heroin treatment

A Comprehensive Guide to the Treatments for Heroin Use Disorder

Heroin use generally remains low, but its popularity continues to grow as people addicted to prescription opioids look for a more readily available alternative. Since 2007, the number of people who say they’ve used heroin in the past year or the past month has risen steadily.

Because of its new ties to prescription opioids, heroin no longer discriminates. Men and women, rich and poor, and urban and rural users are all increasing.

Fortunately, heroin is not a new drug. It has hundreds of years of history, and its understanding among scientists and the medical community mean that heroin users have more treatment options than users of drugs like meth.

Still, heroin devastates individuals, families, and communities. It increases the risk of HIV/AIDS as well as hepatitis B and C. Overdose deaths also continue to grow, and the medical consequences of chronic use include bacterial infections, collapsed veins, and abscesses.

Heroin treatment is available for those who need and want it. It includes a combination of psychological and pharmaceutical therapies designed to target the chilling effects of heroin.

Keep reading to learn more about the types of heroin addiction treatment available to you or your loved ones.

Types of Heroin Addiction Treatment

Like many forms of addiction, heroin treatment includes a psychosocial element that provides counseling, therapy, and behavioral changes. However, heroin users may also receive access to pharmacological therapies.

The two are used in combination to serve as a withdrawal method and long-term treatment plan with the ultimate goal of preventing relapse.

Psychosocial Heroin Treatments

Psychosocial treatments are used at both stages of heroin treatment: detoxification and maintenance treatment for opioid dependence.

Studies show that when treatment providers combine both the psychosocial and pharmacological elements, they have more tools for helping users through the initial detoxification phase and preventing chronic relapse.

The four treatments most commonly studied are:

  • Contingency management
  • Community reinforcement
  • Psychotherapeutic counseling
  • Family therapy

Therapists use all four routinely in addiction treatment and the treatment of substance abuse.

Contingency Management

Contingency management (CM) is a behavioral therapy that offers rewards to encourage positive or desired behaviors. It may also use disciplinary actions to handle or prevent undesirable behavior.

Therapists use CM for substance abuse disorders and issues with impulsive behaviors.

The theory suggests that when you reward desirable behaviors, then the subject is more likely to not only continue the action but do so at an increased frequency and over a more extended period. The opposite is true of punished behaviors.

CM also uses a no reinforcement policy to ignore behaviors that aren’t undesirable but aren’t worthy of punishment. Those behaviors, too, should eventually disappear.

Why does CM work in heroin addiction treatment? It tackles the social, biological, and environmental indicators of abuse and gives the patient a tool to manage them.

Community Reinforcement

The Community Reinforcement Approach (CRA) is traditionally used among alcohol use disorders. Today, therapists use it to treat abuse and addiction across the spectrum.

CRA helps people rearrange their lives so that living without drugs looks and becomes more rewarding than a life using drugs and alcohol.

During the practice, therapists encourage patients to increasingly engage in enjoyable social activities away from substances. They also receive encouragement to work on their communities of family, friends, and co-workers.

CRA includes two branches including one for adolescents and one for families who want to encourage their loved ones into treatment.

Psychotherapeutic Counseling

A simpler term for psychotherapeutic counseling is talk therapy. Therapists use it across the board for everything from depression to severe mental illness to substance abuse.

The process allows the patient to build a therapeutic relationship with a psychologist. The psychologist, in turn, gets to know the patient and helps identify things like:

  • Comorbid disorders
  • Personality characteristics
  • Unhealthy coping mechanisms
  • Learning disabilities

Psychotherapeutic counseling may begin during the client’s detox phase. This form of counseling is often mandatory, and it does not differ significantly from psychotherapeutic uses in the wider population.

Facilities use psychotherapeutic counseling as a tool to help patients through the detox phase. Research finds that using it during the three-week period helps more patients enter a long-term treatment once their detox is complete.

The goal of talk therapy is to start to resolve some of the problems related to and underlying substance abuse. By approaching these problems, the patient will begin a path of understanding so that they can build both psychological and social tools for resilience. These tools then help them tackle the everyday challenges that come with heroin abuse.

Family Therapy

Family behavior therapy (FBT) is a vital part of treatment for many patients. It has shown to be useful for both adults and adolescents. Like psychotherapy, it aims to deal not only with the substance issue but with co-occurring problems.

FBT doesn’t require the entire extended family. Instead, it typically occurs with a cohabitating partner. For adolescents, FBT usually takes place with one or both parents.

The goal of FBT is to use two people in the behavioral contract for greater success.

For example, parents of an adolescent with a substance abuse disorder may learn goal setting skills that promote positive parenting. Then, the following session includes a review of the goals and the rewards

Pharmacological Heroin Treatments

Pharmacological treatment is the use of medication to help heroin and opioid users kick their habits as safely as possible.

The medication works to help users get through the first and one of the most painful phases of treatment: withdrawal.

Opiate Substitution Therapy

Because withdrawal can be dangerous, some organizations use opiate substitution therapy.

Opiate substitution therapy offers users an alternative to heroin in the form of a legally prescribed opioid taken in a supervised clinical setting. The two most common substitutes include methadone and buprenorphine.

Organizations may use the therapy for several reduces including reducing the risk of death from overdose and reducing illicit opiate use generally. An opiate substitution program may attract users who would otherwise avoid health services or interventions.

Using methadone or buprenorphine doesn’t mean that the patient won’t go through withdrawal. The symptoms of withdrawal largely remain the same, but they may be milder in severity. At the same time, methadone, in particular, takes longer to exit the body than heroin does so that withdrawal may take as long as six weeks.

What Is Heroin Withdrawal Like?

To grasp why both the psychosocial and pharmacological treatments work together so well, it’s essential to get to grips with heroin withdrawal.

Heroin withdrawal may or may not be the first step to recovery. Users may move from the withdrawal/detoxification phase into long-term recovery, or they may relapse.

Withdrawal is both a painful and sometimes fatal experience that requires regular monitoring and often medication. Opioid withdrawal syndrome acts like the flu in the sense that it feels severe to those suffering it but may be mild regarding a threat to life.

When a person goes through opioid withdrawal syndrome, they may experience symptoms like:

  • Muscle aches
  • Nausea
  • Fever
  • Vomiting
  • Diarrhea
  • Sweating
  • Insomnia
  • Dysphoria
  • Pupillary dilation
  • Piloerection

Two particular signs pose a problem for those going through this phase: vomiting and diarrhea.

These two symptoms work together to lead to dehydration when left untreated. They also contribute to hypernatremia, which is an elevated blood sodium level. The combination may result in heart failure, which then becomes fatal.

Opioid withdrawal deaths aren’t part and parcel with recovery. All these deaths are preventable when the patient has access to proper supervision and healthcare.

These deaths are preventable and needless, but the likelihood of death is still high. Because of this, those caring for opioid users who do not provide adequate care for the withdrawal phase may be seen to be violating their human rights.

Several people who passed away as a result of a preventable withdrawal death were at the center of court cases in the United States and Europe. Lawyers successfully argued that the facilities in charge of their care – typically jails and prisons – breached their duty of care in all such cases.

Drugs Used to Ease Withdrawal

Stopping opioid use in one fell swoop is no longer the recommended course of action. Instead, the method of tapering and substituting with drugs like methadone and buprenorphine is now a more common practice.

These drugs may be used to help calm the symptoms of withdrawal and kick the cravings that people experience during those time.

In this way, substitute therapy is often likely intertwined with detoxing and withdrawal.

You might find that a person going through opioid therapy may continue to use methadone or another prescribed drug over the long-term. Research shows that the best success occurs when patients take on plans that include both pharmacological interventions and psychosocial remedies.

Unfortunately, even though opioid users have more treatment options than other drugs, like methamphetamine, none of the current treatments cure addiction.

That’s why the psychosocial element is so crucial in withdrawal. Using substitutes helps the user move away from heroin. Counseling and therapy help them take control of their lives and build up tools and resources to eventually kick the alternative.

Treating a Heroin Overdose

A heroin overdose is a dangerous syndrome that can result in death. Heroin-related deaths grew by a scale of five between the years 2010 and 2016 alone. In 2016 alone, nearly 15,5000 people died from heroin-related overdoses.

Reversing a heroin overdose with medical help is possible. Emergency medical practitioners can provide Naloxone to help eliminate signs of intoxication and reverse the overdose.

Naloxone works to bind to opioid recepts, which prevents activation.

It is possible to use naloxone even if you are not a medical professional. The FDA approved a nasal spray in 2015 than anyone can use to stimy an overdose while you wait for medical help.

The same treatments are used in hospitals and rehabilitation facilities if a person is found to be suffering an overdose.

An overdose may lead to further treatment including detoxification and long-term therapy to overcome opioid addiction. However, not all those who survive an overdose make a choice to enter treatment.

Can I Compel Someone into Heroin Treatment?

Heroin use scares families, and it should. It is a dangerous drug with a high potential for abuse and a growing related-death rate. However, because it is so addictive, it is difficult for heroin abusers to seek help on their own.

Even in the case of an overdose, a person may find it physically more comfortable to go back to using than to go through the detoxification process.

The question many families ask is whether it is possible to force someone into treatment.

The legal answer to that question depends on your state of residence. Some states allow concerned families members to seek a court order to compel a person into rehab under certain conditions.

However, the most success comes from supporting a person’s decision to go on their own rather than forcibly admitting them.

Help Your Loved One Through Treatment

For many, the addiction to heroin is as much physiological as it is psychological and social. Many drug users find that they have environmental, behavioral, and psychological indicators that contribute to their drug use.

Engaging in your loved one’s treatment and supporting your role in it may be essential to the process in some cases.

As their spouse or parent, it may mean participating in therapy with them and creating a safe space that helps everyone focus on their ideal behaviors. It may also mean encouraging new hobbies and holding them accountable.

Although you play an active role in their recovery, remember that you need support, too. Make time for yourself and seek support groups to reach out to people in a similar situation.

Are you concerned about someone you love? Maybe it’s time to seek help. Contact us today to learn more about heroin treatment and recovery services.