Heroin is a highly addictive opiate drug that users inject, snort or smoke. Purging heroin from the system of an addict is referred to as heroin detoxification or detox. Rapid-detox centers allow addicts to undergo medical detox under general anesthesia. All rapid detox centers are private and are not covered by health insurance. Medical detox can occur in a hospital, clinic or on an outpatient basis, depending on the severity of the addiction and other factors. The primary detox drug is buprenorphine, sometimes given in combination with other medications.
Heroin Withdrawal
Heroin withdrawal is unpleasant enough to prompt many addicts to resume using to stop the withdrawal symptoms. According to Drugfree.org, serious addicts might begin to experience withdrawal symptoms within hours of the last use. Withdrawal symptoms include intense drug cravings, muscle and bone pain, agitation, insomnia, depression, vomiting, cold sweats, involuntary muscle movements, fever and diarrhea. Without detox medications, withdrawal symptoms peak within a few days, and subside in roughly one week. Withdrawal without medical supervision can lead to death.
Methadone
Methadone can be used either as a short-term heroin substitute in the process of detoxification or be a long-term maintenance option. According to RxList.com, a brief course of methadone can provide stabilization prior to medically supervised withdrawal. In these cases, about 40mg daily of methadone is used initially, which is gradually decreased after two to three days. Individuals absorb and metabolize methadone at highly variable rates, requiring particular caution during treatment, especially initially and during dosage changes. Methadone is highly addictive in its own right.
Subutex
Buprenorphine is less addictive opioid medication than methadone, and has less risk of overdose, according to RxList.com. Like methadone, buprenorphine can dangerously diminish respiration, especially when other depressants such as alcohol are used. Side effects include headaches, flu-like symptoms, sweating, mood swings, and sleep problems. Subutex is the brand name for buprenorphine. It is generally the initial drug given during medically supervised detox.
Suboxone
Suboxone is the brand name for buprenorphine combined with naloxone. When taken sublingually, Subutex and Suboxone function similarly. Naloxone is an opioid antagonist, meaning it blocks the effects of opioids. Therefore, Subuxone is the preferred maintenance treatment for unsupervised usage because it decreases the danger of combining heroin with buprenorphine. According to RxList.com, treatment recommendations are for Subutex for the first two days, followed by Suboxone from day three onward.
Adjunctive Detox Medications
During heroin detox, other medications might be given adjunctively. These include clonidine, a hypertension drug that also lessens withdrawal symptoms from all opiates, as well as from alcohol and even nicotine. Benzodiazepines such as Valium or Ativan can also aid in reducing anxiety, sleeplessness and agitation during detox. Because of the potential for abuse inherent with benzodiazepines, they are usually given under medical supervision only.
