August 24th, 2010
08:34 AM ET

How can I get clean from heroin?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Question asked by Kenneth, Illinois

I don't understand how to get clean off heroin. I want to so bad but why do they make it cost so much? For Suboxone, you pay close to $350 for the visit plus $720 for a monthly prescription. Methadone is cheap, but my treatment center doesn't believe in methadone. Do you think methadone is that bad? I feel so lost.

Expert answer:

Dear Kenneth,

In the short question above you've really given voice to the horrible pain that is common in the world of heroin addiction. Recognize, please, that I can give you only general thoughts and that at the end of the day you will need to take concrete action to conquer your addiction with the resources you've got access to.

For the sake of our readers who aren't aware of the medications you refer to, let me make a couple of quick comments in this regard. Methadone, like heroin, directly stimulates opioid receptors in the central nervous system, and thus is subject to many of the same risks and liabilities as heroin. However, whereas heroin rushes into the brain when consumed, leading to an intense and very psychologically addictive "high," methadone comes into the brain slowly and stays there for quite a while at stable concentrations. These qualities allow it to take the place of heroin in terms of protecting against the horrors of opioid withdrawal and to do so in a legal and medically controlled manner.

Suboxone is a combination of a medication called buprenorphine and naloxone. Unlike methadone, buprenorphine acts like an opioid at lower doses and like an "anti-opioid" at higher doses. As a result it can protect against heroin withdrawal, but is not as likely to lead to abuse as is methadone. Naloxone is included in Suboxone as a strategy for further reducing the danger of abuse, because its presence guarantees that if the medication is abused it will immediately set off severe withdrawal symptoms.

People have very strong feelings about methadone. Some clinicians swear by it, others (such as your clinic) stay away from it altogether. If you take all the studies together, my sense is that methadone works as well as Suboxone for keeping people off heroin, but with a higher abuse potential. Neither Suboxone or methadone work all that well - meaning that lots of people still find themselves unable to quit using heroin.

I truly believe that the best way out of your predicament is to get help that would allow you to come off the heroin all together without being chained to some type of opioid or partial-opioid agonist therapy for the rest of your life. This is not something you can do yourself. Given the desperation of your question I am pretty sure that you would need inpatient detox and then intensive outpatient follow-up. I have seen this strategy release many people from the bondage of heroin. But having said this, if you cannot face doing this, or if it is not an option for you for monetary reasons, let me strongly emphasize that being in a methadone maintenance program is infinitely better than being enslaved by heroin.

soundoff (331 Responses)
  1. Ryo

    eat, you are likely getting your stuff cut with sugar and slowly confusing your hunger for heroine addiction. So eat. When you feel like being a racist, eat. When you feel crouchey, eat. Try to stay away from people who have placism tendencies, or better still if you want to hang with people, be sure it envolves food. Food has always been a good bridge between culture. And don't be embarrassed, it happens.

    August 24, 2010 at 09:09 | Report abuse | Reply
    • shibumi

      Instead of eat, you could try exercise ALONG WITH A DETOX PROGRAM run by professionals. Exercise can actually stimulate the release of natural endorphines that can mimic some of the feelings drug users experience, and it can help with withdrawel.

      August 24, 2010 at 10:04 | Report abuse |
    • Citizen Val

      Eat? WTF kind of advice is that?

      August 24, 2010 at 13:23 | Report abuse |
    • Davec41

      Once again we're substituting one thing for another. The best to stop is in a medical environment. It's going to suck big time but can be done quicker this way and the medical end MAY come in handy. ............. That's the easy part. Once stopped the hard part to stay stopped. ............If you are willing to go to any lengths to stay clean, there are a couple of paths open to you. The best I've found is to learn from others who have found a way to stay stopped. Frequently in a 12 step program but not always. Find what works for you. What keeps you what not to use today. ................ As to the eating, Jimi Hendrix once said, "All you need is love! But a little chocolate never hurt."

      August 24, 2010 at 15:29 | Report abuse |
    • GooGoo

      RYO: You sound like a bad song translated from Japanese to English. It makes no sense whatsoever.

      August 24, 2010 at 17:18 | Report abuse |
  2. jsc3

    The advice above sounds like a good way to get really fat. I am overweight, but not grossly obese (6'0", 200 lbs), and I think being social and eating is all good, but getting into a cycle of "If you feel bad, eat!" just doesn't sound like a healthy solution to me. Being overweight is better than being on heroin, but being grossly obese and enslaved by food may not be the best alternative to heroin.

    August 24, 2010 at 09:27 | Report abuse | Reply
    • Bob W

      It's really about replacing one addiction with another, because it's really hard to just stop cold. Food's an easy "addiction" to start with. Then maybe try to replace that with an exercise addiction?

      August 24, 2010 at 19:34 | Report abuse |
  3. Warren Zevon

    Carmelita, hold me tighter; I think I'm sinkin' down; and I'm all strung out on heroin on the outskirts of town.

    August 24, 2010 at 09:34 | Report abuse | Reply
  4. cdr

    Have any of you that are posting comments actually ever been addicted to drugs of any kind? It doesn't seem that way. Going to inpatient detox for at least 28 days, followed by outpatient treatment does help. Plus just like with treatment for alcohol, the treatment center usually suggests a support group, such as AA or NA (Narcotics Anonymous). I know people who have been clean for well over 20 years by following these simple programs. Having a support group of people who have been through the same circumstances helps more than a non-addict could ever imagine.

    August 24, 2010 at 09:50 | Report abuse | Reply
    • Clyde

      Thank God for treatment, for medications, for caring professionals and for recovering addicts willing to help a friend get and stay clean. The statistics for recovery from heroin, vicodin, oxycontin are much much higher than for many other drugs of choice. So don't give up friend. You CAN do this. Getting off is much easier than staying off. aatami has it right.

      August 24, 2010 at 18:56 | Report abuse |
  5. NONE

    I was a daily heroin user for 8 years. I have been clean for 7 so far. I have had friends get clean by using suboxone and I have had friends get clean using methadone. The unfortunate truth about drug replacement therapy is that unless you are committed to taking it for the rest of you life, you will eventually be dope sick.

    Methadone withdrawal even with a taper is worse then heroin withdrawal. Even tapering off suboxone will not leave you unscathed. I have no great advice for you. If you insist on drug replacement then do what ever you can afford as if you find yourself dope sick with nothing, chances are you will go back to doing dope. (I done that route before)

    Anyway. Good luck. I personally suggest going cold turkey. It will suck and it will be a struggle but after 2 weeks the dope is out of your system and after a month or so you will sleep more then 6 hours at a time but you only need to do it one. Just remember when you are getting clean. Every day you spend sick is another day you don’t need to repeat unless you choose to.

    Good luck

    August 24, 2010 at 10:05 | Report abuse | Reply
    • Clean

      Good job for you 🙂 We have similar stories. You just get to that point where youre either going to live or youre going to die.And I chose life 😉

      August 24, 2010 at 10:14 | Report abuse |
    • jenngg

      Kudos to you for staying clean and sober for 7 years!! Thank you very much for your insightful post. So many of us out here are struggling with addiction or have a loved one that is struggling- the pain of it all is incredible. Simply put, after hearing all the horror stories your story is inspiring.

      August 24, 2010 at 12:17 | Report abuse |
    • Tiss

      I am so happy for you that you got off heroin. No one knows the hell unless they have been there, or, watched a love one suffer from this terrible addiction. My son is 26 and has been taking drugs since age 13. I have him in treatment centers, etc. but nothing has lasted. Now he is battling heroin and (I think) oxycontin. I pray he makes it like you did. Please continue to give encouragement that this addiction can be overcome. As for me, his mother, I wait for that terrible phone call but pray it never comes.

      August 24, 2010 at 12:28 | Report abuse |
    • Andrew

      I wouldn't suggest going cold turkey unless you are able to get a decent quantity of benzo's (ex xanax) to help distract you from what you would be going through. I am currently clean, and my method was to obtain a two week supply of suboxone (however you can, I'm sure if you can find H you can find suboxone). Only take enough suboxone to keep you out of bad withdrawal and taper down the amount every couple of days until you are taking .25mg's a day (1/32 of an 8mg pill). After stopping that, I start taking xanax only at night to sleep and a decent amount of Tylenol to help the other symptoms. Caffeine seems to help, I would start trying to exercise once your energy levels start getting back up. You need to really want to quit, and in/out patient rehab is the best way to go. You can get county or government funding to pay for it if you can't afford it, there's no reason this shouldn't be an option. Like someone said above, every day off will get better. Good Luck!

      August 24, 2010 at 17:25 | Report abuse |
  6. Clean

    The only way to get off heroin is to go cold turkey. You did it to yourself, man up, woman up, taper yourself off slowly over a period of a week. Give yourself limits on how many baggies per day. And stick to it. I went from 8 bags a day down to 1 and then I went to zero. I was sick for about 2 weeks. I had nausea and diarrhea for about 2 weeks. It was rough. But I didnt use methadone and I didnt use suboxone. I was dope sick but so what. You get over it. Being sick is something you live with on a daily basis as an addict. I have been clean for just over 7 years. I dont believe in using other drugs to get clean. It makes the withdraw too easy. If you feel the real pain it will be harder for you to use again.

    August 24, 2010 at 10:13 | Report abuse | Reply
    • uksurf77

      NONE and Clean are right. The only thing they didn't mention was being ready, which i felt was implied with their advice. If your ready, its kind of personal how you go about it.

      Food? Seriously? We are not talking about quitting Nasonex. Tell me about how food and being dope sick, and how they go together.

      August 24, 2010 at 10:20 | Report abuse |
    • Andrew

      Ha yeh, food and exercise like people said above are worthless against H WD. Maybe after a week or two that's a good idea, but not at first. I don't agree with the cold turkey method, it's definitely harder on your body than switching to Suboxone for a SHORT period of time then tapering off that. Also, your chance of relapse during that time would be extremely high. Tapering off of full opiates would help WD, but takes a ridiculous amount of will power.

      August 24, 2010 at 17:30 | Report abuse |
  7. Valerie

    Congratulations and God bless those of you here that have gotten yourself clean, and have reclaimed your life. I have never used drugs, but, like a lot of people, have had several people close to me in this world struggle with addiction.

    August 24, 2010 at 10:24 | Report abuse | Reply
  8. Frank

    From a medical perpective heroin withdrawl can be accomplished safely without the help of big pharma and the substitution of an illegal drug for a legal drug. Alcohol withdrawl on the other hand can be deadly if not dealt with by professionals and can result in death. (go figure) Switzerland has had many harm reductio programs which have been promising. However our drug laws are so messed up that they in no way consider harm reduction only incarceration. CNN also has a wonderful article detainling the medical benefits of psychedelics and cannibanoids to help cure addiction and other dependence health disorders. It's come time to regulate, educate and not incarcerate.

    August 24, 2010 at 10:40 | Report abuse | Reply
    • Andrew

      I agree marijuana is a great way to get distracted from the WD and to help you quit. However, if your an H addict, you probably don't want to be doing any drugs after this, as you will quickly become dependent on them.

      August 24, 2010 at 17:33 | Report abuse |
  9. Boom Boom (Norfolk, Va)

    I, too, am at a loss as to the advice of "eating" in place of drug usage. That's crazy. I was a heroin addict for 40 years subtracting 20 years I spent going back and forth to prison for the crimes I committed to get the drugs. 20 years active drug use, 20 more locked up still w/ the dope fiend mentality. I don't know if I could ever have quit on the street...this last bit I did (4 years and some change)...I had just had enough. I enrolled in the prison therapeutic community, followed it up w/ Narcotics Anonymous and bottom line just MADE UP MY MIND to change. And I did it. I've been out 6 years now and my whole life is different...it's amazing how easy it was once I made up my mind. However, I had the luxury of being locked up and away from drugs physically enabling me to focus on changing myself. I don't know a lot of people who get clean on the streets...detoxing yourself is a joke, unless you have someone who is willing to lock you up in a room and dole out the drugs to you, weaning you off gradually. The methadone program is good if it's used for its intended purpose and I only know of one person on the Suboxone and it's working great for her. I wish the writer good luck in his endeavors for a drug free life. It can be done...and my friend, it's so worth it!!!

    August 24, 2010 at 10:43 | Report abuse | Reply
    • Boom Boom (Norfolk, Va)

      Forgot to mention...when I got jammed for a crime, I'd go to jail and kick cold turkey EVERY time...only to hold onto my addict thinking ("stinkin' thinkin'") and once released, pick up where I left off. The kicking didn't phase me...it was part of "the life". Changing my behavior was the biggest challenge for me, not the physical addiction.

      August 24, 2010 at 11:41 | Report abuse |
  10. so sad

    God Bless you all that are going through this horrible epidemic. I have never been addicted to drugs but I too have someone that I love & care about who is a recovering addict. I pray for him everyday that he has the strength to over come it because I know it is something he struggles with constantly. And I worry that he could go back at any minute. I even find myself suspicious that he might be. Its only because I care about him and don't want to lose him. But all I can do is have faith. I hope those of you in this struggle know my God and draw close to him. He will help you and protect you if you tell him you need him. God Bless!

    August 24, 2010 at 10:43 | Report abuse | Reply
    • Tiss

      So sad,
      that could be my name too. I hope your loved one makes it, as well as my loved one.

      August 24, 2010 at 12:30 | Report abuse |
  11. Katrine

    Good luck to you!! I am praying, for me the combo of exercise, 12 steps, methadone for a while and eating properly. Forget your clinic get to the methadone. That other drug is only for the wealthy, just like that new method of detox where it only takes 45 minutes to get the opiates out of the system. The exercise gives me so much more energy! XOXO

    August 24, 2010 at 11:00 | Report abuse | Reply
  12. FreeAtLast

    There is an herbal alternative to suboxone/subutex and methadone. It's called Kratom (Mitragyna speciosa), and it is a medicinal leaf harvested from a large tree native to Southeast Asia (Thailand in particular). It has mild psychoactive properties, the strongest being mu-opiod receptor agonists (it stimulates the same opioid receptors as heroin/methadone/etc.). It is legal to purchase in the USA (you can find it online and although it isn't necessarily cheap, it is much less expensive than a monthly suboxone/subutex prescription), although in some jurisdictions, it is not legal for human consumption (go figure! you can buy it legally, but you can't take it legally!). Anyway, I used it to kick a MAJOR 3+ year oxycodone habit (more than 2400mg/day when I quit). I had to use Kratom for about a year but eventually I was able to stop taking it entirely. Please note, however, that first I had to stop taking the oxycodone completely before taking Kratom (but not for the same reasons as suboxone/subutex). And I agree with Clean - the best way to get off the junk is cold turkey - maybe not medically speaking (going cold turkey does carry health risks), but I promise you that once you get clean, NOTHING will motivate you to stay clean more than the baptism by fire hell of being dope sick. I know it's scary, but being enslaved to any opioid for the rest of your life is even scarier.

    August 24, 2010 at 11:17 | Report abuse | Reply
  13. BeenThere

    Like both None and Clean, I too was an addict who overcame my habit, and they are correct about the only way out being cold turkey. It's tough, requires a lot of willpower, and you will go through both physical and psychological effects during withdrawal, so prepare yourself for that. I had a marriage at stake at the time, and I drew on the thought that if I continued to use, I would lose both my wife and child. Throughout withdrawal, I focused on that thought and drew the strength from it to eventually overcome my addiction. It was toughest thing that I ever had to go through, but it was was well worth it. Your focus may be something different, but whatever it is, don't give up. Good luck!

    August 24, 2010 at 11:18 | Report abuse | Reply
  14. charls

    Drug addiction is a terrible disease. Too bad our society treats it as a crime instead of a medical problem. Dr A. Hoffer, MD, PhD believes that Niacin can be helpful in treating drug addictions: http://www.doctoryourself.com/hoffer_niacin.html

    The fact that you are asking about how to stop is a very good sign.

    August 24, 2010 at 11:42 | Report abuse | Reply
  15. Buddee86

    My sister, now in her early 40's, has used heroin since she was about 14 yrs old. She lost a friend to the drug, has almost lost her hands and feet from circulation issues, and twice that I know of almost lost her life. I tried for years to help her as did our parents but all the love and support seemed to almost allow her to continue her life style. She would be clean for 3 months here, 6 months there, and even a year at one point (thought I doubt she went the whole year w/out), but always return to her old ways. She has been a a state program for methadone during at least the last 20 yrs....so my taxes are paying to keep feeding her this drug that just enables her to never have to change. I was told the program is supposed to slowly wean a user off the methadone, but they just keep giving it to her like it's candy. I went with her once and stood in line (to make sure that was the only place she was going and not getting any other drugs), and the line was full of people who were still using heroin but getting methadone. Yes they take random drug tests but it only cuts you out of the program temporarily, you can always get back in! As for the group Narcotics Anonymous, what a joke. It's a bunch of people who sit around and talk about how much they want to quit, but after the session they meet in the parking lot to talk about where to get the next dose. I went through a lot trying to help and I learned the inner circle of that activity...and eventually I had to stop contact with my sister because there was just no helping her. She worked maybe 2 years of her entire time on this earth, the rest was paid by the tax payers.

    I am sad and I wish things were different, but heroin can really take over a life and I believe you truly have to WANT to quit or it will consume you. My sister is now just out of her mind nuts from all the drugs, looks horrible (she used to be beautiful and a strait A student), and because she's so whacked out of her mind and not trustworthy, we don't have her over anymore. It was all I could do to try and be nice when we lost our father recently, she made a scene at the hospital and it was horrible. Shortly after she went out and used and as far as I know is back on the streets (her roommies kicked her out, probably because she was using).

    To those who found the strength to kick this nasty habit, I applaud you. I'm sure your family is thankful to have you in their lives. I wish I had a sister....but that part is lost to me forever.

    My point.....state assisted METHADONE is a JOKE. If it helped some one else, I'm glad...but for my sister it's just state assisted drug use.

    August 24, 2010 at 11:51 | Report abuse | Reply
  16. Jorge

    Strange thing, I had a girlfriend who was on methadone, tapering off, when I met her. She had a really hard time, but as she had come off a habit that had taken a toll into a really good program, she was looking gorgeous and fit. She would make me buy her a six-pack of wine coolers every day, trap me in the bedroom for hours on end and have food urges like three pregnant women put together, but I let her have her way whenever I could. When we had to part ways (because of career choices) she was squeaky clean, healthy and she thanked me profusely for helping her through, and she still calls me to talk years later. I didn't get it too well then, but I think a lot of her ability to cope had a lot to do with alternate stimulation of the pleasure center in her brain. This brings to mind how maybe we should treat our friends and loved ones who are under a similar situation.

    August 24, 2010 at 12:11 | Report abuse | Reply
  17. FrankW

    At age 56 I found myself again addicted to heroin. I say again because that had been my story for ten years from 1974-1984, and again in 2006-2008, with periods of total abstinence from all mind and mood altering drugs intermingled that totaled some 14-years. At 58, I have been clean for 21-months. I have tried both Suboxin, in and outpatient, and methadone as a de-tox tool as well. For me, methadone was a waste; it simply substituted one drug for another. Suboxin has worked for me on both an in/out patient basis with one caveat–to be truly successful one, in my opinion, must have a support group. I suggest that those who are not aware of the Narcotics Anonymous support group contact them directly. They are located in virtually every City of any size, and many small ones as well. Good luck, it can get better if you so choose.

    August 24, 2010 at 12:13 | Report abuse | Reply
  18. FrankW

    As a follow-up, I just read the posting by Buddee86. Suffice to say, what they describe as NA is fairly accurate if they are a non-addict observer. It ain't that way for an addict.

    August 24, 2010 at 12:17 | Report abuse | Reply
    • Buddee86

      Hey FrankW – While I never did heroin I do have a vast knowledge of addiction – I'm not just a "non-addict observer". I see how my post could be portrayed that way but at the time I wrote it I was explaining my experiences with methadone and NA, not necessarily thinking of the fact that NA might work for some people. My sister told me outright that she met new dealers during and mostly after her NA sessions. I know some sessions were helpful to her for short spells, but it was always a temporary solution....and sometimes a great way for her to find a new high while we were all at home wondering where she was. I also am not trying to seem holier than thou and I respect that some are helped by their individual NA sessions. My experience with them (and yes I did sit in on a few), and my experience (still have an addicted sister), is that it doesn't work. I certainly don't want to discourage anyone from trying though, each person must find what works for them and I wish everyone the best of luck in kicking their habit for good. Heroin can kill more than just the user, it can kill the family bond and tear people apart.

      August 24, 2010 at 17:36 | Report abuse |
  19. Jerry LH

    I am a physician treats patients addicted to heroin and other opiates on a part time basis with three other like minded physicians. Our routine visits are $95 and usually lasts at least 15 minutes. With all due respect. Dr Faison really doesn't know what have much of a handle on this problem. First of all, Buprenorphine (Suboxone or Subutex) is now sold as generic subutex and in my area costs $1.86 per pill . the usual dose is 1/2 pill four times a day under the tongue. Secondly, out patient is every bit as effective as in patient detox. The problem is that there are so many physicians who are not really trained for detox that really don't know how to do it correctly, such as psychiatrists. My personal opinion is that Suboxone is infinitely better than Methadone for maintainance. The most difficult part of detox is that before you can go from Heroin to Suboxone, you have to be off all opiate like drugs for 22 to 24 hours. We use clonidine and Clonazepam to minimize the symptoms, but all of the patients state that it is just awful. Inicidently, we have discovered a very simple way to elminate that 24 hours of misery. I can't tell you what it is, but if all goes well, we will be presenting a paper on this at the annual meeting of the American Society of Addiction Medicine next April in Washington, D.C.


    August 24, 2010 at 12:25 | Report abuse | Reply
    • Tiss

      Dr. Jerry,
      Have you heard of the Iboga root being used for dope sickness? It is a plant from Gabronne, West Africa. I've read about it and wonder why studies are not being done on it.

      August 24, 2010 at 12:35 | Report abuse |
    • dmloucas

      I agree wilth Jerry LH. Psychiatrists are simply the most uninformed people about the treatment of addiction. Their notions are formated by archaic thinking. From my personal experience I have gotten patients off from methadone without any withdraw what so ever. This is also true for Heroin, and other opiates. It is regrettable that psychiatrists remain a source of such poor training and misinformation. In most cases their lack of experience and understanding about the disease of addiction results more harm than good. There is simply no basis for bearing any withdrawal or pain in the treatment of opiate addictions.

      August 24, 2010 at 14:58 | Report abuse |
  20. ee80

    For the former dope addicts that say "just go cold turkey" ... you guys are not only extremely lucky you are sober but you are definitely the exception to the rule. I have know many many heroin addicts in my day( myself included) and kicking cold turkey.. is close to impossible!!! WD's Suck more than anything and your dealer is always a phone call away! You know you have that # memorized too.. there is no deleting it from your cell. Rehab, detox, those all make a huge difference as well as NA and AA. I can't say enough good things about suboxone. It saved my life and with insurance I only pay 10 a month for a perscription and 20 a month to see my doc. I have been sober for 3 and 1/2 years and i am on 1 mg of sub a day. When i feel ready and comfortable i will jump off my 1mg dose with help from doc using some other meds for about a week. IT SAVED MY LIFE.

    August 24, 2010 at 12:27 | Report abuse | Reply
  21. addictparent01

    We look for quick fixes or cures for everything, but for heroin addiction, it does not exist. My son is a "recovering" addict and will be for the rest of his life. He was in quite a few programs and always relapsed and I think that they were all good. I think that through persistence he finally was able to get the picture. I agree that neither Sub or Methadone are good options especially in an outpatient environment. I think that atleast for 90 days, 6 months is better, an in patient program is the way to go. There is money available for some in patient programs if you look for it, but the patient has to be committed to changing their life...there is no future with drugs.

    August 24, 2010 at 12:29 | Report abuse | Reply
  22. DD

    I am currently taking suboxine and i really feel like it has saved my life. I was addicted to Lortabs for 6 yrs and I finally got myself in an outpatient detox, and have been taking suboxine for 6 months now, and i have had no cravings. I cant believe the cost your dr office gave you, look around, i only payed 85 bucks for the initial visit and i pay 25 bucks a day for my medicine that i have to take in my dr office every morning, and that is with NO INSURANCE. Dont give up, look around, there is affordable help out there for you...

    August 24, 2010 at 12:36 | Report abuse | Reply
  23. Romeo

    Do a Google search for 'suboxone withdrawal', click on 2nd link...it should be http://www.drugs.com. Try to contact Robert325 on this web site. He has inducted many users onto Suboxone, the right way. The doctors will want to keep you on a maintenance dose, DON'T DO IT...I was on Suboxone for 3 years before i finally quit, today is day 81 clean, I quit June 4-2010. It was horrid. I was on it for way too long at way too high a dose, but i got so tired of being dependant on drugs i finally just quit. That is the most important part of quitting...having a very strong desire to be done with it all. You should be on Suboxone no longer than several weeks, Robert will guide you through it.
    Be warned though, there is no magic pill, diet or actions you can take to avoid withdrawal completely...it just doesn't exist. I know it's scary, it took me 13 years of hydrocodone-oxycontin abuse before i got on Suboxone, then another 3 years on Sub before i got up the nerve to quit. You can do it because i'm the worlds biggest cry baby and i am making it. At some point in time you will come to the realization that you MUST quit...what i outlined above is what i believe to be the best way. Good Luck and remember you can do this.

    August 24, 2010 at 12:37 | Report abuse | Reply
  24. Jerrylh

    Hi addictparent01. I am sorry for the difficulty your son is having. However, you are just wrong about outpatient treatment. Inpatient is an artificial environment where you cannot get drugs. Many of our patient become chemical free for years, although far fewer than we would like. However, we have numerous patients who wake up every day and take 1/4 of a suboxone and feel fine and remain chemical free for years. We including counselling each and every time we see our patients. Do we have patients with relapses?? Plenty. However, as we tell them every time, most people have several failed attempts before they are success. I do agree with you that your son will always be a heroin addict. However, it is not hopeless. Keep him away from his so call friends who are users or suppliers. Keep supporting him and his chances will improve


    August 24, 2010 at 12:38 | Report abuse | Reply
    • Tiss

      Dr. Jerry,
      Where are you located if you don't mind my asking? My son lives in San Francisco. I would love for him to see someone that really "gets" heroin addiction.

      August 24, 2010 at 12:51 | Report abuse |
  25. george

    we have many NA people in my AA groups. they announce as addict/alcoholic. these people that work hard on the program love it. i'm a 62 yr old alcoholic that came to it late in life. i'm sober 2 yrs. my wife got a fatal illness & i could not cope. rehab, and AA saved my life. it's all about bringing god back into your life. spirituality is the key. admitting to a problem, and that your life is screwed up, being honest, all lead to getting back what you lost. i lost my soul and when i turned my will over to god things began to get better. it's his will, not mine. i'm back to being a dad, and a grand dad, instead of someone that truly wanted to die. there is hope in talking to someone that has lived your life.

    August 24, 2010 at 13:01 | Report abuse | Reply
  26. AcuK

    Find an acupuncturist who treats addiction with the NADA protocol (National Acupuncture Detoxification Association)


    August 24, 2010 at 13:08 | Report abuse | Reply
  27. KilgoreTrout

    As a former heroin addict (clean now for 9 years), I'm disturbed by some of the previous posts saying that the ONLY way to get clean is ... etc, etc. Each method has it's benefits and draw-backs. The most important factor in getting clean is mindset. You have to REALLY want to quit. Cold-turkey for 30 days in a rehab center didn't work for me. N.A. didn't work for me. I got clean using Methadone and tapered my dose gradually over a long period of time.

    It's absolutely true that Methadone has a unfavorable track record, because it is easy to abuse. I've seen it first-hand at the clinic I used to attend. The difference between me and those I witnessed at the clinic was that I was there to quit. I wasn't there for a cheaper, safer high than copping junk on the streets. I communicated with my doctor openly, honestly and frequently in order to ensure I was getting the proper dose. Enough so that I was not getting dope-sick, but not enough to get high. Once I was stable, I was able to get my life straightened out (full-time job, healthy relationships, etc); all the while, lowering my Methadone dose by baby-steps when I felt comfortable doing so. It took years, but those years of renewed stability eventually purged me of my desire to use. By the end of my treatment, I was on such a low dose that getting off the Methadone actually wasn't too uncomfortable. I just felt a little achy and listless. Like I was recovering from having a mild flu. By then I no longer had the desire to use, so I did not go into addict panic mode. I just woke up one morning and decided I was ready to stop. I had my week's worth of Methadone from the clinic at home. I could have taken it at any time. But like I said, I didn't feel so bad that I felt like I needed to take it anymore. I had the proper mindset to stop.

    I wish you luck in getting clean. The unfortunate fact of the matter is that every person is different and finding the method to get you off of heroin is a trial by fire process. You will fail. You just just have to keep trying different things until you find something that works for you.

    August 24, 2010 at 13:17 | Report abuse | Reply
  28. BABAK

    Dear friend; There is one way and only one way; You must take the pain. Yes, the vomiting, the knee and joint pain, lack of sleep .. the whole works. You can try a little meds to help at the begining, but there is no way to avoid the pain if you are serious. Just keep in mind, you were not born with it, you will not die without it. It will be hard, very hard. But you will come out a much better man at the other end of it. The first week is the hardest. Take a week off from work and leave your enviroment. You will probably need a whole new set of friends as well. This will be one of the hardest things you will ever do for yourself, and so worth it! There is nothing like being freed from the need of drugs ... I tell you from personal experince.

    August 24, 2010 at 13:28 | Report abuse | Reply
  29. Jerrylh


    I am on the other side of the country in florida. I don't want to advertise on this site. However, if we present at this year's meeting of ASAM, we will be listed in the program.
    BABAK-you are wrong!! I think that your belief system is that the more discomfort, the more likely you will stay clean. I just disagree with you. However, I should also add that your method has worked for a few people. Unfortunately, it is not so easy to just up and leave. If you move,you need to have a good support system at your new location.

    August 24, 2010 at 13:48 | Report abuse | Reply
    • Tiss

      I will be following ASAM closely. I hope and pray that there is a breakthrough in helping our addicts get well. I understand not wanting to advertise on this site. I'm sure there are many people in San Francisco that could help my son but unfortunately, he is not at that mindset of knowing he needs help.

      August 24, 2010 at 14:21 | Report abuse |
  30. EZJ

    Could cannabis maybe suppress withdrawl symptoms in heroin addicts? Yes it is illegal but cannabis seems to have many medical properties that may help with some negative physical withdrawl symptoms such as nausea and vomiting. As far as mental withdrawl my the best bet in my eyes would be NA or some kind of support group. While I have never used heroin I have had a close friend die from passing out and choking on his own vomit while using heroiin and drinking alcohol. As far as people who put fault on addicts on degrade their activity, we all fight our own demons and every expiriance we have in life is different from the person next to us. Dont judge but instead have some empathy bc everyones pathway through life is different and some have to travel a rockier road than others.

    August 24, 2010 at 13:59 | Report abuse | Reply
    • Stacie

      Marijuana affects a different part of the brain than an opiate does. It won't really do anything to help withdrawal symptoms.

      Think of it this way: if you had the worst flu you've ever had, with sneezing, coughing, fever, aches, etc....getting high off of weed isn't going to really help you forget you're sick.

      August 24, 2010 at 14:02 | Report abuse |
  31. Stacie

    As someone who worked at a Methadone clinic for 5 years, I know how it can be both beneficial to someone addicted to heroin, as well as a highly abused drug that is used as a substitution when heroin was not available.

    I like this article and I feel that the doctor gave great advice. The only way to ever get off of heroin is to either do it cold turkey and deal with the withdrawal symptoms, or use a mediation to help you taper off. Either way, you need support and a lot of it. NA/AA are great places to meet people who want to help you.

    August 24, 2010 at 14:00 | Report abuse | Reply
  32. former

    I too was addicted to herion for several years. I kicked cold turkey twice. I went to a fancy inpatient detox followed by an intensive outpatient counseling program w/required AA/NA meetings. It didn't work. I started heroin again less than a month after completing that program. As a side note, I never liked AA/NA, I personally never felt comfortable. The next treatment I did was a 3-5 day detox in an inner city hospital. While I was there I had a death in the family. My world got turned upside down and I knew I couldn't continue the life I had been living. It's been almost 9 years now, and I've never gone back to heroin. Over the years I struggled w/taking prescribed pills that I needed here and there, but it only reinforced the fact that I CAN'T do drugs, because after a few days on vicodin from the dentist I felt like a junky. It scared me. My point is, no matter what I tried, I could never stay clean until I was READY. There is no right or wrong way, just the way that you find that works for you- at the right time. Good luck to those who struggle with addiction, and also to those who love them.

    August 24, 2010 at 14:06 | Report abuse | Reply
    • KilgoreTrout

      - "There is no right or wrong way, just the way that you find that works for you- at the right time."

      Well said, former. That's exactly the point I was trying to make when I posted.

      August 24, 2010 at 14:30 | Report abuse |
  33. Just4-2day

    I have done detox, I have tried the other drugs to come off herion in the end I did it cold turkey. I myself have been clean for over 4 years cleans. When I truely made the decision to get clean, I did. I had to put all the energy I used to get high into getting clean, what did I have to lose that I hadn't already lost. I myself am a member of NA and thank god for it everyday. The disease of addiction is nasty and being around others who understand it is more powerful than you can imagine. My suggestion is find an NA meeting or ANY kind of support group.

    August 24, 2010 at 14:34 | Report abuse | Reply
    • george

      i've run into quite a few na's that prefer aa because aa tends to be a more mature group (older!). there are people with more time (sobriety), and more good sponsor availability. na is fine, just many more young people. also more people ordered in by the courts. these kids really don't want to be there. i saw it 1st hand in rehab. there were a lot of kids in there for drugs, and ordered in by the courts either to stay out of jail, or reduce their parole. they tended to be disruptive, and did piss me off at times. i was there to start the journey back. i HAD to get better or die. some of these kids didn't care. they went right back out as soon as they were discharged. i'm not saying compassion isn't a good thing, i just think sometimes there is too much coddling. i was told, get better, stay sober, or i lose it all. job, family, money, place to live. everything. that's where i was, but as of today i've come back to life...life on life's terms...

      August 24, 2010 at 15:15 | Report abuse |
  34. Fr. Billy Clark

    For those suffering from addiction that would like to include prayer in their battle to overcome the addiction and ask God for assistance, here is a prayer that is very helpful.

    "Heavenly Father, I ask that any unHoly Angels in, on, near or around me be nailed, held fast and silenced. I decommission, bind and encapsulate the spirit of addiction and all remaining unHoly Angels through the power of the shed blood of Jesus Christ and bring them up to your presence now to deal with as you see fit. May you fill any empty place or lonely space within me with your love and your light. In Jesus' name, Amen."

    Remember you are not alone and you are loved. You are a child of God and you need not try to do it on your own. There are others who can help and those who will support you helping you to remember the love you were created to be. We are all born with a place within us that can only be filled by receiving the love of God. No matter what it is that you try to put in this God-spot or what you try to cover this up with, you will still feel the longing for that love. Receive the Love of God and know without a doubt you are His Child and well loved. Peace be with you and courage in your journey.

    August 24, 2010 at 14:41 | Report abuse | Reply
  35. AceRider

    Message boards are a good path to sobriety.... Full of good advice that you won't find in an actual clinic run by trained professionals. Me? I'd start by visiting CNN.

    August 24, 2010 at 15:02 | Report abuse | Reply
  36. LVX

    Outside the U.S., Ibogaine has shown a lot of promise – in the U.S. it's schedule 1... It appears to immediately 'reset' the body and take away all physical withdrawal symptoms over the course of a somewhat lengthy 'psychedelic' trip. It's not for everyone though and can be dangerous if not overseen by a physician/therapist. According to NPR there is 'black market' therapy available in the U.S., but I don't know how it's accessed.

    August 24, 2010 at 16:09 | Report abuse | Reply
    • Tiss

      My son went through this 'treatment' last year and he tells me it has been successful. I want to believe him but he is still involved in the drug lifestyle. I have to say he sounds much better in that he doesn't sound like he's high on heroin when I talked to him. He did not do this in a supervised manner but with someone on the black market who has been "trained" to do Ibogaine detoxes. I do wish someone would do studies on this treatment as it looks very promising from what I've read.

      August 24, 2010 at 16:21 | Report abuse |
  37. CATom

    Be a man about it and stop cold turkey and stop whining and crying like someone made you get addicted to heroin.

    August 24, 2010 at 16:09 | Report abuse | Reply
  38. Terry W. Brookman

    I did it with Valium and beer in 1971 then I dropped the Valium and then the beer. I was spending from $100.00 to $200.00 a day. Clean since 1986

    August 24, 2010 at 16:43 | Report abuse | Reply
  39. sls

    Many people are very successful on methadone and on buprenorphine. However addiction is stigmatized, medication for a addiction is stigmatized so they don't talk about it. Some of my patients go to AA/NA as they want support but don't dare say they are taking medication. Some people on these medications continue to use for a variety of reasons. But they are far less likely to die of an overdose, to get HIV, to get a criminal record, to maintain employment. All of these are good things, particularly if the addicted person in question is someone you care about.
    Methadone is cheap but requires a major time commitment. However federal regulations have improved allowing less clinic visits much more quickly for those who stop using and become employed. Methadone (or bupe) may save – or improve your life. Give both consideration. And if you do choose detox and inpatient be careful. As you know relapse happens and when people relapse they are at high risk of overdose.
    Best wishes

    August 24, 2010 at 16:45 | Report abuse | Reply
  40. DudeWhoDidIt

    I did it, i kicked heroin 10 years ago and have been straight ever since. I had a prescription for pain killers and a proscription for Xanax. The pain killers help when the sickness became unbearable and the Xanax helped me sleep. I took a 2 week vacation from work and just dug in and did it. I will never touch heroin again. Believe me the pain was worth it and helped me to never forget why I hate heroin. I still smoke a little pot but thats as far as I will ever go

    August 24, 2010 at 16:48 | Report abuse | Reply
  41. thj

    if you can afford heroin, you can afford to get sober. it pays off in the long run.

    August 24, 2010 at 17:00 | Report abuse | Reply
  42. Warren Zevon

    I been sittin' here playin' solitaire with my pearl-handled deck; the county won't give me no more methadone, and they cut off your welfare check.

    August 24, 2010 at 17:07 | Report abuse | Reply
  43. Dave

    You're F-ing kidding right? "I don't understand how to get clean off heroin?"
    You figured how to cook the crap, how not to O.D. and die from it, how to tourniquet and shoot in the best and sometime obscure veins, and you don't understand how to NOT BUY IT AND NOT COOK IT AND NOT SHOOT IT???

    August 24, 2010 at 17:08 | Report abuse | Reply
    • aatami

      Dave, unless you have experienced what it means to be an addict you have nothing to share of any value, least of all your ignorance. Put a sock in it pal.

      August 24, 2010 at 18:17 | Report abuse |
  44. buffiesguy

    I cannot begin to relate to what is inside the hearts and minds of the addicts. Though I grew up in a chemically-dependent family (multi-generational), and attended Alateens and Al-Anon, I chose another life – a drug-free life.

    It is my hope all those posting here who are addicted will forward the entire page – with postings – to those in their lives who are and are not "users." Trite as it may sound, if one chooses to NOT use drugs, there is nothing from which one need become "clean."

    Best wishes to those addicted, and to their co-dependents.

    August 24, 2010 at 17:31 | Report abuse | Reply
  45. TxTraveler

    Wow, easy to see from all these posting why H is illegal.

    August 24, 2010 at 17:40 | Report abuse | Reply
  46. aatami

    Having been clean myself now for over 8 years and having worked in a Methadone clinic for a couple of years, I can say that the least painful way to kick is by doing a medically prescribed detox on methadone. Heroin withdrawal is no fun but it won't kill you either. In fact getting off is way easier than staying off. Staying of heroin, statistically speaking, is most successful with a twelve step program. The issue of addiction has less to do with the drug itself than it does with the issues addressed in 12 step programs. Developing a more positive system for dealing with reality is key.

    August 24, 2010 at 18:16 | Report abuse | Reply
    • Dianenj

      Great advice.

      August 25, 2010 at 11:32 | Report abuse |
  47. JRNeuberger

    The good Dr.'s comments are more than irresponsible. Methadone has been declared the "gold standard" of treatment for opioid dependence by our National Institutes of Health. Why? Because it WORKS. If your treatment center "doesn't believe" in methadone then RUN away from that outfit and find a more competent provider that will utilize ALL of the tools at the disposal of an addict seeking treatment - those who "believe" in one treatment over another are likely more interested in the financial benefit to themselves over what is best for you. Abstinance based treatments have a miserable rate of success–suboxone is unaffordable for any but the very rich and methadone is the gold standard and is affordable and has a high rate of success. You do the math and choose what is best for YOU.
    J.R. Neuberger
    National Alliance for Medication Assisted Recovery

    August 25, 2010 at 06:54 | Report abuse | Reply
  48. haunted willow

    The only thing holding you back is fear. Just fear of being sick. Not fear of dieing but fear of being sick like a really really bad three day flu. I had to grow up – put on my big girl pants and quit being scared of being sick for a couple of weeks ....... depending on your habit you could be feeling better in a suprisingly short time. You have to be ready to just lie down and do it. It wont kill you – your just sick. You can do it. Millions of people do it. I did it alone, I found that was best ......It was three days before I could actually leave the house and walk outside, five before I could drive, at about three weeks I could tell I felt better everyday. At 6 months I could sleep through the night. When i made the decision to do it I gritted my teeth and didn't waver. Good Luck – you have everything you need with you at this moment

    August 25, 2010 at 11:58 | Report abuse | Reply
  49. SubBoy

    I've been on Suboxone for close to one year..my story is like others...went to the doc for back pain, got prscribed everything from vicodin all the way up to fentanyl patches. Fentanyl scared the hell out of me and I tried to taper with vicodin, but ended up with 30+ 10mg per day way too much for the liver. I went through nights of pure hell and marijuana seemed to make it worse for me. Then I found my Suboxone Doctor and have had success with it. I don't know about others, but Suboxone gives me an energy high, not like the vikes, but a cleaner more normal feeling energy..I have tried to get off of it, but the withdrawals are just as bad for me as opiate withdrawals. I do feel WAY dependent on Subs, but I take it one day at a time and I know I have to get off of them soon. Some people say Tramadol helps with withdrawal, but didn't work for me. Sub can be a life saver!

    August 25, 2010 at 14:34 | Report abuse | Reply
  50. Ryan Bemis

    The National Acupuncture Detoxification Association has a toll free referral line
    (888) 765-NADA
    Call this number and ask where you can receive acupuncture as part of comprehensive addictions treatment in your area.

    Acupuncture is recommended the 1997 National Institute of Health Consensus Development Panel as an adjunct to comprehensive addictions treatment.

    Click here to download a copy of the US Substance Abuse and Mental Health Services Administration best practice guide do addictions treatment and detox services, which on page 123-124 describes how acupuncture can assist in addictions treatment.

    Ryan Bemis, CADC1
    Certified Alcohol and Drug Counselor

    August 25, 2010 at 14:40 | Report abuse | Reply
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