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Heroin Detox Centers

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 01/24/2021

Heroin can be an extremely difficult drug to quit, due in part to the extreme discomfort that frequently accompanies cessation. Quitting heroin can oftentimes be unsuccessful unless someone has help. Heroin detox centers can provide that help, and in this article, we will look at when one of these centers may be recommended, the intake process, and some of the treatments they use to help increase someone's chances of successful heroin detox and recovery.

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When is a Heroin Detox Center Recommended?

Medical help is always recommended when detoxing from heroin so as to minimize the risks as well as to give someone the best chances of success in overcoming heroin addiction. A heroin detox center can provide many treatments to ensure safety and comfort during the process.

This is especially true for anyone who fits into one of the following categories:

Severe Withdrawal Symptoms

The medications prescribed for heroin detox treatment are specifically intended to reduce the severity of these symptoms, giving someone the best opportunity to make it through the most difficult and high-risk phase of acute withdrawal. The symptoms felt during detox will range from uncomfortable to agonizing, and minimizing the pain of detox is where heroin detox centers are most effective.

IV Drug Users

Heroin presents a special case since it is one of the most commonly injected drugs. Shooting up heroin is not a prerequisite for drug detox, however, in the case of IV heroin use, medical detox is strongly recommended. Another risk with shooting up is the increased risk of infection, diseases, particularly hepatitis or HIV, and blood or heart infections. Entering a structured detox program will provide some relief from the physical and psychological symptoms as well as help someone establish a firm footing in sobriety, thus increasing their chances of long-term recovery. Being treated in a heroin detox center will also provide opportunities to get tested for these health issues and more.

People With Heart Disease or Diabetes

During heroin withdrawal and detox, there are a series of blood pressure and heart rate changes throughout the detox process. These will both begin to rise during the first few days of detox and may fluctuate during the peak intensity of detox symptoms. This is mostly due to fluctuating levels of cortisol and norepinephrine during the heroin detox process. These are both stress hormones, cortisol is responsible for stress responses and anxiety while norepinephrine is a moderator of the cardiovascular system. Additionally, minor heart arrhythmias may result from heroin detox and this is normally not an issue, however, if someone already had heart issues this could lead to a variety of serious complications.

Detoxing from heroin may be dangerous for someone with diabetes in some cases. Blood glucose levels rise dramatically during the detox process, and normally this is handled by a properly functioning pancreas. In diabetic patients, these spikes in blood sugar levels can increase the risk of dangerous complications and if they are not treated quickly may result in diabetic ketoacidosis or diabetic hyperosmolar disorder. Either of these conditions can be extremely dangerous, and medical care during heroin withdrawal is highly recommended in people with diabetes to avoid these potentially dangerous complications.

The Intake Process

This will consist of a medical and psychological assessment to determine the specific needs of each client. The symptoms of heroin withdrawal will vary between people depending on the length of time someone used and the amounts they used. Additionally, co-occurring mental health issues are fairly common with addicts and additional care may be required to treat these issues.

To determine the exact risks or specialty care someone requires, an assessment is performed before entry into a heroin detox center. This can include an interview with facility staff as well as a physical exam and a medical workup to determine someone’s overall health. This could include:

  • Interview regarding drug use habits
  • Blood work to monitor liver function and electrolyte balance
  • A questionnaire regarding past health issues, allergies, etc.

Finally, heroin use of any kind (particularly IV use) can increase the risk of diseases or other serious conditions, such as liver failure for example. A determination of the exact risks or challenges someone faces will give the treatment team at a heroin detox center the information they need to provide the safest and most effective care.

Medical Monitoring of Heroin Detox Related Dangers

Heroin detox is very rarely fatal in and of itself, however, the physical effects, in particular, can increase the risks and dangers of negative outcomes. The body of someone undergoing detox will be extremely stressed due to the neurotransmitter imbalances that result from heroin addiction. Aside from these simply unpleasant symptoms, there are some physical symptoms that can create additional risk.

Some of the most common symptoms which could lead to further complications without oversight from a heroin detox center include:

  • Dehydration
  • Malnutrition
  • Insomnia
  • Cardiovascular Abnormalities
  • Blood Sugar Fluctuations

These risks become more dangerous if someone were to have a preexisting condition such as heart disease or diabetes. In these situations, detox could potentially be fatal and medical assistance should be sought out immediately.

The medical staff will monitor vitals regularly such as heart rate, blood pressure, and hydration levels. These are typically abnormal during the heroin detox process and really only pose a risk if someone has underlying conditions such as heart disease or diabetes. Ensuring patients stay safe and as comfortable as possible is the entire goal of a heroin detox center.

Heroin Withdrawal Timeline

Medications Used By Heroin Detox Facilities

There is a small set of very effective and well-tolerated medications that are commonly used to make the heroin detox process as comfortable as possible. These medications interact with the same receptors that heroin does, except instead of someone getting high, the uncomfortable symptoms of detox are reduced. In effect, they are tricking the brain to achieve relief. Some of the most commonly used medications for heroin detox include:

Some FDA-approved medications for treating heroin withdrawal that are used during heroin detox may include:

  • Buprenorphine (Suboxone/Subutex/Sublocade): This medication is what is known as a partial opioid agonist, meaning it will strongly bind to opioid receptors and remove true opioids from these receptors in the process. While it has a higher binding affinity than most other opioids, it produces much less activity, meaning it will not produce the same “high” as would heroin. Additionally, suboxone includes the medication naloxone which is inactive when taken orally, but if injected it would precipitate severe withdrawal symptoms. The use of this medication may begin during detox, but it is often used more long-term.
  • Methadone: A very long-acting and potent synthetic opioid, this medication is usually dose tapered during the course of detox. It acts in the same fashion as heroin does, and therefore is very effective at reducing discomfort during detox. Similar to buprenorphine, the use of this medication may begin during detox, but it is often used more long-term.
  • Lofexidine (Lucemyra): This medication was recently FDA approved specifically to treat opioid withdrawal. Originally a blood pressure medication, it works in a very similar fashion to clonidine. Also reducing adrenaline responses in the brain, it can help moderate blood pressure issues and reduce the nervous system hyperactivity during detox.

Some other medications that can help in a more general way could include:

  • Clonidine: This was originally a blood pressure medication, but has been found very useful in heroin detox and treatment. It affects adrenaline responses in the brain which leads to less discomfort during detox by reducing many of the worst symptoms such as sweating, chills, tremor, and insomnia.
  • Sleep Aids (usually Trazodone or Zolpidem): Insomnia is a very common symptom during the heroin detox process, and these non-habit forming sleep aids are frequently used to let patients rest.
  • Hydroxyzine (Vistaril): Technically an antihistamine, this medication has a mild sedative effect and can reduce anxiety and help encourage sleep.

Therapy During Heroin Detox

While getting through the detox process is an achievement, to be sure, there is still much more work and healing which usually needs to be done. The therapies used at heroin detox centers, especially the talk and behavioral therapies are hugely beneficial in the treatment of heroin addiction. These therapies can help an addict to identify some of the unhealthy habits, thinking patterns, and attitudes that may be pushing them towards addictive behaviors.

These therapies undergone in heroin detox are often the first time someone has been in a position to really examine the inner workings of their mind. Beginning therapy can help someone see how their patterns of thoughts and behaviors were not very healthy and maybe contributed to their problems. Beginning to understand and accept this fact can help someone to be more motivated and thorough in the rest of their recovery. Finally, it can drive home the importance of being open and honest with others, and encourage those in recovery from an addiction to invite others into their life.

Some therapies that can help the heroin detox process may include:

Behavioral Therapy

Heroin addiction in particular is characterized by isolation and avoiding pain or discomfort. A therapeutic part of the treatment process and typically takes the form of cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), which is technically a type of CBT, as these techniques are used to uncover patterns of behavior that promote addictive behavior. Better understanding the processes which influence addiction may help someone to interrupt and eventually change these processes. CBT is mainly focused on the interplay of thoughts, feelings, and behaviors. Discovering how they may influence each other can be a powerful tool in avoiding self-destructive habits. DBT is additionally used to promote acceptance and to reduce reactivity to negative emotions while also improving communication skills to improve interpersonal skills and relationships. These techniques, when used together, are very powerful tools that can help an addict not only become less isolated but they help create the desire to build new relationships as well.

Support Groups

These can take the form of group therapy in the detox program itself as well as volunteers bringing in outside groups, such as 12 step programs. Group therapy can be extremely useful during detox, as many people with addictions feel completely alone. This is often of their disease process, as behaviors related to heroin addiction often push others away through neglect, violence, or betrayal. Being around others who are going through the same process can be a great help toward someone realizing that they are not alone after all. Additionally, having 12 step or other recovery fellowships bring meetings into a detox center is beneficial in showing that there is a life after heroin. These groups are often made up of people in recovery themselves, and seeing them in the flesh and hearing their stories can give hope and reassurance that things will get better.

Aftercare Planning

Having a thorough and comprehensive aftercare plan can be one of the greatest assets for someone to continue their recovery after heroin detox. These plans are typically developed with a caseworker and leverage the connections that all heroin detox centers have with the local recovery community. By laying out a foundation and roadmap for the next steps, someone in recovery will be much better prepared to stay sober after completing the detox program.

This could include finding 12 step meetings near someone’s home, finding a sober living community, getting a sponsor, starting therapy, and many other recovery aids. Often when someone leaves detox without any plan, they end up back in a detox in a short time. Being informed and prepared to continue their recovery can greatly increase someone’s chance of success.

Continuing Heroin Addiction Treatment

Heroin detox is only the beginning of recovery from heroin addiction. Addiction produces many habits, behaviors, and outlooks which will need adjustment or even complete overhauls. Once completing a program at a heroin detox center, someone will be in a much better position to begin repairing their life, although they will still need help. Heroin addiction is a powerful illness, and it takes time and help from others to begin to fix the damage produced during active addiction. Recovery is possible, but it requires the courage to ask for help, and the willingness to accept help. If someone wants to change, they can start the journey right here, right now; find a heroin detox center with our search tool below…

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