Heroin Treatment & Rehab

Aftercare programs are an important part of preventing relapse when a person has a heroin addiction. Someone with a heroin addiction needs access to resources that support sober living.
Evidence Based
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Heroin is an opioid. It is derived from morphine and used by snorting, sniffing, injecting, or smoking it. Like all opioids, heroin is highly addictive. Using it changes the brain and affects a person’s ability to function without the drug.

Spoon and needle filled with drugs

What Causes Heroin Addiction?

When someone uses an opioid, the drug binds to the brain’s receptors. There is a release of dopamine, and the person experiences a euphoric sensation. Over time, if someone continues using heroin, the brain loses its ability to function normally. The person must take larger and more frequent doses to achieve the same effect they had when they first started using. It becomes impossible for the person to experience these feelings without heroin.

Many heroin addictions begin with a person using prescription pain medications. When someone can no longer gain access to the legal opioid, they transition to heroin.

Symptoms of heroin use include:

  • Drowsiness
  • Agitation
  • Slurred speech
  • Small pupils
  • Depression
  • Memory problems
  • Needle marks
  • Runny nose
  • Nose sores
  • Constipation
  • Reduced sense of pain
  • Lapse in hygiene
  • Behavioral changes
  • Financial problems with no other explanation
  • Problems at work or school
  • A tendency to engage in risky behavior

The primary symptom of heroin abuse and addiction, or an addiction to any drug, is the inability to stop using despite the desire to do so.

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Treatment Timeline for Heroin Addiction

  1. Stage an Intervention

An intervention is a group meeting in which people who care about someone with a heroin addiction confront that person and ask him or her to seek treatment. The intervention includes people sharing how the individual’s addiction affected them and why they want them to seek help for their addiction. Most interventions also include an addiction specialist who suggests treatment options.

  1. Inpatient Treatment

Heroin addiction treatment programs almost always begin with inpatient treatment. Heroin detox is intense and is best done with medical supervision. Inpatient treatment also means the person addicted to heroin will be in a safe, drug-free environment, away from the triggers that fueled the addiction.

Heroin detox is painful and uncomfortable. It also includes intense cravings. Detox is a time when relapse risk is high. Medication eases cravings and physical withdrawal symptoms, improving the odds of successful detox and recovery. Although it’s possible to detox without medical supervision, doing so is not recommended and increases the risk of relapse.

  1. Heroin Addiction Medications (Detoxification)

Several medications treat heroin addiction. These medications ease withdrawal symptoms, reduce cravings, and prevent other side effects that increase the risk of relapse. They include:

Clonidine

This is a generic drug intended to treat high blood pressure that is also effective for treating opioid withdrawal symptoms. It’s a sedative and reduces many of the initial symptoms of heroin withdrawal.

Methadone

Methadone is a long-acting, full opioid agonist. It treats severe pain but is safer than heroin because there is no overdose risk. One approach to heroin treatment is to switch someone from heroin to methadone to lessen withdrawal symptoms and decrease cravings for heroin. Methadone doses are gradually reduced until a person is drug-free.

Buprenorphine

Buprenorphine is a partial opioid agonist. It blocks receptors in the brain that would normally be triggered by heroin. It also reduces or eliminates withdrawal symptoms and cravings by tricking the brain into thinking it’s getting what it wants. 

Naltrexone

Naltrexone is an antagonist. It causes no opioid effect and blocks full agonist opioids, such as heroin.

Benefits and Drawbacks of Medication-Assisted Treatment for Heroin Addiction

Medication-Assisted Treatment (MAT) for treating heroin addiction has helped many people manage their addiction. It is effective for preventing heroin overdose and reducing the risk of relapse. But many believe it to be trading one addiction for another. 

Some 12-step groups look down on MAT because members believe those using it are not living the sober or clean lifestyle promoted by the programs. Additionally, taking just a single dose of heroin (or any opioid) during methadone treatment can result in a fatal overdose.

Despite the drawbacks, MAT offers benefits and is the preferred treatment method for many. Benefits include:

  • Creating an environment in which someone is open to behavioral treatment that aid in long-term recovery
  • Reducing drug-seeking behavior by satisfying the opiate receptors in the brain
  • Improving the retention rate in therapy which boosts the odds of lasting sobriety
  1. Behavioral Therapies

A variety of behavioral therapies help treat heroin and other opioid addictions, including:

  • Individual therapy
  • Group therapy
  • Contingency management

These approaches help someone with a heroin addiction identify his or her drug use trigger and learn to cope with them in a healthy manner. They learn new behaviors and coping skills for dealing with cravings. Therapy also helps them develop new ways of dealing with emotional discomfort that does not involve drug use.

  1.  Counseling

Counseling is an important part of recovery. In counseling, someone can explore the reasons for drug use and better understand themselves and their addiction. Counseling for heroin addiction often includes family therapy, which helps loved ones learn to support a successful recovery.

  1. Aftercare Programs

Aftercare programs are an important part of preventing relapse when a person has a heroin addiction. Most treatment centers and programs begin exploring options for aftercare from the beginning of recovery. Someone with a heroin addiction needs access to resources that support sober living.

Some of the things included in aftercare programs include:

  • Attendance at support groups, including Narcotics Anonymous or SMART Recovery
  • Identifying a sponsor and maintaining ongoing communication
  • Avoiding places where heroin use is common
  • Ending relationships with people who are still using heroin
  • Changing people, places, emotions, and thoughts
  • Practicing the coping skills learned in therapy
  • Discussing with family and friends what is needed from them to maintain sobriety
  • Adhering to continuing care plans, including therapy appointments

Resources

Herndon, Jaime. “Heroin Addiction: What You Should Know.” Healthline, Healthline Media, 24 July 2018, www.healthline.com/health/heroin-addiction.

Walsh, Lynne. “Medication and Counseling Treatment | SAMHSA - Substance Abuse and Mental Health Services Administration.” Samhsa.Gov, 15 June 2015, www.samhsa.gov/medication-assisted-treatment/treatment.

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Updated on: June 24, 2020
Author
Michael Bayba
About
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Medically Reviewed: May 29, 2020
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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