Home/Substances/Heroin

Heroin Addiction Treatment

Find professional treatment for heroin addiction. Browse 12 specialized treatment centers offering evidence-based recovery programs across Canada.

Call: +1-877-254-3348

Understanding Heroin Addiction

Heroin is a highly addictive opioid drug synthesized from morphine, which comes from opium poppy plants. It appears as a white or brown powder, or as a black sticky substance known as "black tar heroin." Once Canada's most feared illicit opioid, heroin use has declined as fentanyl has overtaken the drug supply. However, heroin addiction remains a significant problem, and today's street heroin is frequently contaminated with fentanyl—making it far more dangerous than ever before.

Heroin can be injected, snorted, or smoked. When injected, it reaches the brain within seconds, producing an intense "rush" of euphoria. This rapid onset makes heroin extremely addictive—many users report becoming dependent after just a few uses. With repeated use, the brain adapts by reducing natural opioid production and decreasing receptor sensitivity, leading to tolerance (needing more to feel effects) and physical dependence (experiencing withdrawal without the drug).

Overdose Risk

Heroin suppresses breathing and heart rate. Overdose causes respiratory failure and death within minutes.Today's biggest risk: fentanyl contamination. Street heroin may contain unpredictable amounts of fentanyl, dramatically increasing overdose danger.

Warning Signs

  • • Track marks or scarring from injection
  • • Constricted (pinpoint) pupils
  • • Drowsiness, "nodding off"
  • • Slurred speech, slowed movements
  • • Withdrawal symptoms (sweating, vomiting, muscle aches)

Treatment Works

Medication-Assisted Treatment (MAT) with buprenorphine or methadone reduces overdose deaths by 50% and significantly improves long-term recovery rates. Combined with behavioral therapy, recovery is possible.

Heroin in Canada's Opioid Crisis

While heroin once dominated the illicit opioid market, fentanyl has largely replaced itin Canada's drug supply. Data from Health Canada shows:

  • • 96% of opioid deaths in 2022 involved fentanyl or analogues
  • • Pure heroin without fentanyl is increasingly rare
  • • Many people seeking heroin unknowingly consume fentanyl
  • • Treatment approach is the same for both: Medication-Assisted Treatment (MAT)

Source: Health Canada Opioid and Stimulant-related Harms (March 2023)

How Heroin Affects the Brain and Body

Heroin enters the brain rapidly and converts back into morphine. It binds to opioid receptors throughout the brain, spinal cord, and other organs. This produces several effects:

  • • Euphoria ("rush"): Intense pleasure from dopamine flooding the reward system
  • • Pain relief: Blocking of pain signals in the nervous system
  • • Sedation: Deep relaxation, drowsiness, mental clouding
  • • Slowed breathing: Depressed respiratory function (can cause death in overdose)
  • • Reduced heart rate: Slowed cardiovascular function

With repeated use, the brain undergoes neuroadaptation: natural endorphin production decreases, opioid receptors become less sensitive, and the brain becomes dependent on external opioids to function normally. This creates both tolerance (needing more for the same effect) and physical dependence(experiencing withdrawal when the drug wears off).

Health Consequences of Heroin Use

Short-Term Effects

  • • Immediate: Euphoric rush, warm flushing, dry mouth, heavy limbs
  • • Following hours: Drowsiness, clouded thinking, slowed breathing/heart rate
  • • Overdose risk: Respiratory depression, unconsciousness, coma, death
  • • Injection risks: Collapsed veins, infection at injection sites, blood-borne diseases

Long-Term Damage

  • • Infectious disease: HIV, hepatitis C (shared needles)
  • • Bacterial infections: Endocarditis (heart valve infection), cellulitis, abscesses
  • • Lung complications: Pneumonia, tuberculosis
  • • Liver/kidney damage: Especially from adulterants in street heroin
  • • Mental health: Depression, antisocial personality disorder
  • • Cognitive impairment: Memory problems, decision-making deficits

Heroin Withdrawal

Heroin withdrawal is not medically dangerous (unlike alcohol or benzodiazepine withdrawal) but is extremely uncomfortable and drives relapse. Symptoms begin 6-12 hours after last use and peak at 1-3 days:

Early Symptoms (6-12 hours)
  • • Muscle aches and pain
  • • Restlessness and agitation
  • • Anxiety and insomnia
  • • Sweating and tearing
  • • Runny nose and yawning
Peak Symptoms (1-3 days)
  • • Severe muscle cramps
  • • Nausea and vomiting
  • • Diarrhea and abdominal cramping
  • • Dilated pupils and goosebumps
  • • Rapid heartbeat
  • • Intense drug cravings

Acute withdrawal symptoms subside after 5-10 days, but post-acute withdrawal syndrome (PAWS)— anxiety, depression, insomnia, cravings—can persist for weeks or months.

Evidence-Based Treatment for Heroin Addiction

Medication-Assisted Treatment (MAT) is the gold standard for heroin addiction. Research consistently shows MAT reduces overdose deaths by 50%, improves treatment retention, and supports long-term recovery when combined with behavioral therapy.

FDA-Approved Medications for Heroin Addiction

1
Buprenorphine (Suboxone, Sublocade)

Partial opioid agonist that reduces cravings and prevents withdrawal without significant euphoria. Available as sublingual film/tablet (taken daily at home) or monthly injection (Sublocade).

  • • Can be prescribed by certified physicians/nurse practitioners
  • • Take-home dosing allows more flexibility than methadone
  • • "Ceiling effect" reduces overdose risk compared to full agonists
2
Methadone

Full opioid agonist dispensed daily at specialized clinics. Long-acting (24-36 hours) prevents withdrawal and reduces cravings. Highly effective for severe heroin addiction.

  • • Reduces overdose death risk by 50-75%
  • • Requires daily clinic visits initially (take-home doses earned over time)
  • • Strong evidence base—used for decades
3
Naltrexone (Vivitrol)

Opioid antagonist (blocker) given as monthly injection. Prevents heroin from producing effects, reducing relapse if use occurs.

  • • Requires 7-10 days completely opioid-free before starting
  • • Non-addictive (no opioid activity)
  • • Best for highly motivated individuals after completing detox

Treatment Duration: What the Research Shows

MAT works best when maintained for at least 12 months, with many experts recommending longer durations. Research shows:

  • • Staying on MAT for 12+ months reduces relapse by 50% compared to shorter durations
  • • Many individuals benefit from maintenance MAT for years (similar to managing diabetes or hypertension)
  • • Early discontinuation dramatically increases overdose risk due to lowered tolerance
  • • Treatment should be individualized—work with your medical team to determine the right timeline

Behavioral Therapies

MAT is most effective when combined with counseling and behavioral support:

Cognitive Behavioral Therapy (CBT)

Helps identify triggers for drug use, develop healthy coping strategies, and modify thought patterns that lead to relapse. Strong evidence for opioid use disorder treatment.

Contingency Management

Provides tangible rewards (vouchers, prizes) for verified abstinence through drug testing. Particularly effective for promoting initial abstinence during early recovery.

Group Counseling & Peer Support

Mutual-help groups (Narcotics Anonymous, SMART Recovery) and structured group therapy provide community, accountability, and learning from others in recovery.

Finding Heroin Treatment in Canada

When seeking treatment for heroin addiction, look for programs that offer:

  • • Medication-Assisted Treatment: Buprenorphine or methadone programs
  • • Medical detox capabilities: Safe withdrawal management if needed
  • • Dual diagnosis treatment: Many heroin users have co-occurring mental health conditions (depression, anxiety, PTSD)
  • • Infectious disease screening: Testing and treatment for HIV, hepatitis C
  • • Continuing care planning: Connection to ongoing MAT providers, counseling, and support groups after residential treatment
  • • Harm reduction services: Naloxone training, safe injection education for those not yet ready for abstinence

Harm Reduction: Staying Safe

If you're not ready for treatment yet, harm reduction strategies can save your life:

  • • Carry naloxone (Narcan): Available FREE at Canadian pharmacies—reverses overdoses
  • • Never use alone: Use with someone who can call 911
  • • Use fentanyl test strips: Test drugs for fentanyl contamination (available at harm reduction sites)
  • • Start small: Test dose potency before using a full amount
  • • Use clean needles: Prevents HIV, hepatitis C, and bacterial infections
  • • Know supervised consumption sites: Legal sites where trained staff can reverse overdoses immediately

Sources & References

1. National Institute on Drug Abuse (NIDA). Heroin Research Report. 2024.

2. Health Canada & Public Health Agency of Canada. Opioid and Stimulant-Related Harms. 2023.health-infobase.canada.ca

3. Canadian Research Initiative in Substance Misuse (CRISM). National Guideline for the Clinical Management of Opioid Use Disorder. 2023.

4. CAMH (Centre for Addiction and Mental Health). Opioid Use Disorder Treatment. 2024.

5. SAMHSA. Medication-Assisted Treatment (MAT). 2024.

6. Lancet Public Health. Effectiveness of Medication-Assisted Treatment for Opioid Use Disorder. 2023.

7. Journal of Addiction Medicine. Duration of Medication-Assisted Treatment and Relapse Rates. 2023.

Get Help for Heroin Addiction

Heroin addiction is dangerous and often deadly, but recovery is absolutely possible. Medication-Assisted Treatment combined with counseling gives you the best chance at long-term success. Don't wait— every day increases the risk of fatal overdose.

Call +1-877-254-3348Request Consultation

Find Heroin Addiction Treatment Centers

12 treatment centers specializing in heroin addiction across Canada

CCMA Certification Badge

Medically Reviewed By

Michael Leach, CCMA

ISSUP Certified | Nearly a decade of experience in addiction treatment and recovery services

View Full CredentialsLast Reviewed: February 2026

Disclaimer: This content is for informational purposes only and does not constitute medical advice. Treatment decisions should be made in consultation with qualified healthcare professionals.

Take the First Step Toward Recovery

Recovery from heroin addiction is possible. Connect with professional treatment programs and start your journey today.

Call Now: +1-877-254-3348Browse All Centers