Heroin Addiction and Abuse

Heroin is a powerful opioid with a high potential for abuse. For several years, heroin has been driving overdose deaths across the country.

Heroin Addiction

One of the reason opioids like heroin are so addictive, is because they target areas in the brain that control reward and motivation. One neurotransmitter that is very important in this process is called dopamine.

The result of millions of years of evolution, our brains are wired to seek experiences that are pleasurable and avoid ones that cause pain. Consequently, we get a dopamine kick when we perform simple behaviors like eating or having sex and more complex situations such as getting a promotion at work or accepting an award.

We may not always know what will strike our fancy from one moment to the next, but we naturally gravitate towards activities that will release this pleasure chemical.

Addiction occurs because our brain is not good at discriminating against harmful behaviors when they are paired with a pleasurable sensation. When using heroin, people experience rushes of dopamine followed by intense euphoria and pleasure.

Overtime, the brain craves the dopamine rush that heroin provides. Once the body becomes accustomed to having it, being without the drug will result in withdrawals.

Understanding Heroin

Heroin or diacetylmorphine was first synthesized in 1889 by the Bayer company. Once heralded as a breakthrough drug for pain treatment, heroin was prohibited after its potency and addictiveness became a public health crisis.1 It is now listed under US law as a schedule I drug and only exists on the black market.

Heroin is a substance synthesized from morphine which is found in the seed pods of the opium poppy. Once made into heroin, it is consumed by being snorted, smoked, injected, or even eaten.

Owing to its illicit nature, heroin is processed in several ways appearing as a brown, white or black sticky substance called black tar heroin. Sometimes, drug dealers will increase the potency of heroin by mixing in cocaine, speed or fentanyl or ad fillers like baking soda and starch to cut costs.

Symptoms of Heroin Addiction

Heroin users can quickly get trapped in a cycle of severe dependence. When this occurs, individuals can experience significant changes in behavior and psychology such as:

  • Powerful urges to use heroin
  • Needing ever increasing amounts of heroin to feel normal
  • Physical and psychological discomfort when without the drug
  • Prioritizing the drug over work, family, and personal needs
  • Feeling unable to abstain from using the drug even with significant effort

Heroin Effects

Heroin is not only addictive but comes with both short and long-term effects such as:

  • Nausea and vomiting
  • Difficulty breathing
  • Dry mouth
  • Sleeplessness
  • Extreme itching
  • Slowed pulse
  • Skin abscesses
  • Losing consciousness randomly (being on the nod)
  • liver and kidney disease
  • Stomach cramping
  • Constipation

Heroin And Other Drugs

As the opioid epidemic raged on, an increasing amount individuals abusing prescription pain meds have turned to heroin to satisfy their cravings. This is usually due to the difficulties with obtaining prescriptions and their costs. Heroin on the other hand is relatively cheap, potent and produces more intoxicating effects.

In other cases, heroin is mixed with other drugs to increase its potency. One drug in particular, fentanyl, has cropped up more and more in recent years. When powerful opioids are combined with other potent drugs like heroin, the risk of overdose and death increases dramatically.

“One to two mg of naloxone should be plenty for a patient still alive, but it may require three to five times that for near-death from heroin if fentanyl is the culprit. Most abusers who happen to encounter fentanyl-contaminated heroin, however, die before they ever make it to medical care.” Philadelphia Department of health9

Treatment For Heroin Addiction

Heroin addiction can result in a variety of symptoms that without proper treatment can lead to an endless cycle of relapse.

Like other forms of substance abuse, heroin use disorder (HUD) can be treated with a combination of, counseling, medication assisted treatment (MATS) and sustained effort.

Many kinds of treatment exist to help those in recovery overcome addiction and achieve sobriety.

Inpatient programs, provide secure live-in facilities for those in the early stages of heroin addiction. These programs can provide detox services, evidence-based treatments, nutritional support, and medications that aid in heroin detox.

Outpatient programs can provide flexible scheduling for those who can live at home while remaining committed to recovery. Outpatient programs are more than just a part of the continuum for care, they are also an affordable option for many as nearly all insurance policies cover outpatient treatment.

Heroin Withdrawal Timeline

Once a person has become dependent on heroin, withdrawal symptoms can occur in as little as 6-12 hours. Since heroin is short lasting, many find themselves using it several times a day.

At the 2–3-day mark withdrawal symptoms are at their highest point. These include minor to moderate symptoms like nausea, stomach cramps, diarrhea, irritability, insomnia, and more severe symptoms such as rapid heart rate, hypertension, difficulty breathing and intense feelings of depression and anxiety.

Usually, major withdrawal symptoms subside within 5-10 days but psychological effects such as depression, anxiety and cravings may remain and continue for several weeks or months after the last use. During this this time, patients in detox will complete their detox program and move on to the next phase of their treatment.

Heroin Abuse Statistics

  • From 1999 to 2019, people in the US died from both illicit and prescription opioid overdoses8
  • Approximately 9.2 million people in the world use heroin.
  • Heroin-related deaths have increased significantly over the last 10 years.
  • Heroin-related deaths are 3 times greater among men than women.
  • In 2014, 47,055 drug overdoses occurred in the United States. Of those, 61 percent were due to opioids like heroin and others.

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