Inpatient vs. Outpatient Rehab Clinics
When selecting a heroin treatment center, you have the option of choosing between an inpatient facility and an outpatient clinic. Individual treatment needs are naturally going to vary, and there are certain benefits (and drawbacks) to both types of treatment for heroin addiction that may inform the decision for treatment type.
Outpatient facilities can vary widely. Many outpatient rehabs provide treatment in the form of education, group therapy, individual therapy, and in some cases, access to psychiatric care or medication assisted treatment. Outpatient programs range in levels of intensity and, to some extent, the treatment plan can be tailored to each client, with the number and type of scheduled weekly groups varying based on the individual's needs.
The time commitment can be substantial in an inpatient (residential) rehab setting, and studies suggest that a minimum of 90 days in treatment is essential for successful outcomes and long-term sobriety. Due to the tenacious nature of heroin addiction and the many facets of an individual's life it affects, an inpatient treatment program is commonly sought.
Heroin is highly addictive, both mentally and physically. Those who attempt to quit often suffer from a withdrawal period that can be extremely uncomfortable. A benefit of many inpatient treatment programs is that they commonly include some form of medically supervised detox and around-the-clock support to keep those recovering a safe and comfortable as possible—minimizing relapse risks.
Residential Heroin Treatment
Not everyone who tries heroin will go on to need residential heroin treatment program. It is possible to use any drug recreationally and not become addicted, although amongst all drugs of abuse, heroin is an exquisitely addictive substance. If heroin abuse is an issue, there are some questions you can ask yourself to help you decide if you or someone you love would benefit from inpatient or residential treatment:
- Do you find that your heroin use makes you more isolated?
- Is your heroin use causing problems at work, home, or school?
- Has your financial standing suffered due to heroin?
- Do you have problems in your relationships because of heroin use?
- Are you unable to stop even though you want to?
- Have you ever stolen money or other items in order to buy heroin?
If you answered "yes" to any of these questions, you might benefit from inpatient or residential rehab for heroin addiction. These are all warning signs of an opioid use disorder, which can be effectively managed if treatment is sought.
Tolerance vs. Dependence
Tolerance and dependence on heroin are two different things. The body develops a tolerance to the effects of heroin when it is used regularly enough for the brain to adapt to the level of heroin present. The more tolerance the body builds up, the more heroin it will require for the user to feel its effects. Tolerance is generally a warning sign that an individual is developing heroin dependence.
Dependence occurs when heroin users begin to feel that they need the drug to function normally. Heroin dependent individuals frequently experience uncomfortable physical withdrawal symptoms, including agitation emotional and physical discomfort, which may prompt additional drug-seeking behaviors. The chronic use of heroin seen in those with opioid dependence can also prompt increased tolerance to heroin, requiring the use of ever increasing amounts of heroin to stave off withdrawal symptoms. It's a tough cycle to break out of, which is why heroin rehab center, for many, offer the best chance of recovery.
Advice from people leaving treatment
When making the decision to enter a heroin rehab center, it is normal to be concerned about privacy and confidentiality. All inpatient heroin rehab facilities offer a level of privacy and confidentiality as mandated by a federal law known as the Health Insurance Portability and Accountability Act (HIPAA).
Addiction is a medical condition (diagnosed as a substance use disorder), and treatment centers are legally required to respect your privacy and keep your treatment confidential unless you have provide consent to share information or there is a valid, emergent reason to do so.
Beyond informational privacy, if you're looking for a higher level of personal privacy along with amenities such as a private room or spa facilities, then the type of heroin rehab center that may be best for you is a private luxury facility. No two heroin treatment programs are the same, but all place a priority on keeping your treatment private and confidential.
Duration of Treatment
The length of time spent at an inpatient heroin rehab center varies by individual. The appropriate length of treatment depends on many factors. A commonly offered treatment duration is the 30-day program. Some heroin treatment facilities also offer 60- and 90-day programs.
Longer programs are available, and may provide additional support for those who have completed a 30-day program and relapsed, individuals with co-occurring mental or physical health issues, or those who lack a stable home environment. There are also heroin rehab centers that offer inpatient treatment for as long as a year. Deciding which option is right for you is an important step toward starting your recovery.
The treatment process begins with an intake appointment at the heroin rehab center. During the intake, you will sign formal consents for treatment and the program rules will be explained to you.
The intake process also includes questions about your physical and mental health, a substance use history, and sometimes a physical exam, which helps the heroin rehab facility determine the best treatment plan and length of stay for you. Your questions can also be asked at this time.
The next step in the heroin rehab is detox from heroin. The main objective of detox is to relieve the your withdrawal symptoms while your body adjusts to functioning without the drug. Detox from heroin should be completed under medical supervision.
The type of detox program will depend on the facility chosen. Some facilities choose to ease the detox process through medication-assisted treatment. Providing tapering doses of replacement medications such as Suboxone (buprenorphine and naloxone), buprenorphine, or methadone can reduce the symptoms of withdrawal in a safe, medically monitored setting.
Another type of detox method is abstinence-only or social detox. With this type of detox, there is no replacement drug, and the patient will simply stop using the drug, with no opioid replacement support to minimize the symptoms of withdrawal. Many find this form of detox quite challenging in cases of heroin withdrawal. More recently, medication assisted detox is becoming an increasingly common method for managing heroin dependence.
Addiction Treatment Therapy
After you complete detox, you will enter into addiction therapy. There are many different options for therapy at heroin rehab facilities. Most rehab centers provide both individual and group therapy, along with education about addiction. Some facilities will also incorporate family therapy sessions into the treatment process, or provide psychiatric treatment if the individual has an underlying mental health disorder.
Aftercare & Ongoing Support
Because every recovery process is as different as the person recovering, heroin rehab centers will carefully plan for ongoing care once the initial treatment duration has ended. To do so, many treatment programs will offer their own aftercare programs or will go to great lengths to plan for or arrange extended treatment or aftercare for all treatment alumni.
People in recovery tend to do best when they have a plan in place for when they check out. During the treatment process, trained counselors will work with you to develop an aftercare plan, which can include outpatient treatment, private therapy, 12-step meetings, long-term residential treatment, and sober-living housing.
Paying for Treatment
A common question is in regard to what it will cost to complete a heroin addiction rehab program. Costs vary between centers, but there are various options to help pay for treatment, including private insurance, sliding-scale fees, loans, or payment plans.
Should You Go to Rehab Near or Away From Home?
Whether you should travel or check in to a heroin rehab center that is near you is a personal choice. If there are a lot of family members and sober supports within the community, staying close may be a better choice.
Some individuals find that traveling helps them start the new path of recovery and avoid outside stressors or triggers. The most important aspect is that the individual seeking treatment feels sufficiently safe and comfortable to focus on treating the addiction.
About Luxury Rehab and Executive Programs
Many luxury treatment facilities provide cutting-edge treatment, posh amenities, and increased privacy. These allow individuals to recover in a comfortable setting that can include exercise facilities, massage, and other upscale comforts.
Similar to those treatment programs offered in luxury settings, executive treatment facilities can allow individuals to receive the treatment they need while handling important duties. For example, pairing high-quality substance use and behavioral addiction treatments with the flexibility of occasional computer and phone access allows an executive to get sober away from the spotlight.
Are You Ready for Rehab?
Knowing when it is time to enter a heroin rehab center can be difficult. If you have decided that it is time to fix the problem, this is a good indication that you are ready to explore your treatment options.
How to Hold an Intervention for a Loved One
Many people struggling with a heroin addiction are in denial about their condition. They may believe that they have their use under control and that they can stop any time that they’d like. Others may rationalize their use (e.g. “I only use on weekends” or “My work hasn’t been affected”). Some people may refuse to recognize the negative consequences of their heroin abuse, or they may blame the negative consequences on others (e.g. “I got fired because my boss hates me.) Whatever the case may be, an intervention may be effective in opening your loved one’s eyes to the need for addiction treatment.5
It’s important to remember that when you approach your loved one, you should not have a confrontational or judgmental attitude. People with heroin addictions often have a lot of shame surrounding their substance abuse and confronting them could make them feel blamed or guilty, which in turn causes them to become defensive or closed-off. A better alternative is to approach them in a compassionate and caring way; express to your loved one how concerned you are without using any blame language. It can be more effective if you frame your statements as “I feel” statements. It’s important that you communicate to your loved one how their heroin abuse has negatively impacted you, using specific examples, if possible. It’s important that you view the heroin addiction from a collaborative and supportive perspective; the person isn’t the problem, the heroin is.5
If your loved one is receptive, you may ask if they would be willing to enroll in a professional treatment program to help them get clean and sober. If they’re open to discussing that, you can always write down a list of the individual’s treatment priorities and preferences and use that information to search for the appropriate treatment facility. Listen to them and help them overcome any barriers to treatment that they may have (e.g. cost, travel, childcare, telling their boss, etc.).5
If they are not willing to talk about rehab, it may be best to drop the topic so that they don’t get upset or angry. You can always revisit it once the person has had some time to think about what you said. If they are still resistant, you may want to consider hiring a professional interventionist to help facilitate a formal intervention.5
Finding the Right Program
It's never too late to turn your life around and free yourself from heroin addiction. Recovery is a long and sometimes difficult process, but it allows individuals the opportunity to live a healthy, happy, sober life.
1. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide (3rd edition).
2. National Institute on Drug Abuse. (2014). DrugFacts: Heroin.
3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA. American Psychiatric Publishing.
4. U.S. Department of Health and Human Services. (2016). Your Rights Under HIPAA.
5. American Addiction Centers. (2018).