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Recovering From Heroin Addiction

Joseph Sitarik, DO

Medically reviewed by

Joseph Sitarik, DO

April 11, 2019

Addiction does not stem from a weakness of character or willpower, or of a lack of morale; instead, it is something far more complex that is rooted in intense physical, physiological, mental, and emotional problems within a person’s life. For these reasons, recovery is a multi-faceted journey.

A heroin addiction is one of the most severe addictions known to man. Heroin as a drug is exceedingly addictive. According to NIDA, as of 2011 “4.2 million Americans aged 12 or older (or 1.6 percent) had used heroin at least once in their lives. It is estimated that about 23 percent of individuals who use heroin become dependent on it.”

Detoxing And Withdrawal

When a person addicted to heroin either significantly reduces, or entirely quits their drug use, they will begin to experience withdrawal as their body starts to detox. The following are the most typical symptoms of withdrawal; some many arise within a few hours of the last use.

  • Severe cravings
  • Muscle and bone pain
  • Restlessness
  • Sweating or runny nose
  • Mood swings, often accompanied by depression or anxiety
  • Insomnia
  • Nausea; may be accompanied by diarrhea, stomach cramps, and/or vomiting
  • Fever, or cold flashes characterized by goose bumps
  • Kicking movements or spasms
  • Increased heart rate and blood pressure

These symptoms may vary person to person, and may often be quite severe. It is for this reason that certain medications may be especially useful; these can aid in this detoxification process by lessening a person’s cravings or physical symptoms, two things that many times push a person to relapse. Additionally, undergoing detoxification and withdrawal within a medically supervised environment or rehabilitation facility can ensure that you receive the best treatment for your unique circumstances and receive the supportive care and attention that can be crucial at this time.

Medically assisted detoxification is simply the first step, it is not a treatment for the addiction proper; however, if it is followed by what NIDA calls “evidence-based treatment,” it provides a stronger foundation by which a person can base their recovery.

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The Dangers And Truths About Relapse

Relapse is a viable concern; in fact, it is very likely that a fair amount of people within recovery will come to relapse during this journey. It is important to realize that this is not a failure, nor does it mean that sobriety is unattainable; however, it is not without risks.

Studies show that the risk of death increases for a person if they leave recovery and begin using again. Additionally, the risk is higher for those that have recently become clean, or reduced their use. This is because of two reasons: first, the person is no longer aware of what their tolerance is, and secondly, their tolerance has likely decreased.

NIDA puts relapse in perspective with the following statement: “relapse rates (i.e., how often symptoms recur) for people with addiction and other substance use disorders are similar to relapse rates for other well-understood chronic medical illnesses such as diabetes, hypertension, and asthma, which also have both physiological and behavioral components.”

If a person with any one of those diseases relapsed, you wouldn’t automatically think that they were doomed; instead, you would think that they simply needed more help and different treatments to assist them in achieving success and health. It is important for someone in recovery to view relapse the same way so that they may maintain their sense of hope and purpose.

If a person relapses, they need to reinstate treatment, reevaluate their current module, or consider trying a different treatment. Any time you make a decision such as this, you gain the greatest benefit by seeking the help and wisdom of an addiction specialist.

Treatment Options

Today there are a variety of treatment options for heroin addiction, including the pharmacological approach (medications) and behavioral health care. Here, we briefly outline the various treatments that are most commonly used to treat this addiction.

Medication

NIDA explores the benefit of utilizing medication within treatment, stating that “scientific research has established that pharmacological treatment of opioid addiction increases retention in treatment programs and decreases drug use, infectious disease transmission, and criminal activity.”

NIDA breaks down the classification of the three types of opioid medications here:

  • Agonists, which activate opioid receptors.
  • Partial-agonists, which also activate opioid receptors but produce a smaller response.
  • Antagonists, which block the receptor and interfere with the rewarding effects of opioids.

The choice of medication is dependent on a person’s specific needs and circumstances. This choice is best made under the supervision of a trained medical professional that can thoroughly examine your medical and drug use history.

These are the medications used to treat heroin addiction:

  • Methadone: This is a slow-acting opioid agonist which works to decrease the “high” a person experiences when they use heroin. It helps to prevent withdrawal symptoms caused by the detoxification process. It is also used for methadone maintenance treatment. This is a good method for individuals that may have not had success with other medications. This is only available when dispensed through an approved outpatient treatment facility.
  • Buprenorphine: This is partial opioid agonist which helps to relieve a person of their drug cravings by way of occupying the opioid receptors. It also provides assistance during the withdrawal process and disables the illicit drug from creating the desired “high” or euphoric effect. Subutex is purely this, whereas Suboxone contains the opioid antagonist naloxone to aid in the prevention of misuse by injection. These treatments are available by prescription so that a person can take them from home.
  • Naltrexone: An opioid antagonist, it works by blocking the action of the drug; it is taken after a person is no longer dependent on heroin. It is not addictive, nor does it cause sedative effects. One downfall of this treatment is that patients often do not take their dose as prescribed, thus disabling its effectiveness. This may be alleviated by the recent introduction of a once monthly injection, Vivitrol.

The first two medications do carry the risk of dependence. Using benzodiazepines at the same time carry a great risk and should not be used at all unless your doctor advises you such.
At times, other medications may be used to contend with the symptoms of withdrawal; these include:

  • Clonidine: This is an antihypertensive that works by altering nerve impulses within the brain. However, taken in the correct context it may help to alleviate the cramping, muscle aches, anxiety, agitation, sweating, and the runny nose that accompany a heroin withdrawal; due to this it may aid in insomnia as these side effects are known to aggravate a person and impair their sleeping.
  • Prescription Or Over-The-Counter Sleep Aids: Sleep deprivation or insomnia may be a side effect of withdrawal; these may help you achieve the rest and rejuvenation that is crucial to your recovery.
  • Medications For Mental Health Care: There are a variety of medications used to treat mental and behavioral health concerns. Treating these concurrently allows you to focus more fully on your recovery, working to eliminate issues that could trigger a relapse.

As always, you should speak to a trained medical professional before beginning any new medication. Some medications may interact or react with each other, resulting in dangerous or life-threatening side effects. Be honest. Take care to speak openly of your health history, your current and past drug use, and any medications that you are currently taking. These things may all effect how your body reacts to a new medication.

Behavioral Health Care

Often times substance abuse and addiction derive themselves out of a person’s pursuit to self-medicate; mental and emotional issues are some of these most common triggers. The Substance Abuse and Mental Health Services Administration (SAMSHA) cites that “about 45% of Americans seeking substance use disorder treatment have been diagnosed as having a co-occurring mental and substance use disorder.” Depression and anxiety are just two of the most prevalent. It addition to precipitating drug use, mental health concerns may also be aggravated or begin from the use itself.

It is very important that with any concurrent health condition, such as an addiction and mental health struggles, that both be treated. The false and harmful misconception that an addiction must be treated before a person can approach their other concerns. In fact, it can be very detrimental to leave these untouched as their very presence may aggravate the drug use, or threaten a person’s sobriety by encouraging a relapse.

NIDA further explains the benefit and purpose as: “behavioral treatments help engage people in substance use disorder treatment, modifying their attitudes and behaviors related to drug use and increasing their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive use. Behavioral therapies can also enhance the effectiveness of medications and help people remain in treatment longer.”

Medication Assisted Therapy or Treatment (MAT) approaches not only the physical and physiological effects of the addiction, but also the mental and emotional ones; this is a method that pairs the use of medications with behavioral health care. The National Institutes on Drug Abuse (NIDA) supports this, stating “although behavioral and pharmacologic treatments can be extremely useful when utilized alone, research shows that for some people, integrating both types of treatments is the most effective approach.”

Behavioral health care may be offered in an outpatient or residential setting, in individual and/or group formats. Some methods that may be employed are:

  • Cognitive Behavioral Therapy: This helps a person to recognize various behaviors, expectations, and circumstances that revolve around their drug use; it helps them to learn to cope with these and their subsequent stress by utilizing various tools and skills the therapy teaches them.
  • Contingency Management: This motivational, incentive-based system utilizes vouchers that represent points; these positive reinforcements are granted to a patient after they have a negative drug test. They can then use the points to “purchase” items that are useful for living a healthier life.
  • Motivational Interviewing: This method is an active and communicative partnership between the person seeking help and the one delivering the counseling. It helps to uproot the ambivalence that can be so counterproductive to rehabilitation and replace it with positive processes the patient has an active role in forming based on their self-actualization and motivation.

This technique may work on its own, however, for person’s that resist the concepts of change that are presented to them within therapy, this can be an important foundation for later therapeutic methods.

Tips For A Successful Recovery

In addition to those methods, there are certain practices you can integrate into your life that will help you maintain the balance and focus that is necessary to keep your recovery successful.

    • Educating Yourself On Your Options: Each person struggling with substance abuse or addiction is unique and has unique circumstances; for that reason the best treatment varies from person to person. NIDA says that “matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society.” Take the time to examine your life and consider what option is best for you.
    • Prioritize Your Recovery: Always, even after you achieve sobriety, place your recovery first. At any point within the process ensure you have an accessible network of people and professionals you can reach out to for sound direction and support.
    • Take It Step By Step: Remember that recovery is not a destination, it is a multi-step process. Be mindful of your thought processes and actions; learn techniques and new behaviors that can keep you balanced and healthy.
  • Reach Out: Communicating is one of the most important parts of recovery. Addiction can breed isolation and loneliness; having a support system can help motivate and inspire you through the ups and downs.

Consider the benefit of therapy as you strive towards your recovery; now consider this, the benefit of therapy and behavioral health care does not cease when you achieve sobriety. If you are feeling doubts or experiencing cravings, reaching out for professional support at any time during this journey may be the difference between staying on a healthy path and falling back into your old habits.

  • Be Mindful Of Your Environment: Research shows that both stress and triggers tied to drug use (such as people, places, situations, or mental states) set the stage for relapse. Strive to stay away from these harmful and potentially tempting circumstances. Instead, involve yourself with supportive friends, and new activities that might stimulate and engage you in a positive way.
  • Diet And Exercise: An addiction depletes your health on many levels. A proper and nutritious diet can help supplement your body in the ways it needs. Additionally, certain nutritional supplements might help you bolster your body and increase levels of the nutrients, vitamins and chemicals that the addiction depleted. Exercise helps the body to flush toxins out of its system, it produces endorphins and has been shown to fight depression and anxiety, and it boosts your immune system.
  • Support Groups: Though these may not be for everyone, they can provide a great network to support and inspire you through your rehabilitation, recovery journey, and beyond. These include Narcotics Anonymous and SMART Recovery. Studies show that people that integrate a form of spirituality into their life have higher rates of success fighting addictions and greater health.

Whether you are just beginning to take steps towards recovery, or have been sober for a fair amount of time, these things can help you to remain constant in your pursuit of wellness. One thing to consider is that as your life changes, so will the demands of your recovery maintenance. It is for this reason you should consistently reevaluate and apart your approach to better serve this.

You Deserve A Successful Recovery

If you find yourself losing focus or hope, or fear the danger of relapse and need assistance and support to help you maintain your sobriety, don’t hesitate to ask for help. If you want to take these important steps towards recovery or find help through a rehabilitation facility, contact us today. We at Rehabcenter.net can offer you support, education, and tools to help you make your recovery a success.

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