Heroin Relapse – The Rates and the Risks of Taking the Drug Again

Strangely enough, relapse is a part of recovery. However, heroin relapse is dangerous due to the high risk of death caused by overdose.

Heroin Relapse

When someone stops using heroin, the body’s tolerance for the drug goes away. Cravings may not. When restarting the drug, a user will use the same amount as they did before they stopped. With tolerance gone, the flood of heroin shocks the brain and slows down breathing so much it stops. To keep everything going like normal, the user will take the drug again. As a result, you have a case of heroin relapse.

How to prevent heroin relapse?

Recovery from heroin is possible with comprehensive treatment. It must focus on biological and behavioral risk factors. Medication-assisted treatment can prevent overdose and relieve withdrawal symptoms. Behavioral and mental health counseling can deal with underlying issues. Furthermore, long-term peer support can help build a heroin-free lifestyle.

Why is heroin relapse so dangerous?

The main reason heroin relapse is dangerous is the mismatch between the body’s tolerance and a person’s craving. Of course, it depends on how long and how much a person was using before quitting. Maybe they will restart with the dosage they were using before, and the body no longer has a tolerance. Then, likelihood of overdose is very high. With tolerance gone, the flood of heroin into the brain slows down breathing so much it stops.

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Heroin relapse rates. Why is it so high?

“Heroin-related overdose deaths have more than quadrupled since 2010.” This is according to data from the Centers for Disease Control (CDC). A severe enough statistic for the CDC to classify death from opioid-related drugs an “epidemic,”. However, it is unclear how many of them are relapse related.

Relapse rates are very high for any opiate addiction including heroin regardless of the method of treatment. With increased national attention on the problem, more resources are pouring into medication-assisted treatment. As a result, it is showing positive results. However, recovery from heroin is a complicated process.

In the beginning, heroin addiction is a positive experience. First, it might be someone starts with prescription opiates and graduates to heroin. Second, it can be that they started with heroin, users report it makes them feel good, and they enjoy it. As the body develops tolerance, it needs more of the drug to feel good. Consequently, the bad feelings associated with withdrawal are more pronounced. You need heroin not to get sick. Eventually, life becomes centered around heroin—getting it and using it. Once life centers around heroin, a person seems to be little choice in the matter.

Heroin relapse risk: biological and behavioral reasons for relapse

There are biological and behavioral factors to consider when assessing the risk of relapse. Biologically, the brain becomes used to large amounts of heroin. This leads to painful withdrawal symptoms and intense cravings. Medication-assisted treatment with methadone, buprenorphine, or naloxone can help calm these effects and prevent overdose.


As mentioned before, people addicted to heroin center their lives around getting and using the drug. Consequently, this means lifestyle changes are necessary when they quit. Before addiction set in, heroin served a purpose for the individual taking it. Without an alternative, a person is likely to return to heroin to fulfill that purpose.

Also, the ritual of getting and using heroin can cause conditional responses to develop. They refer to conditional responses in addiction treatment as triggers. Furthermore, it can be anything such as people, places, smells, drug paraphernalia, music or environments. When a trigger confronts someone with a history of heroin abuse, cravings intensify. As a result, the ability to “just say no” decreases significantly. Triggers are strong behavioral cues, and you need to substitute that with healthier activities.

Social aspects of using are another significant factor for relapse. Someone’s entire life may revolve around heroin use. Then, all their friends and associates are likely involved in heroin use. Asking someone to get rid of social connections can be devastating. Therefore, you need to provide an alternative to replace those social connections.

What to do to prevent heroin relapse

There are so many behavioral and biological factors increasing the risk of relapse. Therefore, it is best to get whole person treatment which includes:

  • Address physical cravings and withdrawal symptoms with medication-assisted treatment.
  • Behavioral therapy to deal with issues related to finding a new purpose in life. It should include identifying and resolving triggers, and building recovery-focused social connections.
  • Mental health counseling to address underlying issues related to drug use and the purpose that the drug fulfilled.
  • Medical services for health complications related to heroin use.
  • Family- and community-based recovery supports including legal, educational, and vocational services
  • Peer support to build comprehensive lifestyle changes and give long-term recovery support.

Not all communities have treatment systems that meet the needs of those seeking help. There are other barriers to treatment as well. It includes an inability to pay for services, failure to get to services because they are far away, or lack of supportive others. By knowing what can help a person in recovery, families and supportive others can help fill in the gaps left by treatment services.

Who is most likely to relapse?

Anyone can experience a relapse while in recovery, but research shows several things increase the chances:


  • Anxiety-related mental health issues
  • No personal connections to lead them through treatment
  • Bad experiences while in treatment or with a treatment provider
  • Nothing to do with their time once they quit
  • No support with finances, jobs, or other life issues once they get out of treatment

Also, heroin users are used to instant gratification. Therefore, waiting lists to begin treatment or between levels of treatment increase the chance of relapse. For example, one might wait a week to get into an inpatient program following detoxification. On the other hand, they might be waiting to get into an outpatient program following an inpatient program. Most users relapse within days of exiting a treatment program.

What to do if you or someone you know relapses?

Are you or someone you know a high risk for a relapse or did they experienced a relapse? Then, seriously consider medication-assisted treatment as an option. These medications significantly decrease the risk of death by overdose. They will cut physical cravings and withdrawal symptoms, and block the high.

Evaluate the treatment. If the person in recovery is not involved in a comprehensive treatment program according to best practices, consider options available. Then, fill in the areas not covered and help them with those areas outside of treatment services. For example, maybe treatment focuses on behavioral triggers and not the use. Then, consider supplementing that with the pursuit of education or vocational training.

Heroin relapse is dangerous due to the high risk of death from overdose. Someone might use heroin at the same level they were using before they quit. However, the body no longer has a tolerance. The person’s craving is the same, and they end up taking too much.

As a result, this causes the breathing to slow to a stop. In most cases, medication-assisted treatment can prevent overdose and relieve withdrawal symptoms. Comprehensive, whole-person treatment can offer alternatives to a heroin-focused lifestyle. Fortunately, recovery from heroin is possible. Ultimately, it must come with a full treatment that focuses on biological and behavioral risk factors.

Heroin Relapse – The Rates and the Risks of Taking the Drug Again

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