Heroin Addiction Treatment  

When Heroin use becomes a problem

Heroin is an illegal opioid drug. 

Very soon after you start using it you will become physically dependent on it. 

Heroin stops the release of a chemical in your body called Noradrenaline. 

If you stop taking heroin this chemical is released, into your body, in very large quantities. This is what causes the symptoms known as withdrawal. 

Signs that it may be time to seek help include: 

* Taking larger quantities to keep you steady 

* Becoming unwell if you stop taking Heroin

* Very strong cravings to use when you try and stop 

* Spending increasing amounts of time sourcing Heroin

* Continuing to use even though you know you shouldn't

* Missing out on deadlines, family commitments and       damaging relationships because of your Heroin use

Why you should not stop using Heroin suddenly 

Heroin suppresses the release of a naturally occuring bodily chemical called Norarenaline. 

When you stop taking Heroin, large amounts of Noradrenaline are released into your body. 

It is this chemical that causes symptoms known as withdrawal. 

Despite what Hollywood and television may show you, looking yourself away with some toilet roll, a bucket and a case of bottled water is not going to do it. 

Acute Heroin withdrawal can be fatal.

The symptoms include: 

* Fever

* Severe bodily pain

* Excessive bodily fluids (extreme sweating, runny nose, 
   streaming eye) 

* Painful stomach cramps

* Nausea and vomiting

* Extreme diarrhea (which, if left untreated, can lead to 
   fatality) 

* Acute low mood

* Lack of sleep 

When you stop taking Heroin, your brain will tell you what you already know: The only way to stop these symptoms is to use Heroin.  This is known as craving. 

The problem is that, when you stop taking Heroin, your brain, very quickly, starts to loose it's tolerance to the drug. 

If the cravings become too much and you use Heroin, you are bound to use an amount you think will steady you. 

This, very often, leads to accidental overdose. 

Trying to reduce your use, at home simply won't work. 


 

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What does Heroin addiction treatment involve? 

Treatment starts with an assessment.  

A clinician will need to get an understanding of the problem which includes: 

* How long you have been using Heroin for

* If you smoke, snort or inject it 

* How much you spend on Heroin (helps to determine 
   amount used) 

* Underlying health conditions 

* Prescribed/unprescribed medications and any other drugs
   used

Treatment for Heroin, as with any other addiction comprises of four elements: 

* Detox: A Heroin substitute is used which will stop the 
   withdrawals. Once you are comfortable on it, the
   medication is reduced and then stopped. 

* Group therapy: The mainstay of all addiction treatment for
   nearly a hundred years. Addiction is a sign of an underlying
   problem. If you can deal with the underlying problem, you
   stand a much better chance of staying abstinent (you can
   opt for a non 12 step centre if you want to). While we
   reccomend group therapy you can opt for a centre that
   utilises individual therapy instead. 

* Relapse prevention skills: If you know how to deal with
  difficult situations when you leave rehab, your recovery is
  going to be far smoother

* Aftercare: All centres provide a weekly aftercare group when
  you leave. You can attend in person, or via video link. Some
  centres have a dedicated support line when you complete
  treatment

• Can I get a rapid heroin detox?

  Yes. A five day rapid heroin detox can be arranged. 

  This process involves being sedated while larges doses of Naloxone are administered, usually over a five day period. 

  Because this is a high risk procedure, it can only be done in a private hospital, under the supervision of a consultant psychiatrist. 24/7 nursing care is also needed. 

  As clinicians, we do not recommend this as you will not receive the psychological support, relapse prevention or aftercare that is essential for long term abstinence. 

• What are the effects of heroin?

  Within a very short space of time after being taken, Heroin rapidly enters the brain and will quickly bind to opioid receptors on cells in many different areas of the brain, especially those that regulate feelings of pain and pleasure, as well as regulating heart rate, breathing and sleep.

• Are there alternatives to Methadone for Heroin addiction treatment?

  Yes. 

  While Methadone remains the mainstay of Heroin addiction treatment, there are alternatives. 

  Methadone is a fully synthetic opioid, that means it was developed in a laboratory. 

  It works by flooding the same receptors in the brain that Heroin works on, thus it will reduce and then stop, your withdrawals. By reducing the dose, at regular intervals, you become drug free. 

  Buprenorphine, also known as Subutex and Espranor, is tablet that dissolves in your mouth/on your tongue. 

  It is also a synthetic opioid but works slightly differently. 

  Buprenorphine sticks to receptors more strongly than Methadone/other opioids, but won’t cover as many receptors. On those receptors it does attach to, it will throw off any Methadone/opioids thus making you withdraw. 

  This means that, before you start Buprenorphine, you need to be in the early stages of withdrawal. If not, the Buprenorphine will force you into withdrawal. 

  A Buprenorphine detox can be done slightly quicker than with Methadone.

   

• How long does someone need to be in a residential treatment centre for heroin addiction?

  This depends on multiple factors, namely how long they have been using heroin and how much they are using a day. In any event, a month is usually a good starting point. There are , rare, occasions where someone can complete a treatment plan within a fortnight, but this would be exceptional.

• How do I book in for heroin rehab?

  A comprehensive and holistic assessment with a clinician is the first step to securing the right treatment plan in an appropriate treatment centre. Not all centers provide opioid treatment and selecting the right centre is a key part of getting into recovery.
  ​
  Same day admissions are sometimes possible, but can usually only be achieved if the referral is made very early in the day and there are no complex medical issues.
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  Sharing information with the persons GP may be necessary.However, a medical summary can be requested from the surgery without the need to identify what it is being used for.

• Is there an injection to treat Heroin addiction?

  Buvidal is an injectable form of Buprenorphine, which is also known as Subutex and Espranor. 

  It is a small needle and is injected into the arm, stomach or buttocks. 

  Originally designed for people who live in rural areas and who are on long term  treatment, Buvidal is increasingly being used for Heroin detox. 

  If you have never had Buprenorphine before, you will be given a very small dose of oral Subutex/Espranor (Buprenorphine in tablet form) and monitored for an hour. If you do not show any significant side effects you will be able to commence treatment: right away. 

  Usually, you have one injection, a week, for a month, then a monthly injection if you want to stay on Buvidal for a long time. 

  If you want to use it as a detox, you would have an injection a week, for a month then a monthly dose. You can then either not have a further dose, swap to oral tablets and reduce that way or have a lower dose injection (and continue until the lowest dose). This is a discussion to be had with your clinician. 

  As with any form of Buprenorphine, you need to be, at least, in mild withdrawal. This is because the drug knocks off opioids and Heroin on receptors. If you are not in withdrawal, the drug will force you to withdraw. 

• Can I have a home detox for heroin addiction?

  Yes. 

  This can be arranged but, as clinicians, would caution against it. 

  A home detox would involve a Heroin substitute such as Methadone  or Buprenorphine/Buvidal. 

  You can attend therapy sessions on-line or in person. 

  Those who have treatment in a rehab centre tend to stay abstient for far longer as they recieve all four of the 

• What is "Going cold turkey"?

  Going “Cold Turkey” is a phrase associated with attempting to detox, yourself, from Heroin without medical intervention. 

  Cold Turkey refers to the appearance of gooseflesh like skin when you are in withdrawal. It is formally known as Cutis anserina. 

  This approach very, very rarely works and can be extremely dangerous. 

  When you take Heroin, one of the effects the drug has on the receptors it that it blocks the release of a naturally occurring bodily chemical called Noradrenaline. 

  Within a few hours of stopping Heroin the brain starts to release massive doses of Noradrenaline around the body. This is what causes the symptoms, known as withdrawal. 

  One of the symptoms is extreme diarrhea. 

  Without electrolyte replacement, this can lead to severe dehydration and fatality can occur. 

  Also, when you withdraw, your brain tells you what you already know: The quickest way to stop the release of Noradrenaline, which is causing you to withdraw, is to take Heroin. 

  The problem is that, since you stopped taking the drug, even if it has been just a day, your brains ability to process Heroin on receptors has dropped: Significantly. 

  You are likely to take as much as you think you need to settle yourself with no intention to overdose. Sadly, many people do accidently overdose at this point. 

  Unless you receive immediate and continuous medical attention you may not survive. 

   

• Is there an implant for Heroin addiction?

  Yes. 

  It is possible to get an implant containing the drug Naloxone, which is a drug that reverses the effects of opioids. 

  An implant detects the presence of Heroin/opioids and releases a dose when necessary. 

  While the implant may save your life, they do not address the underlying issues which lead to addiction. 

  Some people, with an implant, learn how much Heroin they can take before the implant releases Naloxone. This means they continue to use Heroin. 

  It is not uncommon for people with implants to have them removed (some have even done this themselves) or simply mark down the days on their calendar to when the device becomes expired. 

  Implants are not licenced in the UK. 

  This doesn’t mean you can not have one but it means you can not have one on the NHS and only a handful of private addiction specialist doctors provide them. 

  As clinicians we strongly advise against implants. However, we understand that, for some, it is a viable option. We can signpost you to a clinician who would consider this, on a case, by case, basis.