Anxiety is a common occurrence among people who use heroin and is not solely due to anxiety experienced as part of withdrawal.

Anxiety may be a result or cause of heroin use. While heroin and anxiety are not as commonly associated as benzodiazepines and anxiety, heroin use and anxiety disorders do frequently co-occur. For someone who uses heroin, anxiety could be a side effect of withdrawal. Anxiety may also be associated with obsessive urges and cravings to use heroin once someone has become addicted. If someone regularly uses heroin, anxiety occurring days after heroin use can be common.

Article at a Glance:

  • Whether someone has an anxiety disorder or uses heroin first, treating an anxiety disorder and co-occurring substance use disorder requires a trained professional.
  • If you believe you or a loved one may be addicted to heroin, take our self-assessment quiz here.
  • The Recovery Village offers comprehensive treatment for substance use and co-occurring disorders, like anxiety. For more information about our care options, reach out to a representative today.

Do People Use Heroin To Cope With Anxiety?

Anxiety is a common occurrence among people who use heroin and is not solely due to anxiety experienced as part of withdrawal. Someone who experiences anxiety may find that their anxiety is reduced by heroin use. Using heroin to cope with anxiety is likely to lead to heroin dependence.

Heroin use may then increase anxiety during withdrawal creating a cycle of continually increasing anxiety if treatment is not sought. With treatment, it is possible to overcome co-occurring heroin addiction and anxiety.

Can Heroin Use Cause Anxiety?

People without a history of an anxiety disorder may develop anxiety following heroin use. This may occur for several reasons including:

  • Cravings and urges to use heroin may create a cycle of anxiety and anxiety relief through heroin use
  • Chronic heroin use can rewire the brain and have long term effects on brain chemicals resulting in the development of anxiety
  • Use of heroin may impact the development of appropriate coping skills, increasing anxiety

Anxiety During Heroin Detox

Anxiety is a common symptom of heroin withdrawal and may be experienced long term after initial detox. Other symptoms associated with heroin detox may cause anxiety to increase independently of the anxiety caused by heroin detox. Many of the physical symptoms of heroin withdrawal are a cause for concern and distress because they mimic serious illness. Physical heroin withdrawal symptoms may include:

  • Body aches
  • Difficulty sleeping
  • Sweating
  • Runny nose
  • Abdominal cramping and pain
  • Diarrhea
  • Nausea
  • Vomiting

Post-acute withdrawal syndrome can last in differing intensities for months and in some cases years after substance use is stopped. Anxiety is a common symptom of post-acute withdrawal syndrome. Setback prevention strategies will include education and increased understanding of the extended withdrawal process as the brain heals from substance use.

Treating Anxiety from Heroin Addiction

Heroin addiction and anxiety frequently co-occur and to effectively treat one, both must be addressed. Treating anxiety and heroin addiction may include learning to change thinking patterns and styles, medication management, traditional talk therapy or a combination of these approaches. Medications should be managed by a doctor who is knowledgeable about substance use disorders because some medications used for anxiety have a high risk of addiction.

Heroin use may decrease someone’s tolerance for feelings of distress and anxiety. Once heroin use stops this reduced ability to tolerate and cope with anxiety may manifest as severe anxiety. If people use heroin they may wonder, “Can heroin ever cause anxiety attacks?” In some cases, someone who previously has never experienced an anxiety attack may find that they do after using heroin.

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Editor – Jennifer Kopf
Jennifer Kopf is a Florida-based writer who likes to balance creative writing with helpful and informative pieces. Her passion for helping people has translated into writing about the importance of treatment for substance use and mental health disorders. Read more
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Medically Reviewed By – Denise-Marie Griswold, LCAS
Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more

Kelly, T. M., & Daley, D. C. (2013). Integrated treatment of substance use and psychiatric disorders. Social work in public health, 28(3-4), 388-406.

Kelly, T. M., Daley, D. C., & Douaihy, A. B. (2011). Treatment of substance abusing patients with comorbid psychiatric disorders. Addictive Behaviors, 37(1), 11-24.

National Institute on Drug Abuse. “Drug Facts: Heroin.” June 2018. Accessed January 22, 2019.

MedlinePlus. “Opiate and opioid withdrawal.” (n.d.) Accessed January 22, 2019.

Simon, Naomi. “Generalized Anxiety Disorder and Psychia[…]and Substance Abuse.” The Journal of Clinical Psychiatry, April 15, 2009. Accessed January 22, 2018.

Wood-Wright, Natalie. “Opioid Abuse Linked to Mood and Anxiety Disorders.” Johns Hopkins Bloomberg School of Public Health, December 13, 2011. Accessed January 22, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.