Is a Heroin Detox Different From an Alcohol Detox?

Is a Heroin Detox Different From an Alcohol Detox?
Author: Tulip Hill Recovery
Published: September 17, 2021

Detoxification is the key first step in recovery from both heroin and alcohol addiction. These substances are both classified as depressants, and you may be curious about whether it’s the same detox treatment method. The answer is not exactly.

Basics of Depressant Withdrawal

As depressants, heroin and alcohol both dampen communication in the central nervous system - lowering the rate at which our brains fire off neurons and slowing down respective bodily functions.

But the body doesn’t want to be stuck in an impaired state all the time. When you keep using a depressant, the nervous system responds by overreacting to reverse the drugs’ effects and bring you back to equilibrium. However, when you suddenly remove the depressant, your system is still over-firing. This elevates anxiety, irritability, tremors, bodily pain and cramping, heart rate, and blood pressure - the list goes on.

This is why someone addicted to either drug experiences a dangerous withdrawal state when they stop or can’t access the substance they’re addicted to - and why they both benefit from a medical detox.

Different Neurochemistry, Different Withdrawals

Depressant intoxication and withdrawal may have some basic similarities, but the devil is in the details, and alcohol and heroin don’t have that much in common. To understand their unique detoxes, let’s dive deeper into how these two substances work.

Alcohol Withdrawal

Alcohol works partly by increasing the effects of GABA receptors - the docking ports for a naturally produced inhibitory neurotransmitter that has anti-seizure and anti-anxiety effects in the body.

When someone has been abusing alcohol for a long time, either by continuous drinking or binging, the body reduces its number of GABA receptors, losing the ability to inhibit responses. When someone is suffering from alcohol abuse disorder, withdrawal can present with unregulated symptoms of:

  • Anxiety
  • Sweating
  • Tremors
  • Agitation or anger
  • Dysphoria
  • High blood pressure

Alcohol withdrawal syndrome has a long record of dangerous symptoms. Up to 5% of people who cease habits of heavy drinking experience a condition known as delirium tremens. Symptoms include fever, seizures, extreme confusion, hallucinations, and cardiac problems, and can be life-threatening.

Heroin Withdrawal

Heroin overwhelms the mu-opioid receptors for the body’s natural opiates. It replicates a magnified opiate effect in the central nervous system, leading to drowsiness, pain reduction, feelings of contentment, and slowed gastrointestinal, respiratory, and cardiovascular function. However, as we know, the system doesn’t like to be impaired.

With time, we heighten the production of a counteracting chemical, noradrenalin. It cancels out some of the opioid’s effects, stimulating our wakefulness, blood pressure, and alertness. This response is why long-term users develop tolerance, needing more of the drug to reach the same high. It’s also why when heroin is gone from the system, we experience excessive stimulating effects, including:

  • Uncontrollable restlessness
  • Intense anxiety
  • Intense depression
  • Deep muscle cramps
  • Bone pain
  • Insomnia
  • Diarrhea

While most of these withdrawal symptoms are not independently life-threatening, extreme dysphoric moods can result in risky behavior in many people. Moreover, heroin withdrawal produces painful physical symptoms, which, combined with heroin’s deeply addictive nature, can put people in danger of a fatal relapse when they embark on withdrawal without detox support.

Different Detox Methods: Symptom Management and Tapering

The first step in recovery is quitting use and allowing the body’s natural chemistry to return to its original balanced state. A treatment center can offer medical care to individuals entering withdrawal, easing the process. This reduces symptoms, making detox more comfortable and, most importantly, safer.

Detox from heavy alcohol abuse at a rehab facility will often involve medications that manage the serious symptoms of GABA imbalance while your body finds a new equilibrium. The scale of alcohol withdrawal symptoms is quite varied, and so the exact treatment for your detox will be adjusted to meet your specific requirements. This may involve the careful and monitored prescription of long-acting benzodiazepines (to treat symptoms including seizures) or acamprosate (which stabilizes brain signaling). Medications like naltrexone or disulfiram can help manage cravings or relapse where it is a risk.

Heroin withdrawal symptoms like anxiety and dysphoria can sometimes be treated directly, but the most effective medical treatments for heroin detox work by a method known as tapering.

Your medical staff will first assess your initial tolerance before prescribing you a controlled dose of a long-acting opiate medication such as methadone or buprenorphine. They will slowly phase out your dose over the course of weeks until you have fully detoxed, adjusting for symptoms as you progress.

Why Detox?

Heroin and alcohol addiction work in different ways and their detoxes are not the same processes. That said, choosing detox over cold turkey withdrawal for either offers life-changing benefits. Accepting medical care means protecting yourself against severe or unmanageable withdrawal symptoms and putting your safety first in a monitored, professional environment. Detoxing appropriately is more than comfort; it can define your long-term success in recovery.

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