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Article Summary

A Guide To Heroin Addiction

Heroin was first discovered by a pharmaceutical company (Bayer) in 1874 as a less toxic and less addictive synthetic variety of morphine. Officially commercialized in 1898, the drug did not turn out into what the company anticipated.

However, heroin is known for its addictiveness, which is not surprising given that it is 2 to 3 times as potent as morphine. Although this fact was uncovered and could not be purchased legally after 1920, the drug still became the most popular and widest used/abused opiated in the United States and elsewhere on the globe.

Today, heroin is considered to be the most addictive drug and with the highest rates of overdose. Similarly, such overdose on drugs is among the leading causes of death in America for people below the age of 50, according to a report by the New York Times.

The effects of this drug are quite similar to those from prescription opioid painkillers in the sense that they will reduce pain while also adding to the initial euphoric high. However, soon after that, you will start experiencing heroin's negative effects and you will need more of the drug to escape from its longer term withdrawal symptoms.

In this guide, you will learn all there is to know about the effects, side effects, history, addictive qualities, withdrawal symptoms, and signs and symptoms of heroin use, and more.

By so doing, you will understand why the abuse of this drug has reached such epidemic proportions in the United States - a problem that continues growing by the day. Apart from this, you will gain a better understanding of the reasons people continue using the drug despite its negative effects, and how most of the supplies sold on the street are contaminated and make the drug even more dangerous to users.

Last but not least, the guide will take you through some effective treatment options for people addicted to heroin:

Understanding Heroin

Heroin is a chemical derivative created from morphine. The drug is a powerful and addictive opioid that is known for causing slowed breathing, euphoria, pain relief, and drowsiness. The drug's effects are also similar to those from other opioids, such as fentanyl, methadone, and OxyContin.

Today, heroin is considered to be one of the most dangerous drugs. This is particularly because it is usually contaminated with such drugs as fentanyl, which can lead to a deadly and rapid overdose even when used in relatively small amounts.

As an illegal opioid, heroin is now classified as a Schedule I substance. This means that the drug carries high risks of addiction and abuse. As such, it has no known medical use.

Most people who abuse use often obtain it in one of two forms:

  • Black tar heroin, which is sticky and black substance that is popular on the American West Coast
  • A brownish, tan, or white powder mostly found on the American East Coast

Due to its addictive quality, the abuse of heroin has been increasing in almost all demographics. ASAM (the American Society for Addiction) reported in 2015 that the number of people suffering from addiction to the drug was close to 600,000 while about 13,000 fatal overdoses from heroin has been noted.

In a frightening but not surprising trend, the abuse of the drug as well as cases of addiction to it have been increasing in the recent past. Women, in particular, are at great risk of addiction with overdoses in the female population nearly tripled from 2010 to 2013.

At times, heroin is also mixed with other drugs to create a variety of substances with different street and slang names. These include, but are not limited to:

a) Cocaine and Heroin
  • Back to back
  • Bipping
  • Chasing the dragon
  • Crisscrossing
  • Dragon rock
  • Dynamite
  • Eightball (heroin mixed with crack cocaine)
  • Goofball
  • H and C
  • He-she
  • Moonrock
  • Scramble
  • Smoking gun
  • Speedball
  • Tar
b) Xanax and Heroin
  • Bars
c) Marijuana and Heroin
  • Atom bomb
  • A-bomb
  • Canade
  • Dust
d) Diphenhydramine and Black Tar Heroin
  • Cheese
e) Meth and Heroin
  • Methball (injected)
  • Screwball
f) LSD and Heroin
  • Neon nod
g) Ecstasy and Heroin
  • H bomb
  • On the ball

One of the reasons behind the increase in the use of the drug and its rates of addiction in the US might be as a result of the commonly known prescription opioid crisis. This is because of the risk that people who are addicted to prescription opioids sometimes progress to heroin since it is more affordable and readily available on the streets.

Heroin Uses

According to recent statistics, it is estimated that 17 million people (about 0.4 percent of the entire world population) have tried or used heroin at one point or the other. However, the 2016 World Drug Report by the United Nations Organization shows that the drug has fewer users than most of the other illegal substances. Still, the report proves that the rates of death from abusing heroin are the highest.

Although the use of the drug is still on the rise - at least in the United States - the percentage of people in the US who use the drug is quite low compared to other parts of the globe.

Most of the people who use heroin - a number that is over the half a million mark - are unemployed. The 2016 UNODC study shows that the drug has the highest rates of unemployment of all illegal substances (at 35 percent).

Similarly, regular users spend a minimum of $17,500 on the drug a year. This is according to a recent study by RAND, which shows that the associated costs further complicate the levels of unemployment among users.

As mentioned above, individuals who are addicted to opioid painkillers are 40 times as likely as an average person to use, abuse, and get addicted to heroin. Since 2007, the use of the drug has been on the steady increase, with some arguing that these rising figures are as a result of addiction to prescription drugs.

This is because heroin is more easily accessible and costs less than prescription opioids. Therefore, it is the perfect recourse for those who are no longer able to get their hands on a prescription.

Heroin Effects

Using heroin in the long term might leave some long lasting and sometimes permanent effects on your mental and physical health. However, the mode of use, such as injection, might bring additional effects and consequences.

a) Physical Effects

Some of the effects of long term heroin use on your physical health may include:

  • Changes in the functioning and structure of the brain
  • Constipation, which may be severe
  • Contraction of such blood-borne diseases as HIV due to risky sexual behavior and injection use
  • Disease of the kidneys or the liver
  • Insomnia
  • Lung problems that might result in tuberculosis or pneumonia
  • Neonatal withdrawal among infants who are born of mothers addicted to the drug
  • Physical dependence, where your body will rely on the drug to function normally
  • Reproductive problems, including impotence in men and irregular menstrual cycles for women
  • Tolerance
b) Mental Effects
  • Addiction
  • Chronic heroin use also has mental effects, including but not limited to:
  • Depression
  • Difficulties with managing stress and controlling your impulse
  • Impaired ability to make decisions
  • Suicide
c) Effects from Intravenous Drug Use

Apart from acquiring an infectious disease, injecting the drug can also cause the following:

  • Abscesses comprised of painful localized skin infections filled with pus
  • Cellulitis, which is the bacterial infection of your skin as well as the tissue beneath it
  • Collapsed veins
  • Damage to such organs as the lungs, liver, kidneys, and brain from additives to the drug that cannot dissolve and end up clogging your blood vessels
  • Infection of the heart's lining and valves
  • Peripheral edema, which is characterized by swelling of the extremities
  • Puncture and track marks
d) Effects from Snorting the Drug

If you snort heroin, you may also have other issues with your health, including:

  • Damage or irritation of the nose's mucous membranes
  • Perforation or damage to your nasal septum
Legal and Social Effects

If you use the drug chronically, you may also suffer from legal and social issues, such as:

  • Criminal prosecution as a result of selling, buying, or possessing heroin
  • Domestic violence
  • Driving while under the influence of the drug
  • Prostitution
  • Theft

Heroin Side Effects

The brain absorbs heroin quite fast. In the process, it may cause an intense high that is often characterized by the following side effects:

  • Drowsiness
  • Euphoria, which is a rush in feelings of pleasure and happiness
  • Feeling heavy in your extremities
  • Flushed skin
  • Nodding out, which is described as a twilight state where you drift from consciousness to semi-consciousness
  • Reduction in pain

Other side effects might include:

  • Impaired functioning of the brain, including poor judgement, attention span, and memory
  • Intense itching
  • Lack of attention or response to environmental stimuli
  • Nausea
  • Reduced heart rate
  • Slowed breathing
  • Sluggishness
  • Slurred speech
  • Vomiting
  • Your mouth drying out

On the other hand, you may also suffer the following consequences as a result of continued drug use:

  • Coma
  • Death
  • Injuries and accidents from mental and physical impairment
  • Irreversible brain damage as a result of oxygen deprivation and extremely slowed breathing
  • Overdose

Heroin Addictive Qualities

Heroin is a dangerous drug that poses serious threats to the brain. It works by targeting the opioid receptors in the brain, which makes it extremely pleasurable. However, at the same time, it will dull all your other pleasurable experiences and reduce the effects of the pain signals that your body often sends to your brain.

As you might guess, these effects may cause long lasting damage to your body and brain, which is why heroin withdrawal can last so long and feel extremely uncomfortable.

But exactly how does the drug work and why is it so addictive? Essentially, the brain contains neurotransmitters, which are chemicals that bind themselves to opioid receptors located all over your body and brain.

These receptors work to regulate hormone release, feelings of happiness and well-being, and pain. When activated, they will release dopamine, which is why you will feel pleasure.

The drug works by targeting these receptors (and other areas of your body) to create addictive experiences. These experiences may change how your body perceives both pain and pleasure.

After heroin has entered your body, it will be converted into morphine and create pleasurable feelings and effects. Morphine, on the other hand, is similar in chemical structure to the brain's endorphins - the hormones that cause you to feel good after you have a baby or while running.

These hormones, on the other hand, work by activating the opiate receptors in the brain. In the process, they will lessen your pain and provide a sense of general happiness and wellbeing.

The morphine that was originally heroin will activate these same receptors but in an intense way. It will also attach to the brain's MORs (mu-opioid receptors) and generate a rush characterized by extreme pleasure.

Over the course of this short rush, you may experience less pain - which is often referred to as an analgesic or painkiller effect. For example, if your break your hand, the receptors in it will send messages that something is extremely long with it to the body's CNS (central nervous system).

These messages are neurotransmitters and travel all the way up to the brain through neurons passing them onwards to the brain. The pain will register quickly in your brain and your body will start working towards dealing with it.

Analgesics or painkillers fill in the space between the nerve cells and prevent them from sharing these messages. As a direct result, you won't be able to perceive or recognize the pain - making it seem as if you are not in pain.

The morphine generated by heroin will cause euphoria and leave your brain wanting more of it. After attaching itself to the MORs, morphine's effects will be stronger than your body normally feels with ordinary endorphins.

Since heroin is so concentrated, it will give your brain a higher dose of the drug than your body can provide naturally. After your initial rush - which lasts between 1 and 2 minutes, your body will drastically slow down. This will result in a high lasting between 4 and 5 hours. At this point, you will feel drowsy, your mental functioning may slow down, and you might feel dizzy and confused.

Withdrawing from heroin, however, can be just as extreme as its initial euphoria. As a direct result, using the drug regularly tends to cause dependence. This happens when your brain starts becoming reliant on heroin and its resulting effects.

However, if you stop using heroin for a while, your body's neurons will start functioning normally again. As a result, your brain may get overwhelmed because it will no longer be used to the sensation of neurons in normal working mode. This may result in chemical imbalances and cause such withdrawal symptoms as diarrhea, anxiety, cramps, fever, muscle spasms, and nausea.

Heroin Overdose

Overdosing on heroin can happen at any time - even if you are just using the drug for the very first time. Today, people have been using adulterants that are stronger and more potent to cut the drug, which is why there is such a high risk of overdose.

Overdosing on the drug often causes oxygen deprivation, which may lead to permanent brain damage, injury to vital organs, and coma. That said, some of the signs and symptoms of an overdose include:

  • Clammy skin
  • Coma
  • Confusion
  • Convulsions
  • Cyanosis (which is a blue tint) of the lips and fingernails
  • Dangerously slow heart rate
  • Death
  • Slowed and shallow breathing

Risk Factors for an Overdose

If you use heroin regularly, overdosing on it is a major concern. However, there are certain factors that might increase the likelihood of an overdose:

a) Adulterated Drug

Today, heroin is increasingly get cut using highly potent opioids - such as carfentanil and fentanyl. This has raise the risk of a fatal and rapid overdose.

b) Tolerance

If you use heroin repeatedly, your body may start tolerating it. As a direct result, you will need more of it to feel the same effects your body and brain have become used to. Continuously upping your dose, however, is risky and may increase the chances that you will eventually overdose at one point or the other.

c) Concurrent Drug Use

In the same way, most people tend to use other drugs in combination with or at the same time as heroin. This concurrent drug use increases the effects and dangers of both drugs, while also increasing the risk of an overdose.

For instance, if you combine the drug with other depressants like benzodiazepines and alcohol, you will increase the potential for an overdose as a result of the compounded depressant effect on your brain, respiratory rate, and heart. Similarly, mixing heroin together with cocaine will create opposing depressant and stimulant effects. This injectable combination is known on the street as speedball.

In case of an overdose, you may be administered with naloxone (narcan). This drug may reverse the effects of heroin overdose, but only if it is administered as soon as possible.

It works by blocking heroin's effects on the brain and is commonly available as an auto-injector (which is similar to the Epi-pen), intramuscular injection, and nasal spray. The auto-injection and spray varieties are also distributed to individuals addicted to opioids and their loved ones for use in case of emergencies. In the same way, first responders may come with Narcan and use it to treat heroin overdoses and, in the process, prevent fatal death.

If the heroin you took was adulterated with substances like fentanyl, you may require multiple doses of Narcan to reverse your overdose.

Heroin Withdrawal

Heroin dependence will occur when your body and brain get used to the drug's effects and start requiring certain amounts of it to function normally. If you are dependent on the drug, you may suffer from a variety of withdrawal symptoms when you try to discontinue or cut down on your usage.

These symptoms are unique in the sense that they follow a timeline. The early symptoms will appear 6 to 12 hours after your last dose while acute symptoms may peak after 1 to 3 days and subside slowly over the course of a couple of days and/or weeks.

The most common heroin withdrawal symptoms tend to include:

  • Aches
  • Anxiety
  • Cravings
  • Diarrhea
  • Dilated pupils
  • Excessive tearing on the eyes
  • Goosebumps
  • Hypertension
  • Increased heart rate
  • Irritability
  • Loss of appetite
  • Nausea
  • Pains
  • Reduced pain tolerance
  • Restlessness
  • Runny nose
  • Shaking
  • Sweating
  • Vomiting
  • Yawning
  • Insomnia

That said, the severity of these symptoms will depend on a variety of factors, including but not limited to the duration, frequency, and dose of heroin use, as well as the method of administration and your overall physical health condition.

Although such withdrawal is hardly ever dangerous, it may cause extreme discomfort that might be so intense that you will relapse almost immediately. The best way to ease these symptoms is through supervised detox.

You can get detoxified of the drug in any hospital setting, at comprehensive rehabilitation facilities that provide detoxification and inpatient treatment, at free standing detox facilities, or on the outpatient basis.

Alternatively, you may be required to undergo MAT - medication assisted treatment - to ease these withdrawal symptoms. This treatment often uses such medications as buprenorphine and methadone, among others, to lessen cravings and deal with withdrawal.

Heroin Dangers

Heroin is a depressant. Therefore, combining it with other depressants may amplify its effects and slow down your breathing and heart rate. This will invariably increase the chances of overdosing as well as extreme impairment of your cognitive and physical processes. It may also increase your risk of injury and accidents. The depressants that are most commonly used with heroin include alcohol, opiate painkillers (like OxyContin), benzodiazepines (such as Xanax), ketamine, and GHB.

On the other hand, if you mix the drug with stimulants like meth and cocaine, you will be left reeling from different effects from both drug types. Such a mixture is unpredictable and, therefore, potentially fatal.

That said, the main dangers of heroin use include:

  • Addiction
  • Legal risks
  • Long term damage to the body by diseases like HIV and Hepatitis, as well as damage to the blood vessels, kidney, and liver
  • Risk of overdose

Signs And Symptoms Of Heroin Abuse

In case you suspect that you (or a loved one) is addicted to this drug, there are certain warning signs and symptoms you should watch out for. These signs are often used to diagnose heroin use disorders:

  • Continued heroin use even after it has caused/worsened your social and work life and relationships
  • Cutting out essential activities related to recreation, socialization, and work due to continued heroin use
  • Developing tolerance and needing more of the drug to achieve desired effects
  • Experiencing intense withdrawal when you stop using the drug or dramatically reduce your usage
  • Inability to complete essential tasks at work, home, or school as a result of using the drug
  • Intense cravings for the drug
  • Isolating yourself
  • Owing heroin paraphernalia, such as balloons, plastic bags, spoons, lighters, needles, straws, cut off pens, foil, pipes, and more
  • Spending more time with new groups of friends
  • Spending too much of your time looking for, using, or even coming down from the drug
  • Stealing valuables and money to procure heroin
  • Taking the drug even when you know that doing so is hazardous to your physical health, such as while driving
  • Trying to cut back or quit on use unsuccessfully
  • Using a larger amount of the drug than you had originally anticipated
  • Using the drug longer than you intended
  • Using the drug while knowing that it caused/exacerbated your psychological and physical health problems

Treatment For Heroin Addiction

If you are addicted to heroin, you should not give up on trying to find help. Today, there are various treatment methods used to fight such an addiction. These include, but are not limited to:

a) Inpatient Rehabs

Inpatient rehabilitation facilities provide round the clock treatment for drug addiction. Although you may start with detoxification, the main focus of the rehabilitation will be on intensive individual and group treatment sessions. You will also be required to reside in the facility over the course of your care so that you can receive continuous support and monitoring.

b) Partial Hospitalization Programs

Through these programs, you will get to live at home. However, you will spend most of your waking hours at the designated treatment facility. The program will also require you to participate in individual and group therapy sessions.

c) Intensive Outpatient Treatment

Otherwise referred to as IOP, intensive outpatient treatment is relatively intensive and a more structured format of outpatient rehabilitation. You will live at home but be required to attend counseling sessions that are longer than is the norm for most traditional outpatient rehabs.

d) Outpatient Treatment

This is the least restrictive type of heroin treatment. You can continue attending to your ordinary routine at home, school, or work but still be required to learn and practice the lessons needed to help you maintain your abstinence from heroin (and other addictive substances).

Outpatient treatment is best suited for people who are not too severely addicted to heroin and who live in a supportive environment. They are also used as a step-down type of care for those who have completed other intensive treatment formats, such as inpatient rehabilitation.

e) Aftercare

To sustain your abstinence, you may also need aftercare after you've completed the initial treatment. During aftercare, you will work with medical staff to develop long-term plans designed to ensure your sobriety.

The aftercare program might call for additional treatment, participation in a variety of self-help programs, and sober living. All these options are designed to provide continuous support.

f) Sober Living Homes

For some, the best option for following up with formal treatment would be a sober living facility. These homes will require that you maintain your sobriety and participate in the daily activities and chores of the facility. You might also be compelled to gain meaningful employment and attend recovery meetings to help you quit heroin once and for all.

g) Long Term Residential Treatment

On the other hand, if you need tons of extra help in maintaining your sobriety, then you may want to consider undergoing long term residential treatment. This option will provide you with additional levels of monitoring and support as you slowly but surely become acclimatized to living without heroin and any other addictive substance.

The program will typically be highly structured. It may focus on re-socializing you by integrating your actively into the entire community of staff members and other addicts so that you can participate in your treatment journey. Additionally, you may receive support services and employment training.

h) Medication

A variety of medications are approved for treating heroin addiction and dependence. These drugs work by reducing your cravings and alleviating any withdrawal symptoms. As a direct result, they may lower the chances that you will relapse. The drugs include naltrexone, Suboxone, and methadone.

Last but not least, in case you are worried that you might not comply with your treatment, the medication option is ideal. Some of these choices will not even require that you take them on a daily basis. A good example is Suboxone, a combination of naloxone and buprenorphine. It works in the same way as methadone by easing withdrawal and staving off cravings. The drug also provides a ceiling effect in the sense that the effects will not increase even if you take more of the drug. This controls the chances that you will misuse the drug.

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