Heroin is a powerful opioid that’s derived from morphine, a prescription analgesic. Originally synthesized almost 200 years ago, heroin was created to be an over-the-counter cough medication and a safer, less addictive alternative to morphine. Unfortunately, the opposite proved to be true. Despite being banned in the United States for nearly a century, heroin use is still a major contributor to the growing number of overdose deaths in the opioid epidemic.
Efforts to curb prescription opioid abuse and restrict over-prescribing have seen successful. In fact, statistics showed a steady decrease through 2017. However, this effort has had the unintended side effect of driving dependent users of prescription painkillers towards heroin, as it’s becoming easier to obtain.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 900,000 people aged 12 and older reported using heroin in 2017. More than 650,000 of these users met the criteria for a heroin use disorder.
As a central nervous system (CNS) depressant, heroin works the same way as other opioids. It slows down CNS activity and keeps pain signals from reaching the brain, which induces strong feelings of sedation and relaxation.
This process is already carried out by your body, although with much less severity. Natural opioids are neurotransmitters that help you manage pain and stress, and heroin enters the brain by mimicking these opioids. Therefore, it binds with “opioid receptors.”
After binding, it activates these receptors, so they’ll keep producing opioids. Then it repeats this process over and over until the brain and nervous system are flooded with an excess of opioids, which creates much stronger blocks against pain and more intense feelings of sedation.
A secondary effect of heroin use is a surplus of another neurotransmitter: dopamine. This chemical is involved in regulating several key brain functions, including emotions, cognition, and reward-processing. When dopamine is released in excess, it causes feelings of intoxication and euphoria.
The repeated use of heroin rewires the brain and creates an association between the action of using heroin and the reward of getting dopamine. This rewiring leads to compulsive use, which in turn leads to tolerance.
The signs can be difficult to miss after it becomes severe, but being able to spot the more subtle signs of its early stages can save a user’s life and ensure that proper treatment is sought in time.
However, gauging these signs can be more difficult than one might think. The signs of heroin addiction don’t usually appear all at once, as addiction is a progressive disease. It can be surprisingly easy to dismiss isolated acts of abnormal behavior and the side effects of abuse.
Therefore, here are some of the common side effects of heroin abuse:
As abuse progresses into dependence and addiction, the user may lose control and compulsively seek it out. When heroin use becomes someone’s top priority, the signs of addiction will become more and more apparent in their behavior. These signs include:
If you’ve observed these symptoms in the behavior of a loved one or recognize that you’ve been experiencing them, seek addiction treatment services as soon as possible.
Effective addiction treatment for heroin should begin with supervised medical detoxification, which involves ensuring that all toxins are removed from the user’s system. The goals of detox are to achieve stabilization, treat acute intoxication, and stem the damage caused by the presence of heroin in the body. These goals are especially important if someone has unknowingly used heroin cut with fentanyl.
An experienced medical detox team can help manage withdrawal symptoms and any potential complications during detox by administering different detox medications. Medication-assisted treatment (MAT), may also be used to wean people off heroin by replacing it with weaker, safer alternatives, such as buprenorphine or Suboxone.
After finishing detox, the next step in heroin addiction treatment is ongoing care in either an inpatient or outpatient recovery program. The decision between living onsite and commuting to a facility for regular therapy sessions depends on the specific needs of the user.
During addiction rehabilitation, a client learns to understand the issues at the root of their heroin addiction, manage their addictive behaviors in a more beneficial manner, and avoid relapse in the long-term.
Here are some common treatment tactics:
Today, heroin is being laced with more potent and lethal opioids, such as fentanyl and carfentanil. However, the drug is also very dangerous on its own.
If someone has been intravenously abusing heroin, they’re also at risk for a completely separate set of major health consequences, such as:
Finally, there is the danger of overdosing on heroin alone, which is exponentially increased by the addition of fentanyl and carfentanil. The common signs of a heroin overdose include:
If someone is experiencing a heroin overdose, it’s imperative for them to immediately receive emergency medical attention. Otherwise, they could die or experience permanent brain and organ damage.
In the event of a heroin overdose, naloxone (an overdose-reversal drug) is generally used to flush the opioids out of the user’s system. However, it’s not a guaranteed treatment, especially if fentanyl is involved.
Is your loved one struggling with heroin abuse or addiction? Are you? If so, it’s important for you to treat it with the seriousness it requires and get help before it’s too late.
Legg, T. J., PhD. (2016, June). Signs of Heroin Addiction. from https://www.healthline.com/health/signs-heroin-addiction
National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
National Institute on Drug Abuse. (2018, June). Drug Facts: Heroin. from https://www.drugabuse.gov/publications/drugfacts/heroin
Substance Abuse and Mental Health Services Administration. (2018, September). 2017 NSDUH Annual National Report. from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report