Heroin Rehab - Abbeycare

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KEY TAKEAWAYS

Heroin rehab:

Is a process of medical detox using suboxone and therapy addressing underlying causes of heroin addiction
Is successful in 71% of heroin addiction patients 24 months post-treatment [1]

What Is Heroin Rehab?

Heroin rehab is a treatment programme for heroin addiction that includes medical heroin detox, psychosocial interventions and aftercare to ensure abstinence and relapse prevention.

The heroin addiction rehab treatment at Abbeycare is a 28-day inpatient treatment that works by eliminating heroin from the body, leading to sobriety.

At Abbeycare, suboxone is offered as a medical replacement and doses are slowly lowered over 10 days.

After the initial 10 days, patients undergo cognitive behavioural therapy to identify dysfunctional beliefs causing heroin addiction and learn behavioural management to overcome triggers.

Committing to aftercare for 8 months following rehab for heroin addiction increases the chances of sobriety by 50% - Abbeycare offers aftercare for up to 16 months [2].

When Is Heroin Rehab Necessary?

Rehab is necessary for heroin addiction when users continue to use heroin despite the desire to quit or attempts made to stop use.

66% of users experience an overdose during active heroin addiction, necessitating rehab to prevent long-term brain and lung complications [3].

Combined use of heroin with benzodiazepines increases the risk of needing hospital treatment by 8.5% compared to heroin alone, necessitating rehab [4].

Physical complications of heroin addiction, such as abscesses from injections and endocarditis from injection-induced infections are a physical sign that rehab is needed.

Heroin Rehab Process

Detox

The use of Suboxone reduces the length of stay in an inpatient addiction facility by 60% compared to using methadone [5].

50% of patients switching from buprenorphine to suboxone experience adverse side effects in detox; however, these are appropriately managed throughout the heroin rehab programme [6].

Buprenorphine at doses >8mg/day in detox improves cravings and is also used for long-term medication-assisted treatment (MAT).

Rehab

The use of CBT, as well as medication in heroin addiction rehab, improves symptoms of alexithymia by 27.9% compared to using medication alone [7].

40% of those who remain abstinent consistently use cognitive, distraction and avoidance strategies in heroin addiction treatment [8].

Mindfulness in CBT helps to mitigate cravings in heroin rehab by noting thoughts and feelings, allowing users to avoid these actively. (OMIT)

The act of 'noting' as a mindfulness-based strategy in CBT allows users to identify and mitigate cravings.

Openly discussing needle sharing and HIV/Hepatitis risks of heroin in group therapy educates participants, reduces stigma and enables members to relate to one another.

Simplifying CBT homework used for heroin addiction improves completion rates by 7% [9].

Aftercare Planning

Relapse prevention programmes in heroin addiction treatment improve symptoms of anxiety by 86.4% and abstinence rates by 20.5% [10].

Aftercare educates patients about keeping injection paraphernalia and its potential to cause relapse in heroin addiction.

For heroin addiction patients where methadone is necessary, MAT with methadone improves treatment retention by 28% 4 months post-rehab compared to using suboxone [11].

Using CBT alongside long-term MAT following heroin rehab improves medication compliance rates by 22% [12].

Long-term symptom management mitigates symptoms during long-term recovery, such as using SSRIs for depression or melatonin supplements for sleep disturbances.

Heroin Rehab Vs Other Drugs

	Heroin	Alcohol
Detox	Medically supervised	Medically supervised
Therapy Focus	Triggers causing physical addiction	Trauma-informed therapy when alcohol is used for masking
MAT Used?	Yes	Yes
Support Groups	Narcotics Anonymous	Alcoholics Anonymous

	Cocaine	Methamphetamines
Detox	Symptom managed for withdrawal symptoms	Medically supervised and symptom-managed
Therapy Focus	Triggers causing psychological addiction	Cognitive impairments
MAT Used?	No	Yes
Support Groups	Cocaine Anonymous	Crystal Meth Anonymous

Withdrawal Symptoms

	Heroin	Alcohol
Onset	3 - 6 hours	6 - 24 hours
Peak	Days 1 - 3	Days 1 - 3
End	Days 5 - 7	Day 10+

	Cocaine	Methamphetamines
Onset	< 24 hours	< 24 hours
Peak	Days 3 - 5	Day 3
End	Day 10+	Day 5+

(Read about rehabilitation for amphetamines here.)

Heroin Rehab Vs Other Treatment Approaches

	Heroin Rehab	Maintenance Medication
Setting	Inpatient	In clinic, then at home
Detox	Yes, medically supervised	No
Structure	Highly structured	Semi-structured
Routine	Regular therapy sessions, medication and health observations	Daily self-administration of medication Therapy as required
Relapse Management	Relapse prevention with 24/7 available support Aftercare planning	Counselling and psychotherapy
Duration	7-10 days	Months to years
Public Or Private Treatment?	Public and private - insurance funds detox	Public and private

	Narcotics Anonymous	Outpatient Treatment
Setting	Community group meetings	Outpatient clinic
Detox	No	No, but MAT is supervised
Structure	Semi-structured	Semi-structured
Routine	Weekly/monthly group meetings Regular mentor check-ins Workload is self-determined	Regular medication in the clinic Therapy/counselling as required
Relapse Management	Relapse prevention is offered through peer support	Counselling and group therapy
Duration	Months to years	Depends on treatment type
Public Or Private Treatment?	Public and available to all	Public and private - depends on the insurance provider

What Changes Heroin Rehab?

Pregnancy

One baby is born with neonatal abstinence syndrome every 25 minutes, highlighting the importance of referrals for maternal care in heroin addiction treatment [13].

Integrating prenatal care in heroin addiction treatment allows pregnant women to get ultrasound scans and prenatal check-ups to mitigate pregnancy complications.

As 76% of heroin users present with vitamin deficiencies, pregnant women in recovery are offered nutritional support to emphasise the importance of folic acid and vitamin D in foetal development [14].

Teaching pregnant women about the importance of a drug-free home prevents child exposure to heroin, breaking the cycle of addiction.

Interacting Medications

In cases where quetiapine and suboxone are used together in heroin addiction treatment, close monitoring and observations are completed to reduce the risk of heart complications [15].

Combined use of protease inhibitors and buprenorphine increases buprenorphine levels in the blood by 57.4%, so buprenorphine doses are adjusted accordingly [16].

Combining haloperidol with buprenorphine results in an irregular heart rhythm that is potentially fatal in some cases, so patients taking both drugs require 15-minute check-ups in rehab [17].

History Of Non-Compliance

Individuals with a history of non-compliance require mouth checks to ensure tablets are appropriately swallowed and follow-up checks to ensure no tablets have been vomited.

Patients with a history of non-compliance may be allowed to take medication at the same time every day so that medication rounds are as expected.

The use of naltrexone decreases the drop-out rate from 23% 6 months post heroin use, but only in cases where doses are not missed [18].

Behavioural Naltrexone Therapy integrates contingency management with naltrexone maintenance and increases treatment retention by 13% compared to naltrexone alone [19].

Heroin Rehab Outcomes

Women are 5 times more likely to remain abstinent 24 months post-rehab treatment; however, supplementary aftercare support is available for those more at risk of relapse [20].

Residential rehab is 71% effective in achieving abstinence for 24 months, given appropriate aftercare practices are in place [21].

The rate of non-fatal heroin overdoses decreased from 22% to 7% following 1 year following residential rehabilitation [22].

Average mean heroin use days decrease by 62% following residential rehabilitation, in turn reducing the risk for potential overdose [23].

Overdose Prevention After Heroin Rehab

Rehab educates patients on tolerance reduction during abstinence, as this results in overdose if the same doses are taken as before if in relapse.

10% of dispensed naloxone is used in emergency overdose situations, making it an appropriate preventative medication for those at risk of overdose [24].

Intranasal naloxone is 82% effective at reversing the effects of heroin overdose, so educating users on how to use this medication is potentially life-saving [25].

Naloxone is offered in cases where overdose is both apparent or even just suspected to prevent respiratory depression and hypoxia.

Heroin Rehab At Abbeycare

Heroin rehab at Abbeycare involves:

A 10 day combined suboxone and symptom managed detox
A full therapeutic programme tackling the underlying causes of heroin addiction

At Abbeycare, overdose prevention kits of naloxone and overdose prevention training are offered to the patient and family members to mitigate the risk of overdose post rehab.

References

[1] Darke, Shane, et al. “Residential Rehabilitation for the Treatment of Heroin Dependence: Sustained Heroin Abstinence and Drug-Related Problems 2 Years after Treatment Entrance.” Addictive Disorders & Their Treatment, vol. 5, no. 1, Mar. 2006, pp. 9–18. Accessed 16 Mar. 2019. “At 24 months, 71% were heroin abstinent over the month preceding interview, and 18% reported heroin abstinence over the entire follow-up period.”
[2] Vanderplasschen, Wouter, et al. “Long-Term Outcomes of Aftercare Participation Following Various Forms of Drug Abuse Treatment in Scotland.” Journal of Drug Issues, vol. 40, no. 3, July 2010, pp. 703–28. “Although participation in aftercare after initial treatment is rather unusual, the odds of having experienced a drug-free period (after 8 months) (OR = 1.91, 95% CI 1.10–3.33) and of being abstinent from heroin (after 33 months) (OR= 0.56, 95% CI 0.34–0.94) almost doubled.”
[3] Strang, J., et al. “Heroin Overdose: The Case for Take-Home Naloxone.” BMJ, vol. 312, no. 7044, June 1996, pp. 1435–36. “Interviews with 320 heroin users in Sydney found that two thirds had had a drug overdose, a third within the past year, and that 80% had been present at the overdose of another user.”
[4] Yamamoto, T., et al. “Concurrent Use of Benzodiazepine by Heroin Users-What Are the Prevalence and the Risks Associated with This Pattern of Use?” Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology, vol. 15, no. 1, Jan. 2019, pp. 4–11. Accessed 18 Sept. 2022. “Co-users were more likely than lone heroin users to have reduced respiratory rate at presentation 12.7 ± 4.9 vs 13.6 ± 4.4 (p = 0.02) and require admission to hospital 18.3 vs 9.8% (p < 0.01).”
[5] Proctor, S. L., et al. "A naturalistic comparison of the effectiveness of methadone and two sublingual formulations of buprenorphine on maintenance treatment outcomes: Findings from a retrospective multisite study." Experimental and Clinical Psychopharmacology, vol. 22, no. 5. pp. 424-433. "The average length of stay (LOS) in terms of days in treatment for the methadone group (M = 169.86, SE = 5.02) was significantly longer than both the Subutex (M = 69.34, SE = 23.43) and Suboxone (M = 119.35, SE = 20.82) groups."
[6] Simojoki, Kaarlo, et al. “A Retrospective Evaluation of Patients Switched from Buprenorphine (Subutex) to the Buprenorphine/Naloxone Combination (Suboxone).” Substance Abuse Treatment, Prevention, and Policy, vol. 3, no. 1, 2008, p. 16. “During the first 4 weeks, 50% of the patients reported adverse events and at the four month time point, 26.6% reported adverse events.”
[7] Tiwari, Ashutosh, and Sunita Gupta. “Effects of Cognitive Behaviour Therapy on Anxiety and Alexithymia in Heroin Users.” IJFANS International Journal of Food and Nutritional Sciences, vol. 11,s, no. 3, Dec. 2022, pp. 2091–103. “Table 2.”
[8] Gossop, Michael, et al. “Factors Associated with Abstinence, Lapse or Relapse to Heroin Use after Residential Treatment: Protective Effect of Coping Responses.” Addiction, vol. 97, no. 10, Oct. 2002, pp. 1259–67. “Clients who avoided a full relapse to heroin use (abstinent and lapse groups) consistently made more use of cognitive, avoidance and distraction coping strategies at follow-up than at intake.”
[9] Willner-Reid, J., et al. "Cognitive-Behavioral Therapy for Heroin and Cocaine Use: Ecologoical Momentary Assessment of Homework Simplification and Compliance." Psychol Psychother, vol. 89, no. 3. Sept. 2016, pp. 276-293. "Table 1."
[10] Min, Zhao, et al. “A Pilot Assessment of Relapse Prevention for Heroin Addicts in a Chinese Rehabilitation Center.” The American Journal of Drug and Alcohol Abuse, vol. 37, no. 3, Mar. 2011, pp. 141–47. “Significant improvements in scores on SAS, SE, and SES were found in the RP group after completion of the 2-month RP group therapy compared with the LR group (SAS 7.85 ± 6.20 vs 1.07 ± 5.42, SE 3.88 ± 3.60 vs .08 ± 2.89, and SES 3.83 ± 3.31 vs .78 ± 2.55). At 3-month follow-up, the RP group participants had more improvements on ASI scores in most domains and had higher abstinence rates than that in the LR group (37.2% vs 16.7%).”
[11] Timko, Christine, et al. “Retention in Medication-Assisted Treatment for Opiate Dependence: A Systematic Review.” Journal of Addictive Diseases, vol. 35, no. 1, Oct. 2015, pp. 22–35. “Three studies found that receipt of methadone rather than buprenorphine/naloxone was associated with higher retention in MAT at 4 months (73.9% vs. 45.9%).”
[12] Timko, Christine, et al. “Retention in Medication-Assisted Treatment for Opiate Dependence: A Systematic Review.” Journal of Addictive Diseases, vol. 35, no. 1, Oct. 2015, pp. 22–35. "Table 2."
[13] Anbalagan, Saminathan, et al. “Neonatal Abstinence Syndrome.” Nih Gov, StatPearls Publishing, 1 Apr. 2024. “This data is equivalent to diagnosing 1 newborn with NAS every 25 minutes.”
[14] el-Nakah, A., et al. “A Vitamin Profile of Heroin Addiction.” American Journal of Public Health, vol. 69, no. 10, Oct. 1979, pp. 1058–60. Accessed 16 Nov. 2020. “Only 24 per cent of the addicts had no evidence of hypovitaminemia.”
[15] Drugs Online. “Seroquel and Suboxone Interactions Checker.” Drugs Online, 2023. Accessed 3 Jan. 2025. “There is some concern that quetiapine may have additive cardiovascular effects in combination with other drugs that are known to prolong the QT interval of the electrocardiogram.”
[16] McCance-Katz, Elinore F., et al. “Interactions between Buprenorphine and Antiretrovirals. II. The Protease Inhibitors Nelfinavir, Lopinavir/Ritonavir, and Ritonavir.” Clinical Infectious Diseases, vol. 43, no. Supplement_4, Dec. 2006, pp. S235–46. Accessed 15 Nov. 2020. “RTV administration to buprenorphine/naloxone-maintained study participants was associated with a significant increase in the buprenorphine AUC ... representing an 57% increase in the average buprenorphine AUC (figure 2 and table 3).”
[17] Drugs Online. “Buprenorphine Interactions Checker.” Drugs Online. “Using haloperidol together with buprenorphine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.”
[18] Sullivan, Maria A., et al. “Management of Relapse in Naltrexone Maintenance for Heroin Dependence.” Drug and Alcohol Dependence, vol. 91, no. 0, Dec. 2007, pp. 289–92. Accessed 6 Aug. 2020. “Patients with unblocked use had a very high rate of dropout (10% retained at 6 months), dropout usually occurring within 2 weeks after unblocked use. Patients with only blocked use had less dropout (33% retained at 6 months).”
[19] Nunes, Edward V., et al. “Behavioral Therapy to Augment Oral Naltrexone for Opioid Dependence: A Ceiling on Effectiveness?” The American Journal of Drug and Alcohol Abuse, vol. 32, no. 4, Jan. 2006, pp. 503–17. Accessed 10 Mar. 2023. “Most patients retained beyond 3 months achieved abstinence from opioids, but retention at 6 months was only 22% on BNT and 9% on CE.”
[20] Darke, Shane, et al. “Residential Rehabilitation for the Treatment of Heroin Dependence: Sustained Heroin Abstinence and Drug-Related Problems 2 Years after Treatment Entrance.” Addictive Disorders & Their Treatment, vol. 5, no. 1, Mar. 2006, pp. 9–18. “Independent predictors of continuos heroin abstinent were female sex (odds ratio [OR] 5.00), successful graduation from the index program (OR 9.05), and post-treatment MT exposure (OR 0.08).”
[21] Darke, Shane, et al. “Residential Rehabilitation for the Treatment of Heroin Dependence: Sustained Heroin Abstinence and Drug-Related Problems 2 Years after Treatment Entrance.” Addictive Disorders & Their Treatment, vol. 5, no. 1, Mar. 2006, pp. 9–18. “At 24 months, 71% were heroin abstinent over the month preceding interview, and 18% reported heroin abstinence over the entire follow-up period.”
[22] Stewart, Duncan, et al. “Reductions in Non-Fatal Overdose after Drug Misuse Treatment: Results from the National Treatment Outcome Research Study (NTORS).” Journal of Substance Abuse Treatment, vol. 22, no. 1, Jan. 2002, pp. 1–9. Accessed 15 Apr. 2020. “The rate of overdose was reduced both among clients treated in residential programmes (22% to 7%; χ2 = 28.98; p < 0.001) and methadone programmes (11% to 5%; χ2 = 11.46; p < 0.001).”
[23] Stewart, Duncan, et al. “Reductions in Non-Fatal Overdose after Drug Misuse Treatment: Results from the National Treatment Outcome Research Study (NTORS).” Journal of Substance Abuse Treatment, vol. 22, no. 1, Jan. 2002, pp. 1–9. “Table 3. Substance use outcome at 1 year by non-fatal overdose outcome.”
[24] Strang, John. “Death Matters: Understanding Heroin/Opiate Overdose Risk and Testing Potential to Prevent Deaths.” Addiction, vol. 110, June 2015, pp. 27–35. “Audit study of take-home schemes finds approximately 10% of dispensed naloxone is used in real-life emergency situations.”
[25] Kerr, Debra, et al. “Randomized Controlled Trial Comparing the Effectiveness and Safety of Intranasal and Intramuscular Naloxone for the Treatment of Suspected Heroin Overdose.” Addiction, vol. 104, no. 12, Dec. 2009, pp. 2067–74. “Concentrated intranasal naloxone reversed heroin overdose successfully in 82% of patients.”

About the author

Philippa Scammell

Philippa Scammell MSci holds an integrated Master's degree in Psychology
from the University of York and has completed undergraduate statistical studies at Harvard University. Philippa has substantial experience in inpatient psychiatric care (Foss Park Hospital York), Research in Psychology at University of York, and group therapy facilitation (Kyra Women's Project). Philippa writes on clinical psychology and addiction recovery. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: January 9, 2026