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Heroin Detox Medications & Treatment Options

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heroin on tableDerived from morphine, heroin is an addictive and dangerous opioid drug. The number of people who use heroin has been on the rise since 2007. According to the most recent statistics provided by the National Institute on Drug Abuse (NIDA), nearly 669,000 people reported having used heroin in 2012, 156,000 of whom were first-time users 1.

Chronic heroin abuse can lead to significant chemical adaptations in the brain that accompany the development of physiological dependence. Dependence means that your body has become accustomed to the presence of heroin and without the opioid in the system, unpleasant withdrawal symptoms typically emerge. Heroin withdrawal symptoms can be so distressing that a user may relapse in order to alleviate the symptoms.

Participating in a drug detox program can help you begin your journey to sobriety and help you better cope with heroin withdrawal symptoms. Clinical evidence shows that people who complete a detox program and receive long-term maintenance with opioid detox medications are more likely to stay abstinent for longer periods of time 3.

Heroin detox medications, such as methadone and buprenorphine, can help alleviate cravings, may prevent relapse, and can help manage withdrawal symptoms in people who have a heroin addiction.

This article will cover the following information:

  • Detox medications used.
  • Types of detox programs.
  • Benefits of medically assisted detox.
  • Heroin abuse treatment.
  • How to find a detox or recovery program.

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There are two primary types of drug detoxification programs: rapid detox, which takes a fast medical approach to the detoxification process, and tapering off, which requires a longer length of time to complete.
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Medications Used During Heroin Detox

Although often uncomfortable and painful, heroin withdrawal symptoms are not usually life-threatening. However, seeking professional drug detox treatment can be crucial, since opioid withdrawal syndrome can lead to a wide range of complications, including dehydration, electrolyte imbalances, and even lung infection (secondary to aspiration) 4.

To help manage withdrawal symptoms during opioid detox, you may receive different medications, such as 3,4,5:

  • Methadone: This slow-acting, opioid medication helps minimize withdrawal symptoms and alleviates cravings. It can also be used for long-term maintenance to promote abstinence.
  • Buprenorphine: This partial opioid agonist medication also reduces withdrawal symptoms and cravings. It is administered on its own (as an orally dissolving tablet—previously marketed as Subutex), or as Suboxone, a combination formula that also contains naloxone, a medication that blocks opioid effects and reduces the abuse potential.
  • Clonidine: A non-opioid medication, it is often used to reduce autonomic withdrawal symptoms, such as rapid heart rate and sweating, but adjunct medications may be necessary to treat muscle and bone pain, gastrointestinal distress, insomnia, and headache. It doesn’t have potential for abuse the way that opioid medications do.
  • Acetaminophen, aspirin, or ibuprofen: These medications can help symptoms such as headaches, bone pain, and muscle aches.
  • Diphenhydramine: You may receive this antihistamine medication to treat insomnia.

What are Types of Detox Programs Available?

hospital setting rehabYou can choose from a number of different heroin detoxification settings, each of which has varying levels of care and intensity. Some of the heroin detox programs you might consider include:

  • Inpatient Detox Facility: Inpatient detox is the preferred setting for treating opioid withdrawal syndrome, according to the Substance Abuse and Mental Health Services Administration (SAMHSA) 5. You receive 24/7 monitoring and support, medical supervision, and rehabilitative treatments.
  • Hospital Setting: You can enter detoxification treatment in the controlled environment of a hospital as an inpatient, meaning that you remain at the hospital for a certain period of time, or as an outpatient, meaning that you travel to the hospital on a daily basis to receive treatment.
  • Outpatient Detox Facility: You travel each day to the program to receive care, support, and maintenance medications, such as methadone.
  • Outpatient Detox at a Doctor’s Office: You receive heroin withdrawal medication and support on a scheduled basis at a physician’s office. This option is usually best suited for those who have an appropriate and positive level of external social support 5.

The Benefits of Medically-Assisted Detox

Detoxing on your own at home can be slow, difficult, and isn’t usually advisable for people struggling with significant heroin addictions. According to SAMHSA, medically assisted detox facilities are the most beneficial settings for the treatment of opioid withdrawal symptoms. Attempting detox without medication may result in significant suffering in people who already have a low tolerance for pain 5.

Drug detox serves as a vital, early step on your road to recovery. Some of the benefits of medically assisted detox include:

  • Monitoring and care from medical and mental health professionals.
  • A controlled and safe environment free of temptations.
  • A reduced risk of relapse.
  • Assistance and treatment of psychological issues.
  • A reduction in the intensity of withdrawal symptoms.
  • A significant alleviation of heroin cravings.
  • Fostering transition into substance abuse treatment.

What the Best Treatment for Heroin Addiction?

Keep in mind that while detox is the first step in a comprehensive heroin addiction treatment plan, it doesn’t address the underlying issues associated with heroin abuse and addiction. After you complete heroin detox, it can be extremely beneficial to enter a professional opioid abuse treatment program to help facilitate long-term sobriety. Most opioid abuse treatment programs rely on a combination of medication management and behavioral therapies. This combination has been found to be the most effective treatment approach for decreasing drug use and preventing relapse in heroin users 6. Professional opioid addiction treatment provides you with healthy coping strategies, sober social skills, and relapse prevention skills to help you stay clean and sober.

Some of the common treatment programs you might choose from include:

  • Inpatient: You reside at a residential facility for several weeks to several months, receiving 24/7 care and support.
  • Outpatient: You live at home and travel to an outpatient treatment program one to several times per week.
  • Luxury: You live in accommodations that might resemble a 5-star resort, participating in treatment and having access to luxurious perks, such as spa treatments and gourmet meals.
  • Executive: Designed for busy professionals, you participate in treatment while still being able to work and, in some cases, travel for work purposes.
  • Holistic: These programs offer a wide range of treatments that focus on healing the mind, body, and spirit.
  • 12-step: Based on the 12 steps of recovery developed by Alcoholics Anonymous, 12-step recovery programs like Narcotics Anonymous help you stay clean and sober through support from the group and working the steps with the assistance of a sponsor.
  • Non-12-step: People who would prefer an alternative to the 12-step approach may consider non-12-step programs, such as SMART Recovery, which rely on peer support and utilize evidence-based practices.

Sources

  1. National Institute on Drug Abuse. (2014). What is the Scope of Heroin Use in the United States?
  2. National Institute on Drug Abuse. (2007). The Neurobiology of Drug Addiction: 6: Definition of Tolerance.
  3. Kleber, H. (2007). Pharmacologic Treatments for Opioid Dependence: Detoxification and Maintenance Options. Dialogues in Clinical Neuroscience, 9 (4), 455–470.
  4. U.S. National Library of Medicine. (2016). MedlinePlus, Opiate and Opioid Withdrawal.
  5. Substance Abuse and Mental Health Services Administration. (2013). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol, TIP 45. Rockville, M.D.: Substance Abuse and Mental Health Services Administration.
  6. National Institute on Drug Abuse. (2014). What Are the Treatments for Heroin Addiction?

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