We know how tough heroin withdrawal is. We understand the pain and depression that occurs when you suddenly stop using your drug. We are here to help you through detox, which is the first stage on your road to recovery. We are experts at alleviating the worst of your withdrawal symptoms. Some clients may experience no symptoms at all. We don’t want you to suffer. We want you to succeed.
What is Heroin Withdrawal?
Heroin withdrawal symptoms will set in about 12-18 hours after your last dose. They include sweating, nausea, vomiting, insomnia, joint, bone and muscle pain, diarrhea, anxiety, chills and extreme weakness. The whole thing is miserable to endure, and there is really no reason to do so. Medications are available to suppress these symptoms until your body adjusts to the absence of heroin.
Abuse of heroin causes changes to occur in the brain. Eventually these changes cause the brain to be unable to function normally unless heroin is present on the brain’s opioid receptors. The brain’s endorphin system has also become deranged. Endorphins are natural brain chemicals that suppress pain, relieve depression and cause feelings of pleasure and reward. When exogenous, or outside, opioids are taken for a period of time, the brain stops producing its own endorphins. It takes time for the body to begin to produce them again. The brain also grows extra opioid receptors. These extra receptors are abnormal. The presence of the extra receptors and the low levels of endorphins probably contribute to much of the misery of withdrawal. The body will fix itself. But it takes time.
Medications can help by treating your symptoms as they occur. Suboxone is one medication that we use a lot. It contains buprenorphine, a synthetic opioid. Buprenorphine attaches to the same brain receptors as heroin does, but it doesn’t activate them in the same way. Its effect is only partial. However, for many heroin addicts, it’s enough to alleviate withdrawal symptoms and drug cravings. You will not feel much, if any, euphoria while taking Suboxone. You will just feel relief. We will gradually reduce your buprenorphine dose, from high to low, over a period of time. We do it slowly. This gives your body time to adjust. This method of slowly reducing a drug’s dosage over time is known as tapering. It’s highly effective for most people.
If you still experience significant withdrawal symptoms after your Suboxone taper is finished, we can extend the time a bit. Our goal is to get you drug-free, but not everyone is the same. Some clients may need a little longer. That’s okay. It’s not a race to see how fast you can become drug-free.
Some clients may not get enough relief from Suboxone alone. Medications such as muscle relaxants, anti-depressants and benzodiazepines can help. We are careful with benzodiazepines because they are addictive, but we understand that some very anxious clients, or those with severe insomnia, may require a low-dose, short-term, course of these calming medications.
When Detox Doesn’t Work
The goal of detox is to get the client off of all addictive drugs completely. It’s the ideal outcome, but does it work for everyone? No. It doesn’t. Not all heroin addicts will be able to live drug-free for any length of time. Heroin causes profound changes to occur in the brain. Some of these changes may lead to persistent drug cravings in some individuals, even in the absence of withdrawal symptoms. Some people, especially those who abused heroin in high doses for long period of time, simply don’t feel normal without an opioid in their systems. Even high-quality residential drug treatment may not help these people. The problem is physical.
Drug cravings that won’t go away set a clean former addict up for almost certain failure. Living with powerful cravings will nearly always lead to eventual relapse. A person can only take it for so long before giving in. For these people, there is Suboxone and methadone maintenance.
Both Suboxone and methadone are used for detox purposes. Gradually decreasing doses are given over a certain period of time. This allows the body to adjust to the absence of an opioid. If done properly, it almost always greatly reduces opioid withdrawal symptoms. But Suboxone and methadone can also be given on a daily basis as maintenance medications. Both are highly preferable to heroin use.
However, both Suboxone and methadone are addictive. Both are long-acting and will produce withdrawal symptoms, if suddenly stopped, that are far worse than those of heroin. Symptoms drag on for at least a month for Suboxone and even longer for methadone. A person who has become dependent upon either one must either continue to take the drugs or face a highly unpleasant withdrawal syndrome. Both drugs can and should be tapered before stopping them, but they tend to still cause some uncomfortable degree of withdrawal to occur.
But then again, a person using heroin risks death every time they use it. It could be contaminated with dangerous bacteria and toxins. It’s probably been cut with fentanyl, a synthetic opioid many times the strength of heroin. In the United States, there is no such thing as pharmaceutical heroin. All heroin sold there is produced in illegal, makeshift labs with little regard for safety and purity. When you buy heroin, there is no way to be sure what you’re getting. Certainly maintenance on Suboxone or methadone is preferable to death.
The controversy rages on. Opponents of opioid drug maintenance say that it makes no sense to trade one addiction for another, but that’s not exactly true. At least Suboxone and methadone maintenance are medically supervised and safe. Proponents of Suboxone hail it as a life-saving medication. They are partly right, but then again, Suboxone is so new, there is no way to know what its long-term effects might be. It seems that there is no easy answer.
If you’re struggling with a substance abuse problem, we would love to help guide you to the right treatment option for you. We are here 24 hours a day at 866-802-6848. Just call us. A friendly, trained counselor will listen to you and then advise you as to the best options available to you.