The world is facing an opioid epidemic, and while the UK is not facing a crisis of the same proportions as the USA, heroin addiction and dependence on opioid painkillers remains a problem.
This increases the need for heroin detox & treatment services – and this is where our expertise comes in.
If you are struggling with addiction, you are not alone; recent studies show that as many as 1 in 25 adults has taken a class A drug such as heroin in the last year. The journey to recovery begins with acknowledgement, the decision to change, and a well-planned detox programme.
Detoxification, whether it be for heroin, cocaine, alcohol, or any other addictive substance, is the removal of a substance at its metabolites from your system. This is a necessary process when seeking sobriety, and begins naturally when you stop consuming a substance.
Detox is more commonly called withdrawal. Structured and planned withdrawal, however, is more often called detox and is undertaken with the intent of achieving and maintaining long-term sobriety as a part of addiction recovery.
If you are struggling with an addiction to heroin or opioids and wish to begin recovery, detoxification is a necessary part of achieving sobriety.
The signs of addiction include, but are not limited to:
If you see any two (or more) of these signs in yourself or a loved one then you should seek addiction advice and support. Whether or not you choose a formal inpatient detoxification process is something that you should discuss with your doctor first and foremost.
Those who have tried and failed to successfully detox alone in the past should consider seeking assistance.
In the below video, we explain heroin detox treatment offered by Rehab 4 Addiction:
Broadly speaking, there are three types of detox programmes one can undertake. Firstly, there is an unsupported home detoxification process. Secondly, a supported outpatient detox, and finally an inpatient detoxification programme.
Each has its own strengths and weaknesses, as well as a situation which is best suited to:
Medically assisted detoxes are those which are supported by pharmaceutical substances designed to ease pain, suffering, and dangerous side effects caused by withdrawal.
This is fairly uncommon, even when dealing with heroin addiction and is usually deployed only when dealing with severe, prolonged addiction, or when underlying health issues make withdrawal inherently dangerous.
Your doctor, or the medical staff at your detox centre, will decide whether this is the best option for you.
An outpatient detox programme is a plan undertaken with the support of trained medical staff. These programmes involved a number of classes and monitored sessions as well as a detox plan created by a doctor.
Following detox, a schedule of doctors appointments will be issued to encourage continued sobriety by offering support and guidance.
Outpatient detox programmes are vastly preferable to an at-home detox because of the support and guidance offered by trained professionals as well as follow-up support from therapists.
Those who seek outpatient detox are more likely to have a safe withdrawal experience and less likely to relapse than those who try to detox alone. This is also a more attractive option for many because it allows the patient to stay in their own home.
The downside of this, of course, is continued exposure to those who have enabled their addiction and ease of access to old supply lines.
Inpatient detox programmes are those which take place in residential rehabilitation centres. A detox centre is a medical facility which focuses on helping those struggling with addiction to safely stop using and begin building the tools needed to live a sober life.
These services include medical, social, and psychological support. Inpatient treatment is the most effective method of detox and rehabilitation for those struggling with addiction, and when it comes to heroin it is the method recommended by most doctors due to the round-the-clock support which is available.
Home detox is an option for every substance dependency and addiction, of course, but it is far riskier to attempt a home detox when the substance in question is heroin.
As a highly addictive opioid, heroin is notoriously difficult to detox from and avoid and has a severe withdrawal process that carries its own risks. Furthermore, the risk of relapse is much higher when you detox at home.
If you are determined to attempt a home detox process, however, please begin by consulting with your doctor. Be open and honest about your usage levels and reach out to people you can trust. Heroin detox can take weeks, and you may need to be monitored at times.
You should formulate a clear plan and collate emergency details for those supporting you in case you should need medical assistance.
If you are helping a loved one to undertake home detox you must take steps to ensure that they have no access to heroin except at the necessary dosage times (and levels) for a controlled detox.
Every detox centre has its own programme for helping patients to reach and maintain sobriety, nonetheless, they all begin with an assessment and (if necessary) detoxification.
This is especially the case when dealing with severe or protracted addictions to strong, dangerous substances such as heroin wherein the withdrawal stage and its symptoms can be harmful as well as unpleasant. Here’s what to expect from the withdrawal process, if you have never experienced it before.
Opioid withdrawal can be classed as mild, moderate, or severe, but nonetheless has a consistent set of core symptoms which occur because your body has become used to having heroin (or some form of opioids) in its system. Withdrawals are caused by the ways in which opioids like heroin affect the mind and body.
Firstly, they affect the brainstem (which controls functions like breathing), the limbic system (which controls emotions and produces feelings of pleasure and relaxation), and the spinal cord (which sends pain signals and information to the body).
Those who use heroin have reported feelings of pleasure, warmth, relaxation, detachment, and a lessening of pain and anxiety. This emotional response to opioid intoxication may not play a huge role in the physical process of withdrawal, but they contribute heavily to long-term cravings and add to the danger of relapse.
The process of withdrawal can be straightforward or ‘complicated’, but generally lasts from 7 to 10 days depending on a number of factors. These factors are the length of time that a person has been abusing heroin, the amount of heroin they took, how frequently they used, the method by which it was taken (smoked, injected, etc), and underlying health issues.
While any heroin withdrawal is unpleasant, ‘straightforward’ withdrawals are those which exhibit the most common symptoms and progress at the rate expected by medical staff.
These common symptoms of heroin withdrawal include:
‘Complicated’ opioid withdrawal is any withdrawal which includes unusual or dangerous symptoms and medical complications.
Complicated withdrawals can include delirium, hallucinations, tonic-clonic convulsions (seizures, previously called ‘Grand Mal’ seizures), and extremely altered sensorium characterised by agitation, confusion, disorientation, and in severe cases aggression.
The majority of patients who experience a complicated withdrawal have underlying health conditions, either physical or psychiatric, or have favoured inhalation of vapours as their method of intake, though it is not unknown in those who use intravenous methods of consumption.
For most people, however, the withdrawal period is safe, if unpleasant, and comes to an end within 7 to 10 days.
Withdrawals begin within 6 to 12 hours of the last dose, peak roughly 2 to 3 days after, and begin to subside after roughly 5 to 6 days. These are general timescales, but it is rare for withdrawals to recede before 5 days or last more than 10 days.
Following this period, post-acute withdrawal syndrome (PAWS) may see the recurrence of symptoms for up to 24 months. These are caused by the neurological changes that protracted heroin use inflicts upon the body; these symptoms include anxiety, depression, fatigue, insomnia, and irritability.
Alongside the physical and psychological support offered during withdrawal, inpatient programmes offer a range of resources and services designed to help manage long term recovery.
Psychological or psychiatric care and varied therapy sessions are offered alongside 12-step methodologies to enable those recovering from addiction to develop the tools needed for sober living.
For those who have pre-existing mental illnesses or health issues, this may also include a review of appropriate medications to manage these issues long-term.
After all, many people who struggle with heroin addiction turn to illegal opioids to replace strong painkillers following injury, or to self-medicate for other long-term conditions which go on to exist co-morbidly with this addiction.
For some people, total sobriety may take too much of a toll on the body. Those who have been using heroin over long periods of time or in huge quantities may be placed on to a substitute drug such as methadone.
These programmes, known as Heroin Dependency programmes, are in place for those whom withdrawal could be incredibly dangerous or even fatal. Gradually lowering the level opioids the body is accustomed to means a person can be weaned off of opioids over a period of months or years. Many people who choose to join an inpatient detox stay for some weeks or even months after withdrawal has ceased.
This stage of rehabilitation is designed to help them build a stable routine and come to terms with the factors which caused them to turn to drugs, as well as to accept the things they have done as a result of their addiction.
The aim is to ensure that each person has the tools they need to maintain sobriety in the long-term before they leave the safe and supportive environment of the detox centre.
Pharmaceutical assistance is not always needed during detoxification, but heroin is a hugely addictive substance with potentially a lethal withdrawal process and as such medicinal intervention is more commonly required than it would be for cocaine detox, for example.
Medically assistance can make withdrawal less painful but is most often used to mitigate dangerous symptoms of withdrawal such as seizures and hallucinations. Broadly speaking, there are three main medications which are used to aid in the withdrawal and detoxification process, they are; buprenorphine, methadone, and naltrexone.
Below we discuss these medications in greater detail:
Buprenorphine, also called suboxone, is prescribed during heroin detoxification to mitigate and manage some of the more severe symptoms such as nausea, vomiting, muscle aches, cramps, and twitching.
Used to control symptoms during the withdrawal process, this medication can make detox bearable even for people who have severe addictions.
As previously discussed, methadone can be used as a part of a long-term weaning process. This is because it is also an opiate, but unlike heroin, it is slow-acting and fairly weak.
Detoxing with a weaker opioid is a method of detox used when simply removing opioids from the system would be harmful.
Naltrexone is given after detox to manage PAWS and cravings without triggering a relapse. Used to treat those recovering from opiate and alcohol addictions, Naltrexone is neither addictive nor sedative; it works by blocking receptors in the brain which react with opioids.
This is why it must be given after all opioids, including Methadone, are out of the system. As a result, taking Naltrexone in conjunction with other long-term treatment options such as therapy significantly reduces the risk of relapse.
Detox is never a pleasant experience, but for some people, there are complications which can be dangerous or potentially life-threatening. Despite the common misconception that opioid withdrawal cannot be fatal, this is not true. What is true is that almost all deaths which occur during opioid withdrawal are preventable.
The most common causes of death during detox are dehydration caused by severe vomiting and diarrhoea, cardiac arrest as a result of immediate and stressful withdrawal, and choking during tonic-clonic convulsions.
Such deaths occur as a result of poor or non-existent monitoring of the patients’ wellbeing and physical health. These dangers are present in most withdrawals, but with proper management, they can be mitigated and controlled.
More challenging is the complications presented by underlying or co-morbid health conditions.
Those who have pre-existing mental illnesses, for example, may experience exacerbated psychological withdrawal symptoms like anxiety, hallucinations, or delirium, while those with underlying heart conditions may need to undertake longer, weaning withdrawals aided by methadone to avoid unnecessary stress to the cardiovascular system.
These dangers and complications are manageable when you have medical support and guidance, however. This is why attempting to detox at home is firmly discouraged, even for those in good health with a strong support network.
Heroin is notorious for the extremely strong ‘cravings’ which come as a part of the withdrawal process; many in recovery describe these feelings as close to insanity and stress how someone experiencing them might beg, plead, manipulate, or intimidate to get the drug.
These cravings are often the reason for relapse amongst those who are still in early recovery. This is why structured detox is so helpful. By entering into an inpatient programme where access to opioids is severely restricted, you can minimise the risk of relapse.
Relapse is dangerous for a number of reasons. First and foremost, as you withdraw your tolerance for heroin drops; using the dose you are accustomed to after or during withdrawal is more likely to end in a fatal overdose.
Secondly, relapse prolongs the period of withdrawal, increasing the strain on your body and mind. This is why detox centres have methods of pharmacological intervention which protect the process of withdrawal and ease the discomfort, pain, and strain caused by the process.
While NHS and private inpatient programmes follow many of the same principles, the most obvious benefit of a private programme is the speed at which you can find a placement. Private programmes also tend to be better funded, for obvious reasons, and have more resources at their disposal.
Other benefits of a private inpatient detox include:
The only person who can guarantee that you stay sober is you, but a private detox programme can give you all the skills and tools you need to make that happen.
If you are struggling with heroin addiction and you are ready to make a change you should first speak to your doctor. Be open and honest about your levels of consumption and how long you have been taking heroin; your doctor will be able to advise you on your options.
They may be able to give you support and point you to resources, and there are limited spaces in NHS inpatient programmes. If you want to begin detoxing quickly, however, a private programme maybe your best option.
For most people, the first consideration when it comes to choosing a detox clinic is whether or not they can afford the treatment costs. This is understandable, but once financial concerns are put aside there are other important factors to keep in mind.
First and foremost, discuss your medical needs with any clinic you consider to ensure that they are capable of dealing with any special needs you may have. Secondly, think about the type of programme you are choosing; if you are choosing an outpatient treatment then it would be best to find a clinic close to your home.
If you are worried about your environment making recovery harder an inpatient programme may be best for you.
Talk to your family and friends, if you feel that their input will be beneficial, but always stay in contact with your doctor until you have chosen a clinic and programme that is well-suited to you.
Successful detox is one of the most important steps in achieving and maintaining sobriety, but it is only the first step. After successfully emerging from the withdrawal period, it is important to bolster and augment your sobriety with psychological and physical rehabilitation.
Inpatient programmes have this built into their structure in the form of support groups, therapy sessions, and 12-step methodologies designed to encourage personal responsibility, introspection, understanding, and instil the skills needed to manage the stress of day to day life without relapse.
Following discharge from any detox programme, it is important to make use of available aftercare resources and stay in touch with people who are supportive of your sober lifestyle. Heroin addiction is a psychological and physical addiction which means social factors are often as influential in maintaining sobriety as physical factors.
Staying in touch with support groups and attending aftercare therapy sessions minimises the risk of relapse by avoiding isolation, reinforcing the skills and information gained through rehab, and keeping you rooted in a strong and supportive network of like-minded peers.
Don’t be afraid to reach out for support after detox and rehab are over; fighting addiction is a lifelong battle that is made more bearable through support and solidarity.
Put your faith in us and get help for your heroin addiction today. Contact a member of our admissions team today on 0800 140 4690 to discuss your heroin detox options.