Heroin Addiction Treatment

Help For Heroin Addiction with Castle Craig

Find Hope and Recovery With Our Evidence-Based Treatment Programme.
Kerry Canning, MBChB
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Kerry Canning is a Medical Editor at Castle Craig and is responsible for developing and medically reviewing content. More

Key Takeaways

  1. Heroin is an illicit, highly addictive opioid drug.
  2. Individuals receiving prescription opioids, such as oxycodone or fentanyl, can become addicted.
  3. Heroin addiction is a substance use disorder, recognised by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
  4. Chronic, repeated use of heroin leads to changes in the brain which result in tolerance and dependence – Withdrawal symptoms can occur when heroin is stopped abruptly.
  5. Medically supervised detox can be an important first step in recovery.
  6. Medical and psychological treatments are recommended to promote a full and long-lasting recovery.

Heroin Overview

Heroin is a highly addictive opiate drug derived from morphine and other substances. Morphine comes from the opium poppy flower and is used medically for pain management.1 Heroin rapidly binds to receptors in the brain, bringing about a rush (surge of pleasure) and influencing brain and nerve functions.2

Under the Misuse of Drugs Act 1971, heroin is recognised as a Class A drug, meaning that it is illegal to possess, produce or sell heroin in the UK.1

Heroin is typically sold as a white powder (pure heroin) or darker-coloured powder (impure heroin). Pure heroin can be smoked or snorted. Impure heroin tends to be dissolved and diluted for injection into the skin, veins or muscle.2

Heroin has numerous street names, including horse, smack and brown.3

Individuals receiving prescription opioids, such as oxycodone or fentanyl, can become addicted. This can lead to heroin use as heroin can be cheaper and easier to obtain than prescription opioids.1,2

Sadly, heroin use disorder is dangerous and can have fatal consequences. In the UK, heroin-related deaths have more than doubled since 2012.1

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Immediate Effects of Heroin

Heroin use can produce an array of immediate and long-term physical and psychological effects. Immediate effects include a rush, or intense pleasure, brought about by the binding of heroin to opioid receptors in the brain. The intensity of this rush is influenced by the amount of heroin used and the speed at which it enters the brain and binds to receptors.

Other immediate effects can include:

  1. Warm, flushed skin.
  2. Dry mouth.
  3. Heavy sensation in the limbs.
  4. Nausea and/or vomiting.
  5. Extreme itching.

Following these immediate effects, users are typically drowsy for several hours following heroin use. Cognitive functions are slowed, as well as heart rate and breathing. Reduction in breathing rates can be dangerous; leading to coma, permanent brain damage or death.2

Long-Term Effects of Heroin Abuse

When using heroin, you may immediately notice the following effects:

  • dizziness/drowsiness.
  • flushed skin.
  • dry mouth/heaviness in limbs.
  • itchiness.
  • pain relief/nausea or vomiting.

Heroin addiction, also known as heroin use disorder or heroin dependence, is a substance use disorder that can develop with repeated use.1

Substance use disorders (SUDs) are patterns of symptoms occurring from continued use of a substance despite negative consequences. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for SUDs feature four primary categories: impaired control, risky use, physical dependence and social problems. SUDs range in severity from mild to severe, depending on the number of symptoms experienced.4

Chronic heroin use leads to changes within the brain that can affect an individual’s behaviour, stress response and ability to make decisions.

Repeated heroin use over an extended period of time can result in tolerance and physical dependence. These are hallmarks of heroin addiction and lead to an individual having to take increasing amounts of heroin to produce the same effects. As the body has adapted to the presence of heroin, stopping use can result in withdrawal symptoms. These symptoms can occur within a few hours from last use and include restlessness, vomiting, cold flushes with goosebumps (i.e., cold turkey) and muscle and bone pain.2

What Causes Heroin Addiction?

Understanding the causes of heroin addiction is crucial in providing effective treatment and support. Heroin addiction, like other substance use disorders, arises from a complex variation of factors. Genetic, environmental and psychological factors can all impact an individual’s susceptibility to opioid addiction.

Genetic and Biological Factors

Individuals with first-degree relatives who have a substance use disorder are more at risk of developing addiction to opioids, such as heroin. Deficiencies in chemical messengers in the brain, such as dopamine, are also linked to opioid use disorders.

Addiction can lead to changes in brain function, particularly in the reward system. This means that individuals who develop heroin addiction can experience intense cravings and compulsively use the drug despite harmful consequences.

Environmental Factors

Addiction to opioids, such as heroin, can occur in anyone, regardless of educational or socioeconomic background. Those at increased risk include individuals who have been exposed to opioid use through their peers. Individuals who have been prescribed opioids for pain relief are also more susceptible to developing addiction.

Psychological Factors

A history of untreated depression, anxiety, post-traumatic stress disorder (PTSD) or childhood trauma can increase the risk of developing heroin addiction.5

At Castle Craig, we aim to help you identify and find acceptance in these underlying causes. By offering a personalised and comprehensive treatment approach, we can help to address the biological, psychological and social aspects of heroin addiction. Our goal is to empower individuals with the understanding and tools they need to overcome addiction and reclaim control over their lives.

Heroin Tolerance and Dependence

Drug tolerance occurs when changes in the brain’s functioning mean that more of the drug is needed to produce the same effects. This leads to an individual taking increasingly higher doses of heroin to achieve the same pleasurable effects.

Following the development of tolerance, an individual can become dependent on heroin. This means that they are susceptible to withdrawal symptoms when use is reduced or stopped.6 Drug dependence can be physical and/or psychological and can develop within 2-10 days with continuous use. Signs of heroin dependence can include 7:

  1. Compulsive desire to use heroin.
  2. Lack of control over heroin use.
  3. Neglect of other interests.
  4. Persistent use of heroin despite negative consequences.
  5. Presence of withdrawal symptoms when heroin use is reduced or stopped.

Physical Dependence

Physical dependence occurs when your body can no longer function normally without heroin. Addictive drugs like heroin change the circuitry in your brain.

Each time you use the drug, this rewiring grows stronger and physically compels you to continue using it. If you stop using heroin when physically dependent, you’re likely to experience withdrawal symptoms.

Signs and Symptoms of Heroin Misuse

Misuse of opioids, such as heroin, can be classified as a substance use disorder under the DSM-5 criteria. Substance use disorders are diagnosed by the presence of two or more of the following signs and symptoms:

  1. Taking the substance in higher doses or for longer than instructed.
  2. Inability to cut down or stop substance use, despite the desire to do so.
  3. Investing lots of time in sourcing, using or recovering from substance use.
  4. Presence of cravings.
  5. Neglect of other life responsibilities at work, school or home.
  6. Stopping significant activities due to substance use.
  7. Continued use despite relationship problems.
  8. Continued use despite dangerous consequences.
  9. Continued use despite physical or psychological problems that could have been caused or worsened by substance use.
  10. Development of tolerance.
  11. Development of withdrawal symptoms when substance use is reduced or stopped.

These signs indicate the presence of an opioid use disorder (OUD), which includes heroin addiction. OUD can take over people’s lives, leading to an array of health and social consequences.4

Individuals who inject heroin are also at risk of contracting HIV, hepatitis and other infections. Sharing of needles and other injection equipment can lead to the transfer of infection. Unprotected sexual intercourse with an infected individual can also lead to infection, so snorting or smoking heroin does not eliminate the risk of contracting HIV or hepatitis.

Mental illness and drug use are also linked and can exacerbate each other. For example, conditions such as depression and antisocial personality disorder can develop as a result of chronic heroin use.2

Heroin Withdrawal Symptoms

Heroin withdrawal symptoms occur as a result of physical dependence. As the body adapts to the presence of the drug, abrupt withdrawal can cause an array of symptoms to develop within a few hours of last use. Common symptoms of heroin withdrawal include:

  1. “Cold turkey” – a cold sensation with goosebumps.
  2. Restlessness.
  3. Insomnia.
  4. Diarrhoea.
  5. Vomiting.
  6. Bone and muscle pain.
  7. Increased leg movements.

These symptoms can often peak between 24-48 hours after the last heroin use and can last for around a week. Although symptoms often subside after approximately one week, some individuals can experience persistent withdrawal symptoms for many months.2

Heroin Withdrawal Timeline

Heroin is classified as a short-acting opioid. This means the drug takes effect rapidly and also leaves the bloodstream relatively quickly.

Determining an exact timeline for withdrawal is challenging, as heroin withdrawal is different for everyone. However, in many cases, heroin withdrawal follows a similar pattern, known as opioid withdrawal syndrome8:

  1. The onset of withdrawal symptoms at 8-24 hours after last use.
  2. 4-10 days duration of symptoms.
  3. In some cases, withdrawal symptoms can persist for many months.2

Heroin Detoxification

Detoxification, which is also known as detox or managed withdrawal, involves an individual stopping heroin use. This process can occur at a specialist facility (inpatient) or in the community (outpatient). Detox can be an important step following the short or long-term use of heroin.1 Medications such as lofexidine, a non-opioid medicine, can be used during detox to alleviate withdrawal symptoms.

Detox should be followed by evidence-based treatment(s) to manage the underlying addiction and support recovery.2

Heroin Addiction Treatments

There are various treatment options available to manage heroin addiction and promote long-term recovery. These include detoxification, medical treatments and psychological therapies.1

Medical Detox at Castle Craig

At Castle Craig, we operate our specialised medical detox centre to help you stop using heroin and safely progress through the withdrawal process. During our medically assisted detox, safety and comfort are our highest priorities. You’ll receive 24/7 care from our highly trained staff, with the ability to request medical attention at the press of a button.

Stopping heroin on your own can be extremely difficult or even dangerous. At Castle Craig, detox is overseen by a team of psychiatrists, doctors and nurses. Personalised care is delivered through our custom detox plans, which are designed to suit your unique medical history and personal needs. Our teams meet regularly throughout the detox process to monitor your condition and update your treatment plan as you progress through the detox process.

As you move through the detox process, you’ll have the opportunity to start integrating into our treatment programme. This creates a smooth transition to inpatient care, where intensive therapy work takes place to aid long-term recovery from addiction.

As you move through the detox process, you’ll have the opportunity to start integrating into our treatment program. This creates a smooth transition to inpatient care, where you’ll begin intensive therapy work to heal from your addiction.

Safe Detox in Comfort

Castle Craig has a dedicated detoxification centre and 24/7 supervision by doctors and nurses to ensure the utmost patient safety.

Medical Approaches

Opioid Substitution Therapy (OST)

Also known as opioid-assisted treatment (OAT), OST is an approach whereby prescribed opioids are given to replace heroin, thereby reducing the risks associated with its use. OST is provided and overseen by specialist addiction centres and involves regular reviews to monitor progress.

Drugs such as methadone and buprenorphine are options for OST. Both of these drugs act on the same receptors as heroin and so can reduce cravings.1

Methadone is a slow-acting opioid agonist, meaning that, like heroin, it also activates opioid receptors in the brain. It is taken orally in OST and has been used in this capacity since the 1960s. In an outpatient setting, it is dispensed daily as part of approved treatment programmes.

Buprenorphine is a partial opioid agonist, meaning that it activates opioid receptors but produces a smaller response compared to heroin. Buprenorphine was first approved by the Food and Drug Administration (FDA) in 2002 and is more widely accessible than methadone as it is available from non-specialist centres. It is now available in generic forms, which are more affordable. Buprenorphine can be delivered via a subdermal implant which lasts 6 months, once-monthly injection, orally or under the tongue (sublingually).


Naltrexone is another effective medical treatment for heroin addiction. As an opioid antagonist, naltrexone blocks opioid receptors, altering the rewarding effects of heroin. In 2010, a long-acting, injectable form of naltrexone was approved by the FDA for preventing relapse after detoxification.2

Medical Heroin

In heroin-assisted treatment (HAT) programmes, doctors can prescribe diamorphine, i.e., medical heroin. This approach has been shown to reduce the use of heroin and help individuals stay in treatment, particularly if they have failed to do so with other OSTs. Diamorphine is delivered through multiple daily injections and under the close supervision of medical professionals.1

Psychological Therapies

Individualised care plans are incredibly valuable in promoting recovery from heroin addiction. These plans can help to ensure that all aspects of addiction are addressed and managed appropriately.

Psychological and social treatments utilised in heroin addiction management include1,2:

  • Contingency management therapy: Encourages positive behaviours through incentives and rewards.
  • Motivational enhancement therapy: Enhances motivation for change through counselling.
  • Relapse prevention therapy: Identifies and helps manage situations that could lead to relapse.
  • Cognitive behavioural therapy (CBT): Helps individuals to modify addictive behaviours.

Addiction services can also help signpost local peer support organisations, which can provide a sense of community and shared experiences to aid recovery from heroin addiction.1 Although medical and psychological approaches can be effective in themselves, integrating these approaches often enhances recovery.2

We know that everyone comes to treatment with unique life experiences. That’s why we create a custom treatment plan for every patient that takes into account their unique circumstances.

After detoxing from heroin, you’ll enter our recovery programme, where you’ll benefit from a personalised focus on your unique life situation.

No matter what underlying difficulties or co-occurring conditions in your life may have led to or exacerbated your substance abuse, you can begin to heal the root causes in individual and group therapy sessions. These include targeted programmes which aim to address conditions such as eating disorders, and depression or trauma.

Your days at Castle Craig are thoughtfully constructed to create a restorative experience where you can heal from addiction, address underlying traumas, build lasting healthy habits, and connect with others in recovery.

Situated in the beautiful countryside of the Scottish Borders, Castle Craig’s location is highly conducive to addiction recovery. You receive a variety of wholesome meals and have plenty of opportunities to exercise and rest while receiving clinically excellent, therapeutic care.

Because addiction recovery is a lifelong process, your relationship with Castle Craig doesn’t end when you complete residential treatment. Before you leave, you’ll receive a customised, two-year continuing care plan so you can successfully continue into a meaningful and inspired life in sobriety.

Heroin Rehabilitation at Castle Craig

Inpatient rehabilitation is often recommended for substance use disorders such as heroin use disorder. This option involves staying at Castle Craig for typically 30 days to several months.

The immersive nature of inpatient rehab provides a structured and supportive environment, with 24-hour medical and emotional support. It also offers a safe space away from triggers and a comprehensive treatment plan that includes detox, therapy and skills training for relapse prevention. View our foundation programme to learn more.

At Castle Craig, therapy plans are tailored to each person’s needs, ensuring a comprehensive and effective approach to rehabilitation and recovery.

Following our medically supervised detox process, you’ll enter our recovery programme, where you can benefit from personalised treatment plans involving a variety of approaches. These include individual and group therapy sessions, where targeted programmes can help address co-occurring conditions, such as eating disorders, depression or trauma.

Situated in the beautiful countryside of the Scottish Borders, Castle Craig’s location is highly conducive to addiction recovery. A restorative experience featuring excellent clinical and therapeutic care promotes recovery. As part of your journey, you’ll receive a variety of wholesome meals, exercise, rest and opportunities to connect with others in recovery.

We recognise addiction as a lifelong process, so your relationship with the team at Castle Craig doesn’t end when you complete residential treatment. Before you leave, you’ll receive a customised, two-year continuing care plan to empower long-term recovery and sobriety.

What Are My Heroin Rehab Treatment Options?

Exploring your heroin rehab treatment options is a crucial step towards recovery. The primary choices include inpatient and outpatient rehab programs, each designed to cater to different needs and circumstances.

Inpatient Rehab

For substances as potent and dangerous as heroin, inpatient rehab is often recommended. This option involves staying at Castle Craig for a duration, typically ranging from 30 days to several months.

The immersive nature of inpatient rehab provides a structured and supportive environment, crucial for those dealing with severe addiction.

It offers 24-hour medical and emotional support, a safe space away from triggers, and a comprehensive treatment plan that includes detox, therapy, and skills training for relapse prevention. View our foundation programme here to learn more.

Over 10,000 People Have Achieved Sobriety Through Castle Craig

Outpatient Treatment

Outpatient rehab allows patients to live at home while attending treatment sessions several times a week. This option can be suitable for those with less severe addictions, strong support systems, and a high degree of commitment to recovery.

Outpatient programmes provide flexibility, allowing patients to maintain certain responsibilities like work or family commitments while undergoing treatment.

While outpatient rehab might be a viable option for some, the intensity and risk associated with heroin addiction often necessitate the more robust, focused care provided by inpatient programmes.

Inpatient rehab’s controlled environment, constant care, and comprehensive approach significantly enhance the chances of a successful recovery, especially in the critical early stages of treatment for heroin addiction.

Get Help Today

At Castle Craig, we assess each person’s specific situation to recommend the most appropriate treatment plan, ensuring the highest chance of successful, long-term recovery.

If you think you may be addicted to heroin, recovery is within your reach. A fulfilling and rewarding life is possible no matter how much you may be struggling with heroin right now—contact us today to learn how we can help.

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With a wealth of knowledge and services to help you regain control of your life, request a call-back from one of our professionals today. The choice you make today could change your life forever.

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