Our programs
Heroin Detox Centers
Heroin detox in Austin and Houston: buprenorphine started early, comfort medication, nursing around the clock, and treatment arranged before discharge.
Admissions answered 24 hours a day · Most major insurance accepted
Includes reviews of Flourishing Foundations Recovery, now part of Briarwood
The short answer
Heroin withdrawal begins 6 to 12 hours after the last dose with nausea, cramps, sweating, chills and muscle and bone aches. Symptoms peak between day one and day three and are usually subsiding by day five to seven, though some can persist for weeks or months if left untreated. Most detox programs here run 5 to 7 days.
If you are deciding whether to detox at home or with medical supervision, admissions can talk it through with you now on (866) 710-7710. Free, confidential, and answered around the clock.
The heroin withdrawal timeline
The record is explicit that severity varies with how long heroin was used, how it was used and how much was taken each time. This is the pattern, not a forecast.
| When | What commonly happens |
|---|---|
| 6 to 12 hours after the last dose | Mild to moderate symptoms begin — nausea, abdominal cramps, sweating, chills, vomiting, diarrhea, tremors, and muscle and bone aches. More severe symptoms may include rapid heart rate, insomnia, depression, muscle spasms, impaired breathing and extreme cravings. |
| 1 to 3 days after the last dose | Symptoms peak. How severe they get depends on how long heroin was used, how it was used, and how much was taken each time. |
| 5 to 7 days after the last dose | Symptoms should be subsiding, though some may persist for weeks or months after detox if left untreated. |
Withdrawal from alcohol and benzodiazepines can become medically dangerous. If you are unsure whether it is safe to stop on your own, call (866) 710-7710 before you do.
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Heroin withdrawal is the withdrawal people picture when they hear the word: sweating, cramps, vomiting, bone-deep aches, and a craving that makes the third day feel endless. It is not life-threatening, and that fact is the trap, because the relapse that follows an unassisted attempt often is. Most of what is sold as heroin now contains fentanyl, which changes both the withdrawal and the medication used for it. Briarwood runs medically supervised heroin detox in Austin and Houston, with buprenorphine started early and treatment arranged before you leave. This page covers what that involves.
Do I need medical detox for heroin?
You need medical detox for heroin if you are using daily and cannot stop without severe withdrawal, because the withdrawal is survivable but the overdose after a failed attempt frequently is not.
The National Library of Medicine’s guidance is that opioid withdrawal is very uncomfortable but not life threatening, and that its biggest complication is returning to use: most opioid overdose deaths occur in people who have just detoxed, because tolerance falls and a familiar dose becomes fatal. With fentanyl in most of the supply, the margin is thinner still.
Medical detox makes the withdrawal bearable with medication, watches for dehydration and the other complications that do occur, and connects the week to the treatment that lowers the risk of that first relapse. The National Institute on Drug Abuse puts it plainly: detoxification is a useful first step when it is followed by evidence-based treatment.
Source: Opiate and opioid withdrawal, MedlinePlus Medical Encyclopedia, National Library of Medicine.
What happens during heroin detox at Briarwood?
Heroin detox at Briarwood is a medical assessment on arrival, buprenorphine started once withdrawal has begun, in small incremental doses because fentanyl is usually involved, comfort medication, and nursing around the clock.
The assessment covers how much and how often, how it was used, when the last use was, what else is being taken, and medical and psychiatric history, including bloodwork. Buprenorphine, a partial opioid agonist, relieves withdrawal without the high, but its label is specific that it must be started after withdrawal has begun, and that people dependent on long-acting opioids are more susceptible to precipitated withdrawal during induction. Fentanyl behaves like a long-acting opioid after regular use because it accumulates, so Briarwood starts buprenorphine by micro-induction, in doses far smaller than the traditional start, stepped up over days.
Clonidine covers the sweating, agitation and cramping; other medication covers nausea, diarrhea and sleep. A detox counselor meets with you individually and in group, and the step after the stay is arranged from the first day. The micro-induction protocol page describes the fentanyl approach in detail.
Source: SUBOXONE (buprenorphine and naloxone) prescribing information, DailyMed, National Library of Medicine.
What are heroin withdrawal symptoms?
Heroin withdrawal symptoms begin with agitation, anxiety, muscle aches, tearing, runny nose, sweating, yawning and insomnia, then progress to abdominal cramping, diarrhea, dilated pupils, goosebumps, nausea and vomiting.
That is the National Library of Medicine’s sequence of early and late symptoms, and the timeline above sets out when each arrives. Bone and muscle pain, cold flashes and involuntary leg movements are common, and the National Institute on Drug Abuse describes the pain, diarrhea, nausea and vomiting as potentially severe. None of it is dangerous in a healthy adult, but vomiting and diarrhea together cause dehydration, which nursing watches for and treats. The intensity, and the certainty that one dose would end it, is what defeats people at home.
Which medications are used in heroin detox?
Heroin detox uses buprenorphine to relieve withdrawal, clonidine and other comfort medication for what it does not cover, and, after the system is clear, naltrexone or continued buprenorphine to protect against relapse.
The National Institute on Drug Abuse’s account of heroin treatment names the medications: buprenorphine, a partial agonist that relieves cravings without the high; methadone, a full agonist dispensed through licensed programs; naltrexone, an opioid blocker, including the monthly injection approved to prevent relapse after detoxification; and lofexidine, a non-opioid medicine approved to reduce withdrawal symptoms. Briarwood’s detox centers on buprenorphine with comfort medication, and arranges the continuation, buprenorphine with an outpatient prescriber or a first naltrexone dose once the system is clear, before discharge. What Briarwood does not do is anesthesia-assisted rapid detox, for the reasons on the rapid detox explainer.
Source: What are the treatments for heroin use disorder?, Heroin Research Report, National Institute on Drug Abuse.
How does fentanyl change heroin detox?
Fentanyl changes heroin detox because it clears slowly and accumulates, so withdrawal can start later and last longer, and buprenorphine has to be started in very small doses to avoid precipitating it.
Most people who arrive for heroin detox have been using fentanyl, whether they knew it or not, and the assessment assumes so until a test says otherwise. The practical differences are the ones above: a micro-induction rather than a standard buprenorphine start, a stay that may run past the classic five to seven days, and a lower overdose margin afterward. The opioid detox page covers the fentanyl approach for prescription opioids and pressed pills, which is the same approach.
How long does heroin detox take?
Heroin detox at Briarwood usually takes five to seven days, and longer when fentanyl is involved, because fentanyl withdrawal starts later and lasts longer than the classic heroin timeline.
The length is set after the medical assessment, from how much was used, for how long, whether fentanyl is present, and how the first doses of buprenorphine are tolerated. Federal guidance gives the acute phase as four to ten days for most opioids. Insurance typically covers medically necessary detox; the self-pay figures and how the insured figure is worked out are on how much detox costs.
What happens after heroin detox?
After heroin detox comes treatment for the opioid use disorder itself, arranged before discharge, and for most people that means continuing medication, because detox alone leaves the risk of overdose at its highest.
The protection against the overdose that follows detox is treatment that continues past the week, and for heroin that usually means medication: buprenorphine continued from detox, or naltrexone started once the system is clear, alongside residential treatment, an intensive outpatient program or sober living. The National Institute on Drug Abuse’s finding is that integrating medication with behavioral treatment is the most effective approach for many people. Briarwood arranges that step before you leave, including the prescriber who will continue the medication, and the what comes after detox page lays the options out. Everyone leaving heroin detox should leave with naloxone and know how to use it.
Straight answers
Common questions
How long does heroin withdrawal last?
It begins 6 to 12 hours after the last dose, peaks between day one and day three, and is usually subsiding by day five to seven. Some symptoms can persist for weeks or months afterward if they are left untreated.
What are heroin withdrawal symptoms?
Agitation, anxiety, teary eyes, runny nose, yawning, diarrhea, dilated pupils, goosebumps, insomnia, nausea and vomiting, muscle spasms, pain in the bones, muscles and abdomen, sweating, shakiness and strong cravings. The record is direct that these can be very severe and that detoxing without medical supervision can be dangerous.
How long does heroin detox take at Briarwood?
Most detox programs here take 5 to 7 days, depending on individual circumstances. A physical evaluation is what makes a more precise answer possible.
Is heroin withdrawal dangerous?
The withdrawal itself is severe but not life-threatening. The danger is the overdose that follows a relapse, because tolerance drops during detox and a familiar dose becomes fatal, especially with fentanyl in the supply.
Does Briarwood use Suboxone for heroin detox?
Yes. Buprenorphine is started once withdrawal has begun, by micro-induction when fentanyl is involved, and can be continued as ongoing treatment after discharge with an outpatient prescriber.
What if the heroin was actually fentanyl?
It usually is, and the assessment assumes so. Fentanyl withdrawal starts later and lasts longer, buprenorphine is started in very small doses to avoid precipitating it, and the stay may run past seven days.
Do you offer rapid detox under anesthesia for heroin?
No. The CDC documented deaths and hospitalizations from anesthesia-assisted rapid detox with no better symptom relief than standard methods. Briarwood uses medication and supervision over several days instead.
Where does Briarwood do heroin detox?
Inpatient heroin detox in Austin and Houston, and outpatient detox with scheduled medical visits in San Antonio for people whose situation allows it. Admissions is answered around the clock.
Before you arrive: what to expect from our detox covers the medical assessment, how long a stay usually runs, the privacy options and the rooms themselves.
Coverage
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