This is for the family member, spouse, or good friend of someone who’s detoxing from heroin. How do you help that person? Unless you recognize their needs, you may do more harm than good. Here’s a basic primer so you can understand your role.
Seek Education About Addiction Treatment
If you know someone who is detoxing from heroin, pain pills, or other types of drugs, you need to become educated about the nature of addiction. The Center for Substance Abuse Treatment tells us that “families are interdependent groups of people who have enduring emotional, social, and financial connection and commitment to one another,” so that means you if you in some way care about the addicted person.
Although the addict may tell you that he or she created this problem and will face it alone, you cannot accept that. Addiction is a family problem because it affects everybody. The addict is the one person who must make the commitment to treatment, however.
Go to the library or cruise around on the Internet for some good reading material. Learn how the person’s drug of choice affects them. With heroin, the immediate signs that they’ve been using include a warm flush to the skin. The pupils dilate and there is no rush to do any physical activity. There are intensively good feelings—unless the person has taken a bit too much, in which case you will see their eyelids closing as they try not to pass out, the typical “nodding out” you’ve heard about.
Long-term side effects of someone who is not yet detoxing from heroin begin with emotional immaturity. In any kind of addiction, the drug use impacts the brain’s pleasure and reward center. The person comes to depend on the drug to attain any real feelings of pleasure and reward. For that reason, their own emotional development stops. If you’re dealing with someone who became addicted as a teenager, they probably still act pretty much like a teenager.
This snowballs into a persistent disruption of the brain’s physiology, including hormonal and other biochemical imbalances. You can expect your loved one to make rash decisions. During and after his time spent detoxing from heroin, he will not handle stress well.
This is complicated by the fact that since heroin or pain pills are stimulating the brain to produce neurotransmitters—those feel-good biochemicals you’ve probably heard about—the brain stops producing them on its own. So, someone who’s detoxing from heroin enjoys very little in life until the brain eventually learns how to produce endorphins, dopamine, and serotonin on its own once again. If you take your loved one out to dinner and a ball game, for example, don’t expect them to jump up and down with happiness. If it’s a quiet and uneventful outing, then it’s a success.
You should also encourage the person to get a good physical checkup. Many addicts acquire infectious diseases from sharing needles with another person. Some of them make poor decisions and have promiscuous sex while they’re high and they contract sexually transmitted diseases. Others are suffering nutritionally because they’ve neglected their diet and hygiene while they’ve been using, including a lack of good dental hygiene.
No Enabling, No Codependency!
What’s the difference between enabling and codependency? Those are two terms that are thrown about casually in the world of addiction treatment. Enabling means that your actions directly facilitate the addict’s continued use of drugs. Does the person beg you for money, so they can go to the doctor, pay their cell phone bill, or get a textbook needed for college? Don’t give them the money directly; pay in person for immediate and urgent needs. Remember that whenever you pay for any of their needs, however, you are enabling them to keep their own money for the drugs they need. Yes, they’ll be angry.
Codependency is very similar, but your own needs complicate things a bit. If you feel it is your job to take care of that addicted person, and they cannot make it without you, you may very well be experiencing feelings of codependency. That means your own feelings of worth depend upon that other person’s need of you. It’s hard to sort out those feelings and determine whether you are reasonably responding to someone’s requests for help or if you are a little codependent. It may be worthwhile talking about it with a counselor at some point, and you can also read Codependent No More: How to Stop Controlling Others and Start Caring For Yourself by Melody Beattie.
The Physical Symptoms of Detoxing From Heroin
Maybe you’ve seen actors portraying addicts in movies or TV shows. They go through hell for a few days, and then they wanly smile at their family members. That’s not the real world.
While it’s true that the major symptoms of heroin withdrawal include nausea and vomiting, muscle aches, runny eyes and nose, diarrhea, insomnia, and cold flashes, don’t expect them to go away in 72 hours. Most symptoms peak within a couple days of the person’s last use. However, some people who are detoxing from heroin experience withdrawal symptoms for months. Cravings can last for years.
Learn About Types of Heroin Withdrawal Treatment
When most people realize that a loved one needs help, they think right away of a residential rehab like the ones advertised on television. The truth is that most treatment for someone detoxing from heroin is much more low key and under the radar. When substance abuse treatment counselors evaluate a new client, they are required to recommend the least restrictive level of care. For many people, it begins with outpatient counseling once or twice a week.
For someone detoxing from heroin, treatment must begin quickly because heroin is so dangerous. Many residential rehabilitation centers will admit heroin addicts as soon as possible, but success rates are much lower than for those in methadone maintenance treatment.
Medication-assisted treatment offers the best alternative because it helps those detoxing from heroin to deal with unbearable cravings or withdrawal symptoms. Heroin, pain pills, and other opiates are all derivatives from morphine—even tramadol, which is a chemical simulation of morphine—constituting some of the most addictive substances on the face of the Earth. These all fall into the opioid classification of drugs.
Both methadone and buprenorphine are approved for those in heroin withdrawal. They control those cravings and addictions, and while they have many similarities to the drugs that the person has been abusing, they metabolize in the system more quickly and are monitored closely by doctors and nurses at licensed methadone programs. Methadone is available for anybody who wants to begin detoxing from heroin, while buprenorphine—the brand name is Suboxone—is generally reserved for those who have tried and failed at some other kind of detox program.
Your Role Is Important
You can’t force your loved one into treatment, but you can steer them in the right direction. You can become educated about the drug they’re using. You can think about your own role in their addiction and whether you’ve been helping them to cover it up.
Remember that methadone programs and all drug treatment agencies follow strict confidentiality guidelines, so we hope you will understand if we can’t communicate with you without a signed consent form. If you’re reading this because you hope you can talk a loved one into detoxing from heroin, go ahead and put some pressure on them—most addicts refuse treatment unless they face a family or legal ultimatum. Help them to realize that their life is going downhill and seriously in danger. Give them a number to a methadone program and urge them to call.