Opioids and the opioid epidemic have dominated the news in recent years. Heroin is one opioid, as are various prescription pain relievers like codeine, oxycodone, and hydrocodone. The Centers for Disease Control and Prevention (CDC) shared that heroin was connected to the overdose deaths of more than 14,000 Americans in 2019 — a rate of more than four deaths for every 100,000 people. Overall, about a third of all opioid-related overdose deaths involve heroin.
Illegal in the U.S. since 1924, heroin is highly addictive and is known as a psychoactive, or mind-altering, substance. It is derived from morphine, a drug that naturally derives from the seed pod of opium poppy plants. The varieties of the poppy that produce morphine are grown in several areas worldwide, including Southeast and Southwest Asia, Mexico, and Colombia.
Effects of Heroin
When someone uses heroin, they can experience both short- and long-term effects. Some of the immediate experiences and feelings people have with the drug include a sense of euphoria and brain fog or fuzziness. Physical effects range from dry mouth to an upset stomach, itching to increased levels of drowsiness. Using heroin can also slow a person’s breathing and heartbeat.
Over a more extended period of use, heroin causes more significant physical and mental issues. These include:
- Collapsed veins
- Infections of the heart lining and valves
- Skin infections like abscesses and cellulitis
- A higher chance of getting HIV/AIDS, hepatitis B, and hepatitis C
- Liver and kidney disease
- Mental disorders
- Lung diseases like pneumonia and tuberculosis
- Menstrual problems and miscarriage
There are various ways that people consume heroin — it can be snorted, injected, and smoked. Heroin is dangerous to consume in any amount, but how it affects an individual will vary based on that person’s weight, health, and previous use of heroin. The effects of heroin can be felt for three to five hours after taking it.
Signs of Heroin Use
Like any drug, heroin will change how a person behaves. Specific short-term signs of heroin use include slurring or speaking slower than usual, tiny pupils, flushed skin, and a shorter attention span.
More severe health problems can arise the longer someone uses heroin. Symptoms of long-term abuse include depression, chronic constipation, skin infections, intense itching, and vomiting.
Heroin can alter the makeup and functioning of the brain. Like any opioid, heroin attaches to receptors, also known as neurotransmitters, that impact how pain and pleasure are perceived. Known as opioid receptors, these respond to heroin and other opioids differently because they overstimulate the brain’s reward circuit. This tampers with how the brain communicates with the body. The way that heroin affects the brain’s neurotransmitters is central to what makes the drug so addictive.
Withdrawal and Overdose from Heroin
Over time, the person will need more heroin to achieve the same feelings of euphoria. This tolerance eventually becomes dependence as the person requires heroin simply to avoid any unpleasant withdrawal symptoms. Heroin addiction occurs when the drug becomes necessary to feel normal and someone is unable to stop taking it even if they want to do so.
Even someone with only tolerance to heroin is likely to experience withdrawal symptoms if they try and stop using the drug. Symptoms of withdrawal can include:
- Vomiting and diarrhea
- Bone and muscle pain
- Trouble sleeping
- Cold flashes
- Leg movements that can’t be controlled
The risk of overdosing on heroin is very high because the drug can cause both breathing and the heartbeat to slow, or even stop. Other signs of potential overdose are blue lips and fingernails, cold and damp skin, shaking, and vomiting or gurgling.
If someone is suspected of overdosing on heroin, call 911 immediately. Administering naloxone can reverse the effects of an overdose on heroin and potentially prevent death; however, it is important that naloxone be given as soon as possible for the best results. Some states allow doctors to prescribe naloxone to family members of heroin addicts, and many first responders carry the medication in an autoinjector or as a nasal spray.
Treatment for Heroin Addiction
The most effective treatment for heroin addiction currently available is a combination of medication and behavioral therapies. Individuals have the option of either inpatient heroin treatment or an outpatient program. Either will begin with a detox period, which is most safely done through a medically supervised program. A supervised detox will monitor the person and help them safely manage their withdrawal symptoms until all heroin is out of their system.
After detox, if someone has a safe and supportive home environment free from drugs, they can consider outpatient treatment. For those who need more support, may not live in a supportive and drug-free environment, or have a more severe addiction, an inpatient program may be their best course.
Either form of treatment will include medications such as Suboxone or methadone to help manage cravings for heroin and any withdrawal symptoms. Behavioral therapies, such as cognitive behavioral therapy, are used to help the individual learn new ways to manage stress, recognize and avoid potential drug triggers, and give them the tools they need to return to everyday life heroin-free.
Addiction is a chronic health condition that can be treated. While it cannot be cured, people can move beyond addiction and manage it so that they can lead a full and rewarding life without drugs. Ongoing support is advised for anyone with an addiction. Such support can take the form of individual and family counseling and attendance at an appropriate 12-step program. It is never too late to treat addiction, but the sooner someone seeks help, the better.
A licensed mental health and substance abuse intensive outpatient program (IOP) in Scottsdale, Arizona, Rising Phoenix was created to offer a safe, welcoming, and nurturing environment where clients are not judged, but embraced, throughout their recovery process.