Heroin Addiction Treatment Fort Lauderdale, FL

What kind of heroin treatment is available in Fort Lauderdale and Broward County? There is now very effective medical treatment for heroin addiction. Quitting heroin is the easy part. Staying quit is the part that needs medical treatment.

There are many reasons why you are going to want to quit heroin. Heroin is a very deadly drug. It can make you stop breathing and die, quietly, and no one who dies that way planned it.

Nearly all street heroin is now mixed with fentanyl, and sometimes it is only fentanyl. The problem is that fentanyl is very potent. This means that the risk of accidental overdose is very high.

If you think you can manage and avoid relapse, there are other dangers to consider as well. It is possible to get HIV and/or Hepatitis C infections from using needles. It is also possible to spread other kinds of infections. Endocarditis is an infection of the heart that involves bacteria colonizing the heart valves.

It is clear that heroin is a deadly drug in many ways. Even when it does not kill, it takes over. Patients often describe the point where using stopped being about getting high at all, and the whole day became about not getting sick.

You may still be getting through work and still living with your family. Yet, heroin tends to keep taking, sometimes all at once and sometimes one piece at a time.

How do you get started on buprenorphine when you are still using heroin?

You start at home, with your doctor a phone call away, and not in the first hour after you decide. Buprenorphine, the medication in Suboxone and ZubSolv, attaches to the same receptors that heroin uses, and it holds on harder. If it arrives while heroin is still sitting on those receptors, it pushes the heroin off and can bring on withdrawal within an hour or two instead of relieving it. That is the whole reason for the wait.

So, the first dose usually waits until opioid withdrawal has clearly begun, and the timing is worked out with your doctor rather than guessed. Yet, the wait is usually short, even if it is unpleasant.

Patients often try to be precise about how much heroin they use, in bags, in caps, or in grams. Does the number matter? Less than you would think. In fact, nearly all street heroin now contains fentanyl or is only fentanyl, and a gram on a scale is a gram of something unknown. Your doctor will ask anyway, and then plan for the fentanyl rather than for the number.

While a long wait for full withdrawal was the standard way to start, fentanyl has changed the timing, and when fentanyl is involved Dr. Leeds often starts buprenorphine at a low dose and builds up instead. In Dr. Leeds’ practice the start is done at home, by telemedicine anywhere in Florida, with phone support through the first doses, and in-office visits are available in Fort Lauderdale. The details of buprenorphine treatment have their own page.

Methadone is the other medication that works for heroin, and in the United States it is dispensed through a licensed methadone clinic rather than a private doctor’s office. Whichever medication you start, keep naloxone, sold over the counter as Narcan, where you can find it in the dark, before the first dose and for a long time after. The wait is short. How long the treatment continues is a decision that you and your doctor make together, later.

Can a smell bring back heroin cravings years after you quit?

Yes, and if you found this page by asking what heroin smells like, the honest answer comes first. Pure heroin has no smell, heroin that has sat open in the air smells faintly of vinegar, and neither fact tells you what is in a bag today, since nearly all of what is sold as heroin now contains fentanyl or is only fentanyl. Yet, a smell can do something to a person in recovery that has nothing to do with what is in the bag.

The amygdala, the part of the brain that attaches emotion to memory, sits next door to the smell centers, and it files the smells of using right alongside the feelings. A lavender shampoo, a lawn mower engine, or a particular bar of soap can open that file years later without warning. Patients often describe the craving arriving before they have worked out what they smelled.

A craving is not a decision. It is a symptom that rises, peaks, and passes, and it passes faster when there is no easy way to act on it and someone to call while it does.

So, much of the practical work of recovery is putting distance between you and the drug, and every craving that is waited out makes the thinking part of your brain a little better at waiting out the next one. There is a full discussion of triggers, including what to do about the dealer’s number in your phone, in the article on addiction triggers.

While a craving that passes in an hour is not a reason to go back on buprenorphine, a craving that keeps coming back is a reason to call your doctor, and it is not a failure to make that call. Addiction has a way of editing memories, and the worst months of your life can come back to you as good ones. The craving will pass. It passes sooner when the drug is far away.

Is it dangerous to use heroin with Xanax, Klonopin, or another benzodiazepine?

Yes, and the danger is one that the U.S. Food and Drug Administration, or FDA, put inside a black box. A black box warning is literally a black box with a warning in it, at the top of a drug’s official label. When the FDA updated that box on every benzodiazepine in September of 2020, the first thing it said was that taking a benzodiazepine with an opioid can cause profound sedation, respiratory depression, meaning slowed breathing, coma, and death.

Heroin kills by turning down the part of the brain that tells you to breathe. While Xanax, also known as alprazolam, rarely stops breathing on its own, it deepens the sedation and may quiet the alarm that would normally wake a person who is not getting enough air. Together, they can slow breathing until the brain is starved of oxygen, and the person simply does not wake up.

The part that catches people is tolerance. A dose of heroin that you have handled a hundred times, and a dose of Xanax that you have handled a hundred times, can be deadly the first time they land in your body together. Fentanyl in the heroin supply makes that arithmetic worse, and alcohol, which works on the same calming receptors in the brain as the benzodiazepine, makes it unpredictable.

Narcan, or naloxone, is sold over the counter now, and anyone who uses heroin should have it within reach. Yet, naloxone only reverses the opioid. It does nothing for the benzodiazepine, so a person who has taken both may stay sedated and can stop breathing again after the spray. Call 911 every time.

Can a detox get you off of both drugs at once?

Not safely, and this is the danger that nobody warns you about. Why not? Your body has adapted to two different drugs, and each one has its own withdrawal syndrome.

Physical dependence is not addiction. It is what a nervous system does after months of a drug, whatever brought you to the drug, and both dependences deserve medical treatment rather than a lecture.

While opioid withdrawal is terrible, it is rarely dangerous by itself, and buprenorphine relieves it. Benzodiazepine withdrawal is the other kind. Stopping Xanax, Klonopin, or Ativan suddenly after months of daily use can cause seizures, and the same 2020 label update says so in plain language.

Unfortunately, the detox and rehab industry tends to treat both drugs as one problem with one solution. The insurance plan pays for seven days, or fourteen, or thirty, so the benzodiazepine is stopped on day one or rushed off in a week, and the patient is sent home “substance free by discharge.” A seizure does not care what the brochure calls it. Some programs do know the difference, and the way to find out is to ask.

So, the two drugs call for two different plans from the same doctor. The opioid side is treated with buprenorphine, for as long as you and your doctor agree that it is needed. Can you take Suboxone and a benzodiazepine together at all? That is a question with its own answer, and it deserves a straight one from the doctor prescribing both.

The benzodiazepine side is handled the way benzodiazepine dependence should always be handled, with a gradual taper that usually takes months, at a pace your nervous system can tolerate, worked out with your doctor as you go. It is not a bad idea to ask any program, before you sign anything, what happens to your Xanax on day one.

Fortunately, there is a very effective heroin treatment, buprenorphine, that makes stopping heroin bearable and helps you to get back to a normal life. It is long-term medical treatment, taken for as long as you and your doctor agree that it is needed, and it is not a quick fix. Heroin has had more than enough of your attention, and the energy belongs on the treatment now. If you live in Fort Lauderdale, Broward County, or anywhere in Florida, contact Dr. Leeds and discuss how to get started by telemedicine.

Call 911 right away if someone who has used heroin, with or without a benzodiazepine, cannot be woken, is breathing very slowly or gurgling or not at all, or has blue or gray lips or fingertips. Give naloxone if you have it, and stay with the person until help arrives.

Naloxone does not reverse a benzodiazepine, so call 911 even if the person wakes up. If you are thinking about ending your life, call or text 988, the Suicide & Crisis Lifeline, at any hour.

This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.