Heroin - Treatment for Habitual Users

Treatment for Habitual Users

When heroin was first introduced to the medical community at the beginning of the twentieth century, it was used to help people overcome opium and morphine addiction. Heroin was considered a "step-down" drug. However, the cure was worse than the original addiction. It is no coincidence that heroin was the first opiate product declared illegal in the United States. Once a dependence is established, it is very difficult to end.

The "rapid detox" method used in New Jersey in the 1990s was declared illegal after nearly a dozen patients ended up in emergency rooms with life-threatening complications. Many of those who successfully completed the "rapid detox"—being put to sleep while an opiate antagonistPronounced ann-TAG-uh-nist; a drug that opposes the action of another drug., Narcan, was shot into the brain—returned to heroin use due to inadequate psychiatric follow-up. The dream of easy, pain-free detoxification from heroin has remained just that—a dream.

Typically, heroin addicts undergo several steps before seeking treatment. First, they come to recognize that the drug has altered their lives. This may happen when a marriage breaks up, when an addict resorts to crime to pay for drugs, when a friend dies of an overdose, or when an addict begins to have serious health problems related to drug use. At that point addicts might decide to continue to use heroin simply to avoid any withdrawal symptoms. In the next step, addicts may ask about the types of help they can expect and talk to health care workers about what might happen in an inpatient setting or a methadone clinic. (Methadone is a drug that is used to

Once a dependence on heroin is established, it is very difficult to end. Some users seek out treatment in rehabilitation facilities, also known as detox centers. For habitual users, it is important to discover the reason they turned to abusing
Once a dependence on heroin is established, it is very difficult to end. Some users seek out treatment in rehabilitation facilities, also known as detox centers. For habitual users, it is important to discover the reason they turned to abusing drugs initially. © Ed Kashi/Corbis.

help addicts overcome heroin addiction. An entry on methadone is available in this encyclopedia.) In the third step, addicts decide to accept help.

Drug Treatment for Heroin Addiction

Heroin addiction is treated with several other drugs. One of them is the opiate methadone, which is most often taken in liquid or pill form. It is released slowly into the body and keeps withdrawal symptoms away but does not provide the high of heroin. Ideally, recovering heroin addicts begin with high doses of methadone and gradually taper down until they are drug-free. They combine the medication with talk therapy and lifestyle changes. The course of methadone treatment is rarely smooth, however. Sometimes addicts return to heroin. Sometimes they abuse the methadone instead.

As part of a youthful offender program, a former heroin addict takes a biology class as she works to earn her high school diploma. Such programs seek to build confidence and self-esteem. The teen says that without the program, she might have en
As part of a youthful offender program, a former heroin addict takes a biology class as she works to earn her high school diploma. Such programs seek to build confidence and self-esteem. The teen says that without the program, she might have ended up back on the street or in jail. AP/Wide World Photos.

Nevertheless, at the beginning of the twenty-first century, methadone was still the medication of choice for treating opiate addiction.

Another drug, naloxone (Narcan), works differently. This substance quickly frees the pleasure centers of the brain from the opiate. Emergency room doctors use Narcan to revive victims of heroin overdose who have stopped breathing. However, naloxone causes violent withdrawal symptoms if administered by injection. Scientists are experimenting with a continuous release form of naloxone that would be implanted under the skin and would block the effects of heroin even if the user took a dose. Doctors are also prescribing buprenorphine (byoo-preh-NORR-feen), another drug found to block the absorption of heroin in the brain. Buprenorphine (Temgesic, Subutex) lasts longer than methodone—seventy-two hours rather than twenty-four. This allows recovering addicts to make fewer visits to clinics. It is still in the experimental stages.

People can overcome heroin addiction. Self-help groups such as Narcotics Anonymous (NA) provide group therapy and the experiences of other recovering users to bolster the addict's courage. The group provides emotional support during the difficult times. Recovering heroin users must also be willing to undergo counseling to understand what underlying feelings led them to experiment with the drug—and how to cope with the cravings when they occur. It is sometimes necessary to begin a "whole new life," separating from the friends, settings, and personal habits that the user employed during addiction. It is also necessary to realize that cravings for the high will continue, sometimes for years, especially in times of stress or on occasions when something reminds the user of the drug experience.