Heroin Treatment

Detox, Withdrawal and Recovery

Seeking Help for Heroin Addiction


Heroin abuse has become rampant in communities across the United States. What can start off as an addiction to prescription painkillers can quickly morph into heroin addiction. Heroin use is responsible not only for an unprecedented number of overdoses and fatalities in recent years, it is also responsible for dividing families and harming communities.

Heroin addiction usually happens quickly an even those who attempt to maintain their families, homes, cars, and jobs are not able to keep it up for long. Heroin is an extremely hard addiction to beat and the rate of relapse is high but there is hope and many individuals have been able to achieve and maintain lasting sobriety. If you have a loved one suffering from heroin addiction, you may wonder what you can do to help them seek the help they need and the key is doing things that are within your control to help while understanding the nature of addiction as to avoid enabling and codependent behavior that makes the addiction and recovery process more difficult. If you or someone you know is suffering from heroin addiction, you may wonder what can be done to treat the addiction and regain some semblance of normalcy.

For the friends and family of an addicted person, talking to the person about their drug use is an important first step but is often met with resistance. For this reason, some may try to avoid having this conversation for fear of upsetting the person, but it is a conversation that needs to happen. Even if you are unsure of what their reaction will be, it is important to remember that their healing will depend on access to treatment and the love and support of family, friends, therapists, and community organizations.

There is no cure for heroin addiction but people addicted to heroin can recover and live productive, sober lives with the right mindset, support system, and treatment program. In supporting a person addicted to heroin, learning about the recovery process is key to understanding what it will take to make changes and prevent relapse.

Sometimes, family members will be inclined to ignore the addiction of a loved one in hopes that they will ‘figure things out on their own’ or that there is nothing they can do that will change things. This is not the case and the input of caring loved ones is key in helping an addicted individual seek the treatment they need. One of the best ways to assist an addicted loved one is to seek education on the topic of addiction. Learning as much as possible about how addiction starts, the common signs of use, side effects, as well as recovery options can arm concerned loved ones with information essential to coordinating treatment.

Talking to an addicted individual alone can be daunting and many people are intimidated by the thought of having a candid conversation about addiction. Instead of talking to the person alone, an intervention is an approach many people feel more comfortable with. Though it is not easy either, holding an intervention allows family members to coordinate their efforts to help their loved one and airing concerns for the person’s health and safety can have a greater impact if more people get together to say the same things.

In seeking help for someone addicted to heroin, going it alone is rarely a good idea. There is a genuine need for professional, medical detox and ongoing professional rehab services are necessary for long-term sobriety. There are a plethora of treatment providers specializing in dealing with opioid addiction. Facilities can range from intensive, months-long inpatient rehabilitation programs to outpatient rehabilitation progress, to hybrids of the two. Finding a treatment provider will be a highly individualized choice that will depend on several factors.

 

The Importance of a Strong Support System


Recovering from heroin addiction is very difficult but it is almost impossible to do it alone, which is why a strong support system is such an important part of recovery. A support system is a network of individuals and organizations that come together for a common goal – to support an individual battling heroin addiction in their desire for sobriety. Ideally, the persons and agencies in a support network will be there to listen and provide emotional support during difficult parts of the recovery process. In many treatment models, the support network is there to facilitate recovery by making others aware of the person’s addiction. This can result in uncomfortable conversations, but it must be done for the purpose of preventing relapse and the discouragement of enabling behavior.

Enabling occurs when a person is aware of another’s addiction and consistently does things that perpetuate their addiction. Often times, family members and friends know of a person’s addiction but feel that they can do things to help. However, enabling behavior only serves to worsen that person’s addiction. One of the most common forms of enabling is giving the addicted person money to support their habit. The enabling person may be sympathetic to them or might believe that if they do not give them the money, the addicted individual may resort to something illegal or dangerous to obtain the money.


 

Those who continuously help addicts are often scared of what will happen if they tell the person ‘no’.
 


Other forms of enabling include allowing a person to make promises “this one last time,” only for them to break the promise. An enabler will usually give an addicted person several chances with no consequences if the person does not keep their word. Sometimes an enabler will repeatedly make excuses or ‘cover for’ an addict to help them hide their addiction and may even bail the person out of jail over and over again. Taking over the addicted person’s responsibilities is another way in which people enable them. From taking care of their children to paying their bills to completing their household chores, doing things the addicted person is supposed to be doing only makes matters worse. Despite the fact that many enablers think they are helping, this behavior only serves to lengthen the recovery process for the addicted individual.

Another more indirect form of enabling is codependency, which is defined as an addiction in and of itself where the addicted individual manipulates the ‘helper’ in order to fuel their addiction.  When a person is dealing with addiction, they often behave very differently from their sober self and this obvious change can prompt family members to help in any way they can. The tactics that an addict uses to manipulate friends and family encourage codependency and prolongs their addiction.

Those who continuously help addicts are often scared of what will happen if they tell the person no. They may believe that the person will no longer speak to them or will punish them in some other way if their demands are not met. When an enabler continues to help an addict based on fear or threats, they are considered codependent. Codependent friends and family members who help an addict with no boundaries or consequences perpetuate a cycle of addiction an enabling that can be hard to break. The addicted person knows that there are no boundaries and that if they are in trouble the ‘helper’ will step in. Most of the time, addicts are well aware of how they are manipulating others and the power that threats have over ‘helpers.’  Codependency is often rooted in guilt and the ‘helper’ believes that if something happens to the addicted individual it will be their fault. Codependency is one of the barriers to an addict’s recovery and sometimes it requires treatment as well. Codependent individuals can suffer adverse mental and physical symptoms, including, but not limited to, high blood pressure, chronic stress, and heart problems.

 

The Heroin Detox Process


Physical dependence typically happens after a person has been using heroin for a certain period of time and their body becomes adapts to the drug and its associated effects. One of the ways to identify a person with a physical dependence on heroin is they will begin to require higher doses to achieve the desired gratifying effects.
With physical dependence comes inevitable withdrawal symptoms, which most users go to great lengths to avoid. Physical symptoms associated with heroin withdrawals are often painful and debilitating and can cause some users to continue abusing the drug for the sole purpose of avoiding withdrawal symptoms. Sometimes referred to as being “dope sick”, heroin withdrawal is marked by nausea, vomiting, agitation, muscle aches, sweating, diarrhea, and abdominal cramping, among others. The timeline line from last use to when withdrawal symptoms set in can vary from person to person, as can the severity of withdrawal symptoms.

When a person uses heroin, its effects are felt rather quickly and it typically will take the body anywhere from 5 to 7 days to eliminate all traces of the drug. This is known as the detox period and can last as long as 10 days for moderate to heavy heroin users. The withdrawal symptoms can be extremely difficult to endure, which is why it is suggested that users who wish to safely detox do so in a professional setting.

So what typically happens during heroin detox? In most cases, medically-supervised heroin detox involves a gradual withdrawal process intended to keep the individual as comfortable as possible as the drug is filtered out of their body. In addition, a supervised detox process ensures that the person is monitored for any complications that could arise during the withdrawal process, which significantly reduces the likelihood of relapse.

Supervised detoxification may also include the administration of drugs such as Suboxone. This opioid treatment option is regarded as one of the most successful ways to treat heroin addiction and assist in detoxification. Suboxone is a medication that has been used to successfully treat opioid dependence. Comprised of Buprenorphine and naloxone, Suboxone is classified as a partial opioid agonist. This mean Suboxone is capable of producing similar effects as heroin but in a much milder form. Suboxone works by accessing the brain’s receptors in the same way as heroin and other opioids but without the same pronounced effect. It is very difficult to achieve a “high” from Suboxone, which makes it one of the best for treating opioid addiction.

Generally, those who opt to go through a medical rehabilitation program receive medically-supervised detox combined with intensive therapy. Though there are different medications available to assist in opioid detox and long-term maintenance, Suboxone is one of the most effective medical options. In a medical detox program, a person receiving treatment services will typically receive medication does on an outpatient basis or via prescription. The FDA has approved Suboxone as a viable treatment option for opioid addiction withdrawal as well as ongoing maintenance therapy.

Facts About Suboxone Treatment for Heroin

Suboxone works by suppressing the craving for opioids, making it ideal for preventing relapse. Data shows that use of Suboxone in managing withdrawal can increase long-term sobriety by as much as 60 percent.

Though the use of Suboxone in a medically-centered opioid withdrawal regimen has several benefits, there are also some downsides to using medication to treat opioid addiction. Even though Suboxone less powerful than heroin and prescription opioid painkillers, it still has the potential to be abused or used for purposes other than originally intended. Suboxone is sometimes bought and sold on the street as a supplement to a user’s opioid addiction. Those who purchase Suboxone off the street use it as a way to mitigate withdrawal symptoms between opioid doses. Others buy Suboxone to engage in what’s referred to as “chipping,” a slang term for behavior that is more recreational in nature and is not classified as a clinical addiction. Chipping is a dangerous activity as it can result in physical and psychological addiction to Suboxone.

While Suboxone is a highly effective detox treatment option, some individuals may opt to avoid medication altogether. The decision to forgo medication-based detox is an individual one, but assistance from a professional can help make the best choice. In either case, detox followed by professional counseling services, individual therapy, and group therapy have higher rates of success and are critical in helping recovering heroin users achieve long-term sobriety.

 

Signs of Heroin Withdrawal


Heroin withdrawal is the process by which the drug leaves the body. This is not an instant process and it can take several days for the drug to leave the body entirely. Most opioid withdrawal symptoms are physical in nature, though people will also experience psychological withdrawal symptoms as well. Heroin withdrawal can be described in two distinct phases: early withdrawal and late withdrawal.

Early withdrawal is sometimes referred to as the first phase of heroin withdrawal. In this phase, individuals may experience a runny nose, agitation, insomnia, and sweating. These symptoms typically occur several hours after the last dose of the drug.

The second or late phase of withdrawal is certainly uncomfortable but it is more tolerable than the early phase. Common symptoms in the late phase include loss of appetite, diarrhea, and vomiting – all of which can lead to dehydration. Other late-stage withdrawal symptoms include chills, abdominal pain, and dilated pupils.

Phases of Heroin Withdrawal

There is some debate as to whether a third phase of heroin withdrawal exists, as the symptoms – nausea, insomnia, and anxiety – are identical to symptoms experienced in the first two withdrawal phases. The third phase is also marked by cravings for the drug, which can sometimes be very intense.

There are some concerns about using a medical detox approach when it comes to treating heroin addiction. Some believe that using medications such as Suboxone do nothing to address the addiction but are instead just a Band-Aid approach that involves substituting one drug for another. Though in some sense, medication does serve as a substitute for heroin or other addictive opioid-based substances, it is considered one for the most effective forms of treatment. Using medication to manage opioid addiction effectively manages cravings and can assist in helping maintain an individual’s’ focus on recovery and ongoing sobriety.


 

Medical detox is one of the most effective ways to treat heroin addiction.
 


 

Medical vs Non-Medical Detox


Ideally, medical detox works best for individuals who are currently addicted to a substance with dangerous and/or painful withdrawal symptoms, has proper community and family support participate in a medical detox program and has a sincere desire to recover from their addiction. The medical detox model is not only used for treating opioid addiction. It has also been proven to be an effective treatment model for alcohol and benzodiazepine detox.

In addition to medical detox, there are several other approaches to treating heroin addiction. One such option is what is called ‘blending.’ An initiative of the National Institute on Drug Abuse (NIDA), the Blending Initiative is a collaboration between SAMHSA and national Addiction Technology Transfer Centers (ATTCs) that seeks to share knowledge and best practices among treatment team members. The Blending initiative also encompasses strategies for addressing opioid dependence, rapid HIV testing in community rehabilitation facilities along with motivational interviewing techniques with the goal of improving treatment programs across the country.

 

Non-Medical Detox

Pros:

  • Eliminates substances from the body without medication
  • May include alternative therapies such as herbal remedies, hypnosis, or acupuncture
  • Can be more cost effective than medical detox
  • Can be done without residential treatment

Cons:

  • One of the least effective detox methods, statistically
  • Higher incidence of relapse compared to medical detox
  • Managing withdrawal symptoms may be extremely difficult
  • Lack of professional monitoring can lead to more complications

 

Medical Detox

Pros:

  • Better relief of withdrawal symptoms
  • When proper protocol is followed, will not form a new addiction
  • Helps recovering individuals manage cravings and detox symptoms
  • One of the best choices for opioid addiction according to the Substance Abuse and Mental Health Services Administration (SAMHSA)

Cons:

  • Medications used are potentially addictive
  • Usually offered as an inpatient program
  • Outpatient programs may require daily clinic visits
  • Medication is not well-tolerated by everyone

 

Other Treatment Options


Medical detox is a preferred treatment option, but it is not right for everyone. In addition to medical and non-medical detox, behavioral therapy has been shown to be an effective treatment model for heroin addiction. In addition, behavioral therapy is typically used in tandem with other treatment modalities in order to give the individual the coping skills needed to navigate their sobriety. Examples of behavioral therapy include positive reinforcement, which incentivizes individuals who are able to remain drug-free. Some rehabilitation programs offer dual diagnosis support, which assists individuals with managing drug addiction along with co-occurring medical disorders. Group therapy is also used in rehab facilities to encourage supportive relationships, and offer a non-judgemental environment in which individuals can freely discuss their addiction, past experiences, and achieving sobriety and its associated challenges.


 

Ceasing the use of heroin is not easy, but it is definitely possible.
 


 

The Path to Sobriety


Recovery from addiction is entirely possible for any person but it starts with a strong willingness to change. Effective treatment combined with a supportive and safe environment is necessary to successfully beat addiction. Though the process of detox and recovery happens over several months, the process of remaining sober is lifelong.

Active sobriety requires a person to completely change how they look at life. This means working to change behaviors circumstances that contributed to drug use and addiction as well as re-evaluating relationships. In the case of the latter, it may be helpful to change one’s environment if it could negatively impact the desire to live a sober life.

Recovery should also be accompanied by supportive friends, family members, and others living a sober lifestyle. Ongoing counseling is also recommended in order to cope with challenges, lingering symptoms, and any other issues that are pertinent to recovery. Additionally, the post-addiction period may consist of services like medical support, dual-diagnosis programs, group counseling, referrals to community organizations, and a host of other helpful resources. The goal of treatment is to eliminate as many barriers to sobriety as possible.

Life After Heroin Addiction


Recovery after a long-term heroin addiction is not easy but it is within reach with a high level of motivation combined with an intensive treatment plan. The majority of opioid-specific rehabilitation plans last for 30 to 60 days and this can prove to be a sufficient program length for a lot of individuals. However, those who have a history of relapse or have other risk factors such as a history of suicide or violent tendencies, a lengthier, more intense treatment plan may be required to see lasting change.
Once a treatment plan is completed, the work at maintaining recovery does not stop. The likelihood of long-term sobriety requires a daily commitment to maintaining a drug-free life. Aftercare is of extreme importance because the stress of everyday life does not disappear once sober and aftercare can give recovering individuals the skills needed to effectively cope with life’s challenges. Follow-up therapy sessions, 12-step meetings, maintenance treatments, and post-recovery treatment plans are all useful tools in maintaining sobriety in the long term.

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