Heroin Detox FAQ: What You Need to Know

Teenage Couple Taking Drugs At HomeWhether you smoke heroin, snort it, or inject it – or use it alone or in combination with other substances – the fact is that if you don’t get treatment and learn how to stop using the drug safely and avoid relapse, it’s a deadly habit that will eventually take your freedom and/or end your life.

The only way to escape heroin addiction is to undergo heroin detox and follow up with intensive addiction treatment. If you’ve been living with heroin dependence for any length of time, at some point or another you have started to detox automatically when you started experiencing withdrawal symptoms (e.g., bone and muscle pain, sweating, yawning, agitation, insomnia, diarrhea and stomach cramps, nausea and vomiting, etc.). You know that there’s no way around it: you need help to get through to the other side. Here are the questions you should be asking:

How Can I Make Withdrawal Symptoms Less Uncomfortable?

It’s not something you can do alone. The specific withdrawal symptoms you experience will vary depending upon:

  • Co-occurring mental health issues
  • Other drugs of use
  • Physiology
  • Dose of heroin at the time of cessation
  • Length of heroin addiction
  • Use of other medications for medical reasons

The best choice you can make for yourself is to enroll in a medical detox program that is staffed by experienced substance abuse treatment professionals who can provide you with medication (in some cases), therapy, and guidance that will help you limit the severity of your withdrawal symptoms and help you begin to feel stronger more quickly.

What Medications Are Used to Treat Heroin Detox?

  • Methadone: This slow-acting opioid agonist is not prescribed in pill form when a patient takes it for the purposes of treating heroin addiction; rather, it is dispensed daily in liquid form under the supervision of a professional who is trained in substance abuse treatment. Methadone has been in use in the US for the treatment of heroin dependence since the 1960s and is proven to be effective, especially in the case of high-dose addicts who do not do well with other medications.
  • Buprenorphine: One of the most recent drugs to be approved for the treatment of opiate addiction and the only drug approved for nothing else, buprenorphine, or Subutex, is a partial agonist. It can be prescribed outside of an addiction treatment program (unlike methadone); use of the drug can help to mitigate cravings and has been proven to be effective in the treatment of low-dose opiate addicts.
  • Buprenorphine/naloxone: Most patients only take pure buprenorphine (e.g., Subutex) for a few days as they transition from active drug use to medication maintenance in recovery. The sublingual lozenge that combines buprenorphine and naloxone (e.g., Suboxone) is a blocking agent that prevents the user from getting high by injecting heroin and used for the bulk of the patient’s detox experience.
  • Naltrexone: An opioid agonist, naltrexone, or Vivitrol, is a long-acting injection that has been proven effective in the treatment of opiate addiction. Because the patient must only get the injection once a month and because it also blocks the effects of opiate abuse, this drug can be especially effective in helping patients who struggle with relapse to remain clean and sober for the long-term. In other forms, naltrexone alone has been proven to be as effective as the injection form or other methods.

Will I Be Given Medications? Can I Pick Which One I Want?

Most people who have been living with heroin addiction will benefit from some form of medication. In some cases, it may be best for you to take non-addictive medications to treat acute withdrawal symptoms that are most bothersome. In other cases, it may be more effective to take a long-term maintenance medication like the ones described above. The choice will be determined based on:

  • Your past experience in attempted heroin detox
  • The dose of heroin you are taking the day you begin detox
  • Any other medications you are currently taking
  • Any other substances of abuse you use regularly
  • Whether or not you are living with a co-occurring mental health disorder

Though you have a say in what choices are made in your treatment, you cannot necessarily pick the medication you want if it is clear to the prescribing physician that it is unlikely to work for you. Make sure that you ask questions, voice your opinions, and share your thoughts and concerns. You should feel completely comfortable with any course of treatment and understand how it works before you begin.

How Long Can I Put Off Going to Detox? When Will I Know That It is Serious Enough That I Have to Get Help?

man depressed outpatientSince 2000, it is estimated that the rate of heroin overdose has quadrupled. About 2.7 of every 100,000 deaths were caused by heroin overdose in 2013, up from 0.7 of every 100,000 deaths in 2000. Heroin overdose can occur when you shoot the drug, snort it, or inject it. It can happen to first-time users, recreational users, long-time addicts, and those who use the drug alone or combine its use with the use of other substances.

Overdose can result in coma and brain damage, and it can be deadly. It’s just one of 100 different medical emergencies that can be caused or connected to the ongoing and untreated addiction to heroin.
In short, if you are asking questions about detox, if you are experiencing withdrawal symptoms, or if you feel that heroin use is having any negative impact on your life whatsoever and you are not able to just walk away without feeling violently and physically ill and craving the drug to the point of obsession, then you can no longer postpone entering heroin detox. Your time for recovery is now.