Harm Reduction in Heroin Use: an informational sheet on withdrawal

 A successful withdrawl can be accomplished in one of three ways:  cold turkey, a methadone program or detox clinic, as well as tapering heroin or opiate use.  Tapering off of heroin will be difficult because it is not sold in easily measurable quantities.  Tapering can be less painful with small doses of pharmaceutical opiates taken at home. 

If you choose to go to a clinic call at least 2 days ahead of time to reserve space.  It would be best to arrange for masshealth or another insurance company to cover the cost of the program but you will not be turned away for lack of insurance.  Be prepared to lose a certain amount of freedom at a detox facility as it is a restrictive environment and you will be forced to attend NA and AA meetings.  A detox facility will provide 30-25mg of methadone to start and reduce by 5mg daily.  If you have a large habit it may be a good idea to taper off before entering into the program.  

Some side effects of a planned or unplanned withdrawl are sweating, hot and cold chills, intense agitation and aggravation, sneezing and runny nose, joint pain, muscle pain, incessant yawning, insomnia, nausea, stomach pain, diarrhea, sensitivity to light and touch, and basic discomfort.  These symptoms last about a week but are the most intense and painful the first four days after use.  Some post detox side effects are severe depression, mood swings, and feelings of boredom.  These symptoms are the most intense after 1 week of use and can last between 1-3 months

Some side effects of methadone use for detox are joint pain, fatigue, digestive problems, and calcium deficiency.  It may be helpful to begin taking a calcium supplement before methadone use to help counteract the damage to your bones.

A variety of measures can be taken to counteract the side effects of a detox.  Anything that induces an endorphin rush such as exercise, a shower, or sex will help.  Over the counter or prescription tranquilizers help to counteract insomnia and agitation.  Pain relievers such as Tylenol and Alleve help with joint and muscle pain and general discomfort.  Herbal supplements, vitamins, and a general improvement of diet will help alleviate the physical side effects of detox and greatly aid with post detox emotional upheaval.  For the best result from this approach work with a nutritionist or holistic practitioner if possible.  The acupuncture detox protocol is the stimulation of 5 points in the ear which help alleviate the symptoms of withdrawl and post detox cravings.  Opium substitutes such as oxycontin, codeine, bupernorphine, and methadone will also help to counteract side effects.