The entire detoxification process for opiate addiction is about 12-18 months and it happens in three separate stages. The bloodstream, which takes 3-7 days, the physical, which lasts from 60-90 days, then there’s the emotional and psychological detoxification, that starts about 4-6 months, That’s when the brain usually gets to some kind of chemical base line or relative thought process. The key is to get them to this point. Before this point, the brain is at a constant state of chemical incompetence. If anyone isn’t sure of the difference between a constant and a relative here is an analogy….. the sky is blue everyday, no matter what its blue, that is the constant, what is relative is the particular shade of blue in the sky at any given time in the day. After about two months of the brain maintaining this base line, the final detox happens. That is when the receptors and transmitters get to clarity. It happens in just about the same time it takes get hooked in the first place. It all comes back. That person that was lost due to this incompetence starts to emerge again. You can get clean and sober from everything else but with heroin you have to get clean then clear. The easiest way to understand is put a piece of paper in front of your eyes and say, “this is clean”, pull it away and say “this is clear” and repeat it a couple of times. It is important that everyone understands the current treatment plan is not even getting them half way through the physical detox. Now I’d like to break down the physical detoxification process. you will not die from heroin withdrawl. You want to die and you feel like your dying but you probably wont. The symptoms for the first 24-72 hrs are in order…profuse sweating, runny nose, tearing eyes, cold chills, vomiting, diarrhea, dehydration deep muscle pain, headaches, convulsive muscle spasms and bone and joint pain. Everything I just described is the central nervous system purging the body looking for opiates. After the first 12-24 hrs all of these symptoms are happening at once. When an addict says they cant be sick, this is what they are talking about. As these physical symptoms are happening, the psychological symptoms start. Anxiety, depression, anger, insomnia, bi-polar like actions and mild hallucinations. After anywhere from 3-7 days of this, the body starts to stabilize. The addict starts to crave two things besides heroin, Sugar and fluids, which will last 2-3 months. After 7-10 days the vomiting and diarrhea stops, but all of the other symptoms continue to occur for another 60-90 days, until the body is finally detoxed. The brain is still in a complete state of chemical incompetence that doesn’t start to change until 4-6 months of not having opiates or any other mood altering chemicals in the brain. At about the 4 month mark, the psychological withdrawl starts to increase. This is the second stage. This will last 4-6 months. At this point, the brain is trying to manipulate the the addict in any way possible to get high. The disease can no longer manipulate the body so now it moves to the emotional and rational part of the brain. These are trigger symptoms and some of them are, overconfidence, (thinking you can use and stop again), anxiety, depression, guilt, mistrust, money, (either having it, or not having it). One of the other symptoms in this stage is laughing or crying at any given time for no apparent reason. It just happens. I just need to add this. At just about the 30 day point there is a big overconfidence trigger, which relates to the addict in rehab. Finally if the addict makes it to the 6-8 month mark without any major chemical influences, the last step in the process happens slowly. At first the the receptors and transmitters and all that good stuff in the brain starts to come back. Rational thought starts to take hold, the addict’s brain is now at a chemical baseline which it it probably hasn’t been at since they became addicted. Now the addict has finally got clean and clear. Clean from the body and clear in the brain, There is a huge responsibility on the addict to stay clean, but you have to get them to a point of chemical competence so they can fully accept their responsibility.