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What Are Evidence-Based Ways to Quit Heroin?

There is an important distinction to be made between ways to quit heroin. There are legitimate ones that rely mainly on medication-assisted treatment (MAT).1 There are also those which are considered by specialists in the field as unsafe, ineffective and illegitimate, on which we will elaborate further solely for the purpose of emphasizing the dangers of these practices.1

MAT, the combination of safe, supervised medication-assisted detox and tailored rehabilitation and follow-up care, has been demonstrated to be most effective in helping individuals quit heroin and achieve lasting recovery.1

On the other hand, going through unsupervised heroin detox is not only highly unlikely to be effective but may also be downright dangerous, with a potential to lead to a fatal outcome.1 Namely, individuals struggling with heroin addiction may resort to self-treatment, relying on illegitimate detoxification methods. These may include tapering off the drug and quitting heroin cold turkey, which is the colloquial term for attempting to stop heroin use without the help of medications.1 

Kicking heroin cold turkey

Why Does Quitting Heroin Require Professional Assistance?

Individuals struggling with heroin addiction who wish to quit the drug need treatment to maintain sobriety in the long term.2 

Heroin use typically begins as a voluntary decision but if it progresses to addiction, which can happen regardless of the type of heroin used and method of use, the person begins to experience intense cravings and exhibits compulsive drug-seeking behavior.2 

Heroin use driven by addiction spins out of control rapidly and continues despite the awareness that the consequences are serious and dangerous:2 

  • Prolonged, repeated heroin use can cause changes in the brain, in addition to other forms of health deterioration, which can lead to loss of self-control and inability to resist the urge to seek the drug.
  • Due to the potentially persistent nature of these changes in the brain, heroin addiction is a relapsing chronic disease followed by intense cravings and debilitating withdrawal symptoms
  • The risk of relapse is present even among people who have been clean for years. 

This is all the more reason for individuals who have developed addiction to heroin or another opioid to turn to evidence-based ways to quit heroin such as MAT instead of attempting self-treatment. Self-treatment often entails unsafe and ineffective forms of detoxifications such as cold turkey or tapering.3 Cold turkey and tapering practices may quickly lead to relapse and back into the addiction loop, which carries the potential of fatal or non-fatal overdose.4

Why MAT?

For individuals struggling with opioid withdrawal syndrome, 24-hour care is generally considered the preferred setting for detox, based on principles of safety and humanitarian concerns.1

MAT supervised by addiction specialists has a high success rate, in addition to being deemed a safe way to start recovery.1 This type of treatment includes medical stabilization within the medication-assisted detoxification stage and a full continuum of care within the rehabilitation stage.1

What Is MAT?

MAT is a comprehensive, individually tailored program of medication and behavioral therapy designed to address the needs of a treatment-seeking individual.3

MAT is the industry gold standard for treating substance use disorders, including opioid use disorders such as heroin addiction.1 The treatment relies on therapeutic drugs or ongoing maintenance drugs, which are an essential component of treatment carried out in a specialized heroin addiction treatment program.1

Relapse is a legitimate concern even for individuals who have entered MAT for heroin addiction.2 MAT can still be effective as long as it is ongoing, much like the treatment of persons struggling with other chronic diseases.2 

If a person in MAT relapses, it is a sign that their plan needs to be modified and adjusted to their changing needs.2 An effective relapse prevention strategy is to review the recovering individual’s MAT plan periodically.2

What Is Cold Turkey?

Stopping heroin cold turkey is the colloquial term for undergoing withdrawal and detoxing from heroin without medications.4 The practice gets its name from one of the symptoms of withdrawal: cold flashes with goose bumps.4

A person in the process of detoxification from heroin undergoes potentially severe withdrawal symptoms which can best be managed with the use of medication – just the opposite of cold turkey.1 

Quitting heroin cold turkey without supervision and medications is considered an illegitimate, unsafe way to go through the detoxification stage and, by extension, an ineffective way to begin to overcome addiction to heroin.1

While every person with addiction to heroin faces a unique situation, what all individuals struggling with this chronic condition have in common is that they require adequate care during detox.1 The so-called cold turkey approach to kicking heroin which individuals may attempt on their own is a dangerous practice that goes against what specialized heroin addiction treatment centers endorse.1

What Is Tapering?

Tapering off a drug means that the person stops using the drug gradually as opposed to at once.5 In the context of heroin, tapering is not considered a viable solution, and individuals in a heroin rehab facility are given maintenance drugs to help them overcome withdrawal.1

However, gradual, individualized tapering is recommended for addiction to other opioids such as prescription pain-killers.5 Individuals who attempt to taper off of these drugs are advised to do so under medical supervision, as sudden discontinuation of these opioids can be extremely dangerous.5

Frequently Asked Questions

How Effective Is Medication-Assisted Treatment for Heroin Addiction?

MAT incorporates counseling and psychosocial support as well as medication. It relies on drugs for the treatment of opioid dependence which have been approved by The Food and Drug Administration (FDA) and demonstrated to be safe and effective.6

The ultimate goal of this approach to heroin addiction treatment is lasting recovery.3

Due to the chronic nature of heroin addiction and substance use disorders (SUD) in general, the need for continuing MAT is typically re‐evaluated periodically.6 While there is no maximum recommended duration of maintenance treatment, some individuals may need to continue treatment indefinitely.6

MAT has proved to be clinically effective and shown to:3

  • Increase retention in treatment.
  • Reduce the need for inpatient detoxification.
  • Reduce the potential for relapse among the recovering population.
  • Improve patient survival.
  • Decrease illicit drug use and criminal activity at large among people with SUD.
  • Increase patients’ ability to gain and maintain employment.
  • Lower the risk of health complications (improved birth outcomes for pregnant women with SUD, lower risk of contracting infectious diseases such as HIV and hepatitis C, etc.)

Why Is MAT the Gold Standard in Heroin Addiction Treatment?

Despite the stigma frequently associated with medications used in MAT, this form of treatment is the gold standard because of its whole-patient approach. This approach can be effective in the treatment of heroin addiction and in helping recovering individuals stabilize, quit heroin and sustain recovery.6 MAT can guide patients through detoxification and toward recovery.6 In addition to treating substance use disorders, MAT addresses other health conditions recovering individuals may have.7

The treatment is based on a careful combination of medications, counseling, and behavioral therapies. Heroin addiction is a chronic disease with long-lasting effects, and the objective of MAT is to facilitate the treatment-seeking individual’s path to recovery.6 

MAT relies on:7

  • Opioid dependency medications (Buprenorphine, Methadone, and Naltrexone).
  • Opioid overdose prevention medication (Naloxone).

Unlike naloxone which is used solely to prevent overdose and reverse its toxic effects, opioid dependency medications are safe to use for longer periods of time, even a lifetime.7 They are used to treat addiction to short-acting opioids such as heroin.7 Medical professionals decide when and if patients undergoing this form of therapy can discontinue it.7

Is MAT Evidence-Based?

Medications used for MAT are evidence-based treatment options for alcohol and opioid use disorders which have been FDA-approved.7 Instead of simply substituting one drug for another, MAT helps patients safely overcome withdrawal symptoms and cravings within a controlled treatment plan designed to prevent misuse of these medications unlike quitting heroin cold turkey.7

What Are the Benefits of MAT?

MAT is used to:3

  • Teat substance use disorders.
  • Sustain recovery.
  • Prevent overdose.

MAT is designed to provide a “whole-patient” approach to the treatment of substance use disorders, including addiction to heroin.3 The clinically driven program which consists of a combination of FDA-approved medications and counseling and behavioral therapies is tailored to address the needs of each patient, which is why it is always the recommended option over stopping heroin cold turkey.3

What Medications Are Used as MAT?

MAT medications are used for the treatment of addiction to:3

  • Alcohol.
  • Opioids such as heroin, morphine, and codeine.
  • Semi-synthetic opioids such as oxycodone and hydrocodone.

These medications are used to:3

  • Normalize brain chemistry and body functions.
  • Block the euphoric effects of opioids.
  • Relieve cravings.
  • Prevent and reverse the toxic effects of overdose.

Opioid Dependency Medications

Three medications belong to this group, each with a specific effect:3

  • Buprenorphine: suppresses and reduces cravings for opioids.
  • Methadone: reduces cravings and withdrawal, blunts or blocks the effects of opioids.
  • Naltrexone: blocks the euphoric and sedative effects of opioids.

Opioid Overdose Prevention Medication

Naloxone is used to prevent overdose and reverse the toxic effects of fatal or non-fatal overdose.7

FDA-Approved Products Used in MAT

FDA-approved buprenorphine products include:6

  • Bunavail (buprenorphine & naloxone) buccal film.
  • Cassipa (buprenorphine & naloxone) sublingual film.
  • Probuphine (buprenorphine) implant for subdermal administration.
  • Sublocade (buprenorphine extended‐release) injection for subcutaneous use.
  • Suboxone (buprenorphine & naloxone) sublingual film for sublingual or buccal use/sublingual tablet.
  • Subutex (buprenorphine) sublingual tablet.
  • Zubsolv (buprenorphine & naloxone) sublingual tablets.

FDA-approved methadone products are:6

  • Dolophine (methadone hydrochloride) tablets.
  • Methadose (methadone hydrochloride) oral concentrate.

FDA-approved naltrexone products include the following:6

  • Vivitrol (naltrexone for extended-release injectable suspension) intramuscular.


  1. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
  2. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction DrugFacts.
  3. Substance Abuse and Mental Health Services Administration. (2021). Medication-Assisted Treatment (MAT).
  4. National Institute on Drug Abuse. (2020). Research Report Series: Heroin.
  5. Food and Drug Administration. (2019). FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering.
  6. Food and Drug Administration. (2019). Information about Medication-Assisted Treatment (MAT)
  7. Substance Abuse and Mental Health Services Administration. (2020). MAT Medications, Counseling, and Related Conditions

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