When overdosing had become routine, something inside John told him he needed to stop abusing heroin. If he didn’t, John knew he would soon be dead. Deciding to give up heroin had always been easy for John. Choosing to stay off the drug permanently had always been another story. Rather than stop using heroin abruptly – or go “cold turkey” – John spent four weeks in a residential substance abuse treatment facility, where managed doses of methadone relieved him of most of his discomfort from heroin withdrawal and gradually returned his body to balance.
For other heroin addicts who choose to go at it alone, the powerful side effects of heroin withdrawal can be living hell. Although these debilitating symptoms can be quite discomforting when attempting to wean off heroin, withdrawal is rarely fatal. However, the nausea, vomiting, diarrhea, and tremors can be enough to discourage the recovery efforts of even the most committed addict and trigger a return to abuse.
The good news is that addicts can safely wean off heroin, without having to deal as much of the anxiety, sleeping difficulty, sickness and confusion that is common during withdrawal. Thanks to effective medications taken during the detoxification process that restore some normalcy to brain function, heroin addicts are better equipped to overcome cravings and physical symptoms that often provoke relapse.
This type of supervised detox can be found in hospitals or residential substance abuse treatment facilities.
What Is Heroin?
Heroin is an opioid drug made from a derivative of morphine, a natural substance taken from the seed pod of various opium poppy plants. From these flowers, local farmers squeeze out the opium gum, which is sold to drug cartels for transport to nearby labs. Here, a cooking process transforms the gum into heroin, which is spiked with various types of acid including fentanyl, a powerful synthetic opioid, to boost potency.
Users inject, sniff or snort heroin in the form of a white or brown powder or a black sticky substance called “black tar heroin.” Because heroin enters the brain rapidly, people who use the drug report a “rush” or euphoria once the opioid receptors attach to cerebral matter that controls feelings of pain and pleasure.
Those same cells that reduce anxiety can influence heart rates, sleep and breathing. People who use heroin may also experience dry mouth, heavy feelings in the arms and legs, and clouded mental functioning. Continued abuse over longer periods may lead to collapsed veins, infection of the heart’s linings and valves, abscesses, and lung complications.
What Is Tapering Off Heroin?
Tapering is a process of slowly reducing your drug use over time until you stop completely. It is used as opposed to quitting cold turkey, which is an abrupt cessation of a drug after a period of regular use. Tapering may be necessary if you’ve become chemically dependent on a drug. Chemical dependence is when your brain and body adapt to the presence of a drug. It happens over time, as you regularly take the drug. The time it takes for chemical dependence to develop will vary based on the drug you use, how often you take the drug, and how long you have been using it. In some cases, dependence can be avoided by taking breaks. However, that can be difficult to do with highly addictive drugs like heroin.
Once you’ve developed a chemical dependence on an opioid like heroin, quitting cold turkey could cause extremely uncomfortable withdrawal symptoms. Tapering involves taking an opioid to avoid serious withdrawal symptoms and slowly reducing the dose over time. The best way to get off heroin is to consult a doctor. A doctor or medical professional can help create a tapering plan that helps you reach sobriety without severe withdrawal symptoms. This process can be tricky and requires a doctor’s guidance. Taking doses that are too high may lead to a long or ineffective tapering process. Doses that are too low could cause severe symptoms or relapse.
What Are Heroin Withdrawal Symptoms?
Addiction to heroin can begin as early as two weeks into abuse. Common signs that should trigger a concern occur when the same dose of heroin no longer provides the same effects or behaviors. Without a structured recovery plan, a decision to stop using heroin can be both dangerous and painful.
Some of the side effects of heroin withdrawal or quitting “cold turkey” include:
- Restlessness or anxiety
- Increased pain
- Trouble sleeping
- Nausea, vomiting or diarrhea
- Sweating or fevers
- Rapid heart rate
- Blood pressure changes
Avoiding these symptoms is not always possible. The best chance at reducing the level of withdrawal discomfort and eliminating dependency on heroin means partnering with medical supervision to gradually wean off heroin, manage symptoms and develop behavioral therapies for coping with stress and life on life’s terms.
What Weaning Off Heroin Involves
When you’re tapering off prescription medication, you will likely use that same medication during the tapering process. However, when tapering off an illicit drug like heroin, you will likely use another substance. Heroin may be a harder drug to taper with. Heroin offers an intense euphoric high, and it’s notoriously addictive. Other opioids may be able to curb your heroin withdrawal symptoms without leading to the addiction-causing euphoria.
Heroin can also cause intoxicating symptoms, including heavy drowsiness and sedation. Other medications may offer fewer intoxication symptoms so you can attend to your life or go through other treatment options for addiction.
The length of time required for tapering off heroin depends on the individual and the medication prescribed to ease withdrawal discomfort. A physician can determine what medication best addresses both medical needs and minimizes health risks.
Prior to and during this tapering off period, a medical professional will:
- Monitor pulse, blood pressure, and temperature
- Determine through urine or blood samples what other medications or substances are in the body’s system
- Obtain medical information that may help with treatment
- Introduce other pain therapies as needed
- Prescribe other types of medications to help manage withdrawal signs and symptoms, such as sleep, appetite and mood disturbances
What Medications Are Prescribed To Wean Off Heroin?
Medications to wean off heroin and treat withdrawal attach to the same opioid receptors as heroin does but are safer and less likely to lead to harmful behaviors associated with abuse. What medication is administered is based on a patient’s specific medical needs and other factors. Effective medications prescribed to wean off heroin safely include:
- Methadone. A slow-acting opioid that saturates receptors in the brain to dampen the “high” is a popular option for treating withdrawal symptoms, particularly for patients who do not respond well to other medications.
- Buprenorphine. A partial opioid agonist that relieves drug cravings without producing the “high” or dangerous side effects of other opioids.
- Suboxone®. A form of buprenorphine that contains the narcotic naloxone is a popular sublingual tablet or film to treat heroin dependence.
- Naltrexone (Vivitrol®). An opioid antagonist that blocks the action of other opioids is not addictive or sedating and does not contribute to physical dependence.
Are Behavioral Therapies Used To Wean Off Heroin?
Most effective behavioral therapies to wean off heroin addiction are conducted following completion of the detoxification process at an inpatient or outpatient substance abuse treatment facility. These approaches include:
- CONTINGENCY MANAGEMENT: A voucher-based system in which patients earn “points” based on negative drug tests that can be exchanged for items that encourage healthy lifestyles.
- COGNITIVE-BEHAVIORAL THERAPY: This is one of the most common therapies in addiction treatment. It modifies the patient’s expectations and behaviors related to drug use and increases coping skills for various life stressors. This is a useful therapy for creating relapse prevention strategies.
- Dialectical behavior therapy (DBT) – This is a type of cognitive behavioral therapy that emphasizes acceptance and uses the principles of mindfulness. While traditional CBT emphasizes improved coping strategies to take on challenges, DBT can help you accept things you have little control over.
Anyone who abuses heroin can benefit from the support and company of other addicts, accredited addiction treatment counselors, and strong perseverance. If detox and rehab at a residential treatment facility can get an addict clean, support groups, such as Narcotics Anonymous and Alcoholics Anonymous will keep them clean.
Why Should I Detox?
Quitting heroin cold turkey can be extremely hard, especially if you’re doing it on your own. Heroin, like other opioids, is not usually associated with life-threatening withdrawal symptoms, but withdrawal can be extremely unpleasant.
Weaning off heroin is like fighting fire with fire. In other words, it is extremely dangerous. Because of the painful side effects associated with heroin withdrawal and the strong potential for those symptoms to lead to relapse, professional medical supervision is strongly recommended. This type of safe detoxification can be overseen at a hospital or a residential substance abuse treatment facility. Here, doctors can prescribe medications, such as methadone and buprenorphine, to temper symptoms, lower cravings and safely wean off an addiction to heroin. Licensed medical staff can also monitor progress, prevent complications and provide the emotional support needed for a return to good health.
What Is The Next Treatment Step?
Heroin addiction can be beat. You’ve already expressed a willingness to take control of what you want to do with your life. And those desires no longer include heroin. However, there is more to achieving sustained sobriety than you may have thought.
If you are serious and believe you have the resolve to commit to recovery, inpatient rehabilitation should be your next treatment step after detox. Under the supervision of certified health and substance abuse professionals, addiction to heroin can be fought through individualized recovery programs that include one-on-one counseling, group therapy, and educational workshops that prevent relapse and increase the chances of continued sobriety.
What Are the Drawbacks of Tapering Off Heroin?
Tapering off heroin with a doctor’s help may be the most comfortable way to get through heroin withdrawal, but there may be some drawbacks. The main drawback is it will prolong your withdrawal process. Because you are tapering more slowly, you may experience more mild withdrawal symptoms for longer. Medical detox without tapering typically lasts for around a week to 10 days. If you’re in an addiction treatment program, longer withdrawal periods may be associated with higher treatment costs.
Can you wean off heroin more quickly? The tapering process will be tailored for your needs, and it’s unlikely you could speed it up without experiencing more intense withdrawal symptoms.