Substance use
Heroin addiction treatment in Ohio
Heroin is assessed and treated as opioid use disorder, with the fentanyl content of the current supply changing withdrawal timing and how medication is started. Ambulatory detox is available for mild to moderate withdrawal.
- Ambulatory detox
- Available for this substance
- Treated at
- Ambulatory detox, Partial hospitalization, Intensive outpatient, Outpatient, Virtual IOP
- Where
- Columbus, Dayton
- Admissions
- (614) 665-8878
Diagnosis and supply
There is no separate diagnosis for heroin. It is assessed as opioid use disorder against the eleven DSM-5-TR criteria, and severity follows how many you meet.
What has changed is the supply. Much of what is sold as heroin now contains fentanyl, and some of it is fentanyl alone. Fentanyl builds up in body fat and leaves the body slowly, so withdrawal can start later than expected and last longer. Xylazine also turns up in the supply. It causes heavy sedation and skin wounds, and naloxone does not reverse it. Give naloxone anyway in a suspected overdose, since opioids are usually present.
Withdrawal timing
- Onset
- 8 to 24 hours after last use.
- Peak
- first three days, easing over roughly a week.
- Sleep, mood and craving
- weeks longer.
- Usual symptoms
- aching, cramping, vomiting, diarrhea, insomnia.
Ambulatory detox at Leora
Heroin and fentanyl are both in the scope of Leora's ambulatory detox, which runs at both facilities. Nurse practitioners and registered nurses assess you and monitor you through the acute phase. Medication for symptoms is prescribed as needed. You sleep at home.
It is limited to mild to moderate withdrawal that does not need 24/7 medical supervision, and not everyone is a candidate. Leora has no beds and does not provide inpatient or overnight care. If the assessment points to inpatient care, you are told so.
Say plainly at the assessment if you have been injecting. Abscesses, infected sites and fever need medical attention a therapy group cannot provide.
Medication
There is no fixed end date for medication. Stopping early raises the risk of return to use and overdose, so the timing belongs in the plan.
- Buprenorphine, usually taken with naloxone in a combined film or tablet, holds withdrawal and craving down. Leora's medication assisted treatment uses it.
- Extended release naltrexone blocks opioid effects for a month at a time. It cannot start until you have been off opioids for seven to ten days, so it follows detox.
- Methadone can only be dispensed through a federally certified opioid treatment program, not by a general outpatient provider. Leora does not publish that it holds that certification. Ask admissions.
- Tell the prescriber about alcohol, benzodiazepine or stimulant use. It changes overdose risk and what can be prescribed safely.
Levels of care
- Partial hospitalization
- 5 days a week, about 6 hours. 4 hours of group therapy, 1 hour of relapse prevention, 1 hour of nurse education, plus 1 to 2 individual appointments. Lunch provided, nurse practitioner weekly.
- Intensive outpatient
- 3 to 5 days a week, 3 hours of group a day, 9 to 15 hours a week. Nurse practitioner every 2 to 3 weeks.
- Outpatient
- 1 to 2 days a week, 2 hours of group plus individual appointments.
- Virtual IOP
- fully remote, anywhere in Ohio, with morning, afternoon and evening sessions.
- Alongside
- case management, peer recovery support and an alumni program after discharge.
Risk after a break
Withdrawal is rarely fatal in itself, though vomiting and diarrhea can dehydrate someone badly, which matters more if another medical condition is in the picture. The danger comes after. Tolerance drops within days, so a familiar amount can kill in the first weeks after any break in use. Keep naloxone, since fatal overdoses usually happen when a person is alone. Ohio's Project DAWN sites distribute it free.
Common questions
Is heroin withdrawal life threatening?
What if what I have been using is really fentanyl?
Can heroin withdrawal be managed as an outpatient?
How long do I stay on medication?
Where can I get naloxone in Ohio?
Where this is offered
Hope inspired
Talk to admissions about the right next step.
Outpatient addiction and mental health treatment in Columbus and Dayton, Ohio, from ambulatory detox to outpatient therapy groups. Walk-ins welcome. Call now, or leave your number and admissions will call you back.
