Heroin: Treatment and rehabilitation

Last modified: Sunday, 31. May 2009 - 4:12 pm

A variety of treatments and treatment programs that are available to people addicted to heroin, though the treatment options available and the quality of the care provided greatly increase with the ability to pay. In a recent Rolling Stone interview, one anonymous addict said it cost his parents $150,000 for his two-year stay in a drug treatment center. Publicly subsidized treatment programs frequently have waiting lists and are forced to turn people away. The cold realities of drug treatment are even more troubling.
Despite progress, most studies post the failure rate of most treatment programs at or near 80%. Most addicts who try to abstain relapse at least once, and often several times before successfully kicking their drug addiction.
A common first step of treating heroin addiction is detoxification. The objective is to relieve withdrawal symptoms while allowing patients to adjust to life without heroin. “Detox,” as it is sometimes called, is not an end in itself but a beginning that must also include broad therapeutic programs. Most successful programs of this type are in-patient residential regimens lasting three to six months.
Because any opiate derivative will suffice to soothe heroin cravings associated with withdrawal, methadone, a synthetic opiate that has no sedating side effects, has been an effective treatment for heroin and morphine addiction for more than 30 years. The medication is taken orally and suppresses narcotic withdrawal for a period of 24 to 36 hours. Methadone can be taken continuously for 10 years or longer with no harmful side effects.
Like methadone, LAAM (levo-alpha-acetyl-methadol) is a synthetic opiate used to treat heroin addiction. LAAM can block the effects of heroin for up to 72 hours. This makes outpatient treatment much more convenient, given that patients need to dose only two to three times a week. Naloxone and naltrexone are new medications that are also effective at blocking the pleasurable effects of heroin, helping motivated individuals to abstain.
Buprenorphine (Temgesic, Subutex) is a new medication that has been shown to be even more effective in blocking the effects of heroin than methadone. Recent preclinical studies have shown that buprenorphine may also significantly reduce cravings associated with cocaine addiction.
Though drug-based treatment regimens can be helpful in conquering heroin addiction, integrating them with behavioral and therapeutic programs (both individual and group counseling) have consistently proven more effective at preventing relapse over the long term.

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