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Heroin Addiction and Related Clinical Problems: 2026, 28: 15-18

Psychological Counselling for Heroin Addicts in the Sri Lankan Context

Isuri De Silva, Nuwan Darshana, and Vijitha De Silva

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2026-3

Summary: Heroin addiction is a chronic relapsing disorder associated with significant psychological, social, and economic consequences. While pharmacological treatments such as methadone maintenance therapy are essential for managing physiological dependence, psychological counselling plays a crucial role in addressing the cognitive, emotional, and social dimensions of addiction. This narrative review examines global evidence on psychological counselling interventions for heroin addiction and evaluates their applicability within the Sri Lankan context. Globally, counselling approaches such as cognitive-behavioural therapy (CBT), motivational interviewing (MI), contingency management (CM), and supportive psychotherapy have demonstrated effectiveness in reducing heroin use, preventing relapse, and improving treatment retention, particularly when integrated with pharmacotherapy. CBT helps individuals identify and manage maladaptive thoughts and triggers, while MI enhances motivation and engagement in treatment. CM reinforces abstinence through structured incentives, and supportive psychotherapy improves psychosocial functioning and therapeutic alliance. In Sri Lanka, heroin use has increased, particularly among young males, yet treatment infrastructure remains limited. Psychological counselling is available in some rehabilitation settings, but access is uneven and systematic evaluation is scarce. Preliminary local evidence suggests that CBT and MI, especially when combined with pharmacological treatment, improve treatment adherence and reduce heroin use. However, multiple challenges hinder effectiveness, including stigma, limited availability of trained counsellors, urban-centric services, and reliance on Western counselling models that are not fully culturally adapted. The review highlights the need for integrated, culturally sensitive counselling approaches that incorporate family involvement, community support, and socioeconomic considerations. Strengthening training, expanding access, and generating local evidence are essential to optimize psychological counselling for heroin addiction in Sri Lanka.

Keywords: Heroin addiction; Psychological counselling, Sri Lanka