The National Institute on Drug Abuse (NIDA) recommends at least 90 days of treatment for heroin addiction, either in an inpatient or outpatient program—although inpatient provides more structure. However, people may choose medication-assisted treatment (MAT) options, such as Suboxone or methadone, which they can take for months, years, or even indefinitely, as long as it is helping aid their recovery. [1] At the end of the day, overcoming heroin addiction takes a different time for everyone; it’s a very individualized process.
Treatment type | Recommended minimum | Maximum |
---|---|---|
Inpatient rehab | 90 days | None, though the cost could be prohibitive |
Outpatient rehab | 90 days | Could attend ongoing |
MAT | 1 year | Indefinitely |
How Long Should You Attend Heroin Addiction Treatment?
Everyone’s heroin addiction treatment progression and process are different, so there isn’t one predetermined length of rehab. Rather, treatment is individualized and tailored to meet each individual’s needs, and the treatment plan is evaluated on an ongoing basis to ensure quality care.
That said, research indicates that the longer you’re in treatment, the better the outcomes. At least 90 days is the recommended period of time, although many people may attend treatment for six months or a year. [1]
When it comes to methadone maintenance or other forms of MAT, 12 months is the minimum amount of time recommended for heroin addiction. Many people take medications for addiction treatment for several years or even a lifetime. [1], [2]
Research indicates that the longer you’re in treatment, the better the outcomes.
How Long Does it Take to Recover from Heroin Addiction?
Heroin addiction develops over time—most people do not develop an addiction after one or two uses. Rather, addiction progresses from trying heroin and experiencing the pleasurable effects to abusing it regularly. This regular use can lead to tolerance, which means you need more and more heroin to get high. When you take higher and more frequent doses of the opioid to overcome this tolerance, this increases the development of physiological dependence. When you are dependent on heroin, you need to keep taking it to avoid painful withdrawal symptoms. The effort to avoid or alleviate these withdrawal symptoms is one of the most powerful drivers of compulsive heroin abuse and addiction. [3]
Chronic heroin abuse, and subsequent tolerance and dependence, create profound changes in the brain’s reward system and other areas that alter how it functions. This is why experts refer to addiction as a brain disease. These changes can’t be reversed overnight, but they can be managed and treated over time with professional treatment. [3]
The most important key to breaking a heroin addiction is seeking comprehensive and integrated heroin addiction treatment that is individualized and tailored to meet your needs. And at a quality rehab, the treatment team will evaluate your progress and check in with you regularly in order to make any adjustments to the treatment plan, if needed.
Although everyone has different needs, generally, overcoming a heroin addiction may take a combination of:
- Comprehensive addiction treatment
- Therapies like cognitive behavioral therapy (CBT)
- Medication-assisted treatment (MAT) with Suboxone or methadone
- Commitment
- Patience
- Self-care
- Peer support
- Self-forgiveness
- Sticking to a recovery and relapse prevention plan
Detox: The First Step to Overcoming Heroin Addiction
The first step on the continuum of heroin addiction care is medical detox. There are many different settings for detox, which can help manage distressing heroin withdrawal symptoms. However, the Substance Abuse and Mental Health Services Administration (SAMHSA) recommends 24-hour inpatient medical detox for heroin withdrawal. This is due to concerns about how painful these symptoms can be. [5]
Inpatient detox settings for heroin withdrawal may include: [5]
- Acute hospitals
- Psychiatric hospitals
- Free-standing medical detox facilities
- Medical detox facilities within a rehab program
In a medical detox setting, you can receive around-the-clock care from a team of doctors and nurses who will monitor your vitals, symptoms, and potential for complications. During detox, you’ll receive opioid withdrawal medications, such as methadone or buprenorphine. These medications ease your cravings and mitigate withdrawal symptoms to reduce your discomfort during this time. Once you finish detox and achieve medical stability, the treatment team will work with you to help you transition into a long-term heroin addiction treatment program where you can begin your recovery journey.
SAMHSA recommends 24-hour inpatient medical detox for heroin withdrawal.
Options for Heroin Rehab
There are several options for heroin rehab, ranging from the most intensive option of inpatient to the most flexible option, outpatient care. Ultimately, the best treatment for heroin addiction depends on your needs, addiction, insurance, and more.
Inpatient Care
Inpatient drug rehab involves living at the facility for the duration of the treatment program, which should last at least 90 days in order to have the best outcome.[1]
Many people benefit from this treatment setting because of its high frequency of care, highly structured environment, and rigid routine. People can escape their everyday triggering and using environments in order to focus solely on their recovery and healing.
It’s common for people who finish an inpatient program to then “step down” to less intensive forms of care, such as an outpatient program, where they can continue to build upon what they learned in rehab.
Outpatient Treatment
Outpatient treatment involves living at home while attending therapy and counseling at a treatment facility. These programs range in intensity, from just a few hours of care per week to up to 30. Here are the options:
- Standard outpatient/continuing care: This is the most flexible outpatient setting, including a few hours of therapy per week. It may be best used after attending a higher level of care or as an option for ongoing support.
- Intensive outpatient programs (IOPs): This treatment setting involves attending counseling for anywhere between 9 and 20 hours each week.
- Partial hospitalization programs (PHPs): This option involves up to 30 hours of therapy per week while returning home during non-treatment hours.
The recommended amount of time to attend any outpatient program is 90 days, although it may be helpful to attend them for much longer. Generally, the longer you attend treatment, the better chance you have of achieving long-term recovery from heroin addiction.[1]
The recommended amount of time to attend any outpatient program is 90 days, although it may be helpful to attend them for much longer.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) is the gold standard of care for heroin addiction treatment. It involves a combination of addiction treatment medications and behavioral counseling or psychotherapy. Medications used in MAT for heroin addiction include: [2], [4], [5]
- Methadone: A long-acting opioid agonist that binds to opioid receptors, relieving withdrawal symptoms and cravings.
- Buprenorphine: A partial opioid agonist that attaches to opioid receptors, mitigating cravings and withdrawal symptoms.
- Suboxone: A combination medication including buprenorphine and naloxone, an opioid antagonist, the addition of which reduces the risk of abusing the medication.
- Naltrexone (Vivitrol): An opioid antagonist that binds to opioid receptors and blocks heroin at the receptor sites so you don’t experience pleasure when using it.
The recommended minimum period of time to be on methadone for heroin addiction is 12 months, although many people take this medication for much longer than that. [1] The same can be said for other MAT options like Suboxone. These medications greatly improve patient outcomes and reduce the risk of relapse.[6]
What Helps People Stay in Treatment and Improve Chances of Long-Term Recovery?
Unfortunately, about 30% of people drop out of addiction treatment programs.[7] This may be for many reasons, including: [8]
- Lack of motivation
- Logistical issues
- Personal problems
- Severe symptoms
- Negative attitude toward medications
- Non-compliance with medications
- Dissatisfaction with treatment
- Poor relationship with a therapist
However, there are many things you can do to motivate yourself to stay in treatment and improve your chances of long-term recovery from heroin addiction. Some factors that can encourage finishing treatment include: [1]
- Having a high motivation to change and quit using heroin
- Having good support from friends and family
- Having a good relationship with clinicians
- Having individualized treatment tailored to your needs
- Having social, psychiatric, and medical services available
- Creating aftercare plans for ongoing support
You can also try writing down your treatment goals and keeping them somewhere where you’ll always see them. Positive affirmations and motivational phrases can also help you stay focused when you feel yourself disengaging.
Aftercare and Long-Term Heroin Addiction Recovery
An essential part of recovering from heroin addiction is aftercare, which involves post-treatment relapse prevention and support services. Once you near the end of your treatment program, you’ll collaborate with your treatment team to create a plan that works best for you. Examples of aftercare services include:
- 12-step meetings, such as Narcotics Anonymous
- Non-12-step meetings, such as SMART Recovery
- Group counseling
- Individual therapy
- Partial hospitalization
- Intensive outpatient
- Drug education classes
- Vocational classes
- Sober living homes
You don’t have to choose just one type of support—ideally, you’ll receive support from many different parts of your life. You can lean on these people and services whenever you are going through a hard time, such as experiencing cravings or triggers, or simply need someone to talk or vent to.
Defining Recovery
The reason there is no set timeline for how long it takes to treat heroin addiction is because addiction is never truly “cured”—however, it can be managed and treated so that you can live a happy, healthy life.
This can make it difficult to define recovery. But everybody has their own definition of what heroin addiction recovery looks like. Ideally, this means that you’re no longer using heroin, whether that means you’re on a maintenance medication like methadone or Suboxone or not.
Recovery often means that you’ve made important and radical life changes that promote a sober life, free of heroin and other substances. You’ve likely created a recovery and relapse prevention plan for yourself. You likely attend support group meetings, have a sponsor, or are a sponsor yourself. You likely engage in self-care practices, such as:
- Getting enough sleep
- Eating balanced, nutritious meals
- Spending quality time with loved ones
- Engaging in exercise or joyful movement
- Practicing stress-management techniques
- Meditating
- Doing things that fulfill and enrich your life
Recovery from heroin addiction doesn’t mean that you don’t experience cravings or don’t feel triggered to return to heroin use—these things may pop up, even years after you’ve stopped using. It’s about how you deal with these challenges that matters. And even if you do wind up relapsing, know that that doesn’t mean you are a failure or that you are not in recovery—relapse is often a normal part of the recovery process. And if you return to heroin use, this might indicate that you need to return to treatment or adjust your treatment plan.
- Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). (2014). National Institute on Drug Abuse.
- What are the treatments for heroin use disorder? (2018). National Institute on Drug Abuse.
- The neurobiology of opioid dependence: implications for treatment. (2002). Kosten, T. R., & George, T. P. Science & practice perspectives, 1(1), 13–20.
- Effective Treatments for Opioid Addiction. (2016). National Institute on Drug Abuse.
- Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45 (2006). Center for Substance Abuse Treatment. HHS Publication No. (SMA) 15-4131. Rockville, MD.
- Medications for Substance Use Disorders. (2016). Substance Abuse and Mental Health Services Administration.
- Dropout rates of in-person psychosocial substance use disorder treatments: a systematic review and meta-analysis. (2020). Lappan, S. N., Brown, A. W., and Hendricks, P. S. Addiction, 115: 201– 217
- Factors associated with dropout from treatment: An exploratory study (2021). Grover, Sandeep; Mallnaik, Sridhar; Chakrabarti, Subho; Mehra, Aseem. Indian Journal of Psychiatry 63(1):p 41-51