The opioid epidemic has made heroin addiction a central concern for recovery professionals. While Narcotics Anonymous serves all drug addicts, Heroin Anonymous exists specifically for people whose lives have been affected by heroin addiction—offering focused identification for those who want it.
Understanding HA helps recovery professionals offer another option to clients struggling with opioid addiction, particularly those seeking heroin-specific community.
What is Heroin Anonymous?
Heroin Anonymous is a fellowship of people who have found a solution to their heroin addiction. Founded in 2004 in Phoenix, Arizona, HA adapts the Twelve Steps specifically for heroin addiction, providing a space where members share their common experience with heroin and its grip on their lives.
HA's First Step states: "We admitted we were powerless over heroin—that our lives had become unmanageable."
This specific focus distinguishes HA from NA's broader "addiction" language. For some people, naming heroin directly provides more powerful identification.
Who Attends HA?
HA primarily serves:
- People whose heroin use is or was central to their addiction
- People addicted to any opioid who identify with heroin addiction
- People who want heroin-specific fellowship
Like other Twelve Step programs, the only requirement for membership is a desire to stop using heroin. HA welcomes people regardless of other substance use, length of addiction, or recovery time.
The HA Program
HA uses the Twelve Steps, substituting "heroin" for "alcohol" in the First Step. The program's approach mirrors AA and NA, emphasizing:
- Spiritual awakening as the basis for recovery
- Moral inventory and amends
- Ongoing personal inventory and spiritual practice
- Helping other heroin addicts recover
Key HA Principles
Heroin-Specific Focus – HA provides space to discuss heroin addiction specifically—the rituals, the lifestyle, the particular devastation—without having to translate for people with different drug histories.
Complete Abstinence – Like NA, HA emphasizes abstinence from all mind-altering substances, not just heroin.
Identification – HA meetings often feature more immediate identification for heroin addicts than broader NA meetings where drug histories vary widely.
Carrying the Message – HA emphasizes reaching heroin addicts who still suffer, recognizing the urgency given heroin's lethality.
Meeting Culture
HA meetings follow standard Twelve Step formats but with heroin-specific content:
Speaker meetings – Members share their stories of heroin addiction and recovery.
Discussion meetings – Topics often relate specifically to heroin addiction experiences.
Step study – Working through the steps with heroin-specific focus.
Cultural Characteristics
Raw honesty about heroin – HA meetings often involve explicit discussion of injection drug use, overdose experiences, and the particular degradation of heroin addiction.
Strong identification – Members share common experiences with copping, withdrawal, overdose, and the specific obsession heroin creates.
Urgency about reaching others – Given heroin's lethality, particularly in the fentanyl era, HA members often feel urgency about carrying the message.
Smaller, more intimate meetings – HA has fewer meetings than NA, and those that exist are typically smaller, creating intimate settings.
HA, NA, and the Opioid Landscape
Clients addicted to heroin have several Twelve Step options:
Heroin Anonymous – Heroin-specific focus, smaller fellowship, may offer stronger identification for heroin addicts specifically.
Narcotics Anonymous – Broader focus on addiction, much larger fellowship with many more meetings, welcomes all drug addicts including heroin addicts.
Alcoholics Anonymous – Some heroin addicts attend AA, particularly if alcohol was also significant in their history or if AA is the only local option.
The "best" choice depends on individual preferences:
- Where does the client identify most strongly?
- What's available locally?
- Does the client want heroin-specific community or broader addiction fellowship?
Many people attend multiple fellowships, finding value in each.
HA and Medication-Assisted Treatment
Like NA, HA must be understood in context of medication-assisted treatment for opioid use disorder.
HA's program emphasizes complete abstinence, which creates tension with MAT medications like buprenorphine and methadone. Individual meetings and members vary in their attitudes toward MAT—some are accepting, others hold stigmatizing views.
For professionals working with clients on MAT who want HA involvement:
- Discuss this potential challenge openly
- Validate that MAT is evidence-based medical treatment
- Help identify MAT-friendly meetings if possible
- Have alternatives ready if HA doesn't work out
- Consider NA or secular alternatives
Who Benefits from HA?
People who identify specifically as heroin addicts – For those whose identity is wrapped up in heroin specifically, HA offers direct identification.
People who want to discuss heroin openly – HA provides space where everyone understands heroin addiction firsthand.
People who tried NA and didn't connect – Sometimes the heroin-specific focus makes the difference.
People in areas with active HA meetings – When available, HA offers a valuable option.
Who Might Look Elsewhere?
People without access to HA meetings – HA has far fewer meetings than NA. Most areas don't have HA meetings, though online meetings help.
People on MAT who encounter stigma – If local HA meetings aren't MAT-friendly, this becomes a barrier.
People who want more meeting options – NA's larger fellowship provides more meetings, more diversity, and more sponsor options.
People whose opioid addiction didn't involve heroin – Someone addicted to prescription opioids who never used heroin might not identify with HA's specific focus.
Practical Information for Professionals
Finding Meetings
HA's meeting finder is at heroinanonymous.org. Meeting availability is limited:
- Some major cities have HA meetings
- Many areas have no HA presence
- Online meetings have expanded options
When to Suggest HA
Consider HA when:
- Heroin was central to the client's addiction
- The client expresses interest in heroin-specific fellowship
- HA meetings exist locally or client is open to online meetings
- NA hasn't provided the identification the client needs
Integration with Treatment
HA works alongside opioid addiction treatment. For clients whose heroin use is the presenting problem, HA can provide:
- Peer support from others who understand heroin addiction specifically
- Sponsorship for step work
- Community after treatment discharge
- Ongoing recovery support
However, ensure treatment and recovery support align—particularly regarding MAT.
The Evidence Base
Research specifically on HA is minimal given the fellowship's relatively small size and recent origin. However, HA uses the same Twelve Step framework demonstrated effective in AA and NA research. Similar mechanisms—social support, behavioral change, spiritual development—likely apply.
HA and Multiple Pathways
HA is one option for heroin addiction recovery:
- NA serves heroin addicts within its broader fellowship
- Medication-assisted treatment addresses opioid addiction medically
- SMART Recovery offers secular peer support
- Professional treatment programs (particularly MAT-focused)
- Harm reduction programs for those not ready for abstinence
The best approach depends on individual needs, preferences, and circumstances.
Help Your Clients Find HA Meetings Near Them
SobaSearch maintains a focused database covering select communities of HA (Heroin Anonymous) meetings across the United States. Enter a zip code to find meetings in your client's area.
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