Heroin and Opioid Rehab
for Men in Arizona

Opioid calls come in two shapes. One is a man who was prescribed something after an injury or a surgery, did what the doctor said, and found years later that he could not stop. The other is heroin, and more and more, heroin that is really fentanyl. Often it is the same man at two different points.

This page is for both, and for the wife, mother or brother calling on his behalf. If you read one section, read the overdose section. If it is fentanyl you are dealing with, the fentanyl page goes further.

Signs of heroin use, and the signs of opioid addiction

The signs someone is on heroin or pills in the moment are hard to miss once you know them: pinpoint pupils, heavy eyelids, nodding off mid-sentence, a slow voice, scratching. The signs of heroin use over time are about what goes missing: money, possessions, time he cannot account for, long sleeves in summer, and spoons, foil or small bags turning up.

The signs of opioid addiction that matter more than any single one of those are about control:

• He runs out of a prescription early, or is getting it from more than one place.
• He gets sick, sweaty and restless when he goes without, and feels better once he uses.
• He has tried to stop and gone back within days.
• Pills became powder, or swallowing became smoking or injecting.
• He is using more than he used to for the same effect.

You do not need to be sure to call. Admissions will not ask you to prove anything.

Opioid overdose, and why every house needs naloxone

This is the most important section on this page, so here it is plainly: if he cannot be woken, is breathing very slowly or not at all, or his lips are turning blue, call 911 and give naloxone if you have it. If he is talking about not wanting to be alive, call 911, or call or text 988.

MedlinePlus is clear that naloxone can reverse a heroin or other opioid overdose if it is given in time, that there are forms anyone can use without medical training, and that people at risk are encouraged to carry it. It is sold as Narcan. If there are opioids in the house, there should be naloxone in the house, and everyone should know where.

The most dangerous days are not always the ones people expect. They are the days after he stops: after a detox, after a program, after release from jail or prison. Tolerance drops quickly, and a dose he used to handle can kill him. That is the single strongest reason not to let a detox end in an empty week at home.

Heroin and fentanyl, which are now the same conversation

MedlinePlus reports that most heroin in the United States is now combined with illegally made fentanyl, and that nobody using it knows the actual strength of what they are taking. NIDA says the great majority of recent overdose deaths involved illicit fentanyl and other synthetic opioids.

So a man who says he uses heroin is almost certainly using fentanyl as well, whether he knows it or not. That changes the medical picture at detox and it is why the overdose section above is not an exaggeration. The fentanyl page covers what that means for treatment in more detail.

From pain pills to heroin

A lot of men here started with a prescription. MedlinePlus notes that opioids are often prescribed after a major injury or surgery, and that some people later switch from prescription opioids to heroin because it is cheaper and easier to get. That is not a moral story. It is a supply story, and admissions hears versions of it from veterans and from men with old injuries.

If he is still on pills rather than heroin, the prescription drug page is written for that. If the pain is real, and it often is, it is part of the assessment here rather than something to be dismissed.

Heroin detox, and why opioid detox at home rarely holds

Holdfast is not a detox facility. For heroin and other opioids, a medical detox is usually the first step. Opioid withdrawal is rarely dangerous in the way alcohol withdrawal can be, but it is severe enough that men who try it alone almost always use again to make it stop, and the tolerance they lose in those few days is what makes that next dose dangerous.

That is the problem with opioid detox at home. It is not that it cannot be survived. It is that it so rarely holds, and the way it fails is the most dangerous way it could. Admissions finds a detox that fits, speaks to the intake nurse for you, and collects him when he is medically clear so he comes straight into treatment. That is how detox placement works, including for men traveling in from other states.

Heroin withdrawal symptoms, and the opiate withdrawal timeline

MedlinePlus covers opiate and opioid withdrawal in plain language, and it is the right place for the clinical detail. We are not going to publish a heroin withdrawal symptoms checklist or an opiate withdrawal timeline here, because it depends on what he has been using, how much, how long, and whether fentanyl is in the picture, and a detox physician can tell you that in ten minutes.

What we will say is what it means for planning. The acute part is measured in days. The harder part, when sleep does not come back and nothing feels like much, can run for weeks after. That second stretch is when men relapse, and it is exactly what treatment after detox is for.

Medication for opioid use disorder, and staying on it here

NIDA reports that people treated with methadone or buprenorphine are less likely to overdose or die. If he is on one of them when he arrives, it continues. Suboxone is managed in the program. Methadone stays with his clinic, and admissions helps him get to his dose. Nobody is required to come off to be admitted, and whether to taper is a conversation he is part of.

What is not offered is medication on its own with nothing around it. The methadone and Suboxone page goes through staying on, coming off, and the overdose risk after a taper.

Heroin rehab, and what heroin addiction treatment covers here

Around ninety days, stepping down through levels rather than ending on a date:

• Residential, at AnchorPoint, our residential program in Prescott. Living on site, full days, the most structure.
• Partial hospitalization, clinical hours most of the day, with housing in the evenings.
• Intensive outpatient, fewer hours, with work starting to fit around them.
• Outpatient and sober living, where the structure comes off slowly rather than all at once.

Inside that: a full medical and psychiatric assessment in the first days, psychiatric care on site for the sleep, mood and anxiety that come with the first weeks, EMDR and trauma-focused therapy from early on, CBT and DBT, group work, and the twelve steps with a real sponsor. The therapies are set out here. NIDA's summary of treatment research is worth reading on why length and continuity get this much weight.

Speedballs, and heroin with stimulants

Some men are not using one drug. A speedball, heroin with cocaine, is named by MedlinePlus directly, and heroin or fentanyl with meth comes up on calls here too. MedlinePlus also notes that heroin with other drugs or alcohol increases the risk of overdose. Say everything on the call. A plan that hears about only one drug is a plan for the wrong ninety days. The cocaine and meth pages cover the other half.

When he is not ready, and you are the one calling

Many of these calls come from a wife or a mother whose man is hesitant. He knows. He is not ready to say yes.

You do not need him to agree before you start. Admissions can check his coverage, tell you which level of care fits and hold a plan ready while he is still saying no. That is how admissions works.

Take the practical objections off the table. Work is usually the biggest one. The page for working professionals covers FMLA and short-term disability and what an employer is told.

Keep naloxone in the house while you wait. Not because you expect the worst, but because it is the one thing that works if the worst happens.

Once he is a patient, his clinical information is his. We cannot discuss his treatment with you without a release he signs. What you do get, if he consents, is family therapy and regular updates. There is more for families and spouses here.

What is usually underneath it

Opioids are very good at turning off pain, and not only the physical kind. What admissions hears underneath is often depression, grief, trauma, and for veterans, both an injury and everything that came with it. Because we are licensed for dual diagnosis, that is treated here at the same time by the same clinicians. There is a separate page for veterans.

How much heroin rehab costs, and whether insurance covers it

Holdfast works with commercial insurance, and out-of-network benefits are usually worth considerably more than families expect. We work with TRICARE West policies, and admissions confirms yours before anything is booked. Admissions runs the real numbers against your actual plan before anyone commits to anything. You can check your insurance here, or read how paying for treatment works.

We do not work with Medicare or Medicaid, including AHCCCS or another state's plan. If that is your coverage, say so at the start of the call and admissions will point you to programs that take it. If he is leaving jail or prison, say that too, because the timing matters for both the detox and the overdose risk.

Christian heroin rehab, and what faith-based means here

Faith comes up on a lot of these calls, usually as a question: what does it mean day to day, and is the clinical side thinner?

Here it means the higher power is named as God rather than left blank, that chapel and scripture are part of the week, and that the twelve steps are worked with a real sponsor. The medication, if he is on it, is a clinical question and is handled clinically. You can see who the clinicians are and what they hold, how the program works for Christian men, and the clinical model.

Where to start

If he cannot be woken or is barely breathing, call 911 and use naloxone. If he is in a detox, a hospital or about to be released, call admissions today with the date. If he is still using, call anyway, because the detox placement takes the arranging and it can be started before he says yes. The phone is answered around the clock.