Treatment For Heroin Addiction

Are you looking for treatment for heroin addiction? As experienced addictions clinicians, who work in different settings, including private rehab centers, we understand how this works and what treatment you will need.

Heroin addiction, also known as opioid use disorder (OUD) is a very serious illness. It is not a choice. No one wakes up one day and decides to become a heroin addict. Addiction is borne out of pain: Raw psychological pain. It is an escape from the grim reality of your life. Unresolved childhood trauma, relationship difficulties, bereavement: It really doesn’t matter what causes it as the treatment is the same.

Treatment for heroin addiction hasn’t changed for decades: and it doesn’t need to. While there have been some developments with opioid substitute prescribing, the essence of the approach remains: Detox, therapy, relapse prevention and aftercare.

What is Heroin?

Heroin is a bi product of morphine which is derived from the Opium poppy. Typically grown in Afghanistan and countries with a similar weather environment it is used for pain control, sometimes in childbirth and often in hospices as diamorphine. Heart attack patients are given diamorphine for pain and it can also be used to treat acute breathlessness when there is fluid on the lungs.

Within a medical environment it can be given in tablet form, by injection or by infusion.

How Does Heroin Relieve Pain?

Just as with prescribed medication, alcohol and caffeine, heroin affects receptors in your brain. They do this by either opening or closing chemical channels which, in turn, exaggerate (or inhibit) naturally occurring brain chemicals to flow or slow down/stop. Some drugs/alcohol/medications partially open or close receptor sites.

Heroin affects opioid receptors as an agonist: They open up channels. This means that, when you take heroin, there is a release of naturally occurring chemicals resulting in a “feel good” rush. The problem is, if you keep taking heroin over a period of time, your brain will become used to it’s presence. This is known as tolerance. If you stop taking heroin (or reduce too quickly) the brain can not make an immediate adjustment. When this happens you will go into withdrawal.

What is Heroin Withdrawal?

When you stop taking heroin your brain will go into a state of flux. Certain neurons in your brain will go into overdrive and the resulting chemical signals cause withdrawal. Left untreated this can be fatal. Forget what you see in the movies and on TV. Going cold turkey can end your life.

The symptoms can include:

• Excessive yawning
• Uncontrollable coughing
• Persistent sneezing
• Streaming/runny nose
• Elevated blood pressure
• Dilated pupils
• Fast pulse
• Cold skin
• Severe diarrhoea
• Chronic nausea
• Tremor
• Extreme anxiety
• Uncontrollable restlessness
• Heightened irritability
• Very poor sleep
• Rapid onset depression
• Overwhelming cravings
• Goosebumps

Withdrawal can start as quickly as six hours after you last use. The symptoms will reach a critical mass within three days and should start to subside within a week. The problem is that the withdrawals will be 24/7 and can be so debilitating and distressing that, if you try and treat yourself, you are most likely to relapse.

When you stop using heroin the tolerance your brain developed will start to wear off: Very quickly. this means that when people are in withdrawal and succumb to cravings they will tend to use a larger amount than they used before stopping to try and stabilise themselves. This puts them at extreme risk of overdose: which can be fatal.

Naloxone can be given in these situations (either up the nose or by injection). The problem is that this is a very short term measure and while TV shows and films depict people recovering instantly, the reality is somewhat different.

What is a Heroin Detox?

Opioid substitute prescribing is the process of replacing heroin, on the receptors, so that withdrawal symptoms are minimised. This, together with therapy and the support of 24/7 staff in rehab, will get you through the cravings while your tolerance to heroin (on your receptors) dissipates.

There are two mainstays of opioid substitution therapy: Methadone and Buprenorphine (Subutex/Buvidal/Espranor). The internet is awash with misinformation about these medications. Our clinicians, who have decades of experience prescribing these medications, heard all kinds of outlandish claims such as Methadone turns your bones green and rots your teeth: It doesn’t and it won’t. Indeed when I spoke to some of our clinicians about medication for opioid detox they all said the same thing: Don’t get hung up on which medication you use in rehab: This is a very small part of the process.

Methadone is a fully synthetic opioid. As soon as you start to experience withdrawals, your clinician will prescribe this for you in rehab. The process involves an escalating prescription so that you don’t feel any withdrawals and are not overwhelmed by cravings. Once you are comfortable, the medication is reduced, over a period of time to zero. Ideally, you should stay on the dose you feel comfortable at for six months to a year. However a year in rehab would cost you a fortune! Usually, an admission for opioid detox is 4-6 weeks. Sometimes it can be shorter, but that depends on various factors.

Buprenorphine (Subutex/Buvidal/Espranor) works in a slightly different way to Methadone. While methadone covers all the opioid receptors in your brain, Buprenorphine covers some of them, but will stick to them very strongly. As such, you must be in a greater state of withdrawal before you commence Buprenorphine. If you start too early, the medication will “knock off” any opioids left on your opioid receptors and force you into withdrawal. This would make you feel unwell and put you at risk of relapse.

Your clinician, in rehab, will also prescribe adjunctive medication to help with some of the physical withdrawals though these medications are secondary to Methadone/Buprenorphine. If you tried to detox solely with adjunctive medication you will, most likely, relapse very quickly.

Why Do I Need Rehab For Heroin Addiction?

A detox, while a vital component of recovery, is actually a very small part of the process. Unless someone who is caught up in the grips of heroin addiction, understands why they became addicted, in the first place, a relapse is almost guaranteed. Treatment for Heroin Addiction is not just about detox!

Nursing staff will monitor you to ensure the dose of methadone/buprenorphine is not too high or low and provide your medication, but this only take a few minutes a day. If necessary, your rehab clinician will review and amend your treatment plan.

The mainstay of rehab is therapy: Group therapy. Every rehab centre, the world over, is centered around a group therapy model. 12 STEPS/SMART/Eclectic: It really doesn’t matter. What does matter is that you are somewhere where you can recovery: Safely with the right expert help.

Weekly individual therapy sessions will also form part of recovery. Bolt on therapies are also a common feature in rehab: Music and art therapy as well as gentle exercise. You will be able to get to grips with why you became addicted, deal with the emotions you suppressed while using Heroin and learn how to deal with situations, in the future, that could be tricky. This is known as relapse prevention.

One of the most beneficial aspects of rehab is being in an environment that will help you through the cravings. Rehabs are not secure psychiatric units: You are free to leave at any time. However, the support of the therapy team, 24/7 support staff (many of whom are in active recovery) and your peers will get you through the cravings.

Will power, drinking water and going to the gym is not going to get you through. Cravings, withdrawal, feeling as if you can not cope without heroin is all about chemical changes in your brain: Not you failing as an individual. Treatment for Heroin Addiction is a medical treatment just as treatment for physical illness.

Can I Detox From Heroin At Home?

Yes: This can be done. Would we recommend it? No.

Without the intense support and therapy in rehab, trying to detox at home is incredibly difficult. The vast majority of those who try it will fail. As above, this is nothing to do with a lack of will by the person trying to detox but everything to do with science.

If you detoxed at home who is there to support you at 2AM when the cravings are so intense all you want to do is call your dealer? Will any of your family/friends understand what it is like to experience that overwhelming desire to use? How will you be able to see your clinician if your treatment plan needs amending?

Cost wise, it can actually cost more to have treatment at home than in rehab. Treatment for Heroin Addiction doesn’t need to be expensive.

Can My GP Prescribe Methadone or Buprenorphine?

Yes, for pain. For addiction? No.

Due to the way GP services are commissioned, they are simply not funded for addiction services. As such, they simply can not write you a script for a detox. In any event, because of Home Office regulations a GP will not have the special prescription pads for installment prescriptions (necessary for methadone and Buprenorphine when prescribed for a detox).

What About Local Authority Free Services?

All drug and alcohol services in the community are provided through your local authority. They can contract in a private company, charity or the NHS: It is up to them. These services will provide a methadone or Buprenorphine script but you will have to go to the chemist: daily (in the first instance).

Some of our clinicians work in this sector. The emphasis in these services is stabilisation and crime reduction. The clients tend to want to maintain on their script (and there is nothing wrong with that) rather than to detox.

While these services run groups, the support is no where near as intense as rehab. There budgets are extremely tight and they will only ever fund a very short residential detox after you have gone through a lot of hoops. You will have to attend many meetings, assessments and group sessions. If they do fund you for a detox it will be where they have negotiated very preferential rates and will, most certainly, be where they decide, at a time they can get you in: Not, necessarily, when you are free.

How Can Find Me a Rehab Help?

Our experienced addictions clinicians work in private rehabs, as well as a multitude of other settings. They have treated hundreds of patients with Methadone and Buprenorphine. When you call you will be speaking with one of them who will give you honest, impartial, free and confidential advice. If you need a referral to a rehab centre they will not charge you for this. The only time we charge for our services is if you want treatment at home (and only after a free initial assessment.)

If you are looking for Treatment for Heroin Addiction call and speak to an experienced addictions clinician in total confidence. We are registered with the Information Commissioners Office. Your personal information can never be shared with anyone (including your GP) unless you give expressed permission. As rehab centers are required to be registered with the Care Quality Commission we only recommend those that are.

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