Detoxing From Heroin
Heroin is a very addictive drug, and people often become addicted quickly. Most who try to stop using heroin will experience a number of physical withdrawal symptoms that can be very unpleasant. A heroin detox center or recovery program can help someone detox safely from heroin and begin to recover.
Heroin Withdrawal Symptoms and Effects
Heroin is a central nervous system depressant that causes feelings of euphoria, sedation and decreased pain. Regardless of how heroin is used, over time users develop tolerance, which means that they will require more and more heroin to feel the same effects they experience before.
The drug is physically addictive, so when people stop using it, their bodies experience physical symptoms of withdrawal.
Heroin withdrawal symptoms typically include:
- Cold chills.
- Fast pulse.
- Abdominal cramping.
- Body aches.
- High blood pressure.
These withdrawal symptoms vary from person to person and depend on such factors as the length of time a person has been abusing heroin, genetics and other emotional and physical factors. 1 The symptoms of heroin withdrawal can be extremely uncomfortable and difficult to endure.
Risks of Withdrawal
One difficult side effect is a decreased tolerance of pain while undergoing heroin withdrawal. People who are withdrawing from heroin may find themselves in pain that can be quite severe, particularly dental pain or back pain.
However, while it is uncomfortable, withdrawal from heroin seldom results in serious medical issues or life-threatening complications. On occasion, people withdrawing from heroin may develop such severe nausea, vomiting and/or diarrhea that they become dehydrated and require supportive medical intervention, such as IV fluids. For some people with underlying heart problems, the withdrawal process can lead to some cardiovascular instability due to an increase in heart rate or a rise in blood pressure. 1
Heroin Detox Timeline
Detox Process and Protocol
The thought of going through detox can be frightening for someone who has never experienced the process. Media portrayals of detox have frequently shown confrontational counselors forcing someone to admit that he or she is an addict or have shown people becoming violently ill while undergoing heroin withdrawal. In reality, the processes involved with formal detox programs are much more supportive, and typically involve:
Intake. Mental health professionals or physicians assess you for the appropriateness of admission to a detox program. This may be partially completed on the phone. But it is generally completed in person. The person doing the intake will ask you a variety of questions about your physical and emotional health. They may also take your vital signs and conduct other physical examinations.
Community. In most detox programs, you are interacting with other people in a community. You usually share meals with them and participate in a variety of activities, which often include support groups or games.
Medical care. In most programs, you are seen by a physician within 24 hours. In addition, nurses routinely check on you, take your vital signs and assess your physical condition on a routine schedule. Other personnel, such as therapists and support staff, will talk with you and assist you throughout the program.
Medications. Medications are frequently given in detox. The types of medication used and the prescribed dosages vary according to your needs. Your physician may initially taper your replacement opioid dosing, which means they will gradually reduce the dosage over time to prevent serious withdrawal symptoms.
Setting. The environment can range from a hospital-like setting to a setting that is more like your home, depending on the program you choose. Some of the more expensive luxury programs may have a spa-like environment and may offer such amenities as massages and highly trained chefs. In most programs you will have a roommate, but some facilities do have private rooms.
Diet. Some people require special diets due to medical conditions such as diabetes and celiac disease. These types of dietary restrictions are handled by the dietary staff as needed. In many programs, the food is a typical hospital-type menu that is served cafeteria style. Many people in heroin detox have nutritional deficiencies. Your physician will check for such deficiencies and prescribe vitamins and other supplements as needed.
Medications for Detox
Methadone is highly regulated, and it can usually only be given at a Substance Abuse and Mental Health Services Administration (SAMHSA)-certified methadone clinic or program. However, it can also be given in a regular hospital setting if the person is being treated for another medical condition while in the hospital.
Methadone acts much like heroin in the way that it affects the opioid receptors in the brain. It can be a highly effective treatment to ease withdrawal from heroin. However, methadone used improperly can lead to an overdose, and it also has the potential to be abused. Therefore, it must be used under strict supervision.
One disadvantage to methadone treatment is that methadone creates dependence, even though it is a legal drug given under medical supervision. If a person later decides to detox from methadone, it is a more drawn-out process than heroin detox. Inpatient treatment is advised for methadone detox. 1
Clonidine has been used for heroin withdrawal for many years. Unlike methadone, clonidine has no real potential for abuse. It is also much easier to find programs that use clonidine for heroin detox because it does not require that doctors or detox programs maintain special certification for its use.
Clonidine doesn't interact with opiate receptors in the brain, so withdrawal can be accomplished without using an opioid substitute medication. However, clonidine does not help with muscle aches, insomnia or cravings for heroin during the process of heroin detox.
Typically, less than half of those people who undergo detox with clonidine actually complete detox. As a result, many people who are going through heroin detox and withdrawal would rather be given methadone.
Buprenorphine is another medication that affects the opioid receptors in the brain, and it can affect those receptors in much the same way as heroin does. Buprenorphine has been found to be effective for heroin withdrawal.
It is safer than methadone and has a much lower potential to result in intoxication or overdose like methadone does. Buprenorphine can also be given in a physician's office and does not require inpatient treatment. However, detoxing on an outpatient basis can be much more difficult than inpatient and may increase the chance of relapse.
Subutex is the oral form of buprenorphine , and it is given to those in the first stages of detox from heroin.
Suboxone is another form of this medication that also contains naloxone and is given as part of treatment for people who are already receiving other medications such as methadone.
Detox Centers and Addiction Treatment Programs
Detox centers. Some programs operate solely as a detox center , meaning that they offer only a short stay of usually 1 to 3 days to allow a person to detox safely under the supervision of medical personnel. Ongoing treatment is needed to continue the process of recovery from heroin abuse and addiction.
Inpatient. Some detox programs are part of an inpatient rehab treatment program , which provides group and individual counseling in a structured environment. People in rehab programs usually stay anywhere from a few days to a few weeks. Long-term programs lasting many months are also an option for those who have not been able to remain free from heroin despite repeated stays in detox and/or other shorter-term programs.
Outpatient. Some providers offer detox, inpatient rehab and then follow-up care on an outpatient basis. You also receive group and individual counseling, but you do not have to live at the facility.
Detox Centers vs. Treatment Centers
Detoxing at Home
Further, just stopping the use of heroin does not give you the opportunity to examine why you started taking heroin in the first place. Without getting to the root causes of the addiction, the risk of relapse is very high.
In addition, many people who abuse heroin also have co-occurring disorders such as depression or anxiety. These issues may worsen under the stressful conditions of going through a heroin detox without medical oversight.
At this time, no natural detox methods for heroin are endorsed by the medical community.
Detox is just the beginning. Ongoing counseling is vitally important to assist with recovery from addiction. Therapy can teach you skills to help you resist using drugs, work on problem-solving skills, remain motivated to continue staying drug-free and replace drug-using activities with other activities that promote sober living. Therapy can also assist in improving family relationships that have suffered as a result of heroin addiction. 4
There are many different forms of ongoing treatment after detox:
12-step programs are free and exist in almost every community. Narcotics Anonymous (NA) is one such group that helps give a recovering person a supportive environment in which to work on maintaining a drug-free lifestyle and preventing a relapse. Twelve-step programs are an important part of many aftercare efforts following other forms of treatment.4
Group counseling gives you an environment with positive feedback to aid in the recovery process. Isolation is a major issue for many recovering addicts, and group counseling helps keep an addicted person from feeling isolated from others. In addition, members of a group who have been in recovery for a sustained period of time can be role models for those who are just starting the recovery process. Seasoned members of a group can show the newly recovering person who is trying to abstain from heroin that recovery is possible.4
Individual counseling may also be beneficial. It usually involves cognitive behavioral therapy , which helps you work on changing the behavioral patterns that trigger your use of heroin. In addition, individual counseling programs often use contingency management, which provides you with rewards for remaining free from drug use.5
Frequently Asked Questions
Can Heroin Detox Kill You?
Detoxing from heroin seldom results in death or other serious medical issues. Medical complications, such as cardiac issues or severe dehydration from vomiting, can arise occasionally. In general, heroin detox can make you feel very sick and uncomfortable, but it is not life-threatening.
Should I Use Kratom to Help Me Detox From Heroin?
Using kratom is not advised. The Food and Drug Administration (FDA) recently issued a statement that the herb is dangerous and has the potential to be abused. 6
How Does Heroin Detox Affect Pregnancy?
Detoxing from heroin while pregnant is possible and usually involves a medication protocol. However, it must be done under close medical supervision to ensure the safety of the mother and the baby.
How Do I Pay for Heroin Detox With No Insurance?
Some programs offer low-cost heroin detox. Many offer sliding scale fees, long-term payment plans and other options if you do not have insurance. Contact the Substance Abuse and Mental Health Services Administration's toll-free helpline at 1-800-662-HELP (4357) for more information about these programs.
Are There Free Heroin Detox Centers?
Some community-based services may offer low-cost or sliding scale payment options. These programs are often administered by county, state or local government agencies. Many programs will not turn anyone away due to an inability to pay the full amount. Various programs may offer free services to those in need who meet certain criteria.
Find a Heroin Detox Center
Whether you have concerns about your own heroin addiction or are seeking help for a family member or friend, call 1-888-319-2606Who Answers? today. Our specialists will help you locate a treatment center in your area based on your insurance coverage and on your needs for treatment and recovery.
If you do not have health insurance, you can contact SAMHSA at 1-800-662-HELP (4357) for referrals to a heroin detox center that can work with you to find low-cost or free programs in your area.
. Center for Substance Abuse Treatment. (2006). Detoxification and Substance Abuse Treatment: 4 Physical Detoxification Services for Withdrawal From Specific Substances . Treatment Improvement Protocol (TIP) Series, No. 45. Rockville, MD: Substance Abuse and Mental Health Services Administration.
. National Institute on Drug Abuse. (2014). Heroin: What are the long-term effects of heroin use?
. National Institute on Drug Abuse. (2007). Understanding drugs and drug addiction: What science says .
. Center for Substance Abuse Treatment. (2005). Substance abuse treatment: Group therapy . Treatment Improvement Protocol (TIP) Series, No. 41, Report No. (SMA) 05-3991. Rockville, MD: Substance Abuse and Mental Health Services Administration.
. Substance Abuse and Mental Health Services Administration. (2015). Treatments for substance use disorders .
. U.S. Food and Drug Administration. (2014). U.S. marshals seize botanical substance kratom from southern California facility