Blocking and Preventing Heroin Cravings

Withdrawal from heroin can lead to intense cravings. Here are a few tips and tools to help you block and prevent heroin cravings.

Heroin is one of the most addictive and dangerous drugs currently available. Medical detox for heroin can help someone embrace a new sober life. However, a person should know what to expect — and what will help — in terms of heroin withdrawal and cravings.

Going Through Heroin Withdrawal

Heroin withdrawal is not an easy experience. Symptoms will generally appear within four to eight hours after the last dose, and symptoms may include:

• Agitation
• Anxiety
• Chills
• Depression
• Diarrhea
• Dilated pupils
• Goosebumps
• Insomnia
• Irritability
• Lack of appetite
• Leg cramps
• Restlessness
• Runny nose
• Stomach cramps
• Sweating
• Tremors

Heroin withdrawal symptoms generally peak within 24-72 hours and subside after seven to 10 days.

Spotting Heroin Cravings

After withdrawal, a person will likely experience cravings. The prominent symptom of cravings is the powerful desire to use the drug. Other signs to watch for include:

• Clammy or sweaty skin
• Inattentiveness
• Memory problems

There are also triggers that may induce cravings, such as:

• Being around people who use heroin or with whom a person used heroin in the past
• Having extra spending money
• Feeling anxious, depressed or worried

It is important to remember that cravings are normal. Cravings do not mean that a person wants to or should start using heroin again.

How to Prevent Cravings With Medication

There are a number of medications that help prevent cravings for heroin.

• Methadone can be used for the maintenance of heroin addiction and has been used successfully since the late 1970s. The majority of studies on methadone maintenance show that it reduces narcotic-related deaths, involvement in crime and the spread of HIV. Methadone has also shown efficacy in helping people gain control of their lives after addiction.
• Buprenorphine is a semi-synthetic narcotic that was approved in 2002 for the treatment of heroin use disorders. Compared to other medications, buprenorphine tends to cause less respiratory depression and appears to be a safer treatment option after an overdose. Buprenorphine is also less addictive and produces fewer withdrawal symptoms than methadone, so discontinuing it is much easier.
• Naltrexone blocks the effects of heroin (and other opioids) in the brain so that a person cannot get high from using it. This effect may help to prevent relapse, but it may not help with drug cravings.
• L-alpha acetylmethadol, or LAAM, was approved in 1994 as a Schedule II drug for helping treat substance use disorders and cravings. It lasts longer than methadone, so someone may only need to come to a clinic three times a week to receive medication instead of every day. It produces no euphoric effects, but it can produce negative side effects such as rashes, nausea and heightened blood pressure.

Dealing With Cravings in Other Ways

If a person would rather not use medication to combat cravings or if they feel like they are ready to cope with cravings on their own, there are a few techniques to try: 

• Distraction, or doing something else that gets the mind off of the craving. Distractions are generally physical activities, like going for a walk, cleaning or relaxation exercises. Making a list of distractions in advance can help when cravings arise.
• Talking about cravings, or sharing feelings of anxiety and vulnerability with a support system, whether that be friends, family, a sponsor, a therapist or a medical professional. Be sure to choose a person or group of individuals who will be able to handle and understand heroin cravings.
• Allowing a craving to happen, peak and pass without drug use. This practice can help people with heroin use disorders feel more in control of their cravings when they occur.
• Recalling negative consequences, or making a list (mental or physical) of the reasons a person want to live a heroin-free life (or the difficulties and problems that arose from using the drug).
• Using self-talk, or challenging thoughts like, “I’ll die if I don’t use,” and normalizing cravings with new thoughts such as, “This is an uncomfortable experience, but many people go through it, and I can deal with it, too.”

Related Topic: Relapse Prevention Plan.

Preventing Relapse Therapeutically

There are a couple of different types of therapy that are effective when dealing with heroin use disorders and cravings for heroin.

• Cognitive behavioral therapy helps people deal with stressors without using drugs, identify and change behaviors and ways of thinking that may lead to negative consequences, find their personal motivation to change and develop ways to refuse heroin in the future.
• Contingency management exchanges vouchers for negative drug tests. The vouchers can be saved and exchanged for items that promote healthy living.

Heroin withdrawal and cravings can be difficult, but with the right medication, therapeutic techniques and coping mechanisms, they can be dealt with effectively. If you feel that you have a problem with heroin use, call a free, confidential heroin hotline to get help today.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed 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