Rapid Heroin Detox

When someone is ready to quit using heroin, withdrawal symptoms are often something that gives them pause.

When people undergo rapid detox, they are told they will go under general anesthesia, and upon waking, they will be detoxed completely.

Rapid detox can seem like a miracle — a method to get through withdrawal quickly, without any pain or discomfort. As the saying goes, it is too good to be true, then it is. Rapid heroin detox comes with a bevy of risks, including death

The Typical Heroin Detox Timeline

Once someone decides to stop using heroin, they can expect withdrawal symptoms for an average of five to seven days. Some symptoms may linger for up to several months.
Lingering symptoms are associated with post-acute withdrawal syndrome, which some people develop. This is a prolonged period of withdrawal that can last for months or even a full year after a person quits using heroin.

MedlinePlus relays the following are possible heroin withdrawal symptoms:

• Anxiety
• Diarrhea
• Increased tearing
• Goosebumps
• Runny nose
• Yawning
• Vomiting
• Agitation
• Abdominal cramps
• Muscle aches
• Dilated pupils
• Insomnia
• Nausea
• Sweating

In an effort to prevent people from having to experience these effects, some facilities offer rapid heroin detox.

Most reputable facilities offer more traditional medication-assisted treatment (MAT). This treatment is not rapid.
When medications are used as part of MAT, it is a long-term approach to detox. Generally, individuals take the medication for weeks or months until they are stable in recovery. At that point, they are slowly tapered off the medication.

Rapid Detox Methods

While the exact sedatives used may differ among facilities, the purpose of rapid detox is to sedate someone while also giving them naltrexone.

As a type of narcotic antagonist, naltrexone induces withdrawal. The person receives sedative drugs, so they do not experience the full effects of withdrawal. In some cases, general anesthesia is used instead of sedatives.

During rapid detox, health care professionals monitor patients. The patient is under anesthesia or sedation for approximately four to six hours. This gives naltrexone time to work.

The person usually remains in the facility overnight for monitoring after the sedatives or anesthesia are discontinued.

What the Research Says

Research does not favor rapid heroin detox.
One study published in the Journal of the American Medical Association concluded that people who received rapid detox had a higher rate of adverse events. Their relapse rate did not decrease, and they experienced more discomfort after detox. This was compared to people who went through detox using traditional medications, including clonidine and buprenorphine.

More research was published in the Cochrane Database of Systematic Reviews. The researchers concluded that the benefits were uncertain, and rapid detox should be regarded as experimental regarding the risks.

Researcher Dr. Eric Collins performed a study with his colleagues. His research concluded that there is no good reason to treat opioid addiction with anesthesia. He stated that his research determined that rapid detox from heroin does not make withdrawal any easier.

Other Heroin Detox Methods

Since rapid heroin detox is not recommended by health care or addiction professionals, people who are looking to achieve sobriety should consider other detox methods. In most cases, detox and long-term treatment for heroin use disorder include a combination of medication and behavioral therapies.

During the detoxification stage, certain medicines may help to reduce cravings and make the withdrawal symptoms easier to cope with, according to the National Institute on Drug Abuse.
One medication that is FDA-approved to ease heroin withdrawal symptoms is lofexidine, a non-opioid medication.

Other medications that might be used to treat heroin use addiction include:

• Methadone. This is a type of opioid agonist. It prevents withdrawal symptoms, but it doesn’t induce euphoria unless abused. People taking this long term to recover from a heroin addiction need to be part of an approved outpatient treatment program. They usually need to visit a methadone clinic daily to get their dose.
• Naltrexone: This drug is an opioid antagonist. People get injections once a month to reduce their risk of relapse.
• Buprenorphine: This drug is a partial opioid agonist. It does not produce a high and can reduce cravings for heroin. It is often used in the form of Suboxone, a combination medication that also contains naloxone (an abuse-deterrent component).

These medications may be combined with different behavioral therapies to treat heroin addiction.

• Contingency management therapy uses incentives to encourage people to continue with their recovery. The monetary value of the incentives or rewards starts low, but they increase with time to keep the person motivated.
• Community reinforcement therapy with vouchers aims to highlight how rewarding living a sober life can be. This therapy combines recreational, social, familial, and vocational reinforcers.
• Family behavioral therapy allows the family of the client to join in on therapy. It improves communication skills and addresses issues the addiction has caused for the entire family.
• Cognitive behavioral therapy helps people identify issues that may have caused them to develop an addiction. It also teaches them coping strategies, so they can deal with stress and cravings in a healthy manner to reduce their risk of relapse.

Total recovery from heroin addiction is possible. The disease can be effectively managed for life with proper treatment and support.
While rapid heroin detox can be tempting, it isn’t a recommended detox approach. Instead, choose evidence-based methods that are supported by research.

Sources

(July 2018) Understanding Drug Withdrawal Symptoms. Verywell Health. Retrieved February 2019 from https://www.verywellmind.com/what-is-withdrawal-how-long-does-it-last-63036

Opiate and Opioid Withdrawal. MedlinePlus. Retrieved February 2019 from https://medlineplus.gov/ency/article/000949.htm

(November 1996) Rapid Opiate Detoxification. American Journal of Drug and Alcohol Abuse. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pubmed/8911587

(August 2005) Anesthesia-Assisted vs Buprenorphine or Clonidine-Assisted Heroin Detoxification and Naltrexone Induction. Journal of the American Medical Association. Retrieved February 2019 from https://jamanetwork.com/journals/jama/fullarticle/201451

(2001) Opioid Antagonists Under Sedation or Anesthesia for Opioid Withdrawal. Cochrane Database Systematic Review. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pubmed?term=11279746

Study Finds Withdrawal No Easier with Ultrarapid Opiate Detox. National Institute on Drug Abuse. Retrieved February 2019 from https://archives.drugabuse.gov/news-events/nida-notes/2006/10/study-finds-withdrawal-no-easier-ultrarapid-opiate-detox

Heroin. National Institute on Drug Abuse. Retrieved February 2019 from https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder

(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide. National Institute on Drug Abuse. Retrieved February 2019 from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies