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Aftercare for Heroin Addiction Recovery

Heroin addiction is characterized by an uncontrollable or compulsive need to use the drug in spite of its harmful consequences. Like many chronic, relapsing health issues, the course of a heroin addiction may include relapses where a person returns to drug use after a period of abstinence.1

For this reason, aftercare, or continuing care after rehab, is extremely important.

What Is Aftercare?

Being offered helping hand
Most people who are addicted to heroin start their recovery with medical detox, where the body clears itself of the drug while treatment staff supervise and offer medical interventions to make the withdrawal process as safe and comfortable as possible. Once this is done, many people continue their recovery by entering a substance abuse treatment program.

Aftercare is ongoing care a person receives after they complete formal addiction treatment. It is meant to lower the risk of relapse into drug use.2

Aftercare can take place in a community or residential setting. It consists of a variety of treatment approaches aimed at helping a person maintain a drug-free lifestyle over time. Treatment can involve medication, counseling, and various social programs designed to help the person maintain a support network. Aftercare programs will vary in intensity based on the person’s needs.2

Effective aftercare usually consists of a variety of components. Each element of aftercare is directed at a particular aspect of drug addiction, such as stress management or coping skills. As part of your aftercare experience, you are also likely to receive support from peers that are going through the same thing.

Why Is Aftercare Necessary?

Because of the nature of drug addiction, many people find aftercare to be an indispensable component of their recovery process. Drug addiction affects areas of the brain that impact behavior and motivation. Although a person has control over whether or not they initially decide to take drugs, long-term exposure to drugs can change the way their brain functions. These changes compromise the person’s ability to choose to stop taking drugs on their own. The need to take drugs becomes compulsive and may be more powerful than a person’s willpower or self-control.2

Between 40–60% of people with addiction relapse at some point. These rates are similar to those seen with some other medical issues such as type I diabetes, in which 30–50% of individuals with the condition experience a recurrence or relapse of their symptoms.3 Just as people that have diabetes must continue to take medications to stay well, people that are addicted to heroin must continue with aftercare treatment to minimize or prevent a relapse of drug-seeking and using behavior.

Aftercare Programs

Today, there are a variety of aftercare options, since no single treatment works for everyone and the best program for each person depends on individual needs.2 Research has demonstrated that matching different aftercare types and settings to specific client preferences can improve outcomes.4

Some of the most common aftercare treatments include:

  • Outpatient substance abuse treatment programs. These often take place in a community setting and can encompass a variety of different treatments, such as individual or group counseling.2 A person may enter outpatient treatment after completing an inpatient program.
  • Individual counseling or therapy sessions. Individual counseling focuses on helping the person stop using the drug while also addressing other areas affected by drug use, such as employment status and legal problems. Individual counseling can help a person develop coping and problem-solving skills to improve their overall functioning.2
  • Group counseling sessions. This approach to treatment is conducted in a group setting. During group counseling, participants provide and obtain support from peers that are also trying to quit using drugs.2
  • 12-step programs. The principles of 12-step recovery benefit the many individuals in groups such as Narcotics Anonymous (NA). These programs usually take place as an adjunct to formal treatment or as part of continuing care. Twelve-step meetings are hosted in most communities throughout the United States. In the program, addiction is seen as a chronic but manageable disease. Participants help others who are addicted by sharing recovery stories during meetings and sponsoring new members.5
  • Non-12-step programs. Not all peer support programs adhere to the 12-step philosophy. Some non-12-step support groups place more emphasis on the latest research into addiction treatment and stress self-reliance to achieve sobriety.
  • Alumni programs. These programs connect you with other people that have completed the same rehab program as you and allow you to come back to the program and share your story with others.
  • Sober living homes. These are sometimes called recovery homes. They are residential homes for people who are newly sober. Sober living homes help residents transition into independent living by providing a supportive, drug-free environment.7 You can remain in this environment while you look for a job, find a place to live, or apply to go to school.
  • Recovery high schools. These are high schools that are specifically designed for students that are recovering from a drug or alcohol addiction. They provide a combination of academic and therapeutic programs.8

The exact type and appropriate length of aftercare depend on the type and degree of co-existing problems. For instance, clients with co-occurring medical illnesses, vocational issues, or legal issues might require a longer length of treatment. A person often develops a plan with the team at the rehab center. The plan indicates the types of services needed and the recommended period of time. Treatment plans are often modified as needs change.2

Benefits of Aftercare

There have been a variety of studies that have examined the benefits of aftercare. For example:

Person refusing alcohol

  • One study tested the effect of continuing care on relapse rates in men with alcohol dependence. The men received home visits from a psychiatric nurse over a period of 1 year. The study found that patients that received the aftercare home visits had substantially higher rates of abstinence from alcohol over those that did not.9
  • Another study examined patients with severe alcohol and/or heroin dependence that had completed residential treatment. The continuing care intervention consisted of 9 coping skills sessions over a period of 6 months. The control group received unstructured continuing care counseling sessions. Instead of receiving structured coping skills sessions, the control group received sessions only when they requested. The study found that patients that received continuing care had one-third the rate of substance use compared to the control group.9
  • A 2006 study found that aftercare interventions for 1 year or longer were more likely to be beneficial, and interventions that were easier for people to participate in were more likely to have higher rates of engagement. The authors recommended more structured and intensive aftercare for people with severe addiction and related issues.10
  • Finally, another study found that aftercare was particularly significant for a reduction in drug use. Participants in aftercare programs were nearly 3 times more likely to be abstinent for all drugs and almost 4 times as likely to be opiate free. They were 5 times less likely to be using any drugs weekly or more often for the 6 months preceding follow-up.11

How to Find Aftercare

There are many ways to find aftercare programs. Here are just a few ideas:

  • If you are in a detox or inpatient program, ask the staff for recommendations for aftercare planning. Aftercare planning is typically a part of discharge planning. Playing an active role in researching and building out your aftercare plan can make a big difference.
  • You can also try asking other people in recovery what they recommend or talk to local healthcare or addiction specialists.
  • Another option is to search for and attend 12-step meetings in your area.

If you’d like help finding a program, you can search for one using the directory listings on this website.

Sources

  1. National Institute on Drug Abuse. (2018). Treatment Approaches for Drug Addiction.
  2. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
  3. National Institute on Drug Abuse. (2014). Drugs, Brains, and Behavior: The Science of Addiction.
  4. Brown TG1, Seraganian P, Tremblay J, Annis H. (2002). Matching substance abuse aftercare treatments to client characteristics. Addictive Behaviors. (4):585–604.
  5. Donovan DM, Ingalsbe MH, Benbow J, Daley DC. (2013). 12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview. Social work in public health. Soc Work Public Health. 28(0):313–332.
  6. Tracy K, Wallace SP. (2016). Benefits of Peer Support Groups in the Treatment of Addiction. Substance Abuse and Rehabilitation. 7:143–154.
  7. Substance Abuse and Mental Health Services Administration. (2013). Recovery Homes Help People in Early Recovery.
  8. Moberg DP, Finch AJ. (2008). Recovery High Schools: A Descriptive Study of School Programs and Students. Journal of Groups in Addiction & Recovery. 2:128–161.
  9. McKay JR. (2009). Continuing Care Research: What We’ve Learned and Where We’re Going. Journal of Substance Abuse Treatment. 36(2), 131–145.
  10. McKay, J.R. (2006). Continuing care in the treatment of addictive disorders. Current Psychiatry Reports, 8(5), 355-362.
  11. Brown, B., O’Grady, K., Battjes, R., and Farrell, E. (2004). Factors Associated with Treatment Outcomes in an Aftercare Population. The American Journal on Addictions, 13, 447-460.

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