Heroin withdrawal is one of the most painful drug withdrawal processes. Though not dangerous like alcohol or benzodiazepines, heroin withdrawal can often be excruciating and medical detoxification is always recommended. Detoxing from heroin can be significantly less painful in a medical setting, as many of the symptoms are reduced or halted altogether. There are many comfort medications that are used in a medical detox in addition to tapering drugs, which are used to slowly withdrawal from opiates, opposed to “cold turkey.”
Heroin withdrawal causes a slew of uncomfortable symptoms:
- Cold sweats
- Severe cravings
- Loss of appetite
- Loss of concentration
- Restless legs
In a medical detox, doctors and nurses will examine the patient and monitor symptoms. As symptoms change or increase, medications can be administered or increased. Medical detox provides 24/7 care so that patients can feel comfortable and safe. These are some things to expect while detoxing from heroin:
Tapers are drugs used to slowly remove heroin or other opiates from the body. At the beginning of detox, an initial larger dose is given. Each day smaller and smaller doses are given. Tapers reduce all withdrawal symptoms. The most common taper used today for heroin is buprenorphine (Suboxone, Subutex). Another common taper is methadone. If a person quits heroin on their own, they will feel the full excruciating symptoms of withdrawal. With tapers, symptoms have a slower onset and are much less severe. Typically patients receive a taper in the morning and before they go to bed. By the end of detox, no more tapers will be given and the patient will be completely detoxed from heroin.
For insomnia, there are several medications that are used. The tapers will help somewhat, but other comfort meds will also help promote healthy sleep. Trazodone is a common drug used for sleep and is a non-narcotic. Other stronger meds are sometimes used, like benzodiazepines or phenobarbital. These drugs are often very effective at stopping insomnia, even while in heroin withdrawal.
Detoxing from heroin often causes a lot of anxiety. Anxiety can be treated with similar meds used for sleep, but there are also other specific medications for this symptom. Non-narcotic blood pressure medications are common for treating anxiety and tend to be very effective. It is common on a medical detox to give a patch that contains the blood pressure medicine clonidine. Clonidine calms the nerves, which is also effective for restless legs. Restless leg is an uncomfortable feeling that can also be painful. It is the feeling of an inability to relax and is prominent when sitting or lying down. Restless legs make it difficult to relax or sleep while detoxing from heroin. Benzodiazepines are also effective in treating restlessness.
There are several medications and remedies used to treat stomach pains and nausea that is experienced while detoxing from heroin. Cola syrup is a common remedy for nausea and vomiting. Promethazine is also a common medication used for nausea and vomiting in medical detox centers. For diarrhea, the most common medication is Imodium. All of these combined makes many of the stomach symptoms unnoticeable.
In medical detox, there are often therapists on site. Patients can talk with therapists and doctors and, if deemed appropriate, antidepressant medication can be prescribed. Sometimes, doctors prefer to wait until after the detox process to determine if depression medication is needed. This is because depression often resolves itself when heroin is completely detoxed from the body. Antidepressants can cause physical dependency, so there should be multiple opinions before a person decides to begin these medications. Depression is a symptom of heroin withdrawal, so sometimes medication is not needed.
Detoxing from heroin often significantly reduces the ability to concentrate. In a medical detox, concentration is not really necessary because most of the time will not require any concentration. If concentration problems persist after the detox process, there are practices and non-narcotic medications that can help. Concentration problems are sometimes symptoms of post acute withdrawal syndrome, so further treatment may be necessary. Meditation can increase concentration abilities and drugs like clonidine can also help without causing dependency.
Detoxing from heroin often results in severe cravings. Cravings can be treated with talk therapy, support groups, and coping skills like meditation. Cravings can also be reduced with new medications like Vivitrol or naltrexone. These drugs can be taken daily as a pill or injected once a month. Not only do these drugs reduce cravings, but they also cause heroin to be ineffective. After taking Vivitrol, if a person uses heroin they will not get high. Vivitrol can also prevent overdose, which is most common during a relapse.