The personal and public cost of heroin addiction is staggering. According to statistics from the American Society of Addiction Medicine, more than 586,000 Americans were addicted to heroin in 2014, with an additional 1.9 million suffering from general opioid addiction. The Centers for Disease Control and Prevention notes that drug overdose is the most common cause of accidental death in the United States, and estimates that the systemic cost of addiction is more than $400 billion annually. The good news, however, is that heroin addiction treatment with a combination of pharmacological and behavioral methods is often effective.
A range of medications can be used to assuage the physical and psychological side effects caused by heroin withdrawal. During the initial detoxification stage, people discontinuing opioid usage experience severe nausea, vomiting, pain, and diarrhea. Doctors typically prescribe medications that help ease this transition by affecting the brain’s opioid receptors without activating the pleasurable feelings associated with heroin. Common options including methadone, which has been used for this purpose since the 1960s; buprenorphine, which was FDA-approved in 2002 and includes naloxone, which induces withdrawal symptoms if the person attempts to use the medication to get high; and naltrexone, which reduces physical dependence to the drug.
Many people who are addicted to heroin have coexisting mental health disorders that must also be addressed. For example, effective addiction treatment will also take steps to treat underlying depression, anxiety, and other issues that may have either been present before addiction or caused by pervasive drug abuse.
Although subverting the drug’s effect on the brain and body is a key component of heroin addiction treatment, behavioral therapy helps prevent relapse. Therapy can be provided in either an outpatient or residential setting. One effective approach, called contingency management, allows patients to earn vouchers for positive drug tests that can be used to purchase items that encourage healthy living. Another approach, cognitive-behavioral therapy, helps the person modify his or her expectations and behaviors, as well as explore and reduce stressors that may have contributed to initial opiate use.
Principles of Effective Treatment
It’s important for those entering heroin addiction treatment to be aware of the ways in which the drug affects the body and brain and the steps that must be taken to break these connections. Addiction alters the brain’s structure and function, which explains why relapse is so common among those addicted to opioids. No single type of treatment is appropriate for everyone, so it may take several false starts to find the appropriate settings and services that help an individual return to a functional, productive lifestyle. Treatment should take into account a person’s medical, psychological, social, vocational, and legal problems in addition to the addiction.
Most people need at least three months in intensive treatment to successfully discontinue drug use. It’s important to plan for the eventuality of leaving a treatment setting, including integrated social and vocational supports that prevent a person from returning to destructive routines, friends, and activities.