Some heroin users and doctors alike may choose tapering off heroin, which allows an individual to quit heroin gradually rather than all at once.

Heroin is a common recreational substance that is part of the opioid family of drugs. It is perhaps the most well-known narcotic due to its dangerous disposition and highly addictive properties.

Opioids such as heroin contribute to tens of thousands of overdose deaths every year in the United States. Because of the availability of these drugs, opioid overdose is one of the leading causes of death across the country. Beyond causing numerous fatalities, heroin contributes to many cases of substance use disorder. The drug is potent enough to make users develop dependence issues even after a single use. Opioids bind to receptors found within the central nervous system which helps control pain and also causes feelings of euphoria (the “high” feeling). These receptors then become accustomed to the drug, and when the drug is no longer in the system, withdrawal symptoms and cravings can occur.

Heroin is among the most difficult drugs to quit entirely and recover from using. When treating heroin addiction, medical professionals advocate for comprehensive care — detox, inpatient and outpatient care, and more, depending on the individual’s needs. These methods have proven to be the most effective means of treatment to achieve life-long recovery from a heroin addiction.   

Still, some heroin users may choose a slightly different approach to their dilemma: self-detox. Many people have heard the term “cold turkey” used to describe drug detox. Stopping drug use outright has its risks, and heroin has, arguably, the hardest withdrawal of any drug. The flu-like side effects are abundant and can be quite uncomfortable. Such symptoms of a heroin withdrawal include:

  • Nausea. Perhaps the most overt of all the withdrawal symptoms, diarrhea and vomiting spells can occur for hours at a time.
  • Excessive energy or agitation. Heroin withdrawal is characterized by restlessness and a feeling of being incomplete without using the drug.
  • Aching. Withdrawal is truly a full-body experience in the worst way. Muscles will throb incessantly, while pain may be felt all over.
  • Hot flashes and chills. The body will attempt to self-regulate, leading to bouts of intense heat, or alternatively, shivers. However, the user may not experience any temperature changes on the surface. Sometimes this is a psychological side effect only.
  • Depression. Getting through heroin withdrawal is challenging. Such trauma will take a lot out of a person both physically and mentally.

The cold turkey detox method is not the physician-recommended course of action for heroin users of any kind, especially for long-time and frequent users with high tolerances, because tolerance vanishes once withdrawal symptoms clear up — approximately a week or so for most users. When this happens, users are at their most susceptible to overdoses. A dosage they may have been accustomed to before is suddenly far too strong. It would take a much smaller dose to result in a potentially fatal heroin overdose.

However, there is another option. Some heroin users and doctors alike may choose to taper off heroin, which provides an intermediate approach — allowing an individual to quit heroin gradually rather than all at once.

Tapering Off Heroin

Heroin withdrawal is challenging. Many people will go to any means necessary to avoid this debilitating event, including continued use. Tapering off heroin is seen as a feasible alternative, or in some instances, a stepping stone to prepare for full medical detox and treatment. Users are often searching for a way to improve steadily and at their own pace, in combination with having a sense of control over their own recovery that they might not experience in a clinical setting.  

A tapering regimen is all about lessening tolerance and dependence over time. Taking less and less of the drug allows the body and nervous system to self-correct and, ultimately, heal itself. By keeping withdrawal symptoms at bay, it is more likely that an individual will continue the recovery process. This is one of the primary reasons replacement therapy is used as well. Additionally, it must be remembered that heroin doses are not exact from batch to batch. For this reason, it can be difficult to taper off consistently, since using less heroin doesn’t necessarily mean it is less potent each time.

How to Taper Off Heroin

Heroin users and their families may wonder how to taper off heroin. While heroin treatment may require using medications such as methadone or Suboxone to wean off the drug, a user tapering on their own does not have this option. Overall, this means that a self-guided approach will be fundamentally less structured (and potentially more dangerous) than a clinical system. It will require extensive forethought and perseverance.

Tapering off of opioids such as heroin requires a strategy. This can be as simple as identifying a date on the calendar — a time frame in which complete cessation or marked improvement is desired. It becomes easier to focus on making a change once a commitment is actually made. From here, the process takes one day at a time. Heroin is one of the most addictive drugs for a reason. It will take resolve to taper off of it successfully.

A person’s environment also plays a vital role in deciding how to taper off heroin. As a recreational drug, heroin is often ingested in the presence of others. Those who are effective in tapering off heroin point to a feeling of loneliness once overcoming the drug. Their identity was tied to both heroin use and the individuals they used the drug with for so long that they begin feeling empty without them. This is a very real issue that can lead to setbacks. In order to avoid this factor entirely, it is best to remove oneself from environments or friend groups that have negative influences. With adequate support, commitment and medical intervention, even a challenge as serious as heroin use can be overcome.

If you or a loved one live with addiction or are using drugs recreationally and want to stop, The Recovery Village® can help. Reach out to one of our representatives today to learn how you can start on your path to recovery.

Christina Caplinger
By – Christina Caplinger, RPh
Christina Caplinger is a licensed pharmacist in both Colorado and Idaho and is also a board-certified pharmacotherapy specialist. Read more
Thomas Christiansen
Editor – Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
Kevin Wandler
Medically Reviewed By – Dr. Kevin Wandler, MD
Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more
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.