Thousands of people—at least 517,000 American adults, says the American Society of Addiction Medicine—are wrestling with debilitating, relentless heroin addiction. Using this potent substance puts everyone who uses it in harm’s way. The substance, which can be up to three times as strong as morphine on its own, can be smoked, snorted, and dissolved in water before it is injected into a vein.
Heroin is also dangerous because it is cut with various substances, including the deadly opioid fentanyl. The list of additives includes sugar, starch, flour, powdered milk, and other products. Dealers add these items to stretch out their supply so that the drug lasts longer. This practice costs them more money, but it puts users at a higher risk of overdose.
Some heroin users turn to the illegal substance after becoming addicted to prescription opioid medications. The street drug is cheaper and easier to access. When they can no longer afford or access these meds, they pick up heroin, furthering a life-threatening addiction.
In past years, heroin has claimed more lives than gun violence, and the National Safety Council reports that Americans are more likely to die of an accidental opioid overdose than a motor vehicle crash. The National Institute on Drug Abuse (NIDA) has reported data showing that the largest spike in heroin use is happening among the adult population that’s between ages 18 and 25.
Some people will try to quit the drug, but what they may not know is how they quit the drug is just as important as the fact that they do. When they do end their use, they will soon find that the journey has a few more twists they may not have seen coming.
Heroin withdrawal is marked by painful symptoms that can complicate ending an addiction to the drug. Among these symptoms are:
Symptoms can be severe. These include physical and psychological changes, such as:
Symptoms of heroin withdrawal vary depending on how long a person has been using the drug and how much they use. Heroin use affects the central nervous system, suppressing heart rate, blood pressure, respiration, and body temperature. Heroin also activates pleasure receptors in the brain, which results in a high. When an addicted person stops using heroin, these effects are reversed.
Quitting it “cold turkey” is not safe or wise. Doing so can not only be physically painful but extremely mentally taxing as well. Some heroin users have even died by suicide while trying to quit without medical help. Undergoing monitored medical treatment at an accredited addiction treatment facility. Read on to learn more about detox for heroin withdrawal and two approaches to treating it: methadone and Suboxone.
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Methadone, a long-acting opioid medication, has been used to help people get off heroin for more than 40 years, according to the National Association of Drug Abuse( NIDA). The federal agency says the medication has been tested rigorously and that it is safely used to treat opioid addiction at that time.
NIDA lists the following as benefits of methadone treatment:
The medication is often used as a long-term alternative for those who have a history of heroin or opioid relapse. Methadone, which comes in a tablet, solution, or a dispersible that dissolves in liquid, works by acting on the brain’s opioid receptors. In the U.S., it goes by the names Dolophine, Diskets, and Methadose.
A person who uses it in addiction treatment will find that the medication eliminates opioid withdrawal symptoms and eases drug cravings. Euphoria isn’t a side effect of the drug, as it is for other opioids, which makes it useful in treating methadone dependence.
Methadone’s long half-life, the time it takes the body to process half of the drug, is around 15 to 55 hours. This makes it easier for users to manage pain and other withdrawal symptoms for a considerable time. It’s long half-life also is why federally regulated clinics can dispense the medication to patients once or twice a day. It is administered by a medical professional if it is determined that methadone maintenance treatment is beneficial to the person in recovery.
Despite its benefits, which have helped countless people end their addiction to heroin, methadone is still an addictive drug that can be abused when it ends up in the wrong hands. According to the National Survey on Drug Use and Health (NSDUH), more than 200,000 Americans misused methadone in 2016.
People who use methadone to treat heroin withdrawal should use it with caution. Take it as prescribed, and if complications arise when doing so, let your doctor know right away.
Be aware that using the drug can be habit-forming, even when taken at standard doses. If a psychological dependence forms after using methadone, some people find it challenging to remain mental and emotionally clear. They also struggle with maintaining a normal sleep schedule.
Suboxone is another option that recovering heroin users have to manage drug withdrawal. The medication is a blend of two drugs—buprenorphine and naloxone. Buprenorphine eases opiate withdrawal symptoms, and naloxone blocks the highs of using opioids.
It is a weaker opioid than heroin and other drugs in the opioid class, which means a person is less likely to abuse it. Suboxone, similar to a breath strip in appearance, is taken by mouth and placed under the tongue. Suboxone users are usually part of a medication-assisted treatment program that uses behavioral therapy along with medication to treat opiate dependence and addiction.
The U.S. Food and Drug Administration approved Suboxone for substance use disorder treatment in 2002, making it a more recent method than methadone treatment. When it is used as part of a complete addiction treatment program, one that also includes therapy, it has been found to help people get a grip on opioid addiction.
People may receive Suboxone treatment either at the start of treatment. Or, they can take it at the start of the maintenance part of the treatment. If it’s the latter, they can’t have any withdrawal symptoms or other side effects, including intense cravings.
As with methadone, Suboxone is addictive, and users can develop an addiction to it if it is not used as designed. Recreational use, which happens because people mistakenly believe prescribed medication is safer than street drugs, is discouraged.
It is helpful to have options for addiction treatment. There’s no one way to treat addiction, as the condition and experience vary depending on the person. If you or a loved one is considering whether to undergo methadone treatment or Suboxone, talk with a doctor or other medical professional first. Overall, a reputable treatment program will administer methadone or Suboxone as a part of a medication-assisted treatment program known as MAT. This method is regarded as a “whole patient approach” to addiction treatment that is regarded as effective.
In a MAT program, patients receive medication along with, therapy, and counseling, which are designed to cover all aspects of addiction, not just the physical one. These include the mental and emotional sides of addiction.
There are differences between the two, which can help determine which is the best one for your situation.
You can obtain methadone only at federally sanctioned opioid treatment facilities or clinics. A doctor must be present to monitor you as you take your daily dose of the medication. People who have demonstrated stability as they take their methadone medication may be allowed to take their dose at home between visits to the clinic.
Suboxone does not have to come from a government-approved clinic. Users can take it at an approved facility, and a doctor can still be present to monitor the process.
Methadone and Suboxone have similar costs. The National Institute on Drug Abuse (NIDA) has compared the costs of both and writes that methadone treatment, along with medication and integrated psychosocial and medical support services, costs about $126 per week or $6,552 annually.
For stable patients in a certified opioid treatment program, buprenorphine, including twice-weekly visits and medication, costs $115 a week or $5,980 annually, says NIDA.
Each medication has its own side effects, and these may be taken into consideration when thinking about which one to use.
Methadone use can cause:
Methadone users may also react physically to the drug and experience:
Another side effect is a fast or pounding heartbeat. Also on the list are:
They could experience hallucinations or confusion.
Suboxone use could cause a reaction with the tongue since a tab is placed underneath it. Common side effects that are possible with this method include:
While both are widely regarded as safe medications to use, keep in mind that they are both opioid drugs that can cause dependence, addiction, and overdose if they are misused or abused. Seek professional guidance when considering either of these drugs for heroin withdrawal.
Opioid Addiction 2016 Facts & Figures. American Society of Addiction Medicine. Retrieved August 2018 from https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
What Can Be Done For a Heroin Overdose. National Institute on Drug Abuse (NIDA). Retrieved from https://www.drugabuse.gov/publications/research-reports/heroin/what-can-be-done-for-heroin-overdose
National Institute on Drug Abuse. (2018, January). Prescription opioid use is a risk factor for heroin use. Retrieved from https://www.drugabuse.gov/publications/research-reports/relationship-between-prescription-drug-heroin-abuse/prescription-opioid-use-risk-factor-heroin-use
Ingraham, Christopher. “Heroin Deaths Surpass Gun Homicides for the First Time, CDC Data Shows.” The Washington Post, WP Company, 29 Apr. 2019. Retrieved from https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroin-deaths-surpass-gun-homicides-for-the-first-time-cdc-data-show/
Americans more likely to die from opioid overdose than in a car accident. (n.d.). Retrieved from https://www.cbsnews.com/news/americans-more-likely-to-die-from-accidental-opioid-overdose-than-in-a-car-accident/
CDC. (n.d.) ”CDC Wonder.” U.S . Centers for Disease Control and Prevention. Retrieved from https://wonder.cdc.gov/mcd-icd10.html
“Part A: Questions and Answers Regarding the History and Evolution of Methadone Treatment of Opioid Addiction in the United States.” Methadone Research Web Guide. National Institute on Drug Abuse. Retrieved April 2019 from https://www.drugabuse.gov/sites/default/files/pdf/parta.pdf
Center for Behavioral Health Statistics. (n.d.). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#adults1