Heroin addiction treatment involves a number of different interventions that are often combined to create an individualized program of therapy: detoxification, methadone or other medication, and behavioral strategies.
Heroin detox is usually the first step in the treatment for heroin addiction, followed by a program of treatment and relapse prevention. Residential detoxification programs involving counseling and medication are usually the most successful. They provide a safe environment for the initial stages of withdrawal, but cannot in themselves “cure” addiction.
The best heroin addiction treatment plans are designed for the individual patient, taking into account their specific needs, which may include additional treatment for mental disorders or infections such as HIV. Addiction is a chronic condition that requires long term treatment for heroin addicts which should evolve as the individual’s needs change. A combination of counseling, behavioral therapy and medication is usual.
Methadone is the most established substitute medication, having been used for over thirty years. It is intended to prevent relapse by relieving the craving for heroin. It is a synthetic chemical that blocks heroin activity and prevents withdrawal symptoms. Patients should still be able to live normal lives while medicated. The dose is administered orally and is usually taken once a day.
Buprenorphine acts in a similar way, but is considered to be safer than methadone, as it is weaker. Patients become less dependent on buprenorphine than on methadone, therefore it is easier to discontinue treatment.
Naltrexone is a different type of medication which blocks the effects of heroin for up to three days, but works best in well motivated patients. It can be successful as a post-detox treatment of heroin addiction.
Behavioral therapy and counseling are an essential component of heroin addiction treatment programs, with an integrated approach being considered most effective. A number of behavioral therapies exist which are tailored for individual patients. Some involve a stay in a residential center. One option that has been recently developed is contingency management, which rewards negative drug tests with points that can be exchanged for various items which encourage a healthy lifestyle. Another way of helping patients is to use cognitive behavioral therapy. This involves modifying expectations and behavior and helping the patient develop new coping skills.
The effects of drug addiction are multiple and complex and successful heroin addiction treatments need to act at a number of different levels, physical, mental and behavioral, helping the patient through both short-term and long-term withdrawal, and also to build a new and productive life for themselves.