Overcoming Heroin Addiction
When considering your treatment options for heroin addiction, you have three main options.
These treatment options include:
- Inpatient treatment
- Outpatient programs
Self-treatment is rarely successful—especially for such an addictive opiate as heroin.
Inpatient treatment is often the most successful choice because it provides the highest level of care and most structure. Inpatient rehab may include a residential treatment program or, in cases where other health issues have occurred, hospitalization.
Outpatient care options include partial hospitalization programs as well as intensive outpatient programs. These outpatient programs provide structure and support without requiring the patient to live at a facility for 30 days or more.
Pursuing Treatment for Heroin Addiction
Ultimately, the type of treatment that you choose for yourself (or for your loved one) may depend on the level of heroin abuse and how long the drug use has been going on. A doctor or other medical professional can help you develop a treatment plan that is unique to your needs, and this plan will include recommendations for the type of rehab program that would be best.
Having a support system can make this transition easier. A person seeking substance abuse treatment should not make any decisions about a heroin addiction treatment program until they speak to a doctor or counselor. Advice from a medical professional is crucial when deciding on individualized care.
Heroin Detox and Withdrawal
Detoxification, or detox, is the body’s natural process of eliminating chemicals or drugs from its system, such as heroin. When a person stops using heroin, they will very likely begin to experience withdrawals as the body continues to detoxify itself.
Withdrawals occur because the brain’s opiate receptors are no longer receiving the heroin that it has become used to. As a result, the body can experience uncomfortable or even painful symptoms as the brain readjusts to the chemical change.
Heroin withdrawal symptoms heroin addiction can include:
- Cold sweat
- Depression and anxiety
- Loss of appetite
- Unstable moods
- Intense cravings (for heroin)
- Muscle cramping
- Nausea and vomiting
Withdrawal from heroin and other opiates is not always dangerous, but in some instances has been known to cause some serious or life-threatening side effects.
Checking in to an inpatient or outpatient rehab facility before going through detox is highly recommended for heroin. While heroin withdrawals are not necessarily fatal, as mentioned above, these side effects can be very uncomfortable and cause the individual to return to heroin use to make the symptoms subside.
By seeking professional care through medical detox, recovering heroin users will be monitored throughout the detox and withdrawal process. Sometimes prescription medication will be provided to help alleviate cravings and other withdrawal discomforts, making it easier for the person to get through the process.
While medical detox is much more effective than quitting “cold turkey” without medical support, it is still just a short-term solution. Seeking additional treatment after detox is strongly recommended to provide long-term success and avoid future relapse.
Both inpatient and outpatient facilities may provide medication to assist recovering addicts with their withdrawal symptoms. These medications are designed to decrease withdrawal symptoms, prevent relapse, and provide stabilization to the patient.
These opioid medications can be broken into two categories: full or partial agonists, and antagonists
- Agonists and partial agonists: By binding the same opioid receptors in the brain that are triggered when heroin is ingested, these types of drugs reduce cravings.
- Antagonists: This type of medication blocks heroin’s effects; if the user were to ingest heroin after taking an antagonist, they will not be able to feel the same euphoric effects as before.
Medication Used During Heroin Rehab
The US Food and Drug Administration has approved a few specific prescription medications for use in treating opiate substance use disorder, which includes the treatment of heroin addiction.
Methadone is a slow-acting opioid agonist that blocks the body from achieving a satisfying high from heroin and prevents withdrawal symptoms. Methadone may appear in liquid, powder, or diskette form. Methadone prescriptions are highly customizable and doses can be tailored to each specific patient.
Methadone is becoming less popular in recent years, as additional studies show that other medication options—such as buprenorphine—are yielding better results from patients (e.g. fewer relapses, more long-term recovery).
Methadone can only be prescribed through an approved outpatient treatment program. Unfortunately, methadone does present a possibility of developing an addiction to the methadone itself and is therefore highly regulated.
Buprenorphine is a partial opioid agonist that relieves cravings without producing the “high” or side effects. If a person addicted to heroin were to inject themselves while taking a variety of this medication they would feel withdrawal symptoms and discomfort instead of the pleasurable feelings associated with the drug.
Buprenorphine is available via prescription and, unlike methadone, can be taken at home or without special supervision.
Some buprenorphine prescriptions may contain other medications, such as naloxone (Suboxone®) to provide additional relief and support for heroin withdrawal and addiction recovery.
Naltrexone is an opioid antagonist, which means that it acts somewhat differently than methadone or buprenorphine.
Naltrexone blocks the effects of opioids completely and will not result in addiction or physical dependence. That means if someone were to take heroin after consuming naltrexone, they would experience zero effects from the opiate.
Behavioral Health and Heroin Addiction Recovery
The most successful heroin addiction recoveries use a combination of medication-assisted treatment along with individual and group therapy to create the best option for the patient.
Mental health is a major focus of any rehab center, both inpatient and outpatient, in order to provide adequate care for the whole person.
In order to keep a patient on the path to recovery, therapy has to address every aspect of addiction.
The main aspects of addiction include:
- Physical dependence
- Psychological dependence
- Risk Factors
Once a treatment option has been chosen, staying on track is crucial. Relying on prescribed treatments and a good support system (group therapy, family members, or health professionals) will help curb any cravings.
Heroin Addiction Behavioral Programs
Therapy for heroin addiction aims to address the mental and emotional sides of addiction and correct them. Addiction therapy is provided through both individual therapy and group therapy sessions.
Using a trained mental health counselor, psychotherapy addresses the external and internal reasons why people turn to heroin. Whether it is outside influences or feelings of helplessness, psychotherapy uses “talk therapy” to explore the behaviors and feelings of someone addicted to heroin. Psychotherapy sessions usually occur one-on-one between a therapist and the patient.
Psychotherapy is a popular and effective treatment but it is most effective when used in congruence with medication and group therapy/contingency management. There are many different types of psychotherapy that can aid those recovering from addiction including cognitive-behavioral therapy, exposure therapy, and psychodynamic psychotherapy.
Cognitive-Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is a type of psychotherapy that focuses on identifying negative thought patterns, then working to “rewire” the brain’s thought patterns into ones that are more positive and healthy.
Therapists and patients have open discussions that will identify the unhealthy patterns of thought that lead to addiction and how these self-destructive behaviors can be reconstructed. Sometimes, a form of homework will be provided to help the patient do additional mental health work outside of the individual therapy sessions.
During therapy, constructive ways to create healthier behaviors and beliefs are developed and hopefully implemented. The point is to replace thoughts that lead to low self-worth with realistic and positive expectations.
Contingency management is a type of positive reinforcement-based therapy, where participants are given tangible rewards to reinforce their progress or positive behaviors such as sobriety.
Voucher-based reinforcement is a method in which people get vouchers if they provide drug-free urine samples consistently. Vouchers can be redeemed for things like movie passes, food items, or other appropriate items.
The value of the vouchers increases as more drug-free samples are provided.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy is a modified form of cognitive-behavioral therapy with a focus on self-destructive behavior (such as substance abuse disorder.) Patients who participate in DBT will work with a therapist one-on-one or in group counseling to develop skills in mindfulness and emotional regulation.
Patients will also work on distress tolerance and developing healthier coping mechanisms, especially for triggering emotions or events where heroin abuse might have occurred in the past.
12-Step Programs for Heroin Recovery
Used widely by rehabilitation centers and support groups, 12-step therapy is an approach to substance abuse that motivates users to acknowledge their problems and join a therapy program. The most well-known user of a 12-step program is Narcotics Anonymous (NA) but it has been incorporated into many different types of in and outpatient treatments.
People recovering from heroin addiction often find solace in continuing to attend support groups and meetings. Many groups, including Narcotics Anonymous (NA), offer milestone incentives that encourage sobriety and allow manageable goals to be set.
Seeking Help for Yourself or a Loved One?
You can find heroin treatment recovery centers near you by speaking with a medical professional or counselor, calling a recovery hotline, or by visiting the SAMHSA treatment center locator.
Frequently Asked Questions about Heroin Rehab
Can a person stop doing heroin without rehab?
While it might be possible for heroin abusers to stop their use early on, heroin is extremely addictive. Stopping heroin use can be difficult at any stage of heroin abuse, but particularly so without professional support.
How successful is heroin rehab?
Heroin rehab can be successful, but it is important to keep in mind that addiction is a chronic disease. Approximately two-thirds of individuals experience a relapse with heroin but that does not mean the treatment is not working.
With solid support and continued efforts toward sobriety, many people are able to quit heroin use for good.
How do you prevent a relapse after heroin rehab?
There are many tools that can help a recovering addict avoid relapse after going to rehab for heroin abuse. During rehab, the patient will have worked with a therapist both individually and in a group setting to identify negative thought patterns and restructure their thinking. They will also have learned additional skills to help them with relapse prevention.
Some recovering addicts continue to attend an intensive outpatient program (IOP) for a year or two after their initial rehab treatment. Through IOP the recovering addict will continue to receive support through professionals and peers in the recovery program.
Additionally, medication-assisted treatment may offer additional support in helping the individual to avoid relapse. MAT medications are designed to decrease or eliminate the positive effects of heroin, making relapse much less desirable.
How long does heroin withdrawal last?
Heroin withdrawal may vary between individuals based on the amount of heroin that was being used and how long it was being used for. The longer someone has used heroin, the more lengthy their withdrawal symptoms may go on.
However, the average length of time for the initial withdrawal symptoms is about one week from the point of the last dose.
How can you stop someone from using heroin?
Generally speaking, YOU can’t. Ideally, the person should be ready to admit they have a problem and willing to make a change in their lives.
If a person addicted to heroin will not willingly admit themselves into rehab, staging an intervention can be a supportive method of encouragement. To learn how to stage an intervention, visit the National Council on Alcoholism and Drug Dependence website for tips and guidelines.