There are two approaches to treatment – abstinence based and harm-reduction based. People may often benefit from both forms of treatment at different stages in their journey.
For many drug-dependent individuals, it is simply a case of “all or nothing”. For these individuals, an abstinence based programme is the best way forward. Many experts highlight the physical and psychological benefits of abstinence-based recovery programs. Heroin use can result in psychological side-effects, and when a person stops using the substance, their overall mental and physical health will improve. In addition, individuals can be more consistently and actively involved in the individual and group counselling process when they are not intoxicated.
There are many clinics out there which can help individuals move away from the problem and towards the route to recovery. Residential rehabilitation is probably the form of intervention most likely to bring positive, sustainable results. The evidence-based ‘golden rules’ of rehab are i) to match the individual to the programme most likely to result in retention in treatment; ii) to commit to at least one month and as long as possible thereafter; iii) to complete the chosen programme duration.
As well as committing to residential treatment, individuals should make sure they have an ongoing form of support within the community. This should take the form of one-to-one counselling with an addictions specialist, and regular attendance of Narcotics Anonymous meetings.
Opioid Substitution Therapy (OST)
Methadone is a synthetic opiate used as a heroin substitute. This is a strong painkiller commonly used to stop the use of heroin. It is usually in a liquid form and is taken orally. Methadone prevents the withdrawal symptoms associated with heroin, but also blocks the pleasurable effects.
Subutex is a long-acting opiate substitute. Subutex should not be given until at least 12 hours after the last dose of heroin, however the more regular and the heavier heroin use has been, the longer one should leave between the last dose of heroin and the first dose of Subutex. People are not usually transferred from methadone to Subutex until they are on a methadone dose of 30mg or lower.
- Needle Exchange
Needle exchange programmes provide access to sterile syringes and other injecting equipment such as swabs and sterile water to reduce the risk of injecting drug users coming into contact with other users’ blood, thereby aiming to curb the spread of blood-borne viruses such as HIV and Hepatitis C. As well as providing clean needles, a needle exchange scheme can also act as a gateway through which users learn about safe injection practices and equipment disposal, safer sex education, free provision of condoms and access to other prevention services such as substitution therapy.
- Blood-borne virus testing
There are facilities that will provide heroin users with free testing for HIV, Hepatitis B and Hepatitis C. Regular screening is intended to reduce the spread of these viruses by increasing awareness of them.
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