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Detoxification Program from opiates(heroin)

A short hospital detoxification program with Buprenorphine


Veresies Clinic offers a treatment of addiction-detoxification from heroin (and other opiates). The program is offered both as an inpatient and outpatient program. It offers an intensive program of personal Psychological Rehabilitation as well as the treatment of co-morbidity, namely the existence of dependence accompanied by a mental disorder.

Heroin is the substance that responds best to the term "drug", because it suppresses the central nervous system.
It is a semi-synthetic derivative of morphine, which in turn is one of the active (alkaloids) of opium.

Mode of use: Heroin can be taken either by inhalation or by smoking, or finally by intravenous injection.

Tolerance and resistance: It is a property of the body by which, after repeated uses, it gets used to certain actions, such as calming or euphoric, and an increased dose is required to achieve this desired result.

Due to the fact that in heroin use only a few weeks are required to repeat the same process, the chronic user needs a daily dose, which is much larger than the one
they used the first time, as well as many times larger than the one used for therapeutic purposes.

If, for any reason, the user stops using heroin for a few days, then the body's sensitivity is restored to baseline and lower doses of the substance are required. In such a case, if a user takes the same as the previous dose, this can be fatal.

The dependent heroin use leads to the development of tolerance towards other substances in the group of opiates (morphine, codeine, pethidine or methadone etc.). This means that the user does not show any withdrawal effects if he passes from one substance to another. This phenomenon is called cross-tolerance and it is important in the development of detoxification therapies and the therapy by substitutes.

The treatment of withdrawal

The goal of the treatment of withdrawal (detoxification) is the cessation of taking the drug as quickly as possible and in a safe way.
Detoxification may involve gradually reducing the dosage of the drug or a temporary replacement by other substances (such as diydrocodeine, buprenorphine and methadone etc) that have less severe consequences. For some people it is safe to treat withdrawal as external patients. Others may need hospital care or treatment in a controlled environment.

Withdrawal from heroin causes various adverse effects and requires different approaches.

Physical withdrawal symptoms

The adverse effects of withdrawal from heroin can range from relatively minor to very serious. The reaction has two phases:

First phase: explosive, lasting a few days
Second phase: long-lasting, until the body can restore the production of endogenous opiates and adjust its functions to the new data.
The intensity of the physical withdrawal symptoms depends on the amount of daily intake of the patient. The symptoms begin a few hours after the last use, culminating in the next two days and de-escalating-removed after 7-10 days.

The period of time after the last use of heroin.


8-12 HOURS

sweating, tearing, yawning, runny nose, restlessness, feeling sick severe insomnia.

12-24 HOURS

Mydriasis chills and hot flushes, muscle spasms, pain in muscles and joints

24-36 HOURS

Anxiety, vomiting, diarrhoea, increased blood pressure, increased frequency of breathing, increased body temperature.

36-48 HOURS

maximum intensity

7-10 DAY

Full restoration of the autonomous functions.

The treatment

Treatment can be done by:
      1.    A heroin antagonist - DHC (external program)
      2.    A heroin agonist / antagonist - Buprenorphine.

Treatment with DHC

Once the calculation of the dose is determined, the dose of substance DHC is set, which is used orally in low doses. Medication is also administered for sleep, as well as antidepressants and several vitamins.

The diet of the patient is rich in liquids, especially fresh juices.

Treatment/detoxification with buprenorphine (SUBOXONE)

Buprenorphine consists of one part of an opiate drug, like methadone and codeine, and one part of a competitor of heroin.
It is used in the pharmaceutical treatment of heroin dependence. Its effectiveness has been demonstrated both in substitution treatment of heroin, and in the detoxification of heroin, but also on methadone. Buprenorphine, like many other opiates, has been used as a powerful analgesic.

The Physical Detoxification Treatment Program implemented by VERESIES CLINIC buprenorphine is administered in the form of sublingual tablet. This is a type of pill that should not be swallowed or chewed, but left to dissolve in the mouth (it takes 15-30 minutes). The action begins after 30 minutes and lasts, depending on the dose, up to three days. The daily dosage is usually between 2 mg and 16 mg, phasing out for no more than 7 days.

What buprenorphine offers?

When buprenorphine is administered in appropriate dosage eliminates withdrawal symptoms of heroin and other opiates and reduces the desire of the dependent person to use heroin, i.e. it has a similar effect as methadone.
In addition to these, buprenorphine has some advantages over methadone: it antagonizes the effect of heroin.

When someone uses heroin, he will not feel the euphoria resulting from its use. Thus, buprenorphine fights one of the main reasons of the use of heroin. If someone uses only buprenorphine, he is unlikely to show an overdose even if he is taking a large enough dosage. He displays far fewer withdrawal symptoms than those caused by methadone, and therefore it is easier to be detoxified of it. For the same reason, it can be used by those who have difficulty in detoxifiying from methadone.

For the prevention of recurrence, Naltrexone is administered.
Consciously refusing to take the drug may lead the user to take heroin.



The use and abuse of  heroin causes severe  physical dependence and strong psychological dependence.

To avoid certain deprivation and psychiatric problems, the problem is often necessary to be dealt with pharmaceutical means.
The psychological detoxification and continued abstinence from the use require the participation in a psychological support program.

The" Step by Step" program is a structured individual rehabilitation program based on rational-emotional-behavioural therapy. It can be applied at any stage of  heroin usage.

The “Step by Step” program is applied on very regular individual meetings lasting half hour each (according to the needs of the patient) by a trained psychologist.
After the successful assimilation of the previous step, the program is applied gradually and step by step covers the following main aspects:

1. Recognition and acceptance of problem
2. The relation of the patient to substance dependence and dependent conduct.
3. The psychological condition of the patient - psychometric test.
4. Psychoeducation
5. The existence of motivation; searching for and enhancing motivation.
6. Changing attitudes and beliefs about the phenomenon of using herfoin and other drugs.
7. Active participation / planning / changing behaviour associated with the use.
8. Demarcation of relations / place/ time.
9. Setting goals
10. The problem of use and the family of the patient / co-dependence / allies.
11. Preventing relapse

It is also suggested to addicts and their families to be involved in treatment programs at home as well as in group psychological rehabilitation programs.

Regular participation in self-help groups for 5-10 years after the therapeutic intervention is something that keeps the addict from relapse.

For more information please contact : +357 99 659659



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