Most addicts will reach a stage where they know that they’ve had enough. One thing that can hold them back from giving up the drug is fear of withdrawals. The truth is that things can get a bit uncomfortable as the body adjusts to the new situation, but these symptoms are usually no worse than influenza. If the person has the right mental attitude and keeps themselves distracted they will easily pass through the withdrawal period. The symptoms are rarely as bad as they are depicted in movies and TV shows. The benefits of giving up make any discomfort well worth it in the end.
Once people have developed a tolerance for a drug it leads to changes in how their body functions. Humans have amazing powers of adaptation, and their body can adjust to functioning even when the individual is using a toxic drug like heroin. When people give up this drug though, it means that their body has to go through a period of readjustment – this is what is meant by heroin withdrawals. As well as physical symptoms the individual will also experience cravings and other mental discomfort because they have become psychologically dependent on the substance – they feel unable to cope without it. If people abruptly give up heroin without any help it is referred to as going through cold turkey.
The symptoms of heroin withdrawal will vary in severity and may include:
* Abdominal cramping
* Nausea and vomiting
* Cravings to use again.
* Inability to sleep at night.
* Restless leg syndrome.
* Muscle aches and other body discomfort.
* Feelings of depression.
* Goose bumps – this is where the name cold turkey comes from.
* Lack of energy and motivation to do anything
* Runny nose
* Eyes may keep on watering
* Dilated pupils
* Low blood pressure – this can mean the individual may feel dizzy if they stand up quickly.
* Loss of interest in food.
* Stomach cramps.
* Body cramps.
* Elevated heart rate.
* Easily made irritable.
These symptoms usually start within 8 hours of giving up heroin. They tend to peak at about 48 – 72 hours, but the individual will usually still have some symptoms up to a week after their quit. Some people will also suffer continued post acute withdrawal symptoms, and these can last a few months –these symptoms will tend to be mild but can include:
* A feeling like there is a fog in the brain. The individual is not able to think clearly.
* Difficulties with establishing a normal sleeping pattern.
* Difficulties managing stress.
* The individual may feel like they are on an emotional rollercoaster some of the time – one minute they are up and the next they are down.
* Cravings may continue to crop up.
* Memory problems.
* Difficulties dealing with other people.
* Repetitive thinking.
* Difficulty with concentrating on anything for long periods.
The expectations that people have about their future can have an impact on what they actually experience. If they expect that the symptoms of heroin withdrawal will be severe then this is what they are likely to experience. This is because they will be overly focused on what is happening with their body, and they will notice every twinge. Their fear of these symptoms will increase their severity because it causes the individual to tense up. When people feel tense it causes an escalation in discomfort and this will have a snowball effect. This is why it is so important that people feel positive about the withdrawal process. They are not going to have to face anything that they are not capable of dealing with.
Distraction can make a difference when it comes to dealing with heroin withdrawals. Distraction refers to the action of turning away from the original focus or interest. The benefit of doing this is that by not focusing on every discomfort in the body the individual will not be overly disturbed by them. If people are suitably distracted by something that engages them they may even completely forget about their withdrawals for a period of time. The type of distractions that can be effective for this include:
* Spending time with other people can be a good distraction so long as these people are not active drug users.
* Watching TV – particularly comedy shows.
* Reading a book.
* Hard exercise can be a great distraction, but it is usually not appropriate for people in early recovery as they may not have physically exerted themselves in a long time.
* Listening to music can also be a good distraction so long as it is not songs that remind the individual of using drugs.
* Going for a walk can be another good distraction.
The grunge legend Kurt Cobain summed up some good reasons for quitting heroin when he said:
> Drugs are a waste of time. They destroy your memory and your self-respect and everything that goes along with your self esteem.
There are things that the individual can do to make their transition through heroin withdrawals easier such as:
* It is suggested that people write a letter to themselves prior to beginning detox where they clearly outline their reasons for wanting to stop as well as their aspirations for the future. If they hit low points during their quit they can refer back to this letter for motivation.
* Distraction is important when going through heroin withdrawals. If people are focused on their symptoms they will only end up intensifying them.
* The individual needs to keep in mind that their withdrawal symptoms are only going to last for a limited amount of time. If they can sit through them they will be well on their way to a much better way of living.
* The mental attitude that people have when coming off heroin is crucial. If they feel ambivalent about the decision to quit it will make the process so much more difficult – they need to be 100% committed.
* It is not a requirement that people feel miserable throughout the detox process – it is optional. If people have the right attitude they will have periods when they forget all about the withdrawals.
* If people expect their heroin withdrawals to be uncomfortable they will create a self fulfilling prophecy. They are expecting the worst and this means the worst will happen.
* Entering rehab can greatly increase the individual’s chances of success. They will be in a protected environment and they will have all the support they need to make the process easier.
* It is worth considering all the many people who have successfully made it through heroin withdrawals and gone on to build a satisfying life. If these people can do it there is no reason why the individual can’t do the same.
* One way to deal with cravings is to put them on hold. This means that the individual makes a commitment to stay clean for one more hour – when they reach the end of that hour they make a commitment to wait just one more hour and so on until there are no more cravings.
* There are certain medications such as buprenorphine or naltrexone that can help people going through withdrawals. These work by blocking the effects of heroin so even if the individual did give into carvings they would not get any real satisfaction.
* It can be a good idea to stock the home with plenty of easily digestible food and anything else that might be required. The individual may not feel up to to leave the house while they are in the middle of withdrawals.
* It is a good idea to have magazines and books to read.
* It is important that people make an effort to eat a balanced diet as soon as possible as this will speed up their recovery.
* It is a good idea to establish a regular sleeping pattern right away. This means going to bed at a certain time and getting up at a certain time each day.
* Companionship can be a big help when going through heroin withdrawal. This is another good reason for why a stay in rehab can be so helpful.
* If the individual intends to go cold turkey they will need to ensure that they are not going to be disturbed by drug using friends.
* Coming off drugs is just the very beginning. The individual will need to have a strategy for how they will deal with life going forward – this involves skills that can be more easily picked up in rehab.
* Some people find that joining a fellowship such as Narcotics Anonymous can be a help to them.
* It is vital that people have realistic expectations when they kick their heroin habit. If they expect everything to be perfect right away they are sure to be disappointed – it takes time but things will get better.
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