When an addict emerges from a detoxification program, that person has purged the drugs from his or her system and is technically considered “clean.” The addict may have worked incredibly hard in order to achieve this goal, struggling through withdrawal symptoms with the help of medications and living in a treatment facility for days or even weeks in order to complete the process. This is an admirable feat, but it’s important to note that the addict can’t be considered fully recovered at the end of the detoxification program. In fact, the journey to long-term sobriety has only just begun.
As an influential article published in The Lancet in 1996 makes clear, addiction should be considered a chronic condition. The authors of the article use diabetes as an example. People who are diagnosed with diabetes are often told to change their diets and increase their exercise rates in order to prevent a relapse. Less than 30 percent of these patients comply. Similarly, while a heroin addict may be told to never, ever use the drug again, many of them do use again. The article states that only 30 to 50 percent of addicts stay clean a year after detoxification treatments.
People with chronic conditions such as diabetes or addiction often need close monitoring, intensive therapies and repeat reminders to stick with the changes they have made. They may need these interventions for the rest of their lives.
See Related: Heroin Detoxification in California
Fundamental AspectsHeroin treatment programs can vary widely, but the underlying principals of successful programs are often the same. They can be summed up in 10 statements:
- Addiction is a chronic disease that changes the way the brain works.
- Therapies must be customized to meet the needs of each individual.
- The treatment plan should change over time, as the addict’s needs change.
- The treatments provided should focus on the entire person, not just the person’s addiction. Medical problems such as HIV/AIDS must also be addressed.
- Addicts must have easy access to treatment.
- People with addiction often have other mental illnesses that must also be addressed.
- Remaining in therapy is crucial.
- Counseling can help.
- Treatment doesn’t need to be voluntary in order to be effective.
- Monitoring of drug use is important, as relapses occur.
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The Role of Counseling
Treatment FacilitiesWhen people think about heroin rehabilitation, they often think about long-term residential programs. Here, the addict lives in the facility for months at a time. In some facilities, the addicted person is allowed to come and go and maintain contacts at work and at home. In other facilities, the addicted person is asked to stay on the grounds at all times until, slowly, the addict is given permission to leave for short periods of time. According to a study published in the journal Substance Abuse and Misuse, these facilities are remarkably effective. Of those studied, 93 percent reported improvement on drug addiction five years after completing a long-term residential treatment program. In a residential program, addicts are asked to participate in counseling sessions on a frequent basis, and they may be asked to take part in group sessions with other addicts. If the person requires medications to ease withdrawal symptoms, those medications are given with a doctor’s supervision.
- Day programs. The addicted person participates in intensive therapies during the day but returns home at night.
- Doctor-provided therapies. Some addicts see their doctors for medication therapies, but continue with the rest of their lives as normal.
- Outpatient counseling. Here, an addict meets with a counselor weekly and continues learning new methods to deal with addiction.
- Community groups. Most communities provide 12-step program meetings multiple times per week, and these meetings are often provided at no cost. For people with extremely low incomes, this may be the most effective way to get help.
Medication TherapiesRehabilitation programs take work, and some people recovering from heroin addiction struggle with withdrawal symptoms for weeks, months or years after they’ve completed detoxification programs. The cravings for drugs may be particularly strong when these people are placed in a stressful situation, such as a long rehabilitation program. These addicts may benefit from medications that ease symptoms. According to an article published in the Journal of Substance Abuse Treatment, the medication buprenorphine may help patients stay clear of opioids like heroin. In this study, over 56 percent of people were still using buprenorphine a year after they began treatment, and more than 67 percent of their months were free of drugs. Buprenorphine doesn’t produce a high, euphoric feeling that heroin does. Instead, it simply blocks the cravings and helps the addict behave normally. Some heroin addicts benefit from methadone treatments, and they may use these treatments for years. Methadone is a narcotic, so it does provide a euphoric feeling, but it’s often given at low doses so the user often isn’t motivated to use methadone just to achieve a high.
Sober LivingSome heroin addicts find it much too difficult to return home once they’ve completed inpatient drug treatment programs. They might find their neighborhoods to be full of temptations, and they may believe that relapse is simply too tempting to pass by. These people might benefit from sober living communities. Here, the addict lives with a group of other people who are also recovering from addiction, and the addict follows a strict set of rules that are designed to teach them new, sober habits. In a sober living community, the addict is often required to spend free time in community meetings and house meetings, discussing addiction. The addict might also be required to clean or perform chores, and hold down a job to contribute to the rent. These are all tasks that people must accomplish when they live in the community in order to stay sober, and in a sober living community, the addict can practice these behaviors until they simply become habits.
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