What is Heroin Rehab Aftercare?Aftercare helps build on the progress made in treatment. Since heroin addiction is a chronic, relapsing disease, aftercare is critical to solidifying and building on gains made in the critical days of detox, early stabilization and initial treatment.
Is Heroin Rehab Aftercare Necessary?
"The longer the duration of interventions such as aftercare, the better the outcome for maintaining recovery..."
The longer the duration of interventions such as aftercare, the better the outcome for maintaining recovery.
While you may be discouraged about the rate of relapse among heroin addicts after treatment, you need to know that aftercare interventions do work.
The Benefit of Relapse Prevention
Relapse often happens, not as the result of environmental triggers—which may be encountered frequently during early recovery—but through the failure to cope adequately with negative emotions resulting from interpersonal conflicts and other problems or stressors.
Effective relapse prevention will emphasize the repair of damaged relationships, helping to form new ones, working on lingering effects of trauma, and enhancing self-esteem and self-efficacy, in addition to learning skills which can sensitize those struggling with addiction to early warning signs of relapse.
In a group setting, continuing care can be extended to a person who has relapsed on heroin. In this scenario, a compassionate group facilitator will 'model' how to overcome maladaptive thinking patterns and feelings which can trigger relapse.
Heroin Abuse is a Chronic Condition
"Chronic illnesses are treatable and people recover, but lifestyle changes and interventions will need to endure for a lifetime to avoid relapse..."
Heroin dependency can be a long-term concern, similar to any chronic illness such as diabetes or heart disease. Chronic illness differs from acute illness in the sense that the latter condition passes with time and treatment, e.g. a bad infection.
Chronic illnesses are treatable and people recover, but lifestyle changes and interventions will need to endure for a lifetime to avoid relapse.
Relapse can happen with chronic illnesses, which does not mean that the treatment has failed, or that you are a failure.
A study of relapse rates for the chronic illnesses of addiction, diabetes, asthma and hypertension found that addiction had a relapse rate of 40-60% compared to 50-70% for hypertension and asthma.
Continuing work in aftercare may include trying alternative interventions which will work for you. That may take time, so don’t get discouraged if you cannot stay off heroin on your first experience with recovery.
Continuing Care Options
Counseling Interventions / Group Therapy
Cognitive Behavioral Therapy (CBT)
12-Step Facilitation Treatment
Follow-up Medical Treatment
Sober Living / Therapeutic Community
Contingency Management (CM)
Supporting Family and Friends with Heroin Recovery
"Interpersonal and familial factors can contribute to the progression of addiction..."
Given the psychosocial nature of addiction, both the heroin-addicted individual as well as his/her family can benefit from focused recovery efforts.
Multidimensional family therapy (MDFT) is an empirically supported family-focused therapy which specializes in youth drug abuse and family interaction.
Interpersonal and familial factors can contribute to the progression of addiction. MDFT focuses on creating a practical and reachable alternative to drug use for the teen and enhanced emotional connection by the parent for the teen.
This in turn fosters what some parents call “soul searching” of themselves, resulting in improved family functioning and cohesion.
Carroll, K.M. (2013). Cognitive Behavioral Therapies. In Miller, P.M. ed. Interventions for Addiction: Comprehensive Addictive Behaviors and Disorders. Volume 3. Boston: Elsevier, pp. 137-146.
Carroll, K.M., et al. (2013). Targeting Behavioral Therapies to Enhance Naltrexone Treatment of Opioid Dependence: Efficacy of Contingency Management and Significant Other Involvement. Arch Gen Psychiatry 58(8): 755-761.
Curran, V., and Drummond, C. (2013). Psychological Treatments of Substance Misuse and Dependence. In Miller, P.M., ed. Previously cited, pp. 209-240.
DeLeon, G. (2008). Therapeutic Communities. In Galanter, M., and Kleber, H.D., eds. The American Psychiatric Publishing Textbook of Substance Abuse Treatment. Fourth Edition. Washington, DC: American Psychiatric Publishing, Inc.
DeLeon, G. (2013). Therapeutic Communities. In Miller, P.M., ed. Previously cited, pp.643-653..
Garcia-Portilla, M.P., et al. (2014). Long-term Outcomes of Pharamcological Treatments for Opioid Dependence: Does Methadone Still Lead the Pack? Br J Clin Pharmacol. 77(2): 272-284.
Hser, Y-I, and Anglin, M.D. (2005). Chapter 20: Drug Treatment and Aftercare Programs. In Coombs, R.H. ed. Addiction Counseling Review: Preparing for Comprehensive, Certification, and Licensing Examinations. Mahwah, NJ: Lawrence Erlbaum Associates.
Kingree, J.B. (2013). Chapter 15: Twelve-Step Facilitation Therapy. In Miller, P.M. ed. Interventions for Addiction: Comprehensive Addictive Behaviors and Disorders. Volume 3. Boston: Elsevier, pp.137-146.
Liddle, H.A. (2013). Multidimensional Family Therapy for Adolescent Substance Abuse: A Developmental Approach. In Miller, P.M., ed. Previously cited, pp. 87-96.
McClellan, A.T., and McKay, J.R. (2009). Integrating Evidence-Based Components into a Functional Continuum of Addiction Care. In Ries, R.K. et al., editors. Principles of Addiction Medicine. Fourth Edition. Philadelphia: Lippincott, Williams & Wilkins.
McClellan, A.T., et al. (2000). Drug Dependence, A Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation. JAMA 284(13):1689-1695.
McKay, J.R. (2009). Continuing Care Research: What We’ve Learned and Where We’re Going. J.Subst AbuseTreat 36(2):131-145.
Petry, N.M., and Carroll, K.M. (2008). Contingency Management is Efficacious in Opioid Dependent Outpatients Not Maintained on Agonist Pharmacotherapy. Psychol Addict Behav 27(4):1036-1043.
Rounsaville, B.J. et al. (2009). Individual Psychotherapy. In Ries et al., editors. Cited previously.
Schoenthaler, S.J., et al. (2015). NIDA-Drug Addiction Treatment Outcome Study (DATOS): Relapse as a Function of Spirituality/Religiosity. J Reward Defic Syndr 1(1): 36-45.
Sigmon, S.C. et al. (2012). Opioid Detoxification and Naltrexone Induction Strategies: Recommendations for Clinical Practice. Am J Drug Alcohol Abuse 38(3): 187-199.
Toneatto, T. (2013). Mindfulness. In Miller, ed. Cited previously, pp. 219-226.
Washton, A.M. (2011). Group Therapy. In Ruiz, P., and Strain, E.C., eds. Lowinson and Ruiz’s Substance Abuse: A Comprehensive Textbook. Fifth Edition. Philadelphia: Lippincott, Williams & Wilkins, pp.575-583.