Heroin Withdrawal Signs, Symptoms, Medication, and Treatment Around Nashville, Tennessee

Statistics and Information About Residential Heroin Addiction Rehab Programs in Tennessee

In Tennessee, 72 out of 297 substance use treatment centers offered non-hospital residential care in 2022, according to a SAMHSA survey. The state provides a range of treatment services, including outpatient programs, inpatient residential care, and Medication-Assisted Treatment (MAT) with buprenorphine and methadone, as reported by the Tennessee Department of Mental Health and Substance Abuse Services. 

However, there are only 22 opioid treatment programs (OTP), limiting access in rural areas. Residential rehabilitation services had the highest demand in 2022, with 134,077 bed days. Opioid Use Disorder (OUD) is the leading cause of death for those under 40 in the U.S., and Tennessee is ranked the 16th least-expensive state for residential drug rehabilitation, according to the National Center for Drug Abuse Statistics.

Methadone

Methadone is commonly used in heroin withdrawal treatment to help manage your cravings and reduce withdrawal symptoms. As a long-acting opioid, it works by binding to the same receptors in your brain that heroin does, but without producing the euphoric high. This helps you avoid the intense cravings that can trigger relapse while allowing you to focus on recovery.

Methadone is generally administered in a controlled setting, such as a clinic, as part of a comprehensive plan. It can be highly effective when it is used in combination with other treatments, like behavioral therapy for addiction. If you’re struggling with heroin addiction, methadone may be an important part of your detoxification and recovery process.

Buprenorphine (e.g., Suboxone, Subutex)

Buprenorphine, found in medications like Suboxone and Subutex, is another effective heroin withdrawal treatment. It works by partially activating opioid receptors in your brain, reducing cravings and symptoms of heroin withdrawal without causing the same high as heroin. This helps you manage the physical aspects of withdrawal while staying focused on recovery.

Suboxone, which combines buprenorphine with naloxone, also helps prevent misuse, as naloxone blocks the euphoric effects of opioids. These medications are often prescribed as part of comprehensive heroin addiction rehab programs that include therapy and other support services. Buprenorphine is typically administered in outpatient settings, offering flexibility if you don’t require inpatient detoxification. If you’re considering buprenorphine as part of your recovery, it can be important in overcoming heroin addiction.

Naltrexone (Vivitrol)

Naltrexone, sold under the name Vivitrol, is used to help manage heroin withdrawal and prevent relapse. Unlike methadone or buprenorphine, naltrexone is an opioid antagonist that works by blocking opioids’ effects on your brain. This helps reduce cravings for heroin and the risk of relapse by preventing heroin from producing any pleasurable effects if you use it.

Vivitrol is usually administered as a monthly injection, making it a convenient option for those in outpatient treatment. It’s often used after detox to help maintain sobriety and support long-term recovery. If you’re dealing with heroin addiction, naltrexone can be important to your recovery, alongside therapy and other supportive treatments.

Clonidine

Clonidine is commonly used to manage the symptoms of heroin withdrawal. It works by reducing the activity of your nervous system, which helps alleviate signs of heroin withdrawal like anxiety, agitation, and sweating. While clonidine doesn’t directly address cravings, it can significantly ease the physical discomfort as you’re coping with heroin cravings that often accompany detoxification.

This medication is often prescribed as part of a treatment plan that includes other medications and behavioral therapy. Clonidine is typically administered in an outpatient setting, but it may also be used in inpatient detox programs. If you’re going through heroin withdrawal, clonidine can help you manage side effects, making the process more manageable and helping you stay focused on your recovery.

Lofexidine (Lucemyra)

Lofexidine, brand name Lucemyra, is a medication used to treat heroin withdrawal symptoms by reducing the physical effects of withdrawal. Like clonidine, it works by calming your nervous system to help manage symptoms such as anxiety, restlessness, muscle aches, and sweating. Lofexidine is specifically designed for opioid withdrawal, offering a more targeted approach than other medications.

Unlike some other treatments, lofexidine doesn’t carry the risk of addiction or misuse, making it a safer option as you’re going through detoxification. It’s typically used in outpatient heroin treatment programs and may be prescribed alongside behavioral therapy for addiction.

Physical Symptoms

Physical heroin withdrawal symptoms can be intense and challenging to manage. As your body adjusts to the absence of heroin, you may experience various discomforts that affect your overall well-being. These symptoms can differ from person to person and may fluctuate throughout the detoxification process.

• Fatigue: Persistent tiredness or lack of energy is common during heroin withdrawal as your body adjusts to the absence of the drug. You may feel constantly drained or unable to focus.
• Muscle Pain and Cramps: Generalized body aches, tension, and cramps, especially leg cramps, can be intense. These discomforts are a hallmark of opioid withdrawal, making movement difficult.
• Sweating: Excessive sweating is common, particularly during the acute phase of withdrawal. Your body may produce an unusually high amount of sweat as it works to detoxify.
• Headaches: You may experience headaches, often tension-related or caused by changes in blood pressure as your body withdraws from heroin.
• Nausea and Vomiting: These symptoms are common in opioid withdrawal and can make it difficult for you to keep food or fluids down, contributing to dehydration and weakness.
• Diarrhea or Stomach Cramps: Gastrointestinal distress, including diarrhea and stomach cramps, is frequent in heroin withdrawal, adding to the overall discomfort.
• Tremors or Shakiness: You might experience shaky hands or an unsteady body, especially during the first few days of withdrawal as your nervous system adjusts.
• Heart Palpitations: Heroin withdrawal can cause irregular or rapid heart rate, which can feel unsettling and may lead to feelings of anxiety.
• Appetite Changes: Withdrawal can lead to a decrease in appetite, though you may experience the opposite, with an increase in hunger as your body tries to stabilize.
• Insomnia: Difficulty falling asleep or having a hard time staying asleep is common, as heroin withdrawal disrupts normal sleep patterns and causes restlessness.
• Dilated Pupils: Heroin withdrawal typically causes pupils to dilate, making them appear larger than usual.
• Runny Nose and Watery Eyes: These symptoms, similar to those seen in a cold, are common during heroin withdrawal as your body clears out the toxins.

Psychological Symptoms

Psychological symptoms of heroin withdrawal can be just as challenging as the physical ones. As your brain and body adjust to the absence of heroin, you may experience a range of emotional and mental health effects. Below are some of the common psychological symptoms of heroin withdrawal, which can affect your mood, thinking, and behavior.

• Anxiety: You may feel restless, worried, or panicked, often without any clear reason. This heightened anxiety is a common part of heroin withdrawal and can make the detoxification process feel overwhelming.
• Depression: Feelings of sadness, hopelessness, or lack of motivation are common during withdrawal. As your brain adjusts to the absence of heroin, you may struggle with low mood and a loss of interest in activities.
• Mood Swings: Heroin withdrawal can cause sudden, intense mood swings. You might feel happy one moment and irritable or upset the next, adding to the emotional challenge of recovery.
• Agitation and Irritability: It’s common to feel restless, on edge, or easily irritated. These mood changes can make it hard to stay calm and patient during the withdrawal process.
• Drug Cravings: Intense urges or cravings for heroin are a hallmark of withdrawal. These cravings can be overwhelming and may make it more difficult to stay committed to your recovery.
• Paranoia: Though more common in stimulant withdrawal, you may experience feelings of distrust or suspicion, feeling like others are watching or judging you, adding to the mental strain during withdrawal.

Cognitive Symptoms

Cognitive symptoms of heroin withdrawal affect your ability to think clearly and focus. As your brain adapts to the absence of heroin, you may experience mental fog, memory issues, and difficulties with concentration. Here are some common cognitive symptoms of heroin withdrawal that can make it hard to function normally.

• Confusion and Clouded Thinking: You may experience difficulty concentrating or making decisions, which may disorient you. This mental fog is common during heroin withdrawal and can hinder your ability to stay focused on daily tasks.
• Memory Problems: Heroin withdrawal can impair short-term memory, causing you to forget recent events or struggle with concentration. This cognitive fog can make it hard to remember important details or stay organized.
• Hallucinations: In some cases, severe heroin withdrawal can lead to visual or auditory hallucinations. While less common, these can occur, particularly if the withdrawal is intense or if co-occurring mental health issues are present.
• Poor Coordination: Heroin withdrawal can affect your motor skills, leading to difficulty with physical coordination. Tasks that normally feel easy, like walking or handling objects, might become more challenging.

Severe Symptoms (Life-Threatening in Some Cases)

Severe symptoms of heroin withdrawal can be life-threatening in certain cases. While many symptoms are manageable with proper treatment, some can escalate to dangerous levels if not addressed quickly. It’s crucial to seek professional care if you experience any severe symptoms. 

• Seizures: While rare, seizures can occur during severe heroin withdrawal. These can be life-threatening, and you may require immediate medical attention to prevent injury or complications.
• Delirium: Severe confusion, agitation, and possible hallucinations may occur in extreme heroin withdrawal cases. This can cause significant distress and should be treated by healthcare professionals to avoid further mental health complications.
• Severe Dehydration: Persistent vomiting, sweating, or diarrhea can lead to severe dehydration. This can become dangerous if left untreated, as it affects your body’s ability to function properly.
• Hypertension: Withdrawal from heroin may cause dangerously high blood pressure, especially if accompanied by anxiety or stress. This can increase the risk of heart attack or stroke and requires immediate medical management.
• Fever: A high body temperature can develop, particularly in severe heroin withdrawal or when the withdrawal process causes intense discomfort and agitation. Fever is a sign your body is struggling with the detoxification process

Statistics and Information on Heroin Addiction Withdrawal in Tennessee

• Outpatient detoxification is a safe and effective option for most patients experiencing mild to moderate withdrawal symptoms and is more cost-effective than inpatient treatment. However, inpatient detox may be required for patients with severe withdrawal histories, medical or psychiatric conditions, pregnancy, or insufficient support, as noted in an American Family Physician article co-authored by Max Bayard, M.D., an assistant professor in the Department of Family Medicine at East Tennessee State University.
• Sixty-eight substance use treatment facilities in Tennessee that were included in SAMHSA’s 2022 National Substance Use and Mental Health Services Survey provided detoxification services.
• The number of nonfatal heroin overdoses in Tennessee is rising, according to the State Department of Health, with a 13.3% increase in outpatient visits (52.1 to 58.7) and a 17.3% increase in inpatient stays (6.8 to 7.9) from 2019 to 2020. Higher rates were observed among white Tennesseans and men.
• Neonatal Abstinence Syndrome (NAS) occurs when a newborn undergoes withdrawal from substances, typically opioids like heroin, methadone, or oxycodone, used during pregnancy, as reported by the Tennessee Department of Health. During the 2021 surveillance period, 734 cases of NAS were reported, reflecting a decline in the rate of NAS per 1,000 live births.
• The University of Tennessee System reports that while various policies and practices have effectively reduced prescription opioid and heroin overdose deaths (ODD), fatalities from overdoses involving fentanyl and other synthetic opioids continue to increase, particularly since the onset of the COVID-19 pandemic.
• Withdrawal symptoms are one of the signs of Substance Use Disorder (SUD) listed in the Diagnostic and Statistical Manual of Mental Disorders, according to the Cleveland Clinic.