Just  12 hours after an addict takes a hit of heroin, the withdrawal symptoms begin.

They include severe cramps, insomnia, full-body muscle and bone pains, diarrhea and shivers.

“It’s like the flu — times 100,” Action Family Counseling founder Cary Quashen said.

Unless an addict takes another hit, the withdrawal symptoms often last up to two weeks, creating agony for the patient as the body craves the opiate drug.

“There is no quick fix for addiction, especially heroin,” Quashen said.

The withdrawal stage is the beginning of a lengthy treatment process just as complicated as the addiction itself. If an addict can make it past the detox phase, he or she faces a lifetime of meetings, treatments and support groups to achieve sober living after a heroin addiction.

“Getting sober is easy — you just have to change everything,” Quashen likes to say.

No simple treatment
As an attending physician at Henry Mayo Newhall Memorial Hospital’s emergency room, Dr. Bud Lawrence said he sees heroin addicts coming off the drug on a weekly basis.

“One of the things that strikes me about what I’m seeing is that before, I would see patients anywhere from 20 to 40 years old,” said Lawrence, who has been at Henry Mayo for eight of his 12 years as a doctor. “Now I’m seeing patients that are 14 to 18 (years old) or in the 20-year-old range smoking heroin.”

Since the drug can be snorted, sniffed or smoked rather than injected, identifying heroin users has become a serious challenge.

Its popularity is also due to low prices, increasing accessibility and high purity, due largely to increased heroin production in Mexico, law enforcement officials say.

Lawrence said he regularly treats patients who arrive at Henry Mayo’s emergency room either by ambulance or drop-off.

“They end up ingesting too much of the drug,” he said. Patients commonly suffer from a slow breathing rate.

“You have someone who is not getting oxygen to their brain.”

Long-term, heroin addicts can experience an infection of the heart lining and valves, infectious diseases and arthritis, authorities say.

Coming off a high
One of the first steps of treatment is ridding heroin from the patient’s body.

While heroin withdrawal isn’t considered life-threatening, it requires medical attention.

“We try to treat their symptoms and then transition to outpatient an rehab facility where they can continue to withdrawal and experience long-term success,” Lawrence said.

Withdrawal can start 12 hours after a last hit and can last a week or two, depending on how much the person has been using. Symptoms usually peak by the end of the third day.

“It can be fairly prolonged, and it is fairly uncomfortable for the patients,” Lawrence said.

A common characteristic of withdrawal is called “kicking,” in which patients lay in bed kicking their legs because their muscles are so sore, he said.

Doctors like Lawrence work to stabilize the patients by treating the withdrawal symptoms before referring them to social workers and addiction specialists to figure out a long-term treatment plan.

“I think the hardest part is to get through the first part of your withdrawal,” Lawrence said.

Kicking the habit
It’s common for heroin addicts to treat their withdrawal symptoms through opiate detox programs that involve medication.

Among the options is methadone, a legal opiate. Methadone eliminates the cravings and allows addicts to function in everyday life as they find a long-term solution to their addiction.

Other medications can include suboxone and naltrexone, which are meant to curb cravings and address withdrawal symptoms.

Most withdrawal can occur in an outpatient setting on a three-times-a-week treatment schedule. However, in severe cases the addict may be sent to a treatment facility for a 90-day inpatient detox program, Quashen said.

Through Action Family Counseling, Quashen runs the only inpatient detox program in the Santa Clarita Valley.

“A lot of times, they have to be taken out of their environment and put into a safe environment,” he said of addicts.

But specialists find that heroin addiction can’t be battled solely with medication.

“Our goal is to get them off all medication,” Quashen said. “Our goal is to get them drug-free.”

That means one-on-one therapy, group therapy and regular meetings through 12-step support organizations, such as Narcotics Anonymous. Even after a patient is considered sober, it’s common for former addicts to go to weekly treatment meetings and undergo therapy.

“We have to teach them how to feel and deal with each feeling,” Quashen said.

Relapses occur
Relapse rates are often hard to track, but relapses often occur during the treatment process.

“People relapse when they get too bored, too lonely or too miserable,” Quashen said.

When a relapse occurs, the withdrawal and treatment cycle begin again.

At treatment centers like Action, counselors will organize events and programs for patients as a way for them to find hobbies and friendships through sober living. It’s common for patients to stay at residence programs three to six months.

“They have to see life,” Quashen said. “It helps them remember where they came from. It gives them a sense of belonging.”

The key to kicking the habit is to remember that addiction is a disease and that therapy can help addicts recognize the causes and triggers of using.

“If the addict wants to get clean,” Quashen said, “then there is hope.”