The National Institute on Drug Abuse (NIDA) recommends at least 90 days of treatment for heroin addiction. However, an even slower MAT process with more access to counseling and support groups may give the best chances of long-term sobriety.
Heroin is a very addictive substance, and it can take some time to overcome this addiction. Detox, which will usually involve Medication-Assisted Treatment (MAT), and behavioral therapy form the foundation of evidence-based treatment plans, but how long you remain in these programs depends on your individual needs.
What Is Heroin Addiction Treatment?
Heroin addiction is a major problem around the world. In the United States, about 136 people die, on average, every day because of opioid overdoses, which frequently include heroin.
Access to heroin and opioid addiction treatment is deeply important, as millions of people struggle with this problem. Fortunately, evidence-based treatment for opioid addiction, including to heroin, is rapidly improving, as is access to these vital programs.
There are also ways to combine treatments depending on what you need or how long you need to be in treatment. Some people are able to complete detox and rehabilitation in a matter of months, while others need support for years to maintain their focus on their health. Everyone has different needs, which is why evidence-based treatment is customizable.
Approaches to Heroin Addiction Treatment
When considering how long you need to remain in treatment to overcome heroin addiction, it is important to understand the components of treatment and to stick with each step until the program is complete. For example, just going through detox without rehabilitation increases the risk of relapse back into substance abuse. Behavioral counseling improves outcomes.
- Detox: This term covers several potential processes for ending the body’s dependence on opioids like heroin.
It is possible, though no longer recommended, to simply quit taking heroin. This works only for people who have not struggled with heroin abuse for very long and who have taken low doses, so their withdrawal symptoms are not intense. Most people who struggle with addiction to heroin benefit from prescription medications to slowly manage the withdrawal process, which is another form of detox.
Quitting “cold turkey” is never recommended. Even if your doctor determines you can safely quit taking heroin without medication management, you should get some medical oversight to help you avoid relapse.
- Medication-Assisted Treatment (MAT): Buprenorphine (Suboxone and Subutex), methadone, and naltrexone are the three recommended medications to overcome heroin addiction. Buprenorphine, a partial opioid agonist, is the current preferred medication, and many physicians are now able to prescribe this medicine on an outpatient basis.
Methadone still requires inpatient treatment or at least visiting a methadone clinic for each dose; however, it is still considered an appropriate and effective medication for heroin addiction. Naltrexone is typically prescribed once the body’s dependence on opioids is over, as a maintenance drug.
- Behavioral therapy: Like detox, counseling or behavioral therapy takes many forms, although modern outpatient and inpatient rehabilitation programs both focus mainly on Cognitive Behavioral Therapy (CBT). Support groups, individual counseling, and family counseling are all recommended forms of therapy once your body has stabilized on MAT, after you detox.
You may need inpatient treatment to get away from stress or triggers, an intensive outpatient treatment program that allows you to live at home but focus on recovery, or a standard outpatient program to manage triggers while you continue to work or support your family. You may move through several levels of counseling during and after MAT.
Current medical research suggests that staying in these programs for longer helps more. While the baseline recommendation is about three months, a longer MAT process and some ongoing form of counseling or behavioral therapy is the most beneficial combination for people recovering from heroin addiction.
How Long Should I Stay in Treatment for Heroin Addiction?
The National Institute on Drug Abuse (NIDA) notes that detox and rehabilitation for any substance abuse disorder should take at least 90 days, or three months, on average. However, many people who struggle with chronic heroin addiction need more time to ease their body off dependence on opioids, change their behaviors around substances, and manage other chronic health problems, including mental illness that may have developed alongside their addiction.
As you overcome heroin addiction, you might move to a lower level of treatment since you have fewer direct medical needs. For example, you might enter detox with a lot of medical oversight and move into inpatient rehabilitation; however, once you complete these intensive treatments, you might move into a sober living home and attend a mutual support group, which is a type of outpatient treatment, twice per week. While you are technically in treatment for several months, or even years, your treatment needs should gradually decrease during this time.
To understand different levels of treatment, the American Society of Addiction Medicine (ASAM) has developed a Continuum of Care, which lists approaches to medical treatment from least to most intensive:
- Early intervention (education) and outpatient services, which includes mutual support groups
- Intensive outpatient and partial hospitalization services, which allow you to live at home but still spend most of your day undergoing treatment
- Residential support services, which offer a range of support options from behavioral treatment to medical supervision for MAT
- Medically managed intensive inpatient services, which provide MAT and counseling as well as treatment for associated chronic health problems like hepatitis, mental health problems, and ambulatory issues
While this continuum moves from least to most intensive services, this is not a straight line. You may enter treatment with some outpatient services, need to move to inpatient care at some point, and then move back to outpatient treatment. While these are points on a spectrum, you, your doctor, and/or your therapist can determine which level of treatment for heroin addiction works best for your current needs.
Maintaining Sobriety After Heroin Addiction
As you undergo treatment, it is important to stick with the program, and talk to your doctor or counselor about adjusting treatment levels as needed. Remaining in a detox and rehabilitation program for at least 90 days improves your recovery success and reduces your risk of relapse. Finding a program that works for all your needs is also important.
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Principles of Effective Treatment. (January 2018). National Institute on Drug Abuse (NIDA).
The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update. (December 2019). American Society of Addiction Medicine (ASAM).
Medication-Assisted Treatment (MAT). (September 2021). Substance Abuse and Mental Health Services Administration (SAMHSA).
Behavioral Therapies. (January 2018). National Institute on Drug Abuse (NIDA).
Types of Treatment Programs. (January 2018). National Institute on Drug Abuse (NIDA).
How Long Does Drug Addiction Treatment Usually Last? (January 2018). National Institute on Drug Abuse (NIDA).
What Are the ASAM Levels of Care? (May 2015). ASAM Continuum.