It’s been said that a journey of a thousand miles begins with a single step. For people wanting to leave a heroin addiction behind, that first step involves drug detoxification. Here, the heroin is removed from the body, leaving the addict with a clean system. For many addicts, detoxification is the most frightening aspect of a drug recovery program. In fact, some addicts may be so frightened of detoxification that they simply avoid the process altogether, and they allow their addiction to continue unchecked.
The truth is that there are many treatments available that can ease withdrawal symptoms and make detoxification less painful and less frightening to contemplate. If you or someone you love is addicted to heroin, don’t let the fear of detoxification stand in the way of recovery. At Michael’s House, we can provide a variety of treatments to assist with detoxification and help you start down the road to recovery.
Heroin is considered one of the most addictive substances in the world, and using the drug can cause profound and lasting changes in the brain. When a user takes heroin, the drug moves to the brain and is converted to dopamine. This substance attaches to receptors in the brain, and causes a flood of pleasurable sensations. Over time, the dopamine receptors become less and less sensitive, and the user must take higher and higher doses of the drug to achieve the same pleasurable response. In addition, some users become unable to produce dopamine on their own.
According to the Harvard Medical School, a single dose of heroin can create symptoms for four to six hours but withdrawal symptoms from that single dose can last for an entire week. Withdrawal symptoms are often mild in the beginning, but they can become more severe as the process continues.
Effects of Withdrawal
- Muscle aches
- Runny nose
- Abdominal cramping and diarrhea
- Muscle spasms in legs
Some people with severe heroin addiction may be incredibly familiar with detoxification symptoms, as they may experience these symptoms between doses of the drug. Some addicts may detoxify on their own on a periodic basis, in order to reduce their chances of developing a tolerance. People who know how painful a detoxification can be, or who have experienced the process on their own without any assistance whatsoever, may be incredibly resistant to the idea of going through the process again.
While these symptoms may not be life-threatening, they can certainly be debilitating. It’s especially hard for an addict to deal with these symptoms when he or she knows that the symptoms will stop immediately, as soon as the body is provided with a dose of heroin.
The Role of Medications
While it might sound counterintuitive, people who are addicted to heroin often need medications during the detoxification process. These medications, prescribed according to your needs by consulting physicians, can ease symptoms and reduce the intense cravings that an addict feels during withdrawal. In addition, addicts might be more likely to participate in treatment programs if they know they won’t struggle with terrible symptoms during withdrawal. This might be the biggest benefit of medications your physician gives you during detoxification.
Often, consulting physicians may give addicts the medication clonidine during detoxification. This drug helps block restlessness and insomnia, and may assist with running noses and headaches. Your physician may give you other drugs to ease abdominal symptoms.
Some people addicted to heroin need more intensive drugs to help correct dopamine deficiencies. One drug, known as buprenorphine, has shown particular promise. The drug is given in tablet form and it’s held beneath the tongue. It provides a bit of the same effects as heroin, but those effects are quite mild. The user feels no real “high” and the drug is nearly impossible to abuse in order to get high. Buprenorphine tablets often contain another drug that kicks in when the tablet is crushed, and this addition renders the drug unworkable when the tablet is crushed. Some addicts are given the medication in a prescription by consulting physicians, and they’re allowed to go through detoxification on their own at home. For people who can’t enter a treatment program at a facility, this could be a real help.Buprenorphine can be given over several days, in tapering doses, or it can be given just once or twice during detoxification. According to a study published in the Journal of Opioid Management,a short course of medications can work just as well as a long course. Of 20 people studied, 10 received one day of medications and 10 received three days of medications. At the end of the study, there were no differences in symptoms and recovery rates between the two groups. Addicts who worry about taking medications for months or years might be reassured to hear that there are other options available.Some addiction providers use herbal supplements to ease symptoms, and others rely on Chinese medicine. It might seem unusual to rely on these methods to deal with withdrawal, but there is some evidence to support the use of these alternative medicine therapies. According to a study published in Cellular and Molecular Biology, Chinese herbal medicine was effective in helping addicts deal with anxiety and mental distress during withdrawal, and those effects became particularly pronounced after a week of therapy. More work needs to be done in this area, but this study does lend support to the idea that alternative medicine might play a role in effective detoxification programs.
Methadone and Maintenance
Methadone is a drug that can be used to wean addicts off heroin, but your physician will have to determine what’s right for you. This medication does provide a bit of a high to users, and for this reason, it often must be given in a specific clinic at specific times by consulting physicians. Users can’t just take doses at home, as it’s possible they might sell their doses or take multiple doses at the same time in the hopes of intensifying the effects. Some consulting physicians provide methadone during detoxification, and then ask the addict to continue to take methadone through a maintenance program.
According to Harvard Medical School, methadone maintenance programs can help some addicted people return to productive lives. When they’re in these programs, they can hold down jobs, pay bills and behave appropriately. About 25 percent of people who enter these programs stay in the programs for life, however, and some people may feel as though they’ve simply substituted one addiction for another.
Michael’s House offers a social model detox program in collaboration with consulting physicians, but some detoxification centers offer “rapid detox” programs for addicts who feel uncomfortable with inpatient treatment programs. In a rapid detoxification, the addict is placed under general anesthesia and a rush of medications is pumped into the system. These medications bind to receptors in the brain and keep them from picking up any heroin that might be remaining in the bloodstream. The withdrawal symptoms still occur, but the addict is under the hold of anesthesia and therefore doesn’t consciously feel any of these effects. The addict is then awakened when symptoms seem to abate. Some programs claim that they can completely clean out a heroin addict in a short stay of just a few days.
Since heroin withdrawal symptoms can include vomiting, a rapid detoxification program can be dangerous. There is a risk that a patient could vomit during detoxification, and since the patient is under anesthesia, that person could breathe in vomit and choke or drown. A study published in the Journal of the American Medical Association documented at least three life-threatening complications that occurred during rapid detoxification, but none of the patients performed any better in recovery than the patients who went through a normal detoxification. In other words, the rapid detoxification program isn’t more effective than a standard program, but it might be much more dangerous than a standard program.
Detoxification, by itself, is not a cure for addiction. Most addictions have their roots in behaviors, including the friends the addict spends time with and the rituals the addict has developed surrounding the addiction. A person who is accustomed to injecting heroin before going to a party, for example, may feel a powerful urge to inject when party time comes, even though no heroin exists in the addict’s body at that time.
For this reason, an addict must follow up a detoxification program with a structured recovery program. Here, the addict can learn how to restructure his or her behavior so that a relapse into addiction is less and less likely. Unfortunately, many addicts don’t commit to a formal recovery program once they’ve completed detoxification. A study in the American Journal of Psychiatry found that, out of 802 people who voluntarily participated in a detoxification program, only 9.6 percent participated in a treatment program. This is a depressingly low number, and it indicates that family members and friends need to do more to influence the behavior of addicts after they emerge from detoxification.