Because heroin’s illegality and addictiveness make it an exceptionally damaging drug, often dragging its addicted users into criminality and life-threatening misuse, heroin rehabilitation programmes can be precarious affairs, battling against the addict’s compulsive drug-seeking and sheer desperation.
In the UK, one common harm reduction approach for heroin addiction is the “needle exchange programme.” Addicts are at risk of other dangers through re-using dirty needles, such as HIV and hepatitis. Providing users with a supply of clean needles can considerably reduce these risks. However, this approach does not treat the chemical and psychological causes of heroin addiction.
Heroin rehab programmes usually begin with a period of detoxification, in which users are helped to pass through the painful and disturbing experiences of heroin withdrawal as humanely as possible. The aim is to achieve a drug-free state whilst alleviating the pain of withdrawal symptoms either through intensive psychological and emotional support in a residential or inpatient unit, or with alternative medications. Detox in a residential therapeutic community can typically be achieved in between 3 to 6 months.
Ideally, behavioural and pharmacological approaches are integrated in to heroin rehabilitation programmes. Cognitive-behavioural therapy helps addicts recognize the ways in which their thoughts and actions around drug use reinforce one another and how they can be changed. Contingency management therapy is also increasingly being used, which encourages addicts to maintain drug-free living through the use of vouchers each time a test proves negative. These vouchers can be exchanged for items that encourage healthy living.
The psychological therapies help restore healthier brain function in the aftermath of the neurochemical changes induced by heroin addiction.