Treatment for Heroin Addiction

Heroin is a highly addictive and illicit opioid commonly injected, snorted, or smoked. It may come in many forms, such as white powder, brown powder, or black tar heroin. Chronic heroin use can lead to tolerance, physiological dependence, and addiction. Heroin addiction can be difficult to overcome without professional treatment—fortunately, there are many rehab options available that can help you stop using heroin and live a life of recovery.

Heroin Addiction Treatment Settings

Treatment Program	Center	Description	Level of Care
Inpatient rehab	Hospital or medical center	24/7 treatment and supervision	Highest
Partial hospitalization	Hospital or medical facility	Attend up to 30 hours per week of treatment	Moderate
Intensive outpatient	Hospital or medical facility	Attend between 9 and 20 hours of treatment per week	Moderate
Standard outpatient	Various settings	Attend a few hours of care each week	Lowest (often used as step-down care)
Medical detox	Medical settings or detox center with medical care	24-hour medical supervision and care to manage heroin withdrawal symptoms	High (short-term)

The Heroin Addiction Treatment Process

Heroin addiction treatment tends to occur on a continuum of care, starting with medical detox and moving to comprehensive rehab programs and aftercare.

Medical Detox for Heroin Withdrawal Management 

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, especially if someone quits cold turkey. [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.

Comprehensive Rehab Treatment

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 Treatment

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 Options

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]

Medication-Assisted Treatment (MAT) for Heroin Addiction

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]

Therapies for Heroin Addiction

Many different therapies may be used during heroin addiction treatment, often in combination with medications. These may vary from program to program and will also depend upon your individual needs.

Various therapies for heroin addiction include:

• Cognitive behavioral therapy (CBT): You work with a therapist to understand the connection between your thoughts, feelings, and behaviors in order to avoid relapse and learn coping skills.
• Dialectical behavior therapy (DBT): This type of CBT involves talk therapy and an education aspect to improve emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness.
• Motivational enhancement therapy: This type of therapy focuses on resolving your ambivalence about entering treatment and stopping heroin use.
• Contingency management: You receive tangible rewards like vouchers or cash for abstinent behaviors, such as drug-free urine tests.
• Group therapy: Facilitated by a mental health professional, you meet with other patients to discuss issues related to heroin addiction, challenges, and successes. You may practice sober social skills, drug refusal strategies, and role-play.
• Family therapy: Facilitated by a mental health professional, you and at least one family member meet to heal the damage caused by heroin abuse, improve family bonds, and learn conflict resolution and communication skills.
• Person-centered therapy: This is an affirming and empowering form of therapy in which the therapist focuses on your strengths and personal goals.
• Eye Movement Desensitization and Reprocessing (EMDR): A therapist works with you to reduce the distress related to traumatic memories, using focused eye movements.
• Holistic therapies: Combined with evidence-based therapies, holistic therapies like creative arts therapy and yoga may help treat various aspects of heroin addiction.

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.

Recommended Treatment Stays

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 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.

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

What to Look for in a Heroin Addiction Treatment Program

With so many heroin rehabs to choose from, it may be difficult to narrow down your choice. Thankfully, there are some qualities and traits you should look for when choosing a treatment program, such as:

• Individualized treatment plans: Choose a heroin addiction treatment program that tailors your treatment plan to meet your needs, situation, history, mental health, and physical health.
• Evidence-based treatment methods: Make sure to choose a heroin rehab that utilizes evidence-based treatment modalities, such as MAT, DBT, CBT, and motivational enhancement therapy.
• Aftercare: Quality heroin rehab programs will create an aftercare plan for you to follow once you complete your initial treatment program.
• Credentialed staff: A quality treatment program staffs people with the appropriate credentials for treating addiction, mental health, and medical issues. 
• Accreditation: The highest quality treatment programs have national accreditations, such as CARF and Joint Commission.
• Insurance coverage: If you have insurance, make sure to go with a rehab that accepts your particular provider and plan.
• Financing options: Quality rehabs understand the financial burden of heroin addiction treatment and will offer financing options and payment plans.

If you are looking for a comprehensive, accredited, and evidence-based treatment program for heroin addiction, contact us at Boca Recovery Center. We have several locations and treat patients from all over the country. We work with most major insurance providers and also offer financial aid.

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.