3. withdrawal (or detoxification)

The goal of withdrawal (also called detoxification) is neuroadaptation reversal, which is getting over the physical dependency and removing the drug from your body. Detoxification is also a time when you can reflect on your drug use and set some future goals. There are a number of different settings for withdrawal programs in Victoria:

residential withdrawal (inpatient);
outpatient withdrawal (when you go to the clinic each day and collect medication or see a counsellor); and
home-based withdrawal (when a nurse or counsellor comes to you in your home and provides support).

Aside from the setting (where it takes place) there are different withdrawal medications that can be used. For alcohol withdrawal, you are usually given medications to help you relax and sleep, and reduce the risk of seizures. For heroin withdrawal there are three main types of medications:

medications to help you with specific symptoms of heroin withdrawal such as loperamide (Immodium) for diarrhoea, metoclopramide (Maxolon) for nausea, ibuprofen (Brufen) for muscle aches and pains, and sedatives to help you sleep and so on;
medications to help you come slowly down (like short-term methadone or buprenorphine); or
medications that actually provoke a severe withdrawal but it lasts a short amount of time (naltrexone).

These three different types of medications are all different programs, so you need to discuss and check out which one you think will suit you. See 'Pharmacotherapy maintenance programs' below.

The really important parts of withdrawal are:

having a calm and supportive environment;
appropriate symptom management (usually pharmacotherapy); and
development of a plan for further treatment after withdrawal has been completed.

It is important to note that withdrawal by itself may not be enough to achieve long-term behaviour change. You may need to link up with some form of counselling, support or therapy after you have finished the physical withdrawal (usually around one week).