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Heroin Addiction: Treatment and Rehab

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Heroin addiction can negatively impact certain aspects of your life and have dangerous health repercussions. Here, we will help you understand heroin addiction, how addiction is treated, and what you should know about heroin rehab centers, including some practical considerations of heroin rehab, such as cost and length of treatment. It’s important to seek heroin addiction treatment as soon as possible; addiction is a complex and chronic disease that may become progressively problematic when not addressed.1

Quitting heroin on your own can be extremely difficult and significantly increase your risk for relapse given the unpleasantness of unmanaged withdrawal. Relapse is a common part of recovery; more than 60% of people treated for substance use disorders experience a relapse within the first year after discharge.1 That’s why seeking treatment for heroin addiction is so important. Treatment for heroin addiction can help you break the cycle of compulsive use. Medications help keep you safe and comfortable in withdrawal, while a combination of medications and evidence-based therapies will continue to help you maintain lasting recovery.2


What is Heroin Addiction?

Addiction is diagnosed as a substance use disorder (SUD), with heroin addiction being categorized as a heroin use disorder or opioid use disorder (OUD).3 Heroin is very addictive. Its use is associated with a rewarding rush and pleasurable euphoria. Such heroin effects can strongly reinforce continued use of the drug.4

Over time and with repeated administration, you can develop tolerance, which means you need more heroin to experience previous effects. Escalated patterns of use to overcome such tolerance may further drive the development of physiological heroin dependence—at which point your body has become so adapted to the presence of heroin that you may feel that you need heroin to feel normal and to prevent withdrawal.4 Dependence, and the resulting drive to avoid withdrawal, may additionally reinforce compulsive use of the drug.


How is Heroin Addiction Treated?

Heroin use disorder is a chronic but treatable medical condition. In many cases, stopping heroin use isn’t just a matter of willpower or wanting to change. Gradual, addiction-related brain changes may take some time to resolve with treatment, according to Dr. George Koob of the National Institute on Alcohol Abuse and Alcoholism.5

Heroin abuse treatment commonly begins with a period of medical detox and withdrawal management. In addition to helping make people more comfortable in early recovery, medical care may also address any potential withdrawal-associated health complications, should they arise. Withdrawal symptoms can include strong cravings and physical symptoms like severe muscle and bone pain, sleep problems, diarrhea, and vomiting.4

Medications and evidence-based behavioral therapies can be used to treat heroin addiction.4 As part of an effective and comprehensive treatment approach, it may also be important to treat any co-occurring medical or mental health issues, as these can impact the course of treatment.2

Before deciding to begin heroin addiction rehab, it may be helpful to consult your doctor or another treatment professional if possible. They can perform an evaluation and help determine the appropriate level of heroin rehab care for your specific needs.


What Rehab Services are Available for Heroin Addiction?

There are a variety of treatment options available to people in recovery from OUD. An effective combination of therapeutic intervention is often tailored to each individual. Additionally, as your treatment needs change during the course of rehab, you may step up or down in treatment intensity levels or receive additional services if necessary.

People commonly begin the heroin treatment process with a supervised medical detox, which helps ensure safety and comfort as the drug is cleared from the body. Detox can take place in different settings, such as hospitals and in- or outpatient detox/rehab centers. The Substance Abuse and Mental Health Services Administration indicates that the preferred setting for detox will include 24-hour access to some form of medical care for people withdrawing from heroin due to humanitarian and safety concerns.6 As important as it is, recovery doesn’t stop with medical detox. Many individuals continue with additional professional treatment for heroin addiction—either inpatient or outpatient—after the detox period ends.

Inpatient treatment means you live onsite for the duration of treatment. In inpatient or residential settings, you may receive highly structured, 24/7 support and care. This can be especially beneficial for those with relatively severe addictions, withdrawal concerns, medical issues, or psychiatric needs, or those who do not have a supportive living environment.1

Outpatient heroin rehab treatment means you’re able to return home outside of treatment hours. As with inpatient/residential levels of care, there may be various levels of intensity of outpatient treatment available to you.

The most highly structured and time intensive forms of outpatient treatment are found in partial hospitalization programs or intensive outpatient programs. Partial hospitalization is the most time intensive of the outpatient treatment settings, requiring as much as 6-8 hours of treatment per day on weekdays.1 In some instances, these relatively intensive forms of outpatient programming are used as a step-down from residential treatment.1

A standard outpatient program is the least time intensive type of care and may only require a few hours of treatment per week.1 This option may be a good fit for individuals with relatively less severe addictions or those who are further along in their recovery journeys.1 In some instances, treatment may be available after work or school or on the weekends, allowing you to participate in treatment sessions as well as tend to your responsibilities.1

If you have co-occurring mental health issues, such as depression or bipolar disorder, in addition to opioid addiction, you may benefit from a specialized, integrated treatment approach for both. Sometimes referred to as dual diagnosis treatment, an integrated treatment model can be particularly helpful since, left unmanaged or inadequately managed, the symptoms of each disorder could influence the treatment outcomes of the other.1

When choosing treatment for heroin addiction, you may also want to consider other factors, such as:

  • Average length of the program.
  • The program location and setting.
  • The cost and your insurance coverage.
  • Whether they offer dual diagnosis or co-occurring disorder treatment.
  • Whether medication treatment is available.
  • Staff experience (such as their licensing and training).
  • Patient to treatment staff ratio.
  • The program’s accreditation.

Heroin addiction is often treated with a combination of medication and behavioral therapies, an approach sometimes known as medication-assisted treatment (MAT) or medications for opioid use disorder (MOUD). Combining FDA-approved medications with counseling and behavioral therapy provides an effective, whole-person approach to help individuals recover from opioid use disorder and resume more productive and healthier lives.7

A combination of different behavioral therapies for heroin addiction may include specific therapeutic types such as:

  • Cognitive-behavioral therapy (CBT). This is used to help modify dysfunctional thoughts and behaviors and improve coping skills so you can avoid relapse.1
  • Contingency management (CM). This provides positive reinforcement using incentives (like vouchers to exchange for tangible goods) to help motivate positive behavioral change.1

Heroin treatment medications may include:

  • Methadone, an FDA-approved opioid agonist that helps reduce withdrawal symptoms and cravings during detox. It is also used to treat opioid use disorder in maintenance/management programs. Methadone is only available through approved Opioid Treatment Programs (OTPs).1,8
  • Buprenorphine, an FDA-approved partial opioid agonist that reduces withdrawal symptoms and cravings during detox. It is also used to help with maintenance. A branded formulation that combines buprenorphine with naloxone is available as Suboxone; naloxone is included in the formulation to deter intentional misuse of the treatment medication. Buprenorphine can be provided by specially waivered medical professionals.1,8
  • Lofexidine, an FDA-approved non-opioid medication to help reduce opioid withdrawal symptoms. Studies have shown that it can ease certain withdrawal symptoms, though it may not be as effective as buprenorphine for this purpose.9
  • Naltrexone, an FDA-approved opioid agonist that blocks the action of opioids. It is used to diminish cravings and block the euphoric potential of any opioid use, thereby making relapse after detox less likely.1,8

What is the Treatment Process Like?

Generally speaking, heroin abuse rehab begins with detox, continues with some form of professional treatment, and concludes with aftercare.

Prior to the start of any treatment, you’ll undergo a comprehensive intake process to evaluate your specific needs and the severity of your addiction. This helps with diagnosis as well as determining the appropriate level of care and the formulation of your treatment plan.1

You will likely enter detox to help you manage withdrawal and stabilize you prior to continuing with more comprehensive treatment. The treatment setting you ultimately enter depends on your needs. Some people begin with inpatient treatment but later transition or step down to some form of outpatient care.1

How Long Does Rehab for Heroin Addiction Take?

The specific time frame for rehab can vary from person to person. Individuals often start with a 3-7 day stay at a medically managed detox program, then transition to residential treatment. Inpatient stays often range from 28-30 days to 90 days or longer, as needed. Though completion of an inpatient or residential program may not necessarily be a prerequisite, some people continue on with additional outpatient treatment once they leave such a program.1 The Surgeon General’s Report on Alcohol, Drugs, and Health recommends that people with serious substance use disorders remain engaged with some form of treatment for at least 1 year.1

Treatment duration can be affected by the recommendations of your treatment provider, your individual concerns, and whether you require additional support or care. Your treatment plan, including an estimated length of treatment, should be personalized to your specific needs, which can include factors like your addiction severity, and mental, physical, social, legal, vocational, and family needs.2


What Happens After Heroin Rehab?

Recovery efforts shouldn’t end once you’ve completed treatment; for many, recovery is a lifelong process that requires commitment and, in some cases, additional treatment or support. This is why treatment programs formulate aftercare plans, which are recovery supports designed to help reduce the risk of relapse and increase long-term recovery success.1

Aftercare can include different types of care/treatment, such as:

  • Individual counseling or therapy. You may work with a counselor on a one-on-one basis to work on underlying issues that can impact addiction or other mental health concerns.
  • Outpatient treatment. Some people seek additional outpatient treatment programming or continue with regularly scheduled traditional outpatient counseling as long as they need to.
  • Sober living homes, also known as recovery housing. These are substance-free residences where you can live while you continue to make progress in recovery, to better prepare you to transition back to your day-to-day life.1
  • Mutual support groups. People often benefit from the camaraderie and support from others who have walked in the same shoes. It can be helpful to join 12-Step groups like Narcotics Anonymous (NA) or Heroin Anonymous (HA), or non-12-Step groups like SMART Recovery.1,10,11
  • Peer recovery counseling. This involves working with another person who is in recovery to help you stay sober. It is not the same as a sponsor. Peer recovery counselors are often found in different settings, such as community organizations, mental health or addiction clinics, or sober living homes.1

How to Pay for Heroin Rehab

You may be concerned about how to pay for a heroin rehab program, but know that there are several options available. After all, your safety, health, and well-being should be a top priority, and cost shouldn’t prevent you from getting the help you need.12

The Affordable Care Act states that health insurance plans must provide coverage for substance abuse and mental health services that are equal to the coverage they offer for medical or surgical care.13 It’s advisable to verify your insurance to check your specific coverage, as each plan is different, and you may have copays, deductibles, or different costs depending on different factors, such as whether your provider is in- or out-of-network. For example, you’ll likely pay less to a preferred provider if you have a PPO, while HMOs may require you to use hospitals or healthcare facilities that are associated with the HMO.14

Some of the other ways people pay for rehab include:

  • Out-of-pocket. You can use savings or ask family or friends for help.
  • Loans. Some people take out loans to cover some or all of the cost of treatment.
  • Payment plans, sliding scales, or scholarships. Some rehabs may offer different forms of financial assistance based on need/ability to pay.
  • Going to a facility with public funding. There are free and low-cost options, and states have money set aside to help people without insurance.12
  • Medicare/Medicaid. Medicare is federal health insurance for people aged 65 and over, those with end-stage renal disease or certain younger people with disabilities.12 Medicaid is government-funded health insurance for eligible low-income adults.12,15

Find a Heroin Rehab Program

It can feel overwhelming when seeking treatment for heroin addiction, either for yourself or a loved one. If you or a loved one need help, contact American Addiction Centers at 1-888-744-0069 to speak with an admissions navigator who will take time to help guide you towards appropriate treatment.

You can also begin by verifying your insurance coverage at an American Addiction Centers facility using the free, confidential form below.

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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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