18 Nov 2024

This blog has been reviewed by Lester Morse, Director of Rehabs UK, who has over 30 years’ experience helping individuals overcome various forms of addiction. Rehabs UK is a leading authority in addiction treatment and recovery and offers a range of connected services and support including detox and rehabilitation programmes as well as therapy.

If you or someone you know is being affected by heroin addiction the most important thing is to seek help. You can contact your GP or direct to Rehabs UK who can refer you to the right services for your individual needs. And you’re not alone - over 300,000 people are addicted to heroin and crack cocaine alone in England.

Here at Rehabs UK our fully trained Treatment Advisors are on hand to offer professional help and advice as well as providing a space with a range of resources to guide you or your loved one through the recovery journey. The first step is to reach out.

Disclaimer: This article should not be taken as medical advice. If you are concerned about yourself or your loved one please contact a medical professional.

The importance of finding the right help

Heroin as a drug is one of the most highly addictive opioid substances and consequently has a huge impact on the individual's body. It can quickly change the brain's chemistry, which in turn can make cravings and withdrawal symptoms a lot more intense. The results of using heroin can have detrimental effects on the body including organ damage, respiratory issues, and a high risk of overdose, because of this it is vital to get professional help to detox.

There is never a wrong time to seek help and it’s never too late. There are thousands of success stories of people who have got clean after many years of addiction. Sonja Pewter, former Admissions Manager at East Coast Recovery and who has been in recovery from drugs and alcohol for 18 years states: “Heroin is a great pain killer for those who cannot manage their feelings but then will soon come around and rip you to shreds. It can take you to heaven but then certainly takes you to hell. There is never a wrong time to seek help.”

As Sonja points out a common reason people may gravitate to use heroin is as a painkiller for past trauma. This topic is often discussed as to whether trauma causes addiction? When seeking help it is important to get the right treatment to address possible underlying trauma or issues which may connect to the addiction itself.

A study by the National Institute on Drug Abuse (NIDA) shows that long-term treatment such as residential rehab combined with therapies and long-term support significantly increases the chances of recovery.

With countless recovery stories that can help offer support and motivation, recovery is possible even if it seems daunting right now. Contact our team today for a free confidential chat and assessment.

How to get treatment

The most direct way of seeking treatment is through your GP or Rehabs UK as treatment itself often involves both medical and psychological interventions. At Rehabs UK the individual will have a free assessment with one of our Treatment Advisors who will then direct you to a medical professional who will assess the individual's mental and physical health, the severity of the addiction, and any co-occurring disorders which will determine the right treatment option for the individual. The treatment could include but may not suit; inpatient and outpatient care.

A large proportion of opiate users in treatment will have started using heroin in the epidemics of the 1980s and 1990s and are now over 40 years old. In 2021 to 2022, 69% said they first used heroin before 2001 and only 9% first used heroin since 2011.

Below are some of the key methods which are used in heroin treatment:

Maintenance therapy and Detox

For some individuals who have a severe addiction, maintenance therapy, which includes the use of medications such as methadone or buprenorphine, can help to reduce withdrawal symptoms and cravings.

Methadone shouldn’t be mixed with various other substances, medication, and some food as it may increase the risk of side effects or reduce the effectiveness.

Substances to avoid with Methadone:

CNS Depressants

  • Benzodiazepines (e.g., Valium, Xanax): These can increase sedation and the risk of respiratory depression, which may lead to overdose.
  • Alcohol: Methadone and alcohol both depress the central nervous system, and their combination can result in life-threatening respiratory failure.

Other opioids (e.g., oxycodone, hydrocodone): Combining methadone with other opioids significantly raises the risk of overdose.

Antidepressants

  • Tricyclic antidepressants (TCAs): Drugs like amitriptyline may increase the risk of heart problems and respiratory depression when taken with methadone.
  • SSRIs (e.g., fluoxetine, sertraline): These can alter methadone levels in the bloodstream, either increasing side effects or reducing its efficacy. A population-based study showed that co-administration of SSRIs such as sertraline or fluvoxamine increased methadone levels by around 30%, heightening the risk of cardiac complications​

Certain Antibiotics and Antifungals

  • Drugs like erythromycin and fluconazole can inhibit the liver enzymes that break down methadone, leading to increased blood levels of methadone and risk of toxicity.

Anticonvulsants

  • Phenytoin and carbamazepine: These drugs speed up methadone metabolism, reducing its effectiveness and potentially leading to withdrawal symptoms.

HIV Medications

  • Protease inhibitors (e.g., ritonavir) and non-nucleoside reverse transcriptase inhibitors (e.g., efavirenz) can alter methadone levels, either reducing its effectiveness or increasing side effects.

Grapefruit and Grapefruit Juice

  • Grapefruit can interfere with methadone metabolism, leading to higher levels of the drug in the bloodstream and an increased risk of side effects, including overdose. Grapefruit juice can increase methadone plasma concentrations by about 17%-40%, depending on individual metabolism.

How long do people stay on methadone?

The length of time a person stays on methadone is personal to each individual. Some people only need it for a short duration and others may continue it for the rest of their lives. Below is a breakdown of common factors that impact durations for methadone use:

  • Severity of addiction: People with severe, long-standing opioid addiction may require extended or indefinite treatment.
  • Stability and progress: Some individuals may remain on methadone for several years to achieve and maintain stability in recovery before tapering off.
  • Medical recommendations: Medical professionals generally advise against short-term methadone use (less than 12 months), as research shows longer treatment increases the chances of success and lowers relapse rates.
  • Tapering off: Some people gradually reduce their methadone dosage over time and eventually stop, but this process can take months or years, and relapse is common if tapering is too rapid.

An NIH study, ‘How effective are medications to treat opioid use disorder?’, suggests that methadone treatment improves the quality of life by facilitating employment and social reintegration for people with opioid use disorders. However, the treatment is most effective when combined with psychosocial support, and long-term treatment (over six months) yields better outcomes than shorter interventions

However, Robert Newman’s British Journal of Psychiatry article ‘Effectiveness of methadone treatment for heroin addiction’ notes challenges with sustaining long-term treatment, such as patient dropout or the ongoing use of illicit drugs during treatment. Methadone remains a cornerstone in the management of opioid addiction, particularly for those with chronic heroin use.

Note: The use of medication is only advised if a medical professional has been prescribed by a medical professional and is combined with a supervised detox program which allows the individual to have round-the-clock support and safely remove heroin from the body to overcome the addiction.

Residential Rehab

For some individuals, inpatient residential rehab may be the best option. This provides a structured environment for recovering addicts. It can offer the individual the ability to focus solely on their recovery without other external distractions such as friends or family, those that may still be in addiction themselves. A study in Scotland looking at residential rehabs reported that residential rehabilitation can reduce heroin use by half.

Residential rehab offers a place to stay as well as 24/7 support and therapy to give the individual the best start and set-up for long-term recovery.

Rehabs UK can offer several different rehab options which can include, short-term detox programs, retreat facilities as well as longer-term residential rehab programs which will include ongoing support after the treatment is complete.

Therapies

When looking at addiction recovery, therapy is a key element. The use of therapy can be beneficial to the individual as it allows them to understand the root cause of their addiction and be able to develop different healthy coping mechanisms to manage their impulse to use and prevent relapse.

There are so many different variations of therapy out there, some of the most common and popular options include;

Cognitive-behavioural therapy (CBT) - About 60% of people who receive CBT for substance use can maintain their recovery for a year.

Group therapy

Person-centred therapy

Online therapy - The rise in online therapy sessions has made it more accessible for people to receive therapy - In 2024, 13% of therapy sessions were conducted online, up from 1% in 2020.

By committing to therapy there is a significant increase in the longevity of long-term recovery from heroin addiction.

Additional treatment methods

In addition to the more standard treatments available, there are alternative holistic or complementary options such as art therapy, mindfulness practices, and exercise programs. They promote and provide overall well-being for the individual. One study that looks at art therapy for mental health disorders highlights that Group art therapy can improve self-efficacy and social function, and reduce social and life function problems.

Stuart Marsh, Programme Lead at a non-12-step facility states: “Everybody deserves a choice, everybody's trauma is different. We focus a lot on lifestyle changes such as daily hygiene, food, and holistic approaches to express creativity. There are options out there.”

If you or your loved one are unsure about what might be the right treatment option please get in touch with our fully-trained treatment advisors today. There isn’t one treatment option that fits all, it’s about what works for the individual, and the best way to discover this is by reaching out.

Get in touch today

Make the first step towards heroin recovery by contacting our fully trained Treatment Advisors who are on hand to answer any questions and can provide expert guidance to connect you with the most relevant treatment options for your specific situation.

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