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Recovering From Heroin Addiction: A Comprehensive Guide
heroin comprehensive guide

How can you tell if someone uses heroin?

It is often difficult to be sure. You may have heard news stories about a famous person overdosing on heroin, and you think to yourself, “How were they using heroin? I just saw them on TV, and everything seemed fine.” While some heroin users will appear to be intoxicated when they use heroin, many others go through life functioning “normally.”

Living on heroin is a matter of survival.

If you are using heroin or fentanyl and going to work every day, you know that you are not functioning at your best. When you come home to your family, you are not the best possible spouse and parent that you can be. When you go through life on heroin, you are living in survival mode. What does this mean? Survival mode means that you struggle to appear normal while constantly obsessing over where and when you will get your next dose of heroin.

Survival mode, while living on heroin, is no way to live.

You may be serving dinner to your children, but you are not enjoying their company. Your thoughts are focused entirely on heroin. And, if you cannot get more heroin, you are struggling with feeling sick. Most likely, you are also covering it up, keeping your heroin habit a secret. While it is possible to get through your day on heroin, that is no way to live. There is a whole life filled with enjoyment and fulfilling moments on the other side of heroin addiction.

You don’t have to hit rock bottom.

In recovery group meetings, people share about hitting a “sufficient bottom.” What does it mean to hit the bottom? It is another way of saying that you have hit rock bottom, as if you are falling into a deep hole, finally hitting the rocky bottom. Things are as bad as they can get. When you hit bottom, things can get no worse for you. The problem is that with heroin addiction, things can always get worse.

Heroin addiction leads to jails, institutions, death, and more.

Another saying in the meetings of groups, such as Alcoholics Anonymous and Narcotics Anonymous, is that your addiction will eventually lead you to jails, institutions, and death. What else can happen as a result of heroin addiction? Regret is a painful emotion to live with after many years of using heroin or other drugs, struggling to get clean and stay clean, only to fall back into active addiction. A heroin user in their 20s or 30s might feel like they have many years ahead to get clean. Yet, years turn into decades, and time passes. Heroin users in their 50s and 60s brag about surviving for so long because they know where to get the good stuff, and they know how to use it without overdosing. Yet, how does it feel to be 50 or 60 years old and realizing that decades have passed? You had dreams and plans for your life. Now, you recognize that you have spent the majority of your life chasing a high. Fortunately, it is never too late to turn things around and change your life. While regret is painful and something to discuss with your therapist, you must also move forward. Realize that at any age, you can get clean from heroin and have a fulfilling life, finally living your dreams.

How do I get clean from heroin?

I hope that I have convinced you that it is time to quit heroin. You should stop, not only because you are risking your life and health, but because it is not the way you want to go through life. Now is the time to start thinking about how you are going to quit. You can start looking at options to see what is out there. Fortunately, there are options. There is more than one way to get clean from heroin.

You can try to quit heroin cold turkey, but I don’t recommend it.

To be thorough, I should include here that you can choose to quit and do nothing more. Quitting an addiction without any help is often referred to as quitting “cold turkey.” I do not recommend that you try this. The main reason that I do not think it is a good idea is that your risk of relapse is very high if you quit cold turkey. If you stop taking heroin and then go about your daily life as if you never had a heroin problem, within the next 24-hours, and probably much sooner, you will start to experience physical opioid withdrawal symptoms. In addition to the opioid withdrawal, you will also likely have opioid cravings. Cravings are thoughts and feelings that lead you in the direction of getting more heroin to use. These are the heroin addiction symptoms that make it so difficult to quit the drug.

If you have been using heroin for a long time, you are probably already familiar with a heroin withdrawal syndrome. You know what to expect. Typically, at around 72-hours, you will experience the worst of it. Between the physical symptoms and cravings, you will find it difficult to get past it without support.

Group meetings may help you to quit heroin.

Alcoholics Anonymous meetings and Narcotics Anonymous meetings are available in communities in nearly every city around the world. There are other groups as well, though group meetings may not be as easy to find. There is heroin anonymous and many other 12-step groups for nearly every addiction. 12-step groups derive their programs and structure from Alcoholics Anonymous. Many 12-step groups even use the AA Big Book and change the word “alcohol” to whatever substance or behavior the group is addressing. There are also non-12-step groups. LifeRing, Smart Recovery, and Celebrate Recovery are examples of groups that do not adhere to the AA 12-steps. You should be able to find meetings online that you can attend from the comfort of your own home.

Can the steps alone help you to quit heroin?

Members of AA and other 12-step programs believe that the steps will always work if you work them. If you are not successful, your AA sponsor may tell you that you did not work the steps adequately. Is this fair? 12-step programs have come under some scrutiny recently. Do they work? Scientific studies are not in agreement on this point. There is a saying in Narcotics Anonymous: “The therapeutic value of one addict helping another is without parallel.” Whatever we want to believe about how well group meeting programs work or do not work, there is no doubt that the support of like-minded friends who are working towards the same goal is helpful. By attending meetings, you will be able to meet new friends in recovery and make connections, building your support network.

Can therapy help in heroin treatment?

There are different types of therapy that you may consider trying. There is family therapy, addiction counseling, psychology, and more. Family therapists can have masters or doctorate degrees, yet their training is usually not in the psychology department of the university, but in the philosophy department. Psychologists often have doctorate degrees and have studied a wide variety of psychotherapy techniques to help their patients. Beware of therapists who have minimal credentials in their field. For example, there are addiction counselors who have a simple certificate of completion of a course in counseling. Expert therapy provided by a qualified psychotherapist will help you to quit heroin and stay clean.

What about coaching as a component of heroin treatment?

Coaching has become popular in recent years. There are life coaches, nutritional coaches, exercise coaches, and now, there are addiction coaches. The benefit of coaching is that it can help you to move forward beyond your addiction towards a life of success in many areas of your life. While other therapies may focus on your past and healing mentally, emotionally, and spiritually, coaching is about moving ahead, creating a plan for your future, and acting on it. While coaching is not a replacement for psychotherapy, I think that it is intriguing in that it can help a person who is predisposed to an addiction to tap into their potential.

Will psychiatry help you quit heroin?

Psychiatrists are medical doctors who are experts in managing complex combinations of psychotropic medications for patients with psychiatric illnesses. In addition to being experts in the medical management of mental illness, psychiatrists also provide psychotherapy to their patients, including traditional psychoanalysis based on the teachings of Freud, Jung, Adler, and others.

What about medical treatment?

Can medication help you to quit heroin? There are several options available. First, there are medications to help with opioid withdrawal symptoms. These include Lucemyra and clonidine, two drugs that work similarly to reduce the severity of withdrawal symptoms. Lucemyra is a newer drug that does not lower blood pressure as much, but it is much more expensive compared to clonidine. Clonidine is an older blood pressure medication that happens to reduce withdrawal symptoms. Gabapentin is an anti-seizure drug that studies have shown can reduce withdrawal symptom severity as well. Beyond these medications to treat heroin addiction symptoms such as withdrawal, are another class of drugs, known as the medication-assisted treatment (or MAT) drugs. These are methadone, buprenorphine, and naltrexone. All three of these drugs work well to keep you clean from heroin. The main difference in deciding which might be best for you is how soon you can get started with each. You can begin methadone right away. Buprenorphine, the active drug in Suboxone, can be started when you enter a moderate opioid withdrawal state, usually at about 24 hours after taking the last dose of heroin. You cannot begin naltrexone until at least a week after your final heroin use. Buprenorphine and naltrexone will both cause precipitated withdrawal if started too soon. Precipitated withdrawal is when a drug causes you to have worse withdrawal symptoms. While unpleasant, it is usually not dangerous. It is good to have clonidine or Lucemyra on hand in case precipitated withdrawal occurs. The time properties of these addiction treatment drugs are significant in determining which therapy will be best for you. While you may think that methadone is best because it has no waiting period, there are downsides to methadone that may cause you to choose another treatment. Methadone is a more dangerous drug, so it must be dispensed daily at a specialized clinic.

Can medication alone help me to quit heroin?

If you had to pick one and only one of these methods for quitting heroin, I would recommend MAT. Methadone and buprenorphine are particularly useful, even if you do not get therapy. Yet, if you genuinely are interested in recovering correctly, you should not just take medication to get clean. Addiction treatment experts do not intend for MAT to mean medication-only therapy. You should plan to get psychotherapy in addition to taking medication for addiction. But what about meetings, coaching, and psychiatry? How do you know what will help you to have the best chance for success?

Is rehab a good idea?

There are many types of rehab available. You may choose to go to detox, followed by residential rehab. Some rehabs include both services. Detox gets you off of the heroin and fentanyl. Rehab keeps you clean for some time and introduces you to therapy and group recovery meetings. There are luxury rehabs, partial hospitalization programs (PHP), intensive outpatient programs (IOP), and more. Rehabs do not have an excellent track record when it comes to people graduating from rehab and staying clean. However, it may be a good option for you to get away from the stress of everyday life and be surrounded by an atmosphere of recovery in a safe place. Many rehabs are starting to adjust to a world where integrated care is best for the patient. They are beginning to include MAT services for patients to ensure the best possible long-term success.

Integrative heroin recovery means working together.

There are a lot of people in the world working hard to make things better for people struggling with heroin addiction. In British Columbia, Canada, the government has allowed many forms of harm reduction to be used to keep people addicted to heroin safe until they are ready for treatment. They have supervised consumption sites, clean needle and supply exchanges, and even prescription heroin and Dilaudid-dispensing machines. In the US, government officials oppose these forms of harm reduction. When it comes to MAT, many rehab administrators oppose the use of medication in addiction treatment, calling it the replacement of one drug with another. There is a lot of in-fighting when it comes to addiction treatment. Experts disagree on what is best for patients and clients. Members of some 12-step groups oppose the use of medication. While the “experts” fight over what works best, people continue to overdose on heroin and fentanyl. The best thing we can do is learn to work together. By being open-minded, we can see that there is value in many different types of treatment. By working together, patients can get the customized care that will work best for them in their heroin recovery.

So, what heroin treatment works best?

As you can see from this discussion, there are choices. You do not have to follow one path to a successful recovery. Having options is essential. We are all different, and what works best for one person may not work as well for another. However, I can make some recommendations about what you should do and not do in your heroin recovery. First, I recommend not bothering to try quitting cold turkey. Ask for help. If you are not sure where to start, make an appointment with your family doctor. Your doctor can do an initial evaluation and begin medical treatment or at least refer you to a doctor who can start treatment. Second, medication-assisted treatment should be a part of your treatment. It works and is proven to have the highest success rate of all forms of treatment for heroin addiction symptoms and heroin addiction. Finally, the most important thing you can do for yourself and your family is to get started now. You will be surprised how the transition from heroin to being clean is not as difficult as you imagine it to be. You simply need to make a decision and then make an appointment. Then, you will be on the path to recovery and freedom from heroin and all opioids.

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