Substance Use

Heroin Use Disorder Treatment

powder drugs and syringe and spoon

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Most people who first use heroin report that their use began with prescription opioids. About one-third of heroin users in treatment started directly with heroin. Heroin activates areas of the brain that involve the control of emotions, pain, and reward. When used, it boosts the neurotransmitter dopamine in the reward areas of the brain, which results in the euphoria and sense of well-being associated with opiate use. (1)  

Heroin is popular as a street drug because it is often cheaper than cocaine, MDMA, and other drugs. However, it is often mixed with other substances, including fentanyl, cocaine, and sometimes household products such as baby powder, sugar, or starch. Treating heroin use disorder requires a comprehensive approach that addresses both the physical dependency and the psychological roots of addiction. (2)

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What Is Heroin?

Heroin is an illegal opioid derived from morphine. It is usually found as a white or brown powder or black sticky substance. It is a psychoactive drug, which means it has mind-altering properties.

Heroin belongs to the class of drugs called opioids, which also includes prescription pain relievers like codeine, oxycodone, and hydrocodone. Heroin abuse and the number of deaths caused by heroin use have increased dramatically over the last decade. (1)  

The increased use of heroin is related to the rise in misuse of prescription opioid pain relievers such as Codeine, OxyContin, and Vicodin. People can easily become addicted to these prescription pills and then seek out heroin because it has the same effects but is much less expensive and easier to find. (3

Can You Get Addicted to Heroin?

Heroin is highly addictive. When a person starts using heroin, they develop a tolerance very quickly. This means they need more and more of the drug to obtain the high they are used to having. This turns into dependency and then addiction.

Many people first become addicted to other opioids, such as prescription painkillers, and then seek out heroin because it is more easily available on the street. 

As a disclaimer, it’s possible to get addicted to both legal and illegal opioids in just a few weeks of regular use. The main signs of addiction are when people cannot discontinue the use of the drug even though it is causing obvious consequences.

These include:

  • Financial issues
  • Losing a job
  • Problems in relationships
  • Inability to meet responsibilities (4)

Addiction also means a person will face withdrawal symptoms if they stop using the drug. The withdrawal symptoms can be so painful that they often prompt a person to seek out the drug as quickly as possible.

Addiction is characterized by the compulsive seeking and using of a drug. Even if a person feels that their drug use is out of control, they are unable to stop. A person addicted to heroin will continue to seek out and use it, or other drugs like it, even though they are experiencing trouble in their personal lives, health problems, issues at work, or other complications related to their drug use. Addiction is the most severe form of substance use disorder and opioid addiction. 

Heroin Abuse Overview

Heroin is an illegal, extremely addictive drug sold on the streets in the U.S. The National Survey on Drug Use and Health reported that in 2016, about 948,999 Americans reported using heroin in the previous year. This number has been steadily growing since 2007. Heroin is most popular with young adults aged 18-25. (5

More and more people are starting to use heroin every year, causing a rise in deaths from overdose, drug abuse, and other complications. The impact of heroin abuse is felt all over the United States.

Heroin use is the most troublesome drug issue in many areas of the country. It used to be more commonly found in urban areas, but heroin use has become so widespread that it is on the rise in rural parts of the country as well, leading to fatal opioid overdoses.

What Are the Risks and Causes of Heroin Abuse?

Heroin acts on specific receptors in the brain that are referred to as mu-opioid receptors. Our bodies naturally produce chemicals called neurotransmitters that bind to these receptors and allow the body to regulate pain, control hormone release, and create feelings of pleasure and well-being. (6)

Heroin stimulates these centers, which cause a flood of the neurotransmitter dopamine into the brain. This activates our reward center, causing feelings of euphoria and reinforcing the desire to keep using the drug, which is called heroin dependence.

When synthetic substances like heroin activate opioid receptors (instead of the chemicals our brain naturally produces), it reduces the brain’s ability to make these chemicals on its own. People start to need a substance just to maintain a feeling of normality instead of achieving a significant high. 

Heroin starts to take effect rapidly and acts on the sites of the brain that control pain and pleasure, control heart rate, and regulate sleeping and breathing. When people use heroin, they report feeling a rush of pleasure or euphoria at first.

It also can cause:

  • Dry mouth
  • Skin flushing
  • Heaviness in the body
  • Nausea and vomiting
  • Severe itching
  • Sores from scratching
  • Confusion and mental fog
  • Sometimes losing consciousness
  • Lethargy
  • Nausea
  • Visual disturbances
  • Hallucinations
  • Delirium
  • Analgesia
  • Constipation
  • Low heart rate
  • Low blood pressure
  • Coma
  • Death

One of the major risks associated with heroin use is that there is no way to determine the purity of drugs purchased illegally from countries like Mexico or South America. Often, heroin is packaged with a mixture of other drugs. Sometimes, a drug sold as heroin doesn’t even contain any heroin. Fentanyl is the drug that is most often sold as heroin.

Many people are prescribed prescription drugs such as painkillers, like oxycodone or Vicodin, by their doctors to treat severe pain. While the incidence of this is becoming much less common because these substances are so addictive, it can still lead a person to develop a dependence on opioids.

What Are the Signs and Symptoms of Heroin Abuse?

Heroin abuse is a serious substance use disorder that often involves intense psychological and physical dependence. Symptoms of heroin addiction can be physical, behavioral, or psychological.

Here are some warning signs that someone might be struggling with heroin abuse.

  • Irregular breathing or shallow breathing
  • Flushed skin
  • Itchiness
  • Nausea and vomiting
  • Narcolepsy
  • Small pupils
  • Slurred speech
  • Droopy eyelids
  • Track marks on arms, legs, or feet
  • Poor personal hygiene

You might also notice psychological and behavioral changes, too.

  • Sometimes a person using heroin will suffer from depression, anxiety, irritability, or mood swings.
  • They might exhibit lying or deceptive behavior.
  • You might notice they have a lack of motivation or interest in things they used to enjoy.
  • Often, they will have decreased performance at school or work.
  • Many people tend to isolate themselves when struggling with heroin abuse to hide their behaviors from others.
  • You might notice a person is struggling financially or constantly asking to borrow money.
  • They might seem very flaky and unreliable, missing appointments, school, work, etc. 

What Are the Long-Term Effects of Heroin Abuse?

Prolonged heroin abuse can cause many adverse long-term consequences.

Some of these include:

  • Damage to the brain and heart
  • Insomnia
  • Collapsed veins or infections at injection sites
  • Damaged nose tissue if snorted
  • Liver and kidney disease
  • Abscesses
  • Infection of the heart lining and valves
  • Constipation 
  • Stomach cramping
  • Pneumonia and other respiratory illnesses
  • Depression
  • Anxiety
  • Mood Swings
  • Sexual dysfunction

Anytime drugs are injected, it produces additional risks. People who inject heroin put themselves at risk of contracting HIV and Hepatitis B and C. These diseases are transmitted through the blood when sharing needles or other equipment used to inject drugs. (7

Heroin also has an extremely high risk of overdose, which is often fatal. An overdose occurs when someone uses enough of the drug to cause a life-threatening reaction. Heroin overdoses have become very common in recent years. People are particularly susceptible to overdose if the drug they purchase contains fentanyl.

Fentanyl can cause reduced breathing or can stop breathing altogether, leading to low levels of oxygen in the brain, heart, and lungs. Without enough oxygen, the body’s vital organs are placed under an extreme amount of duress. This can cause a heart attack and brain damage or death. (8

In the case of a heroin overdose, you might see the following signs:

  • Pale, clammy skin
  • Inability to speak
  • Breathing difficulty
  • Vomiting or making gurgling sounds if asleep/unconscious
  • Slowed heart rate
  • Unconsciousness
  • Purple/bluish hue to lips and/or fingernails and toenails

If you suspect a heroin overdose, it is critical to call emergency services immediately and speak with the Department of Health. Heroin overdose can be treated with naloxone, a medicine that binds to opioid receptors to block the effects of heroin, fentanyl, and other drugs. Naloxone can be administered by emergency personnel or health care providers.

What Are Treatment Options for Heroin Abuse?

There are many different addiction treatments available to help people who want to stop using heroin. Each patient has different needs and requires a specific approach to treatment programs.

Some medicines commonly used to treat heroin withdrawal include lofexidine, a non-opioid medicine that can reduce opioid withdrawal symptoms. Others, like buprenorphine and methadone, help by binding to the brain’s opioid receptors to help prevent withdrawal symptoms. (9)

Studies have found that a combination of buprenorphine, naloxone, and an extended-release naltrexone formulation can be very effective in treating heroin addiction. (10)  

Effective heroin abuse treatment also incorporates behavioral therapies. Cognitive-behavioral therapy, or CBT, helps address a person’s expectations and behaviors surrounding drug use. It can be very helpful in managing triggers and stress. (11)

For example, a person might receive points for attending therapy, 12-step meetings, or other behaviors associated with recovery. These points can be traded in for vouchers or small cash rewards if a person submits a negative drug test. Behavioral therapies work best in combination with medicines. 

Before any kind of behavioral or medical treatment begins, however, it is critical to address the physical issues of heroin abuse. As a heroin abuse treatment center, Zinnia Health provides medically supervised detox for our patients to help ease any withdrawal symptoms. This helps address the physical discomfort of discontinuing heroin use to ensure your best chances of recovery. 

The combination of behavioral treatments, human services, and medication has been effective for many people dealing with heroin addiction. During drug rehab, patients receive behavioral therapy to address the underlying cause of addictions and the option of medical treatment to manage ongoing symptoms and cravings. 

If you or a loved one are struggling with heroin abuse or drug addiction, contact us today at (855) 430-9439. Our trained addiction experts can help you on your way to recovery.

Citations

  1. https://nida.nih.gov/research-topics/heroin
  2. https://nida.nih.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder
  3. https://nida.nih.gov/publications/drugfacts/prescription-opioids
  4. https://www.ncbi.nlm.nih.gov/books/NBK458653/
  5. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
  6. https://nida.nih.gov/publications/research-reports/heroin/effects-of-heroin-on-body
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676504/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809788/
  9. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722377/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/
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