Heroin: withdrawal and treatment
Withdrawal
If a dependent person suddenly stops taking heroin, or severely cuts down the amount they use, they will experience withdrawal symptoms because their body has to readjust to functioning without the drug. This usually occurs within a few hours after last use.
Withdrawal symptoms can include:
- a craving for the drug;
- restlessness;
- yawning;
- low blood pressure;
- elevated heart rate;
- stomach and leg cramps, muscle spasms;
- loss of appetite, vomiting and diarrhoea;
- goose bumps;
- tears and a runny nose;
- increased irritability;
- insomnia; and
- depression.
These withdrawal symptoms get stronger and usually peak around 2 to 4 days after last use. They usually subside after 6 to 7 days, but some symptoms, such as chronic depression, anxiety, insomnia, loss of appetite, periods of agitation and a continued craving for the drug, may last for periods of months and even years. Sudden withdrawal from heroin rarely causes direct death, unless the user is also using other drugs and is in poor health. Withdrawal from heroin or opioids is much less dangerous than withdrawal from some other drugs like alcohol or benzodiazepines.
Treatment options
A number of drug treatment options are available in Australia. Some aim solely for the user to achieve a drug-free lifestyle, while others recognise abstinence as one option among a number of strategies that have an overall aim of reducing the harms related to the person's drug use.
Treatment is more effective if tailored to suit a person's specific situation, and usually involves a combination of methods. The different options include counselling, group therapy, medication (pharmacotherapy) and supervised home withdrawal.
Pharmacotherapy based treatments
Methadone
A synthetic opioid that can be used as a substitute for heroin. The intention is to reduce the impact that heroin has on the lives of people who are dependent on heroin by reducing the harms associated with injecting an expensive illicit drug of unknown strength and purity.
Buprenorphine
Can help treat heroin dependence by preventing withdrawal symptoms and by blocking the effects of heroin, so using heroin will not provide the ‘high’ that would normally be expected.
Naltrexone
Naltrexone works by blocking the analgesic and euphoric effects of heroin and other opioids. It can assist in maintaining abstinence from heroin because the person is aware that they cannot achieve a ‘high’ from using heroin.
Ultra Rapid Opiate Detox (UROD)
UROD is a quick method of withdrawing or detoxifying from opioids. It involves high doses of naltrexone given over a 48-hour period or less along with heavy sedation. By the end of the process, the patient should be physically withdrawn from opiates. UROD is currently under trial in Australia.
For more information, please click on the Australian Drug Foundation's DrugInfo Clearinghouse web site link below.
Last Reviewed: 20 September 2006
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