when speaking on withdrawal, as the undercutting, undermining and understatements of this topic are what creates such strong development of misinformation. It contributes to building the stigma, and people do not understand what to expect.
    Perhaps Doctors and Physicians truly believe that the withdrawal isn’t “that bad”, or that it only lasts 72 hours, or that the symptoms are only minor, or that its mostly “psychological”.
    Perhaps, as a result, that’s why they so freely prescribe it with such rapid and consistent instructions on dosage, and no real information on what happens when the prescription ceases.

    People need to understand what it feels like to be addicted to opiates and what can happen as a result of this addiction. It doesn’t matter if it started with recreational drug use or if it was medically prescribed. It can all ruin your life, and it can all become one long, terrifying and painful nightmare that you cant seem to navigate your way out of. You can end up in the same place, even if you were only trying to remedy your pain when it all began.

    The stigma needs to end, and people need to feel comfortable talking about it. This addiction is an epidemic now, and it effects everyone, not just some statistical demographic or some stereotype created by movies and pop culture. This is real and it is overtaking everyone now. It starts with the proper understanding of this addiction, its withdrawal and the drug itself.

    A doctor or physician can only tell you so much regarding these things. They can tell you what it feels like to get high, withdrawal or overdose based on what medical journals and science tells them, but to experience it is a whole different level. I would hope addicts, recovered or not, will come out and start explaining the reality of it all. That is how I believe this will be better understood.

    Reading this article really blew my mind, because people see that is is written by counsellors and doctors, so they believe that they are getting real, raw information. but anyone who has lived these things, knows that its a very bland and diluted version of the truth.

    • Submitted by Alena Chester on 01/12/2017 - 08:38 am.

      By far

      This has to be this best written article I have read yet. You are right in just about every aspect. The 72 hour mark is an understatement by far. I have cold Turkey too many times to count, but the end result and the realization is that my pain is real and unbearable to live with in a daily basis. 800 Motrin gives no relief. Tramadol is a joke. I do not take pain meds to get high, just relief. But in my mind it still sucks to have to take any pain meds to function in life or society. This last time I went 14 days, but my legs hurt so bad, I couldn’t take the pain after 3 days of suffering. My mind wasn’t craving, my body wasn’t craving. I am a 50 yr old female and have been a single mom for the past 20 yrs. I have worked all my life. All of my kids are in college. I have had back surgery and have had restless leg syndrome since I was a kid myself. I will admit, I feel worn out and depleted. But I have not given up.

    • Submitted by mark edmond on 02/03/2017 - 12:02 am.

      opiate addiction

      i read this article and gained a sense of hope.yet of course there,s always a but,or some reason ,excuse what have you why your particular situation is different,worse or perhaps just whatever that pain started without that the common need more for the same euphoria? i have a wonderful support system yet many of these people have everyday stressors that make you feel there,s no time to lay scream moan and groan for you,re afraid in my case my84 year old mom.ive got to be there for her and her partial senility and lack of sensitivity of her needs from the rest of family.i tell myself when she dies all can get well for i can lay and ignore everyone else for they have others to assist in their basic needs.partial truth partial excuse ya think! have had my ar 15 in my mouth thinking ill fix this for death is certainly a cure-all for any and all diseases,yet i want to live again.god bless and why im typing words im so sick i cannot really put together and explain it all.perhaps it won,t save my life but prayers that it might touch someone else to the point i will be remembered from someone for something!acccept my apologies for poor written explaination,however im not from a stranger,mark.

  12. Submitted by Kerry Little on 02/20/2017 - 09:45 am.

    Just my two pennies’ worth..

    I cannot disagree more with what’s written in this article. I have never in my 5 years of heroin addiction experienced any withdrawal that has felt like flu. Or even a really bad flu.

    If you can say that flu feels like every cell in your body is on fire, like you want to tear your own skin off and like you want to cut your legs off due to the rls then yeah it’s like flu. Add to that the psychological terror and extreme anxiety that makes taking ones life seem a plausible option and it might be a bit closer to the truth.

    I think it’s dangerous to say that it’s like a bad flu on such a public platoform because although experienced users already know the truth of the matter, if there’s anyone who’s considering using opiates or anyone who’s just started using opiates they are gonna just think oh it’s like the flu I can do that so I’ll use. I mean it might not deter anyone to tell the truth but it might and it’s a whole lot better than downplaying it drastically like the above article.

    I doubt this will get posted but one lives in hope.

  13. Submitted by Carol Lane on 07/30/2017 - 12:42 pm.

    Opioid withdrawal

    I totally agree with a lot of these other posters….. Trying to say opioid withdrawal is like having the flu, it’s like saying a pot set on low heat is boiling!!! Off course everyone is different but, honestly, in my experience, having been on ms contin for 15 hrs for an injury….. Going through withdrawal is like being burned alive!!! Your whole body feels like someone’s beaten you with a steel pipe, you can’t sleep because your legs are walking on their own, your mind is racing a thousand thoughts per second….. Come on now….. The flu, really???!!!!

  14. Submitted by Erika Cormier on 08/09/2018 - 09:31 am.


    Someone who hasn’t ever experienced opiate withdrawal firsthand, such as any professional in the addiction field who only know info through textbooks or word of mouth from patients/clients, cannot even remotely comprehend the actual severity of pain involved in withdrawal. Also, anybody who says they have experienced withdrawal firsthand & says “It wasn’t that bad”, either completely forgets the experience somehow OR they were not withdrawing from a high daily dose at the time of withdrawing.
    Withdrawal of any & all opiates is absolute hell on earth. I couldn’t disagree more about the part of this article where it states that the psychological withdrawal is just as bad as the physical, maybe that seems like it should be theoretically the case, but actual physical withdrawal is 10 times out of 10, what people think of when they think of withdrawal. Personally, I’d say the physical withdrawal is 99%!!!
    It’s just sad when I read newspaper comments on articles by members of the public –who so obviously have been lucky enough to NOT yet be touched somehow by addiction– say such judgmental things about addicts.
    I’m glad to see ANY article focusing on withdrawal, as the entire opiate/heroin EPIDEMIC- that’s created a multigenerational nightmare that will continue it’s effects for decades to come, IS completely BECAUSE OF THE PAIN OF WITHDRAWAL!!! If withdrawal wasn’t as horrific & severe as it IS, there would BE NO EPIDEMIC. It’s the reason addicts cannot stop! Over 50 yrs of medical research & data shows that cold turkey is the least effective method of stopping opiate addiction, both short term & long term, and the most effective method has been for over 60 yrs & still IS Methadone. Suboxone being a close 2nd, and easier access for a larger spectrum of populations due to less restrictions in accessing such as weekly & monthly scripts vs. Daily methadone dosing, and how available suboxone is because methadone clinics are few and far between many cities & towns in America, especially through the Midwest, so suboxone is the best treatment.
    All in all, replacement therapy is proven most effective, and reason being is it eases or removes entirely the physical agony and pain of Withdrawal! The pain of withdrawal is the reason addicts need to use every day. They don’t use every day after 5, 10 yrs of active addiction to get high, by then it’s impossible as the tolerance level has reached a maximum that cannot be achieved at some point, and that’s a scientific fact. So there is no longer a high for may users. They wake up and begin planning their way to get more drugs, because they’re in a full blown PANIC over knowing withdrawal is unavoidable within hours unless they get more opiates. If judgmental non addicts could experience withdrawal for 1 hr, they’d be much more understanding of the cycle and drive of addiction!!
    My point isn’t that painful withdrawal is an excuse for all the negative aspects of addiction. My point is this……….the reason ppl don’t “just quit” is because it’s long been proven it’s for the large majority of opiate addicts, impossible, because the agony of withdrawal is SO SEVERE that a user will do anything possible to get that drug to keep withdrawal at bay. This is a daily process that has to be done. Most addicts never achiever long term sobriety/recovery without replacement therapy, because replacement therapy is the only thing that also stops the withdrawal experience.
    HOWEVER……..the problem is, has been & continues to be,….that there needs to be MORE access to doctors, insurance, clinics, centers, programs, counselors,…..that OFFER the replacement therapy that works best and long term,…..and the problem with THAT is the EXACT people who are so quick to condemn addicts, happen to be the same ppl complaining loudly that something needs to be done & that this all needs to stop……..are the SAME people who then turn around every time a new treatment clinic wants to go into their town or near their town and say “NOT IN MY BACK YARD!”. They also are the ones who are AGAINST increasing coverage TO access the necessary treatment for recovery, such as expansion of state Medicaid & Gov’t Medicare insurance!!!!!! The cobersations need to address the REAL ISSUES! Dont complain about addicts or the epidemic & all the children affected by drug addicted parents or the $ spent from emergency responders reviving addicts,….don’t complain about increase criminal acts like petty thefts, robberies, burglaries, home invasions and how crime rates increase, unemployment increases, child services is overburdened yet understaffed……….you cannot complain about all that, but then be AGAINST the necessary actions needed to take place in order for addicts to access and receive the only medical treatments in existence, that have the highest data of success, and the programs that are used and required by addicts to fund accessing that treatment!
    Spread this message loud and clear!!!!

  15. Submitted by mary lanese on 01/28/2020 - 08:14 pm.

    I am 54 years old. My parents were lifelong heroin addicts. My mom passed away in ‘09 from liver damage. My father is alive and in a methadone maintenance program presently at a high milligram dose. My husband is currently in a methadone maintenance program and since entering on November 21, 2017 has finally decided he wants to wean off. I also entered the methadone maintenance program on the same date, but I never went higher than 30mg and insisted on weaning almost immediately as soon as I started. My counselor had different opinions. She did not permit me to wean for the entire first year. Once she did permit me to wean, I was lowering my dose about every 6 weeks to 2 months at intervals of 2-5mg drops. I exited the program in August of 2019 when I was at 2mg and let me tell you, it was intense at 2mg! During my methadone maintenance, I created a stash for myself. Once I was permitted to bring home 2 bottles a week, I would often forgo one day’s dose and put it in my stash bottle until I had approximately 60mg worth. When I graduated from the program, I used a 1ml syringe to dose myself at 1mg for a month, then taper to 1/2mg which was the magic number for me to quit methadone and be symptom free of withdrawal.

    Addressing the common myth that withdrawal is like a “flu virus” is asinine. The symptoms are actually completely individual for each individual! For me, I could personally handle the diarrhea, cramps and anorexia. It felt to me like a bad “period”, a bad flu and just no appetite. The real problem for me personally was what I call “wiggly legs”. No matter how tired you are, the inability to sleep or sit still can literally be the thing that drives someone INSANE. CERTAINLY NOT CRAVINGS, as I didn’t have any at all, whatsoever. When a person rejuvenates, it is during the sleep period. How can someone be rejuvenated when they can not even sleep?
    Then, there is that hollow, empty feeling that follows you like a dark cloud day in and day out where truly it seems very little makes you “happy”. I KNEW this was all part of my brain’s chemistry re-setting itself, but I must admit. I am still trying to get back to my old self.

    I can honestly say, I believe with persistence, I will get there. I am sure it will take well over a year or more and I know it takes a conscious effort to re-structure my thinking habits.

    During my weaning process from methadone while at my clinic under my counselor’s instruction and insistence, I was put on an anti-depressant. It truly doesn’t matter which one. I didn’t feel like any of them in my life’s history ever worked. I had been in Zoloft, Paxil and Wellbutrin over several years both prior to my heroin use as well as during my methadone maintenance.

    As soon as I didn’t have to go to my clinic any longer, I quit my antidepressant. My point is…it is quite possible that my lingering feeling of being joyless may be in part due to withdrawal from antidepressants. That is something I chose to do AMA, and I accept my consequences.

    Every day away from mind altering substances is noticeable for me. I feel a little clearer. I also FEEL again. Sometimes more sadness and emptiness on some days and sometimes I am just surviving. Again, I understand my brain is re-setting & it all takes time and persistence.

    I am a healthcare professional with access to most any medication at any time, (except methadone). I choose every day not to take NOT ONE DRUG. It is a small victory for me at the end of my shift and I am proud of myself for that because it is available for me.

    I had recently watched a TED talk about opiate addiction and it frustrates me incredibly that the United States chooses to this very day not to adopt what Portugal has done for their people.
    What I mean is, we all know Portugal has legalized ALL drugs for their citizens. What the media doesn’t tell us is that Portugal didn’t just stop there…that country also opened FREE CLINICS in every province for the citizens who CHOOSE to detox. That country also went a step further and offered vocational training courses to the graduates of the detox/maintenance programs AT NO COST TO THE RECOVERING ADDICT so that they would have valuable skills to offer their potential employers. That country also went a step further and offered TAX INCENTIVES to the EMPLOYERS who choose to HIRE the recovering addict. The result? SUCCESS ALL THE WAY AROUND!

    If this country is truly serious about “fighting the opioid epidemic”, I recommend that multitudes of clinicians and counselors spend at least 3 months either in Portugal or study the way Portugal has chosen to “fight their opioid epidemic” because their way works! The country has NOT gone bankrupt. Crime has decreased and “new addicts” are a thing of the past. That country has somehow “found the money” through their existing funds and taxes to cover the cost of FREE TREATMENT, TRAINING & EMPLOYMENT for all of their citizens. Please, look it all up for yourselves. The stigma doesn’t exist in that country because they changed the way they “fought the opioid epidemic”.

    The money is there I this country for the same results. It is my wish that every city and small town and every jail implement FREE TREATMENT FOR ALL WHO CHOOSE TO QUIT THE HORRENDOUS DRUG CYCLE. It is my wish that every city and small town have FREE VOCATIONAL TRAINING for recovering addicts in this country. It is my wish that every city and small town’s employers receive TAX INCENTIVES for hiring the recovering addict so that we have a thriving country that cares for all!

    Helping the addict through withdrawal WITHOUT STIGMA, FREE OF CHARGE, helping the addict in vocational training and offering STIGMA FREE EMPLOYMENT is something worth trying.

    The money is there. Spend it on our most vulnerable and needy in the ways that would elicit the best outcomes.


    Just for the record, withdrawal is excruciating. Makes one want to die. (Which is why it is just easier to continue the vicious cycle of drug abuse). It is not “flu like”. The flu is flu like. Withdrawal is just like it sounds, something is being ripped from you.

    The saddest part of my life is when my daughter, (29 years old) tried to receive help from 2 separate institutions (hospitals that claim to have detox facilities) and was turned away. The first one because her vital signs and health history was “too good”, the second one turned her away because she didn’t state she “wanted to kill herself”. I was present at the 2nd location. I also heard from 2 separate clinicians at the second hospital that “withdrawal is like a case of the flu”.
    I wanted my daughter to receive help, so I bit my tongue.
    It is disgraceful what she had to endure. There IS STIGMA among clinicians to this very day. There is also a disregard for people who are addicted as if they could just “quit” and all will be better.

    It takes an entire country to pull together and pay attention to it’s precious citizens. Including the addicts.

    WAKE UP! GET WOKE. Whatever it’s going to take, but let Portugal be our guide.

    I love you all. Pray for me as I pray for you.

    • Submitted by North Wilde on 07/06/2020 - 06:54 pm.

      I chose to reply to this particular post for one, because I totally relate to you about your experiences and comments on Opiate withdrawal.

      I am an addiction dual diagnosis nurse who has worked in acute detox and all the other treatment levels (residential, PHP, step down programs, sober livings and IOP). I have also been through withdrawals from opiates in the past myself.

      I want to say this; From my experience personally and working with 100’s of opiate addicts, poly substance, and basically the gamut of addictions and clients who most also have psych issues which are from (as they describe) mild to severe (schizoaffected disorders) so I don’t agree with pigeon holing any one of these comments as right, wrong, bad or good. It seems like the people sharing here are all wanting, needing to share about this with hopefully the common goal of helping each other. What I mean is that although I agree with the people who are stating “opiate WDL is nothing compared to the flu, emphasize NOTHING like the flu”. In my opinion what I have gone through myself (a horrific cold turkey detox for 10 days) and like I said hundreds of people going through this type of WDL, I just wanted to state that if you are suffering currently with opiate addiction, suffering right now while in your withdrawal, or have suffered from an opiate WDL (cold turkey) it will be very hard and probably quite excruciating however it will be your experience and how you choose to describe it. These are all just individual’s stories about their own experience/s (including mine) so please don’t decide that the above will all be true for you. Just be prepared with this knowledge.

      My intent after reading a lot of these stories which sometimes vary greatly in the descriptions of WDL is to say that we addicts must all stick together and stop judging each other and what we say about our own experiences wether it is a description of “Its like the flu” or a description of the worst want to die hell. I think there should be way less judgement and negative reply posts towards other people’s posts about their WDL experience/s. Period! The minute we judge someone, even worse, in a public way, we start dividing and choosing sides, etc… what we will be left with is nothing. It’s a “We, not an I” situation here.

      Thank you for reading this and if you do, I will not read any judgements against what I share.

      Let’s just stick together and help each other.

  16. Submitted by Pamela Parker on 04/16/2020 - 02:41 am.

    The combination increases the efficiency of the drug. Therefore, it is used frequently to relieve the moderate and severe pain of the patient.

  17. Submitted by Leslie Gray on 06/28/2020 - 07:29 pm.

    Also, any time I’ve gone through this I wasnt able to sleep for the first 10 days. Days 5 through 8 were the worst of all the symptoms. Even after day 10, i could only get snippets of a nap here and there. And not a full nights sleep for at least 2 months.

    If withdrawals were easier, instead of making you feel as though you’re descending into madness, into a hell you will never escape, then the addicts whose truly ready to quit WOULD quit. But please remember that part of this disease is that no matter what consequences a person is faced with, they will not quit and stay clean. An addicts brain has tricked them into believing that I can manage this AND the rest of my life… Even though children should never be taken away unless they are being harmed, it happens all the time as a punitive consequence from the government– who will tell you, if you do this and that and jump through all these hoops we MIGHT revisit your case in 6 months or so… But addicts are already depressed and or anxious. And facing that kind of requirement feels like it’s too much. And the addict fears they will not get their child back anyway. So they’re just going to do their DOC this time (to treat their misery and their now intensified anxiety /depression) because even if they dont, they wont get their kids back today.

    Addicts dont believe that theyll actually lose their job or career over this. And what pains me so deeply is that addiction is a DISEASE. It’s not a lifestyle choice or whatever… People with cancer or indigestion dont lose their kids or their jobs over their illness. They aren’t treated as though they are irresponsible selfish trash. They just have a disease.

    (Its not an opinion, if you look up the AMAs definition of “Disease ” you will see that addiction does indeed meet that description. Or if you think that addiction cant ve a disease because it begins as a choice, what about heart disease, obesity, diabetes, etc… what about herpes? People who have herpes may have also made some poor choices in life and now they ate forever suffering. Well not everyone who drinks becomes an alcoholic…ok but not everyone who is exposed to herpes ends up with that either. And not every overeater becomes obese,develops heart disease or high blood pressure or diabetes.

    All I want to say is that articles such as this perpetuate misinformation about drug addiction. And that inhibits our country from ever opening their eyes, ending the discrimination, and offering helpful treatment rather than continuing the cycle of prejudice and mistreatment.

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