Heroin Rehab in New York City
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Fentanyl has overtaken heroin in New York City's drug supply. In 2024, fentanyl was involved in 73% of NYC's 2,192 overdose deaths, while heroin was involved in 21%, according to the NYC Health Department. Fentanyl is 50 to 100 times more potent than morphine, according to the CDC, and people who believe they are using heroin may be using fentanyl without knowing it, which makes every use a potential overdose.
Is heroin still being sold in NYC?
Much of what is sold as heroin in New York City today contains illicit fentanyl — either mixed with heroin or sold in its place. Drug traffickers shifted to fentanyl because it is cheaper to produce and more profitable per dose. Users who believe they are buying heroin cannot distinguish it from fentanyl without drug checking. The NYC Health Department offers drug checking services at select syringe service program sites — but the safest path out of fentanyl dependency is supervised detox and inpatient treatment.
What is fentanyl-xylazine and why is it more dangerous?
Fentanyl is commonly cut with xylazine — a veterinary tranquilizer that extends the sedative effect and is cheap to source. Xylazine is not an opioid, so naloxone (Narcan) does not reverse xylazine-related sedation. A person experiencing a fentanyl-xylazine overdose may briefly respond to naloxone and then lose consciousness again. Xylazine also causes severe, recurring skin wounds at injection sites that can become necrotic. In 2024, xylazine was present in 21% of NYC overdose deaths, according to the NYC Health Department.
What is medication-assisted treatment for heroin or fentanyl?
Medication-assisted treatment (MAT) uses FDA-approved medications — primarily buprenorphine (Suboxone), methadone, or naltrexone (Vivitrol) — to manage cravings, suppress withdrawal, and reduce overdose risk. MAT is the gold standard for opioid use disorder and significantly reduces overdose mortality. Buprenorphine (a partial opioid agonist) and methadone (a long-acting full agonist) stabilize brain chemistry without the highs and crashes of illicit opioids. Naltrexone is an opioid antagonist that blocks the effect of opioids entirely — it requires full detox before initiation.
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What does heroin or fentanyl detox feel like?
Opioid withdrawal is described as an intense flu combined with severe anxiety, insomnia, muscle cramps, nausea, vomiting, and an overwhelming compulsion to use. It is rarely life-threatening but is almost universally described as unbearable without medication. Medical detox with medications such as buprenorphine or methadone relieves withdrawal symptoms, according to MedlinePlus, which also notes that symptoms usually start within 12 hours of the last heroin use. Post-acute withdrawal symptoms (PAWS) — including fatigue, mood disturbance, and sleep disruption — can persist well after the acute phase.