The Centers for Disease Control and Prevention (CDC) warns that America is in the middle of a heroin epidemic, as abuse of the illegal drug is increasing seen across virtually all demographics in the United States in recent years.
As a highly addictive opioid drug that alters brain chemistry and impacts the function of the central nervous system, professional help is generally required to stop using heroin and to remain free from the drug.
The American Society of Addiction Medicine (ASAM) reports that nearly 600,000 American adults suffered from addiction involving heroin in 2015. In 2014, nearly a quarter of all admissions for adults in the United States to substance abuse treatment programs cited heroin as their primary drug of abuse, the Treatment Episode Data Set (TEDS) publishes. Before entering into a treatment program for heroin abuse, however, a person needs to stabilize physically.
Heroin is an opioid drug, and as such, it slows down functions of the central nervous system, such as respiration, blood pressure, and heart rate. It also fills opioid receptors and increases levels of dopamine in the brain. Dopamine is one of the chemical messengers naturally created by the brain to regulate emotions and control impulses. When levels of dopamine are increased drastically and artificially by a drug like heroin, a rush of pleasure, or “high,” is felt. A heroin high is intense and short-lived. As a person continues to take heroin, a dependence can be formed rather easily as the brain now relies on the drug in order to stay chemically balanced. When heroin wears off, withdrawal symptoms can be significant.
The National Highway Traffic Safety Association (NHTSA) reports that heroin withdrawal typically begins within 6-12 hours after stopping the drug and can include physical symptoms that are similar to a really bad case of the flu as well as emotional side effects like depression and anxiety. Cravings can be particularly intense and may lead a person to relapse, or return to using heroin. A relapse after stopping heroin use can be especially hazardous and may result in an overdose. The CDC publishes that more than 8,000 Americans died as the result of a heroin overdose in 2014.
Assessment and Medical Detox First
A heroin abuse treatment timeline often looks something like this:
- Medical detox: about a week, though maintenance medications may be used for months or even years
- An inpatient or outpatient treatment program: around 90 days
- Transitional services: about 3-6 months, as needed
- Aftercare programs: ongoing
A thorough evaluation and drug screening should be completed prior to admission into a treatment program, so families and individuals can ensure that the level of care is optimal. Families should discuss cost, budget constraints, obligations, geographical location, and other logistics before selecting a facility and program.
Often, medical detox is a necessary first step before entering into heroin abuse treatment. Cravings and withdrawal symptoms that occur after heroin use is stopped can be managed and minimized through a medical detox program. Medical detox for heroin generally lasts 5-7 days, on average; however, full withdrawal may take longer due to the use of maintenance medications. Heroin may be replaced with another longer-acting opioid drug and then slowly weaned, or tapered, off that medication in a controlled manner to minimize cravings and some of the more intense withdrawal symptoms. Other medications are also useful during detox to help with specific withdrawal symptoms.
Once heroin is safely out of the body, treatment for heroin abuse will be more impactful.
In general, heroin treatment programs should last at least 90 days and be followed with ongoing supportive care.
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