La heroína actúa como depresor del sistema nervioso central. Sus efectos y señales incluyen:

• Intense initial euphoria followed by drowsiness and apathy.
• Very constricted pupils (miosis).
• Slowing Down de la respiración y el pulso, y descenso de la tensión arterial.
• Nausea, vomiting, and constipation.
• Decreased pain and decreased sexual desire.

In the event of overdose (very slow or absent breathing, blue lips or skin, inability to wake up) act immediately: see the highlighted notice below.
Withdrawal Syndrome (al dejar tras un consumo prolongado): ansiedad, inquietud, dolores musculares, sudoración, lagrimeo, bostezos, pupilas dilatadas, piel de gallina, náuseas, vómitos, diarrea, insomnio y deseo intenso de consumir (craving). Es muy incómodo, pero no suele ser mortal por sí mismo (sí puede causar deshidratación si los vómitos y la diarrea son intensos); por eso se controla con supervisión médica. Importante: la abstinencia del alcohol or benzodiazepines —which is common among poly-drug users— can indeed be dangerous, and this is also taken into account.

Heroin use often coexists with other mental disorders (dual diagnosis): depression, anxiety, personality disorders, and, often, the use of other substances (alcohol, benzodiazepines, cocaine). After years of use, it is also common to see a decline in physical health and social functioning. We assess and treat addiction, associated disorders, and the global health, not just consumption.

Heroin use, especially when injected, can be associated with serious complications. Not everyone has them:

• Overdose with respiratory depression, which can be fatal.
• Infections through the sharing of equipment: HIV, hepatitis B and C, skin and heart infections (endocarditis). The hepatitis C dispone hoy de tratamientos que consiguen eliminar el virus en la mayoría de los casos, y existe vacuna frente a la hepatitis B.
• Respiratory: pneumonia, pulmonary edema.
• Cardiovascular: arrhythmias.
• Others: constipation, kidney problems, sleep disturbances, and decreased libido and fertility.
• Adulteration with fentanyl or nitazenos, which are much more potent opioids that increase the risk of overdose.

An initial medical evaluation, infection screening, and harm-reduction measures protect your health from the very beginning.

It combines medical and psychological approaches and is typically a long-term process. It doesn't require you to come in with a perfect plan: We'll start where you are. Includes:

• Medical Evaluation primary care and general health, including screening for HIV and hepatitis.
• Treatment with agonists when indicated—methadone or buprenorphine (alone or in combination with naloxone)—. It's not about “swapping one drug for another”: es una medicación pautada y supervisada por un médico, en dosis estable y controlada, que estabiliza el sistema opioide, interrumpe el ciclo de intoxicación-abstinencia y reduce de forma significativa el riesgo de mortalidad. Es uno de los abordajes con mayor respaldo científico en la dependencia de opioides y puede mantenerse el tiempo que la evolución clínica aconseje.
• Detoxification and Withdrawal Management with medical support.
• Individual Psychotherapy con respaldo científico (terapia cognitivo-conductual, entrevista motivacional, prevención de recaídas) y trabajo con la familia cuando está indicado.
• Harm reduction y prevención de la sobredosis: te informamos sobre cómo actuar y sobre el acceso a la naloxona.
• Continuity and Coordination: We focus on treatment retention and coordinate your physical health and social situation; if you take a break, you can come back.

Not everyone starts out with the same goal: for some people, it's to stop using drugs; for others, it's first to reduce risks and regain their health and stability. All of these are legitimate goals, and the plan is decided together with you. Our proprietary model, the Unified Transdiagnostic Model (MUT), integrates and coordinates the treatments with the strongest scientific backing—both medical and psychological—and tailors them to your needs. Outpatient or inpatient care, depending on the case.

This treatment is part of our substance abuse treatment in Madrid, where we also addressed the cocaine, the alcohol and the cannabis. We also cover the mephedrone and the nitazenes. You can learn more about our addiction treatment center in Madrid, the detox center and the outpatient treatment.

The primera valoración es una entrevista clínica en la que un profesional sanitario del equipo revisa tu caso y te orienta, sin compromiso. Si a partir de ahí se establece un plan de tratamiento, las sesiones de psicoterapia individual parten de 85 €; el plan completo se detalla en esa misma entrevista, antes de empezar y sin cargos añadidos.

La frecuencia se define después de la primera valoración, con el profesional sanitario que lleve el caso, y se ajusta según la evolución del tratamiento.