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Priority admissions are now available
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Priority admissions are now available - Call 1300 856 847
Priority admissions are now available
Call 1300 856 847
When it comes to heroin addiction treatment, and specifically withdrawal, it is important to separate acute withdrawal symptoms from post-acute withdrawal syndrome (PAWS).
Heroin withdrawal, also known as opioid withdrawal symptoms, occurs immediately after cessation of use and commonly lasts between five and seven days; post-acute withdrawal syndrome, however, can last for weeks or even months after a person has stopped using.
It’s worth understanding that heroin withdrawal has two distinct phases. Most people are familiar with the first, but fewer are prepared for the second.
This is the immediate phase. It begins within hours of the last dose and typically resolves within five to seven days. This is the phase most people picture when they think of withdrawal: the physical discomfort, the sleeplessness, the intensity.
This is what can follow once the acute phase has passed. PAWS is primarily psychological rather than physical, and it doesn’t affect everyone. There is no clear indicator of why some people experience it, and others don’t. What makes it difficult is that it can arrive after someone already feels like the hard part is behind them.
Heroin dependency affects the brain and body together. With regular use, the brain begins to rely on the drug to maintain what feels like a normal baseline, adjusting its own chemistry accordingly. When heroin is removed, the body doesn’t immediately catch up. Instead, everything that was suppressed, including pain sensitivity, anxiety, heart rate, and gut activity, comes back amplified. That’s what withdrawal is: the nervous system adjusting without the drug it has come to depend on.
Symptoms typically begin around 6 to 12 hours after the last dose and peak between 48 and 72 hours. Common acute withdrawal symptoms include:
These symptoms commonly begin about 6-12 hours after the last dose of heroin and can be expected to peak within the first three days of withdrawal.
People often underestimate how intense things can feel mentally during the peak. The body tends to follow a rough timeline, but the emotional side is less predictable. Anxiety can build quickly, sleep is disrupted, and cravings can feel stronger when you’re already exhausted. It can be a lot to sit with, especially without support, and many people struggle to get through it on their own.
When quitting heroin, it is vitally important to seek medical support to assist with the acute withdrawal symptoms, which can be intimidatingly severe. In extreme cases, persons going through heroin withdrawal will experience hallucinations and feelings of terror, which means they may pose a danger to themselves and/or others if left unsupervised.
Withdrawal doesn’t look the same for everyone. Several factors shape its intensity and the time it takes for withdrawal symptoms to ease.
A longer history of daily use means a more deeply established physical dependence, and generally a more pronounced withdrawal.
Many people use heroin alongside other drugs, including benzodiazepines or alcohol. Each creates its own dependence, and some combinations carry specific medical risks that need clinical assessment before withdrawal begins. Australian Institute of Health and Welfare (AIHW) data from 2023–24 shows that over 1 in 3 heroin-related treatment episodes (39%) reported at least one additional drug of concern, with amphetamines being the most common.
Pre-existing anxiety, depression, or trauma can return with force as the numbing effect of the drug lifts, making proper psychological support just as important as physical care.
Withdrawing in a stable, safe setting, away from triggers and access to substances, is measurably different from attempting it in an unsupported environment.
Heroin withdrawal isn’t usually life-threatening for otherwise healthy people, but going through it alone can still carry real risks that are often underestimated.
The physical side of withdrawal can be hard enough on its own. Ongoing nausea, vomiting, cramps, body aches, and diarrhoea can quickly lead to dehydration, especially when eating and drinking feel difficult. If other substances are involved, which is common, the process becomes more complex and may need careful clinical oversight.
The more significant risk, however, is what can happen if someone returns to use after even a short period of abstinence. Tolerance drops quickly during withdrawal, and going back to the same amount as before can lead to much stronger effects and a significantly higher risk of overdose. This period, particularly in the days and weeks after withdrawal, is when many people are most vulnerable.
This is why the best option for those going through detox is to move into a structured treatment setting afterwards, such as a residential treatment program, where support, routine, and accountability are already in place as the next stage begins.
Support during withdrawal is about having structure and guidance while your body adjusts, and knowing that someone with the right clinical knowledge is there if something changes.
At Hader Clinic Queensland, the detox phase begins with a thorough assessment from the GP and nursing team, who review your physical health and discuss any medication that may help ease discomfort during withdrawal. A counsellor also checks in on your mental state early in the process, because the psychological side of withdrawal deserves just as much attention as the physical.
From there, support during withdrawal can include:
Most people spend one to two weeks in the detox phase. It’s a stage that looks different for everyone, and the clinical team adjusts their approach based on what each person is actually experiencing.
Post-acute withdrawal syndrome (PAWS) is a condition that may set in after the initial phase of withdrawal has subsided. PAWS is not limited to recovering heroin users; it is associated with the cessation of a number of drugs, and there is no clear indicator as to why some users are susceptible to PAWS while others manage to avoid it.
The symptoms of PAWS largely impact a person’s mental health and include:
However, some persons affected by PAWS may also experience chronic pains (i.e. joint pain, back pain, and headaches). Unfortunately, there is no clear timeline for PAWS; it can last a few weeks post-acute withdrawal or stay with a recovering user for months.
However, there are many ways to assist a person in coping with the effects of PAWS, including cognitive behavioural therapy and medication. As with acute withdrawal, PAWS will be much easier to manage if a person is properly supported by medical and mental health professionals.
If you or someone you care about is thinking about stopping heroin, it’s worth speaking with a medical professional first. This becomes even more important if:
A GP can help you understand your options and what level of support is appropriate. You can also speak directly with the team at Hader Clinic Queensland for a confidential conversation about your treatment options.
If you or someone close to you is going through heroin withdrawal or is thinking about stopping, you don’t have to figure it out alone.
Support is available across Australia, and reaching out for guidance doesn’t lock you into treatment. Sometimes the first step is simply having a conversation, understanding what withdrawal might look like for you, and what level of support could make it safer and more manageable.
For immediate advice, Australians can contact the National Alcohol and Other Drug Hotline (1800 250 015), a free and confidential service providing counselling, information and referrals to local support services.
In urgent situations, Lifeline (13 11 14) or Alcohol Drug Information Service (ADIS) (1800 177 833) are both available 24 hours a day for emotional crisis support.
Hader Clinic Queensland offers structured, evidence-based care for people going through heroin withdrawal, including medically supervised detox within a licensed private hospital, followed by residential rehabilitation and ongoing aftercare. Withdrawal is only one part of the process, and having support in place beyond those first few days can change how recovery unfolds over time.
If you’re unsure what to do next, you can reach out to the team for a confidential chat. A single conversation can help you understand your options and what the next step might look like, without any pressure to commit.
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Dr Mel Symon is the Director of Hader Group QLD, leading both Hader Clinic Queensland and Hader Clinic Queensland Private. With more than 30 years of experience in human services and over 20 years as a founder and business leader, Mel has played a central role in establishing and growing Queensland’s leading addiction treatment services.
Mel holds a PhD in Addiction Treatment from the University of Queensland, along with a Master of Mental Health, Master of Professional Management, and a Bachelor of Social Science. Since 2016, she has overseen the development of the 40-bed Hader Clinic Queensland residential rehabilitation program and, in 2021, the creation and opening of the 25-bed Hader Clinic Queensland Private Hospital.
Passionate about lifelong recovery, Mel is dedicated to evidence-based care, meaningful change, and supporting individuals to rebuild their lives through sustainable recovery pathways.
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