Step 1: Be aware of what heroin abuse looks like.
It might sound unusual, but it is true that people who have an active addiction can keep that issue hidden from family members and friends for months or even years. A great proportion of people who use heroin are addicted to it. In fact, the National Institute on Drug Abuse reports that 23 percent of people who use heroin will be addicted to the drug in time. Given that statistic, families should know that there is no casual heroin use. People who use are very likely people who will have an addiction at some point.
Signs of use can include:
- Track marks on the arms or legs
- Recurrent sedation
- Sudden need for privacy
- Persistent need for money
- Social withdrawal
- Pinprick pupils
- Slow breathing
People who use heroin may also leave paraphernalia behind. That can include needles, spoons, lighters, or pipes. Some people also create stashes of heroin, so they will have around-the-clock access to the drug. A stack of drugs might look like a pile of powder, separated into clear bags.
Step 2: Assess the damage.
No two heroin addictions are exactly the same. Some people have symptoms that other people simply do not have. For example, some people have physical difficulties due to their heroin use. According to the British Journal of Dermatology, 22-65 percent of people who inject drugs like heroin develop skin infections due to that needle use. Those skin infections can turn into massive ulcers that can be life-threatening.
People who have medical conditions due to heroin addictions might need a different type of care, when compared to people who are healthy with an addiction. It is just one point to consider.
Similarly, heroin addiction severity can vary from person to person. A person who is new to the addiction process and has very little experience with substance abuse might be able to handle an outpatient addiction program, for example. But someone who has lived with addiction for years and who struggles to change generally needs something more intense. In most cases, those struggling from heroin addiction need more intensive care, and that often means inpatient treatment. That is another issue for families to consider.
Step 3: Hold an intervention.
A heroin intervention allows the family to outline all of the symptoms of addiction they have seen, along with all of the reasons they might cite that make addiction treatment necessary. This is a structured and planned talk all about addiction’s consequences and the person’s future, and it could be a great way to get the healing process rolling.
Some families hire professionals known as interventionists to help them address the addiction. The interventionist helps the family to understand the addiction and how it works, and the interventionist helps the family plan what to say in a meeting. The intervention that follows this format tends to take hold in the form of letters that the family has written.
Other families have informal talks, one on one, with a person who has an addiction. They do not try to compel with statistics or data, but they do try to make the addiction problem clear for the person in need. And they make the need for treatment very clear.
Once these talks are complete, the family is ready to move forward with treatment. That treatment moves in a very predictable way.
Step 4: Enroll in medical detox.
Opioid withdrawal is rarely considered life-threatening, according to the US National Library of Medicine, but it can be incredibly uncomfortable. People who have been through the process often compare it to a very severe case of the flu, and while they are in the midst of those feelings, they may find it hard to avoid the temptation to relapse to heroin.
Medical detox can help, as clinicians can use replacement medications that mimic the action of heroin. These drugs do not cause a high, but they can keep flu-like feelings from developing.
Step 5: Choose the right medication.
There are two primary medications that could be used in medical detox program for heroin addiction: Suboxone (buprenorphine and naloxone) and methadone. Both are replacement medications that have the ability to fool the brain into believing it has access to the drugs it wants, but each medication works in slightly different ways. One could be right for some people while the other might be right for someone else.
In a side-by-side comparison study published in the Journal of Substance Use, researchers report that people who use Suboxone feel a higher amount of mental clarity when compared to people taking methadone. They also had more confidence, and they felt subjected to a smaller amount of stigma. All of these are positive points, and they could indicate that Suboxone is the right medication for some.
However, Suboxone is not right for everyone. According to research published in the Journal of Neurosciences in Rural Practice, the severity of the addiction is a key point to consider when choosing a medication. Suboxone has some inner setpoints, which means it can only be taken at a specific dose level before it stops working. So it might not be right for people with severe addictions. They may need more help than this medication can provide.
A person’s medical detox provider typically makes medication decisions, but knowing a little about what medications have been right for others with addictions could be helpful to people in need.
Step 6: Expect immediate help.
When medical detox is complete, people with addictions move on to therapy programs. These rehab programs may last for months, but some of the help provided can bring about huge changes quite quickly. For example, the National Institute on Drug Abuse reports that Cognitive Behavioral Therapy (often used in drug rehab programs) can help people to enhance their self-control. The things they learn in therapy can help them to identify situations that jeopardize sobriety, and in therapy, they can learn skills that allow them to cope when they cannot avoid a trigger.
Skills strengthen with time, but clearly, people can learn a great deal even in the early part of therapy. The skills they learn here could help them to avoid those early relapse triggers they might encounter when the program is complete.
Step 7: Expect long-term changes.
While much of the relief people might feel in rehab happens quickly, within a few weeks of starting the care program, benefits can persist for a very long period of time. For example, some therapists encourage their students to learn more about a technique called mindful meditation. This form of meditation encourages people to focus on what is happening right now, not on what might or could happen if something goes wrong. People often use mindful meditation early in recovery, but they might continue to use it throughout life. According to research published by Harvard Health, ongoing mindful meditation has been associated with a number of key benefits, including a reduction in stress and heart rate.
Therapy could help people to overcome an addiction, and it could also help people to overcome other challenges they might face throughout life. With the help of rehab, people could turn their entire lives around.
Other Schedule I Drugs
Step 8: Enroll in aftercare.
Addictions to heroin can be overcome, but as research in the Journal of Addictive Diseases points out, recovery might not move in a straight line. Heroin addiction can be considered a chronically relapsing condition, which might mean that people who had an addiction can be at risk for relapse for the rest of life.
One way to overcome that challenge is to enroll in a structured aftercare program. These programs offer ongoing support through:
- Support group meetings with peers
- Medication management, as needed
- Touch-up counseling sessions
- Readmission to treatment, as needed
Some people enroll in these programs and stay involved for just a few months. Others stay involved for years. Still others use a stair-step approach in which they utilize some services for a short time and then use only less-intense help (like support groups) as time goes on.
Following the Steps
As mentioned, no two heroin addictions are alike, and neither are two recovery plans. Each person will have different lessons to learn and takeaways to keep in mind. The key is to get started. Customizing a plan is the easy part. People just need to take the plunge and start that recovery process as soon as possible. The sooner they do that, the better things will be.