How To Detox From Heroin?
Heroin detox is the first phase of treatment for heroin-dependent people. Heroin – a highly addictive illicit opioid – poses many health risks that often require medical attention. Drug detox helps clear an addictive substance from the body in a safe and controlled environment.
Detox is an essential step before starting an addiction treatment program. That said, detoxification does not guarantee long-term abstinence. Instead, it prepares and stabilizes a user for additional addiction treatment programs.
Heroin detox aims to:
- Relieve your discomfort.
- Build trust between you and your provider and other treatment staff.
- Prevent complications that may arise when you stop taking heroin (withdrawal symptoms).
How Medically Supervised Heroin Detox Is Ideal?
Professional care in a detox center dramatically reduces the odds of relapses and withdrawal-associated complications. You may be thinking, how to detox from heroin? Well, medically supervised heroin detox is ideal if you have abused heroin for prolonged periods, used large quantities, or have a history of overdose or relapse.
Though most users need detox, it is not recommended if you are:
- Pregnant. Pregnant women with opioid dependence should not undergo withdrawal. Doing so can result in miscarriage or premature delivery. Addiction experts recommend methadone maintenance treatment (MMT) for pregnant women.
- Commencing MMT. Withdrawal is not necessary before starting treatment.
Heroin is probably the most addictive substance humans have ever known. Besides, the drug acts rapidly and is more addictive than other opioids, such as oxycodone and morphine. As such, detox is necessary for most users.
When a person stops taking heroin or takes a lower amount, they may experience unbearable withdrawal symptoms and uncontrollable cravings. For some users, the withdrawal symptoms can be so intense that they may start using the drug again.
Heroin Withdrawal Symptoms and Timeline
Withdrawal symptoms typically begin 8 to 24 hours after last use and can last up to 2 weeks. Symptoms mimic those of the bad flu and may include:
Moreover, some users may struggle with feelings of reduced well-being and strong cravings for up to 6 months. These symptoms constitute what experts call the “protracted withdrawal phase.” Relapses are common during this phase and may require MMT, especially if relapses during withdrawal occur repeatedly.
What Happens During Heroin Detox?
Before starting the detox, a team of health professionals carefully assesses your condition to identify your unique needs that require medical/psychosocial support. Then, they will customize a detox program to address those needs.
Detox aims to make withdrawal symptoms bearable and prevent relapses. To do so, your provider may recommend medications and nutritional support to relieve specific symptoms. Examples include:
- Acetaminophen for headaches and other pains.
- Diazepam to ease anxiety and restlessness.
- Loperamide to treat diarrhea.
- Vitamins B and C for nutritional support.
- IV fluids to prevent severe dehydration.
Specific drugs - Clonidine, Buprenorphine, or Methadone - may be used if you have severe withdrawal.
Once you are stable and have mild withdrawal symptoms, you will receive counseling and psychotherapy. These non-drug approaches are crucial to maintaining long-term sobriety.
You will work with a therapist to uncover the underlying causes of your addiction, such as past trauma, stress, and coexisting mental illness. Then, your therapist will teach you skills and tools to replace addiction-related negative thoughts with positive ones.
Psychotherapy sessions may be conducted individually or in a group and can include:
- Cognitive-behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Contingency Management Therapy (CMT)
- Motivational Interviewing (MI)
- Couples and Family Therapy
- 12-Step and Community Programs
- Maintenance Therapy
Psychotherapy is not started if you are disruptive, aggressive, or confused. In such conditions, health professionals will keep you in a safe environment to avoid self-harm and continue giving you necessary medications.
A doctor or home-based withdrawal worker reviews your condition daily. Continuous monitoring ensures you are responding to the treatment.
Because heroin users may have life-threatening complications during withdrawal, addiction experts carefully design an emergency plan soon after starting the detox program. Likewise, if you are detoxing in an outpatient facility, they will give you tips to respond if an emergency occurs at your home. These can include the phone numbers of counseling support staff, your doctor, and the ambulance.
How Long Does it Take to Detox From Heroin?
Detox from heroin usually occurs in two phases:
1. Acute Withdrawal
Acute withdrawal or simply withdrawal begins 8 to 24 hours after the last intake and can continue for 4 to 10 days.
According to the American Society of Addiction Medicine, withdrawal is “the onset of a predictable constellation of signs and symptoms following the abrupt discontinuation of, or rapid decrease in, dosage of a psychoactive substance.”
Put simply, acute withdrawal symptoms are predictable and tend to go away gradually.
You may experience muscle aches, shaking, diarrhea, sleep disturbances, anxiety, poor concentration, and intense cravings.
Some of your symptoms peak within the first few days. Besides, you may have new symptoms, including irritability, tiredness, stomach cramps, nausea, and vomiting.
The physical symptoms become milder but psychological symptoms may persist.
Long-term or heavy users may struggle with psychological symptoms, such as sleep disturbances, anxiety, irritability, and depression. If these symptoms persist, you may need specialized treatment for a co-occurring disorder.
2. Protracted Withdrawal
Also called extended withdrawal, it includes symptoms (of acute withdrawal) that last beyond the expected timeframes. The protracted withdrawal phase may last for several weeks or months. The most common symptoms include sleep disturbances, anxiety, and depression.
Can You Detox From Heroin at Home?
No. Experts do not recommend at-home heroin detox, mainly for two reasons.
- Doing so may increase the risk of overdose.
- Second, self-medicating to relieve withdrawal symptoms may actually worsen them or cause fatal drug interactions. For example, combining Benzodiazepines (to reduce anxiety) with heroin can cause death.
Outpatient vs. Residential Heroin Addiction Treatment
Residential or inpatient programs offer treatment at a facility away from your home or a place that led you to abuse heroin. Usually, you will need to stay in such facilities for weeks to months, depending on the addiction severity.
Outpatient programs require you to spend a few hours to several hours each day at a treatment center. They are ideal if you have a mild addiction.