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If a heroin user is hooked and wants to end the cycle of chasing the high, there are several treatment options available.

After an individual evaluation, major treatment steps include detoxification, inpatient treatment, halfway houses and outpatient treatment, depending on a client's needs.

To determine the most appropriate level of care for people struggling with drugs or alcohol, clinicians use the Pennsylvania Client Placement Criteria for Adults, a standardized set of guidelines.

If patients are still using heroin, they must first go to a detox facility to rid their bodies of the drug, said Donna Wampole, a licensed clinical social worker at WellSpan Behavioral Health in Spring Garden Township.

The detox process is usually brief — about three to seven days, but usually around five, she said.

With special licensing to treat opioid addiction, doctors can prescribe medications that help curb withdrawal symptoms, making the process "a bit less miserable," Wampole said.

Rehab: After detox, it's important to continue treatment in other forms, said Sarah Hawkins, campus director for White Deer Run of York, a detox and inpatient center in Springettsbury Township.

"We can detox people over and over, but being able to stay in treatment at different levels of care gives people the best chance of staying in recovery," she said.

"We really support that continuum."

After detoxifying their bodies, patients are then encouraged to go to inpatient treatment — rehab — if funding's available, Wampole said.

Once they are stabilized, they're usually pulled off medications they were taking for withdrawal symptoms and begin cognitive behavioral therapy, she said.

They can stay for up to 90 days, but many stay for 21 to 28 days, Wampole said.

Halfway houses: After rehab, clients often continue structured, residential treatment in the form of a halfway house, a sober-living facility that provides services for those recovering from substance abuse, the PCPC states.

This type of living space is meant to provide a "home-like" atmosphere — with no more than 25 beds — that gives no indication of being an institutional setting, according to the guidelines.

Residents receive help with economic and social adjustment, such as finding a job and establishing a support system, and typically stay for three to six months, according to the PCPC.

Outpatient: Once a client is ready to live on his or her own, outpatient treatment options offer ongoing support.

Outpatient treatment offers social support and education about what goes on in the brain of an addict, as well as skills that can help clients cope and avoid potential relapse triggers, Wampole said.

In early recovery, support is vital, whether it's attending 12-step meetings or simply being able to connect and share with people, said Antoinette Sacco, CEO of Colonial House Inc., which has both an inpatient and outpatient location in York County.

Recovery is a lifelong effort, but it gets easier, she said.

Transformation: At Clarity Way in Heidelberg Township, a holistic approach can turn someone's whole treatment around, said marketing director Sharon Reilly.

Group exercise, stretching, yoga and meditation can make all the difference — some people can only walk a few steps when they enter treatment, and by the time they leave, they can walk a few miles, she said.

Hawkins said users who complete treatment at White Deer Run of York make noticeable physical improvements and have a renewed spirit.

The facility takes photos of clients upon admission, and by the time most patients enter the inpatient rehab, they are "really at their worst," she said.

Guilt, shame and low self-esteem bear down on users, but during treatment, as one becomes hopeful for a different life when he or she leaves, those layers peel away and begin to reveal the person inside, Hawkins said.

Sometimes, she said, she catches a glimpse of a patient's photo on his or her chart, and "it's like a completely different person."

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