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Medication for Heroin Addiction, Withdrawal, and Detox Programs

Heroin is an illegal and highly addictive drug that remains a significant concern in many areas across the country.1 As part of the ongoing opioid crisis, the United States has seen a growing number of first time heroin users and an alarming upward trend in heroin overdose deaths over the past few decades.1,6 In 2020, there were 902,000 Americans aged 12 or over who had used heroin in the last year.2 Nearly 691,000 Americans aged 12 or over had a heroin use disorder within the last year.2

This article will help you learn more about what heroin use disorder is, what heroin withdrawal is like, how medications can be used to manage heroin withdrawal, what medication-assisted treatment (MAT) is, what medications are used to treat heroin addiction, the other types of supports that are incorporated into the treatment process, and whether health insurance covers these medications.


What is a Heroin Use Disorder?

Heroin use disorder is a type of opioid use disorder (OUD). An opioid use disorder diagnosis is made based on the presence of problematic patterns of opioid use that cause significant problems in an individual’s life. Several diagnostic criteria are used to make such a diagnosis, including:3,5

  • Inability to control the length of time or amount of heroin you use.
  • Wanting to cut down or stop using heroin but not being able to do so.
  • Spending a lot of time getting heroin, using it, or recovering from using it.
  • Experiencing strong heroin cravings or urges to use.
  • Having trouble taking care of things at home, school, or work because of your heroin use.
  • Inability to stop using heroin even after it has created or contributed to relationship or social problems.
  • Stepping back from or giving up activities you enjoy because they get in the way of heroin use.
  • Using heroin in situations that could be physically harmful, such as before driving.
  • Not being able to stop using heroin even after you know it has caused or worsened a physical or mental health condition.
  • Needing larger amounts of heroin to get the effect you want (developing a tolerance).
  • Going through withdrawal when you don’t use heroin.

Checking Your Insurance Benefits

If you are looking for heroin addiction treatment, it can feel overwhelming. As you consider your options, knowing what your insurance plan covers can give you a sense of calm while you or your loved one is in rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. For more information on what your insurance plan covers, call American Addiction Centers (AAC) at , click here, or fill out the form below.


What is Medication-Assisted Treatment?

Medication-assisted treatment (MAT) involves combining specific medications with behavioral therapy to treat OUDs.7 The medications help to stabilize people in recovery by preventing withdrawal, reducing heroin cravings, lessening relapse risks, and minimizing the rewarding effects of any misused opioids.1, 7 When used as part of a comprehensive opioid use disorder treatment plan, these medications may allow you to focus on your recovery and help you stay in treatment, maintain steady employment, improve your health, and stay sober longer.1,7

Methadone, buprenorphine, and naltrexone are the three FDA-approved medications used to treat OUD.7 While the goal of each of these medications is to help you stay sober, each of them works differently.8 Should a treatment program utilize any or all of these medications as therapeutic options, an initial assessment can help to best determine your needs and which of these medications might work best for you.


Medication for Heroin Addiction Treatment

While the medications used to treat OUD all help to decrease relapse risks, they each work differently. Your treating physician and other healthcare professionals will monitor your recovery progress to ensure that the medications are working as effectively as possible and whether any adjustments to your regimen are required.7 If you are in treatment for an addiction to heroin, medication you may be prescribed includes:1,4-6,8

  • Methadone. This is a full opioid agonist and works by bonding to and activating opioid receptors in the brain. Methadone is a long-acting medication that has been used for more than 50 years, but it is very closely regulated and only provided through specially licensed opioid treatment programs. When used as indicated, it reduces or stops cravings and withdrawal and, via a phenomenon known as cross tolerance, minimizes the effects of any other opioids used while on methadone therapy. This medication can be initiated during detox for withdrawal management and continued as maintenance treatment for as long as needed throughout recovery.
  • Buprenorphine. This is a partial opioid agonist and works by tightly bonding to opioid receptors in the brain and partially activating them. When used for OUD treatment, buprenorphine can reduce cravings and withdrawal without causing the euphoric high of other opioids. It is a relatively safer option for treatment for some people because it has an upper limit to its opioid effects, to minimize the risk of respiratory depression. Buprenorphine is available in combination with naloxone (an opioid antagonist) to decrease the likelihood of intentional misuse. Treatment with buprenorphine can start during detox and be ongoing into further recovery. As buprenorphine may be prescribed and dispensed by specially waivered individual practitioners, it may be more accessible to some people than methadone.
  • Naltrexone. This is an opioid antagonist and works by blocking opioid receptors in the brain so that any opioids used while taking naltrexone will have less positive or rewarding effects. Naltrexone is a non-addictive medication that doesn’t cause any noticeable effects on its own, but it can only be started after you are fully detoxed from opioids to prevent heightened acute withdrawal at the start of recovery.

Detox Medication for Opioid Withdrawal Treatment

Medication for heroin withdrawal can make the detox process much more comfortable for those in early recovery.1 Two of the medications initiated at the detox stage for withdrawal management—methadone and buprenorphine—overlap with those used for more longer-term maintenance treatment of opioid use disorder. Other non-opioid-agonist medications may also be used at this point to help augment withdrawal symptoms management, depending on your individual needs. Medications that are commonly prescribed during detox can include:1,5,9-13

  • Methadone. As previously mentioned, methadone works to blunt withdrawal symptoms and cravings as well as decrease the effects of any other opioids used (such as might occur in relapse) while taking the medication.
  • Buprenorphine. Like methadone, buprenorphine suppresses withdrawal symptoms and cravings during detox. Buprenorphine has a relatively high margin of safety for therapeutic use because of its partial agonist effects.
  • Lofexidine (Lucemyra). This is a relatively recently approved non-opioid medication that lessens some of the physical symptoms of heroin withdrawal.

Heroin Withdrawal Symptoms

The symptoms of heroin withdrawal can range from mild to severe, depending on how long you have been using it and how heavily you use.10 Common symptoms of heroin withdrawal may include:3,5,9,10

  • Anxiety.
  • Insomnia.
  • Increased pain sensitivity.
  • Bone and muscle aches.
  • Involuntary leg movements.
  • Muscle spasm.
  • Runny nose.
  • Watery eyes.
  • Increased body temperature.
  • Sweating.
  • Chills.
  • Goosebumps.
  • Stomach cramps.
  • Nausea.
  • Diarrhea.

Do Rehab Programs Use Medication for Heroin Use Disorder Treatment?

Medication is a common component of treatment for heroin addiction, but not all facilities offer MAT. Current treatment guidelines increasingly recommend against managing significant opioid withdrawal symptoms without effective medication therapy, though each treatment plan may differ.10 Before you begin treatment, facility staff will conduct a thorough assessment to determine what your needs are.10 You will be asked about your substance use, physical and mental health, and any medications you currently take.10 Then you will work with the doctor to determine if you should be taking a medication, and which one would be best for you.5,11


Additional Support Provided at Heroin Rehab Centers

Medication isn’t a magic cure-all, so to be most effective it should be combined with other techniques that can help you learn how to maintain your sobriety while in a heroin rehab program.5,8 If you receive medication through an opioid treatment program (OTP), the facility is federally mandated to provide some type of counseling as well.8 Common techniques and supports that are incorporated into treatment include:1,4-6

  • Cognitive-behavioral therapy (CBT): This teaches you how to change unhealthy patterns of behavior by thinking differently, learning coping skills, identifying situations that put you at risk for relapse and developing strategies to lessen the risk, and learning how to solve problems more effectively.
  • Family support: This can take the form of family therapy or attending support groups where the entire family can work on issues together, improve communication, and learn how to support each other as a group.
  • Group counseling: This involves counseling with your peers, led by a therapist. You will be able to give and receive feedback, and a variety of therapeutic techniques can be used in a group setting.
  • Individual counseling: This offers the opportunity to discuss private issues more deeply than you can in a group setting. You and the therapist will typically focus on short-term goals and how to overcome the obstacles that prevent you from reaching them.
  • 12-step programs: Many programs encourage attendance at meetings when you are in treatment, and you can continue to attend meetings after you graduate. It is a good way to build a sober peer group that you can socialize with, as well as develop healthy coping skills and receive support from.

Does Health Insurance Cover Medication for Heroin Addiction?

The Affordable Care Act (ACA) ushered in major changes for addiction treatment. It ensures that most insurance plans provide some level of coverage for addiction treatment, including MAT, although the coverage can vary depending on your plan.14 The ACA enabled more people to access health insurance, improved coverage of treatment for substance use disorders, and made sure that limits for physical and mental health treatments were similar.14,15 Since individual plan coverage can vary, it is important to check with your health insurance plan to make sure that they cover MAT.


How to Find Medication-Assisted Treatment Programs for Heroin Addiction Near Me

For more information about MAT for opioid addiction, including heroin, you may want to reach out to your doctor. Or you can contact one of our admissions navigators at for the information and support you are looking for as you look for heroin addiction treatment. There are various treatment programs for individuals struggling with drug or alcohol addiction, so don’t give up if the first program you check out doesn’t meet your individual needs or accept your insurance. There are rehabs near me that can provide the treatment you need. Check out the directory to find a list of facilities and programs.

AAC has various rehab facilities around the country that provide drug and alcohol addiction treatment. The following AAC facilities may incorporate MAT as part of your individualized treatment program.


Sources

  1. National Institute on Drug Abuse. (2021). Heroin research report.
  2. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health(HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  4. National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction DrugFacts.
  5. National Institute on Drug Abuse. (2021). Heroin DrugFacts.
  6. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (Third edition).
  7. Substance Abuse and Mental Health Services Administration. (2021). Medication-assisted treatment (MAT).
  8. Substance Abuse and Mental Health Services Administration. (2021). MAT medications, counseling, and related conditions.
  9. Schuckit, M.A. (2016). Treatment of opioid-use disorders. New England journal of medicine, 375(4), 357-368.
  10. Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.
  11. National Institute on Drug Abuse. (2021). Medications to treat opioid use disorder research report.
  12. National Institute on Drug Abuse. Volkow, N. (2018). NIDA-supported science leads to first FDA-approved medication for opioid withdrawal.
  13. U.S. Department of Health and Human Services. (2010). Protracted withdrawal. Substance Abuse Treatment Advisory, 9(1).
  14. Fox, D.M., Grogan, C.M. (2017). The Affordable Care Act transformation of substance use disorder treatment. American journal of public health, 107(1), 31-32.
  15. Department of Health and Human Services. (2020). Does insurance cover treatment for opioid addiction?

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