The United States is currently in the middle of the deadliest drug epidemic it has ever faced.
Overdose deaths have increased steadily over the past decade as the availability of both prescription opioids, and illicit heroin remains high. As of 2019, opioid overdoses kill around 130 people every day, which is more than the daily rate of car crash deaths.
Heroin is one of the major factors in why the opioid epidemic has reached its current state. Heroin is the second most attainable illicit drug after marijuana, but it’s much more dangerous. Illicit heroin is unpredictable, and it’s difficult to know how strong any given hit is or what’s actually in it. Drug dealers routinely cut heroin products to increase their profits.
They may add inert substance to make their supply stretch farther, but this creates a weaker product. People who get used to dilute heroin can overdose when they encounter a purer product without knowing it.
However, discerning heroin users will notice when supply is weakened. In order to give weak heroin a kick that allows them to charge more, dealers have started adding fentanyl, a powerful synthetic opioid, to heroin. Fentanyl is powerful enough to kill the average person in amounts that are as light as a snowflake (two to three milligrams), and it’s about 50 times more powerful than heroin. When someone takes fentanyl-contaminated heroin, they can overdose without ever realizing what they were taking.
Heroin addiction is notoriously difficult to overcome, and every day you spend in it prolongs your chances of experiencing a fatal overdose. If you or someone you know might be struggling with an opioid use disorder, learn more about heroin addiction and how it is treated.
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 been 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 the nervous system is 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.
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.
While the symptoms of opioid withdrawal tend to be milder than those associated with benzodiazepines, heroin detox should never be attempted without professional medical supervision.
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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 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.
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. Chronic abuse of heroin can lead to a range of serious, potentially deadly health problems, including:
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 for flushing opioids out of the user’s system. However, it’s not a guaranteed treatment, especially if fentanyl is involved.
If you or someone you know is struggling with an opioid use disorder related to heroin, it’s important to seek help immediately. Heroin addiction is a dangerous chronic disease, and it may be fatal if it isn’t treated.
Addiction is progressive, and it slowly gets out of control over time. It’s often characterized by compulsive use despite serious consequences. It’s notoriously difficult to get over without help, but it is treatable with treatment.
Addiction treatment can help you avoid some of the most dangerous consequences of opioid addiction, including a deadly overdose. Start your journey to recovery by learning more about heroin addiction and how treatment might help you.
Centers for Disease Control and Prevention. (2019, May 31). Fentanyl | Drug Overdose | CDC Injury Center. Retrieved from https://www.cdc.gov/drugoverdose/opioids/fentanyl.html
Legg, T. J., PhD. (2016, June). Signs of Heroin Addiction. Retrieved from https://www.healthline.com/health/signs-heroin-addiction
National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
National Institute on Drug Abuse. (2018, June). Drug Facts: Heroin. Retrieved from https://www.drugabuse.gov/publications/drugfacts/heroin
Substance Abuse and Mental Health Services Administration. (2018, September). 2017 NSDUH Annual National Report. Retrieved from https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report