Opiates began their popular use in the 1800’s with the derivation of morphine in 1806 and the invention of the hypodermic needle in 1848, just in time for the Civil War. During the war literally hundreds of thousands combatants became addicted to morphine. As the leading pain-killing drug of the time, it was often rubbed or dusted into the wound. . The state of medical knowledge at the time did not know what addiction or how severe the heroin detox was, and so many soldiers came home from the war heroin and opiate addicted.

As the extent of morphine addiction grew it was thought that heroin, first synthesized in by British chemist C. Adler Wright, in 1874, was the best cure for the Morphine addict.
Clearly a cure that simply led to further addiction, now to Heroin. Today the same flawed thinking of the turn of 20th century exists in the form of Methadone maintenance as one of the “treatments” for heroin addiction and as administered during the heroin detox phase.

Heroin as with all opiates has the capacity to create very high tolerance thresholds in the body. Indeed one of the real risks of heroin addiction is that the addict can build up a using tolerance 3 and 4 times the lethal dose limit for the normal population. The high thresholds make heroin detoxification all the more dangerous and physically painful for the heroin addict.

Heroin withdrawal is painful and frightening. During the withdrawal phase usually 48 to 72 hours after the last dose of heroin is consumed the addict often shows visible signs of dilated pupils, panic, chills, muscle cramps, nausea and profuse sweating. Addicts who have withdrawn from heroin often describe their symptoms as the “worse case of the flu” they have ever had.

Drug addiction treatments and detoxification via the administration of drugs such as Naltrexone and more recently Buprenorphine have been shown to help the heroin addict maintain abstinence and thus can prevent the need for future a detox. While no magic bullet, pharmacology advances have made the successful treatment of heroin addiction more hopeful and the detox more humane. Another treatment Ibogaine, while not FDA approved and thus not available in the United States has been shown in recent studies to alleviate the cravings for heroin and may be one of the more viable therapies in the future.

For all the varied treatment methods Heroin use remains a significant addiction problem world wide. In the United States one alarming trend is that the age of first use such that 1.5% of 9th graders report using heroin. Effective treatment of heroin addiction requires specialized skills and thus the choice of the drug rehab becomes critical. Rick Murphy, M.A