Heroin Withdrawal: Why Medical Detox is Essential

Heroin addiction detox treatment. The first word leads to the second. The third word is a start of the fourth.

Heroin withdrawal is not easy.

In fact, for some, if not done under medical supervision: It can be fatal.

Forget what you see on television and in the movies. Locking yourself in a room with a bucket, some toilet roll and some energy drinks. It would be a disaster

A detox from Heroin is a serious medical procedure and certainly not something you should ever attempt on your own.

Heroin addiction detox treatment

You wouldn’t try and remove your own appendix (or at least we hope you wouldn’t!) so why would you try and treat heroin addiction yourself?

What is Heroin?

Heroin is an opioid derived from the poppy plant commonly found in places such as Afghanistan.

It is made from morphine, which comes from the seed of the plant.

Used by doctors in a pharmaceutical form, it is known as Diamorphine and is commonly used in end of life care for pain control.

Heroin is 2-3 times stronger than morphine. When sold by dealers it is a brownish powder with a bitter taste.

Heroin addiction detox treatment

It can be snorted, smoked or injected (on it’s own or mixed with other drugs, usually crack cocaine).

When sold, illegally, dealers want to maximise their profits. Therefore it is usually “cut” (mixed) with other substances, including ground glass, rat poison: who knows what.

There is no such thing as a reputable dealer.

Sometimes it is cut with Buprenorphine which is an opioid. Because of the way Buprenorphine works: If you take heroin cut with it you will withdraw so will need even more: Not a bad business model!

What Happens When You Take Heroin?

Just as with other drugs, alcohol, prescription medication and even caffeine, when you take heroin it works on receptors in your brain. In this case opioid receptors.

Heroin will metabolise back into Morphine and bind to the opioid receptors.

You will experience a warm sensation of euphoria (a “rush”. Your mouth will go dry and your skin will be flushed.

As your central nervous system becomes clouded and depressed you will become drowsy.

Use too much, especially if you are using other drugs and/or alcohol, and you can overdose. This can be fatal. Even the first time you use.

Medical implications of using heroin

When you use heroin, especially when you inject, you run the risk of medical complications such as:

• Collapsed veins
• Abscesses
• Unplanned abortion of a fetus
• Inflammation of the hear valves and lining
• Pneumonia

Heroin addiction and withdrawal

When you use heroin, your brain will become accustomed to it’s presence.

In time, your brain will adjust the way it works due to the continued presence of heroin. When this happens a phenomena known as tolerance occurs.

Tolerance means that you will need more and more to have the same effect as the amount you first started with.

This means if you stop, suddenly, or reduce the amount you are taking your brain simply can not cope with the immediate change.

Your brain will send out incorrect chemical messaging which is why you experience physical symptoms known as withdrawal.

Sometimes, when people are in this situation they succumb to the craving and take an amount they think will settle them. This is where accidental overdose occurs.

Heroin overdose is often fatal. Yes, there is Naloxone but don’t be fooled by film and television drama. One dose of naloxone is not going to do the trick. Most people need several doses and other life saving medical intervention.

Timeline and Signs of Heroin Withdrawal

Every persons experience will be different.

When you start to experience withdrawal relies on a number of factors.

Usually, you will start to feel unwell within six to twelve hours after your last use. The symptoms will include:

• Flu like symptoms
• Severe muscle aches
• Uncontrollable anxiety
• Heavy sweating
• Intense cravings

First 24 hours

The symptoms will get worse and you are likely to experience:

• severe nausea
• Uncontrollable diarrhea
• Continued extreme anxiety
• Persistent vomiting

Days 3-7

While some of the symptoms above may start to resolve, you may well experience the following:

• Abdomninal cramps
• Insomnia
• Rapid low mood
• Intense feelings of hopelessness

Post Acute Withdrawal

While the acute physical symptoms will start to shift, your mood and sleep can continue to be affected for up to a year after you stop using.

Lingering anxiety is a particular problem in this phase of recovery.

Why Do I Need a Detox?

Heroin withdrawal is not something you should ever attempt on your own without medical intervention.

Ignore those who tell you it can be done, even those who tell you they have done it themselves.

If you try and treat yourself you are putting your life on the line: Literally.

It used to be thought that detoxing from heroin, without intervention, was safe. Sadly, it isn’t true. People die.

Heroin addiction detox treatment

Due to the severe dehydration that can occur, without fluid and electrolyte replacement an acute medical emergency can arise.

Even if you were able to manage the physical symptoms the other issue you will face is cravings.

Being unable to resist cravings is nothing to do with a lack of willpower but all about science.

Cravings occur when your tolerance to heroin drops.

When tolerance drops people take an amount of heroin they think they need to stabilise themselves. This is what leads to overdose.

Effective Heroin Recovery

There is much misconception around recovery from Heroin, particularly around the use of Methadone.

Despite the urban legends and misinformation, Methadone remains the gold standard of treatment, those there other medications that can be used.

In short, Methadone is a fully synthetic opioid. When used to treat heroin addiction the process is quite straightforward.

A sufficient dose is given to slow down/stop withdrawals and then, in time, the dose is reduced until you no longer need it.

Other adjunctive medication is also given to assist with some of the physical symptoms but these are of limited use.

Forget what people may tell you.

Methadone no more makes your bones green as it does rot your teeth.

Alternatives to Methadone

Getting hung up on which medication is used for your recovery really doesn’t help.

While Methadone is the gold standard, there are alternatives such as Buprenorphine.

Also known as Subutex, Buvidal and Espranor, Buprenorphine is an opioid that is used for pain control.

It works in a different way to Methadone in that it only partially covers opioid receptors. However, it will stick to them more strongly than Methadone does.

Heroin addiction detox treatment

What this means is that unless you start Buprenorphine when you are in significant withdrawal, it will push you into withdrawal by removing opioids on receptors.

Methadone can be started earlier.

A detox using Buprenorphine can be done in a shorter period of time than Methadone which can reduce costs.

Why Do People Relapse on Heroin?

In an ideal world, Methadone and Buprenorphine would be taken for six months to a year before the dose is reduced in a residential treatment setting.

The brain takes, at least six months, to readjust when you stop taking heroin.

This would be incredibly cost prohibitive.

Those who rush a detox are the most at risk of relapse.

Cravings persist for a long time.

If you rush a detox you are likely to still experience cravings.

Your tolerance will be low and you will be at a very serious risk of overdose.

Why Residential Treatment is the Best Way Forward

Methadone and Buprenorphine is not something your GP can prescribe.

Why? It is because of the way NHS GP services are commissioned.

These medications are available from local authority funded community drug and alcohol services.

However, community services are heavily weighed towards crime reduction and the emphasis is on maintenance treatment (staying on Methadone/Buprenorphine so you don’t steal to buy drugs.)

Heroin addiction detox treatment

Trying to reduce when using community services is very, very challenging. There is a very low success rate.

This is not the fault of the service but the dynamic of reducing while being around drugs, users and dealers. In a rehab, at 3AM, there are staff to support you. Many are in recovery themselves so understand.

At home, you are probably going to score drugs. In rehab, you are more likely to be given a cup of tea, a chat and some moral support: This will stop you relapsing.

Therapy, Relapse Prevention and Aftercare

People don’t become addicted to heroin out of choice.

No one wakes up one day and makes a conscious choice to be an addict.

Drugs are an escape. An escape from the grim realities of life.

The therapy in rehab lifts the lid on why you are using.

The groups will be challenging: That is the point.

Unresolved childhood trauma, low mood, bereavement: These are all common themes in addiction recovery.

Relapse prevention

In most cities you can get drugs delivered to your house quicker than a pizza.

If you know how to navigate difficult situations (and people) you stand a much better chance of staying abstinent.

Heroin addiction detox treatment

Relapse happens: Fact. However, if you know how to deal with it you may well be able to avoid going back down the rabbit hole.

Aftercare

All residential treatment centres provide a minimum of a years aftercare.

This could be a weekly support group as well as telephone check in.

If you are struggling, there will be a dedicated number to call for immediate support.

Speak to an Experienced Addictions Clinician For Free Advice and Referrals

We are addictions clinicians.

Over the past few decades, we have treated thousands of people caught up in the madness of heroin addiction.

We will give you honest, impartial free and confidential advice.

It matters not to us where you go for treatment, as long as it is safe and cost effective.

We can advise on where to access low cost treament.

We do not charge for referrals.

Our service is registered with the Information Commissioners Office.

We only signpost to legally registered services.

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