Heroin, as one of the most highly addictive substances, is perhaps the hardest drug to come clean from.
This is why at Rehab 4 Addiction, we offer high-standard heroin detox and heroin rehab programmes to help those struggling break free from this addiction.
Heroin is a potent opiate that traps victims in its powerful grip. Heroin addiction has wiped out entire communities throughout the world from Glasgow to Karachi.
The personal tragedies behind its use reach far and wide.
Heroin rehab exists to help you or your loved one overcome this powerful and life-threatening condition.
Heroin is an extremely addictive opioid drug derived from the poppy plant that is grown in parts of Asia, and South and Central America.
It was originally developed as Diamorphine in 1898, primarily for medical purposes because of its pain-reducing qualities.
Over time though when it became known that Heroin produced feelings of euphoria it became widely used as a recreational drug that people quickly became dependent on because of the powerful positive effect it had on their emotional state.
This is because its chemicals attach easily to opioid receptors in the brain and activate the reward pathway to initiate pleasurable feelings.
Heroin has a half-life of 3-6 hours which means it is relatively fast-acting and it also has the capability to be injected into the bloodstream where it can start to take effect quickly. (15)
There are several factors that can determine whether a person becomes addicted to Heroin, these factors tend to be genetic, biological, or environmental in nature.
There are many researchers in the Neuroscience field who see addiction as a brain disease that makes some people more vulnerable to becoming addicted than others because of the genetic structure of their brain.
Each one of us has our own unique biology and will therefore physically react to drugs in different ways.
Scientific research has found that some people have very unusual reactions to certain drugs and act as if they have ingested more of the drug than they actually have.
Such differences could be down to our individual physiology. Some people are more negatively affected by drugs as their body is either missing a particular enzyme that breaks down a particular drug or their body produces lower levels of this enzyme.
During therapy many people who have become dependent on Heroin report a lot of upheaval and trauma in their early family life, they may have experienced a lack of care which led to them being continuously anxious.
Experiencing such a traumatic early life can lead to unresolved feelings which set the foundation for individuals to self-soothe via Heroin use in early adulthood. (5,22)
The Biopsychosocial Plus model is used to explain the origins of addiction and proposes 5 dimensions that should be considered to explain how addiction develops these being biological, psychological, social, cultural and spiritual.
However, it must be stressed that it is the way that these factors interact with each other that leads to addiction rather than one factor being solely responsible. There appears to be a wide range of environmental factors that play a crucial role in many cases of Heroin addiction. Many of these will relate to how people deal with stressful and traumatic experiences in their lives. (22)
Heroin and other Opioids are very widely used, highly addictive and extremely harmful, illustrated by the fact that nearly half of all the drug poisoning deaths (2,263) recorded in the UK 2020 were from Opioid drugs.
This is becoming a huge health concern in the UK, highlighted by the fact that there is currently a warning about the use of heroin and other opioid drugs issued by Public Health England.
This is because there has been a significant increase in the number of people overdosing due to a new trend of mixing Heroin with various other synthetic opioid drugs in the latter half of 2021 in London and England. (7)
In the below video, we explain heroin rehab treatment offered by Rehab 4 Addiction:
Below is a list of some of the most common signs of heroin use and addiction.
Physical evidence may include:
There are also a few less obvious signs that relate to the person’s behaviour, which stems from the desire to hide their drug addiction and the need to continue using.
These may include:
When considered individually, each physical symptom and behaviour may seem innocent enough and not a cause for concern, however, when all of these symptoms and behaviours appear simultaneously there is a strong chance that the individual concerned is addicted to Heroin. (13)
Anyone regularly taking Heroin may appear to lose weight as if they are malnourished due to the appetite-suppressing consequences of frequent Heroin use.
They may employ tactics to cover up the physical signs of their drug use such as wearing long sleeve tops and trousers to prevent people from noticing their track marks.
It may also be evident that their behaviour will have become more antisocial, and they may appear depressed, this is more noticeable in people who were previously sociable. (13)
For a clinical diagnosis of Heroin addiction to be made a person’s behaviour would be judged against the eleven set criteria established in DSM 5 for an opioid use disorder.
The 11 set criteria are very similar for most substance use disorder diagnoses and seek to investigate the following aspects of a person’s Heroin use:
If a person was assessed as meeting 2/3 of the criteria, then they would be judged as having a mild addiction, if they met 4 or 5 of the criteria it would represent a moderate addiction whereas anyone meeting 6 or more of the criteria would be diagnosed as having a severe Heroin addiction. (22)
The CAGE Tool is a very brief screening tool to assess whether someone’s Heroin use has become a serious cause for concern.
CAGE consists of 4 items and the responses to these questions will determine the next course of action.
The questions seek to establish whether someone feels they need to cut down on their drug use, whether they are annoyed by people’s criticism of their Heroin use, whether they feel guilty about their Heroin use, and if they tend to take Heroin in the morning to calm their nerves.
Answering YES to 2 or more questions would mean further investigation and a detailed assessment into their Heroin use.
Heroin addiction is a mental illness and it’s not uncommon for people who become dependent on Heroin to have other mental health conditions, which means they could well experience moments of crisis before entering rehab, particularly if distressing thoughts and emotions have taken over their minds.
There are established methods of crisis intervention that can be implemented when the situation arises which have been proven to be effective.
Firstly, a crisis assessment of all the stressors, coping skills and resources available should be made and wherever possible look for opportunities to build a rapport with the person, for example, ask them their name and tell them yours, look for common areas of interest.
Then seek to find out what caused the crisis and let the person express their emotions and feelings and just be a listening ear for them. Finally, talk them through a range of options, before developing a plan of action to ensure their safety and initiate processes for additional assistance if required. (4)
The recovery model for substance misuse consists of a range of important factors that are deemed to be important in helping people give up their Heroin consumption. (21)
SAMHSA proposed 10 guiding principles which can have a significant positive effect on a person’s ability to recover from substance misuse and these principles are based around the following:
Coming off heroin isn’t a simple process and it won’t be easy.
But it is important to understand the steps to recovery to prepare yourself for what is to come.
You can expect to go through the following steps during our heroin rehab programmes:
Heroin is a notoriously difficult drug to become free from, but that isn’t to say that it isn’t possible – it simply requires professional help and treatment.
When choosing a heroin rehab facility, it is important to be sure that the reputation of the facility is good, since there is a range of treatment options with some being better than others.
There are two options for heroin addiction, inpatient treatment and outpatient treatment, which we discuss below:
The most popular choice for those addicted to heroin is being treated as an inpatient.
This treatment, which is made of a variety of things such as therapy, benzodiazepine rehab and a detox amongst others, will usually last up to 90 days.
Whilst this is quite an intensive option, it is very effective.
Whilst taking part in inpatient treatment, you will be given a very structured routine which will be invaluable in your recovery.
You might think that the treatment is completely based on your heroin use, however, many of our facilities offer activities such as holistic therapy and access to leisure and gym facilities.
But one of the most notable aspects of inpatient rehab is that you will have the opportunity to deal with your withdrawal symptoms through the use of supervised medication use, which can be extremely beneficial.
Once the inpatient treatment is complete, you will likely be referred to an outpatient program as a way of maintaining your new lifestyle.
An aftercare programme will then be created to help you maintain sobriety.
For those who are struggling with a heroin addiction that is not severe, outpatient treatment can be effective and brings about less disruption to your day to day life.
Whether or not you meet the criteria to be treated as an outpatient will be decided by a substance abuse professional who will advise you on the best course of action for your addiction.
As an outpatient, you will still have access to therapy and medications as well as continual support.
However, you will take part in this from our own home.
Whilst it may not be as intensive as inpatient treatment, your therapist will monitor your progress and identify any issues along the way.
With the right rehabilitation programme, recovery is not an impossible goal even for long term heroin addicts.
The heroin rehab programme we offer at our centres tackles the associated psychological and physical aspects of heroin addiction.
This approach is vital for long term heroin addiction recovery.
When you attend our heroin residential rehabilitation programme you will be subject to 24-hour medical observation for the duration of detoxification.
This is because the health of our patients is most at risk during this period.
Prescription drugs such as Buprenorphine and Naloxone fight off painful withdrawal symptoms until ‘stabilisation’ is achieved.
Our medical staff may decide to gradually stage your withdrawal from heroin and Methadone may be offered in some cases. This is known as ‘tapering’.
Heroin withdrawal symptoms are serious; they can last for a long time – from a day or two too many weeks – and the cravings themselves may last for months or even years.
The withdrawal is so severe that complications from it can, in some cases, cause death – this is why it is so important to use a medically assisted withdrawal programme like the ones offered by Rehab 4 Addiction.
This clinic includes a specialist heroin detoxification unit, which is essential to help someone manage the withdrawal and also prevent future addiction.
Withdrawal symptoms associated with heroin detoxification linger for around fifteen days.
Around the ninth day into your heroin detoxification, heroin withdrawal symptoms typically begin to decline.
A ‘rapid detox programme’ is not advisable given the prolonged nature of heroin withdrawal symptoms.
Many users find themselves simply unable to break the addiction, partly because of the powerful withdrawal symptoms.
These may include:
The time taken to detox from Heroin can vary depending on the severity of a person’s addiction, on average the amount of time it will take to complete detox treatment will range from one week to three weeks.
However, patients who have been taking Heroin for years may find they will need to continue taking a substitute drug to stave off withdrawal symptoms for several months if not longer. (26)
Ultra-rapid (24 hours) and rapid detox treatments (1-5 days) can be completed much quicker, but these options are not routinely offered due to the potential medical complications that are associated with this treatment. (17)
Substitute medications are used for Heroin detox, they are particularly effective because they contain similar chemical characteristics to Heroin but are not as addictive and do not generate feelings of pleasure.
Substitute drugs are long-acting which means they are only required to be taken once a day to treat withdrawal symptoms. (15,26)
Doctors start patients off on a dose that will eliminate withdrawal symptoms, and gradually over a period of weeks reduce the dose that they give to patients, a process known as tapering someone off the drug.
As the patients’ body adapts, it will over time require less of the drug to prevent withdrawal symptoms until Heroin is eventually eliminated from their system.
The following drugs are used during the detox process:
Methadone is an established treatment for Heroin addiction although there are some people whose personal health circumstances mean that they should extra care when taking Methadone.
These include those with breathing difficulties, those who are prone to kidney and liver problems, and anyone who experiences seizures. (26)
Research has indicated that Buprenorphine is a safer treatment option than Methadone, as there is less risk of a patient overdosing during detox.
This is because Buprenorphine is a partial agonist and does not fully attach to Opioid receptors in the brain.
This means that anyone who consumes Heroin whilst simultaneously taking Buprenorphine will find that the effects of Heroin will be redundant as the chemicals in Heroin will be blocked from taking effect.
Another benefit of using Buprenorphine is that it does not negatively impact the client’s respiratory system compared with other medications, which enables patients with breathing difficulties to receive detox treatment.
It has also been found that Buprenorphine generates less intense withdrawal symptoms than Heroin. (26)
Suboxone is another option to help treat Heroin dependence although at present it is not widely available.
There is still a great deal of uncertainty about Suboxone although many doctors in America do strongly advocate its use in treating Heroin addiction as it has been proven to reduce the risk of fatal overdose by 50%. (15,10)
UROD is designed to shorten the period of detoxification and reduce the amount of time a person experiences withdrawal symptoms and takes place over a period of 24 hours.
The process involves medically inducing withdrawal symptoms at the start of the procedure while the patient is placed under general anesthesia or sedation whilst the procedure takes place.
Rapid detoxification on the other hand takes place over a period of 1-5 days with mild sedation, the normal period for detox procedures is between 7-21 days depending on how severe a person’s addiction is.
The National Centre for Health and Clinical Excellence urges extreme caution with any rapid detox treatment due to the medical complications that can arise when using the necessary medication. (17)
They advise that this option is not routinely offered to patients and any person considering this option should undergo a detailed medical risk assessment.
Once the process of detoxification is concluded you will take part in a number of therapy sessions.
This will include forms of psychotherapy known as group therapy and individual therapy.
Old negative beliefs surrounding your addiction will be replaced with positive coping strategies that are essential for long term recovery.
Once your programme draws to a conclusion a tailored relapse prevention plan will be drawn up.
We encourage you to work within your community upon your return home.
This could include attending Narcotics Anonymous or SMART Recovery sessions which take place in your home town or city.
Once you have successfully completed your detox from heroin, your focus will then shift to staying free of the drug.
Your doctors and therapists will advise you on ways that you can alter your lifestyle to maintain your sobriety from the drug.
This might include things such as changing your social circle and attending support groups.
Furthermore, you can continue with your medication and try finding a new hobby.
Attending regular appointments with therapists is vital in maintaining all the hard work that you have done so far and gives you a chance to talk through any problems. Usually, a key worker will continue to work alongside you for six months after your rehab has ended.
These steps will ensure that you are confident in your rehabilitation and will ensure you receive the correct continued support.
Rehab centres offer many different types of therapy to clients, each patient will have their own unique treatment plan based on the outcome of their initial assessment, the following therapies are very common though:
CBT is a common intervention recommended for people seeking recovery from substance misuse, the main goal of CBT is to help the client understand any irrational assumptions they possess about themselves, other people, and the daily events that they experience.
Negative thoughts cause negative emotions which in turn impact our behaviour.
Many people who turn to substance misuse have a low opinion of themselves and tend to blame themselves for outcomes that are not their fault and do not tend to take credit for positive outcomes when they should.
Once identified these negative thought patterns can be changed under the guidance of a qualified therapist who will take you through a series of cognitive exercises which will enable you to see where your irrational beliefs come from.
Once this has been identified they will provide you with strategies to deal with these thoughts in a more productive way instead of turning to Heroin. (1)
The use of MDFT in the field of addiction has grown significantly in recent years as researchers have started to understand how all the complex factors from a person’s early environment set the foundation for their future Heroin use.
There are 4 significant areas that therapists will work on, these being, the individual concerned and all of their strengths, weaknesses, and challenges, secondly, the individual’s parents and other family members, thirdly the family interaction patterns will be analysed before finally investigating how wider social influences such as schools, sports clubs, and the local community have shaped the individual’s behaviour.
These 4 domains are seen as crucial in helping the substance user change their behaviour for the better. (12)
Anyone undergoing treatment for substance misuse will receive MI sessions to help them initiate and maintain the motivation necessary to change their behaviour.
Therapists will play a key role in working with their clients in a supportive way to help them overcome any resistance they may exhibit at various stages in their journey towards recovery.
MI works well with the Stages of change model developed by Prochaska and Di Clemente (1983).
The therapist will adapt their strategy to whichever stage the client is stuck in and engage the client in a discussion to help them understand the reasons why they are resistant.
This will hopefully trigger an internal dialogue within the client to allow them to resolve any resistance they may have.
The therapeutic alliance between client and therapist is key to the success of this therapy, therapists must show empathy and compassion towards the client otherwise the sessions will be unproductive. (14)
Contingency Management techniques use the behaviourist principles of operant conditioning to help shape the behaviour of people seeking to recover from heroin addiction and the evidence for its effectiveness has consistently been shown in research.
The premise of this approach is that clients should be positively rewarded for changing their behaviour, this reward will reinforce the likelihood that they will maintain this behaviour in the future.
Positive behaviour is more likely to be reinforced if the behaviour is rewarded immediately, or soon after it occurs.
Examples of positive behaviour that could be rewarded include attending therapy for the first time or producing a clean drugs test.
Research has indicated that financial rewards or vouchers for goods have proven to be successful in influencing clients towards positive change. (20)
Any individual that has also been diagnosed with a mental health condition such as Depression or Schizophrenia alongside their Heroin addiction is classed as a dual diagnosis patient, as they have two mental health conditions.
This makes their treatment plan more complicated and extra care needs to be taken by the staff at rehab centres.
All mental health conditions interact with addiction in a different way, and so staff must fully understand the nature of each patient’s specific mental health condition and how this interacts with their Heroin addiction.
They may need to establish which came first as Heroin addiction can both cause another mental health condition and be caused by one. Any treatment plan should endeavour to treat both conditions at the same time rather than prioritise one condition at the expense of the other. (23)
The overall cost for Heroin rehab will differ from person to person as it is dependent on several factors and each person seeking treatment will have a slightly different treatment plan based on the nature and severity of their Heroin addiction.
The factors that can influence the overall cost include:
Location – It is likely that rehab centres situated in more affluent areas will incur higher charges.
Type of rehab – The costs will be higher if you opt for inpatient treatment instead of outpatient treatment due to the extra staffing and monitoring costs associated with staying in a rehab centre for 4 weeks.
There will be food, heating and lighting expenses factored into your costs which will not be the case if you have outpatient treatment.
Length of stay – The longer you are required to stay, the higher the costs you will incur, patients who decide to have a room to themselves rather than share a room with others will pay more.
Types of treatment – Anyone requiring a detox procedure will stay 1-3 weeks longer in rehab depending on the severity of their addiction compared with those who just require psychosocial interventions.
Amenities – Anyone requiring a more comprehensive range of services to help with their recovery will face a higher cost, extra facilities such as health spas, physical therapies and recreational activities are not part of any basic treatment programmes.
Due to the nature of addiction, many substance misuse practitioners believe abstinence is the only way to avoid slipping back into Heroin use.
Because people entering rehab have become physically and psychologically dependent on Heroin then it is in their best interests to set a goal of abstinence. Heroin is a highly addictive drug and once a person has become addicted their body and mind cannot go back to the way it was.
Excessive drug use has altered their individual biology, so even minor, casual drug use can have serious negative consequences.
Even consuming the drug once can lead to a significant relapse which can undo all the progress that has been made to believe total abstinence is the only way to move on from a Heroin addiction towards a more fulfilling life.
There are many support groups to turn to for support to help you maintain the progress you have made during rehab.
SMART Recovery is based in the UK and has established a first-class reputation for supporting people as they seek to overcome their drug use.
SMART recovery’s facilitators will guide you through their online recovery programme which focuses on 4 key principles.
Personal growth is a key ethos of SMART recovery, and their programme aims to enhance people’s cognitive skills, motivation levels, improve their ability to tolerate stress and ensure their clients achieve a healthy work/life balance.
NA is the drugs equivalent of the AA, it follows the same principles of AA but its approach is geared towards those who have struggled with drug addiction.
There will be weekly meetings that will enable its members to connect to each other and talk about how Heroin use has affected their lives and what they can do to work towards recovery.
Just like the AA, anyone attending meetings can work through the 12-step programme which has been adapted to account for drug use rather than alcohol use.
There are regular support groups throughout the UK for families or close friends of people who have become addicted to Heroin.
These meetings provide an opportunity for attendees to connect with other people who have been through similar experiences by talking about their emotions and supporting each other as they come to terms with their situation. (16)
Narateen is a support group for teenagers and young people whose lives have been blighted by Heroin use in their families.
The meetings provide a safe, supportive space where young people can open up about how their lives have been affected.
Acquiring Relapse Prevention (RP) will form an integral part of a person’s treatment plan.
Patients may well progress well in rehab when they are in a safe, supportive, drug-free environment but it is essential that they learn vital cognitive skills which they can implement when they leave rehab and are faced with scenarios that may tempt them back into Heroin use.
RP involves helping clients identify the high-risk situations that they may face which may tempt take heroin again.
Everyone has different high-risk situations, and it is the role of rehab therapists to collaborate with their clients to help them identify the high-risk situations in which they may be vulnerable. (11)
A high-risk situation may be meeting up with certain people, attending a social event or even the strong triggers elicited by visiting a location you associate with Heroin use.
Some individuals may identify they are at risk when they experience certain feelings such as Anger or loneliness.
The therapist will help the client formulate a plan that they can implement in each of the high-risk scenarios that they have anticipated to lessen the likelihood that they will relapse in that situation
Anyone who has been through rehab treatment should be comforted in the knowledge that the support does not end there.
Maintaining recovery from an addiction is a challenging lifelong process that is difficult to achieve alone. There is a range of aftercare services available to help people to maintain their recovery.
The rehab centre where you received treatment will still keep in touch with you to ensure you are doing all the right things necessary to continue your progress
It is essential to continue attending NA meetings after rehab, the principle of fellowship is important in sustaining recovery and maintaining contact with the close connections you have made since you first joined will help you to maintain focus.
It is also important for you to offer guidance and support to people joining NA for the first time as part of your own recovery process.
Thanks to huge advancements in technology there are now many ways of receiving drug education and psychological support as part of an aftercare plan.
You can communicate with a therapist over Zoom and attend support meetings online, as well as utilising the chat room feature which appears on many support groups’ websites. (9)
Other uses of technology include:
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