Heroin addiction has become a serious epidemic in the United States. The report entitled “Results from the 2014 National Health Survey on Drug Use and Health” prepared by the Substance Abuse and Mental Health Administration Services (SAMHSA) showed that for that year, about 586,000 people of ages 12 or older who were living in the country had a heroin use disorder.
The Centers for Disease Control and Prevention (CDC) reported similar findings and pointed out that between 2002 and 2013, the rate of heroin-related overdose deaths had quadrupled. In 2013 alone, more than 8,200 people died from heroin overdose.
Following the warnings issued by the CDC, the White House called for intensified efforts to address the growing crisis and to prevent further escalation of the heroin abuse problem.
Heroin Use and Addiction
Heroin is a highly addictive substance that is synthesized from morphine. The latter is derived from the opium that naturally occurs in an Asian poppy plant. After being chemically processed, heroin is sold in white or brown powder form. It can also take the form of a black sticky substance (black tar heroin). Black tar heroin, however, is tainted with other substances such as coffee, burned cornstarch, or dextrose.
The drug may be smoked, snorted, or injected directly into the veins. When used intravenously, it is two to four times more potent than morphine.
Regardless of the manner of ingestion, the substance enters the brain rapidly where it is quickly converted back to morphine. It then binds itself to the opioid receptors, the cells in the brain which are associated with perceptions of pain and reward. The effects are similar to those caused by prescriptive opioid analgesics.
When administered intravenously, users immediately experience a “rush” or an elevated sense of pleasure and euphoria that can occur within a few seconds from the use. This is followed by a feeling of calmness and the users would shift between states of drowsiness and wakefulness. Heroin is used and abused for the “rush” or pleasurable feelings that the drug elicits.
Immediate Effects of Heroin
Aside from experiencing euphoria, followed by a sense of general well-being and calmness, users have also reported negative effects. These include dry mouth, nausea, vomiting, flushed skin, and clouded mental abilities. Soon after, the users are likely to experience a different set of symptoms. The “delayed” symptoms include drowsiness, slowed breathing, slowed heart rate, heaviness of the extremities, and uncontrollable itching of the skin.
Heroin overdose can cause a suppression of breathing that affects the delivery of oxygen to the brain. It can also cause respiratory depression. Both effects are fatal and can lead to coma, permanent brain damage, and death.
Various studies have been conducted to determine the long-term effects of heroin use disorder. Among the effects that have been established are the following:
Heroin abuse has been linked to a number of serious health risks and medical complications. These include bronchial and lung infections such as pneumonia, liver diseases such as hepatitis, kidney diseases, heart diseases, collapsed veins, skin abscesses and infections, arthritis, seizures, constipation, and gastrointestinal disturbances.
Sharing of needles among fellow drug users also tremendously increases the chances of contracting HIV, Hepatitis B, Hepatitis C, and other blood-borne viruses.
Pregnant women are at risk of miscarriage and premature birth. They also place the unborn child at risk of low birth weight and neonatal abstinence syndrome (NAS). NAS is a condition where a child is born with drug dependence and exhibits withdrawal symptoms.
Among non-pregnant women, heroin abuse can cause hormonal imbalance and inconsistent menstrual cycles.
In addition, those who consume street heroin are at a high risk of overdose and death because these variants may be mixed with other addictive and toxic substances.
Tolerance and addiction
Chronic use of heroin can lead to tolerance and a user will need to use higher amounts of the substance in order to achieve the same results. Over time, he will develop a physiological dependence on heroin which is manifested by an uncontrollable compulsion to consume the drug despite knowledge of its harmful effects. This compulsive behavioral pattern is called substance use disorder, abuse, or addiction.
As with other cases of substance use disorder, the abuser will experience several withdrawal symptoms whenever he tries to quit using the drug. These symptoms include restlessness, anxiety, depression, insomnia, vomiting, diarrhea, sweating, body malaise, cold sweats, chills, involuntary spasms, muscle and bone pain, fever, and intense drug cravings. These can manifest anywhere between 6 to 24 hours from discontinuation of drug use.
Heroin is extremely addictive and regardless of the chosen route of administration, a user has a high probability of developing tolerance and dependence. Once addicted to the substance, an abuser’s solitary objective is to use the drug.
Behavioral and social changes
Heroin addiction substantially affects a person’s behavior and character. As an abuser’s life revolves around drug use, drug acquisition, and recovery from use, his daily routines and concerns are significantly altered.
Addicts may begin to display sudden changes in behavior such as lying, stealing, underperformance in school or work, loss of motivation, loss of self-esteem, lack of concern for personal appearance and hygiene, lack of interest in hobbies and social activities, disassociation from friends and family members, and hostile behavior.
These changes will give rise to more serious problems that are likely to upset his family and home life, interpersonal relationships, employment, social standing, and financial stability or status.
Effects on the brain
Some research studies have shown that repeated use of heroin alters both the physical structure and function of the brain. These changes can lead to long-term neuronal and hormonal imbalances that are difficult to reverse.
Heroin use disorder also causes a corrosion of the brain’s white matter. This affects the person’s ability to make decisions, analyze and solve problems, control behavior, and cope with stressful situations and environments.
Detection and Diagnosis
Knowing the initial signs and symptoms of heroin use and addiction can help a person detect if a family member, friend, or co-worker is abusing the drug. Tell-tale physical indicators include flushed skin, vomiting, sweating, and shallow breathing.
The behavioral changes that indicate drug abuse include impaired reasoning and judgment, changes in mood, aggression, irritability, depression, neglect of appearance, underperformance in work or school, financial problems, frequent lying, and criminal tendencies.
Heroin addicts also use a number of paraphernalia such as syringes, hypodermic needles, spoons, cotton or q-tips, cigarette filters, lighters, aluminum foil, glass or metal pipes, and rubber balloons where they sometimes store heroin. Finding these in their possession or hidden in their drawers or medical cabinets strongly suggest that they are abusing heroin.
The drug is retained in the body and may be detected via drug test within 24 to 48 hours from last use. A urine test is the most common method for determining whether a person has recently smoked or ingested an opioid. A hair opiate test may detect heroin for up to 90 days from the last use.
What’s great about recent developments in the field of heroin drug testing is that home-based test kits are now available in the market. Some of these products include IDenta Confirm Heroin Substance Detector and iCassette Premium Complete OPI2000 Urine Drug Test Kit.
Aside from these standard drug tests, a person suspected of heroin use must also be evaluated by a physician or drug counselor to confirm whether or not he suffers from heroin use disorder.
Treatment options are available for heroin abuse including behavioral and pharmacological approaches. Either treatment method may be resorted to in order to re-establish a person’s normal brain functions. For most abusers, however, a combination of both approaches is necessary to achieve effective results.
Below is a brief discussion of these therapies:
Research investigations have established that the use of medications in the treatment of opioid and heroin addiction effectively manages withdrawal symptoms, promotes abstinence and supports retention of learning gained from behavioral therapies.
During the detoxification phase or the period during which the body eliminates the effects of the drug, a patient experiences withdrawal symptoms. These symptoms can be managed or relieved by the administration of certain medications. Some of the medicines that have been clinically proven to be effectual are the following:
Methadone is a slow-acting opioid agonist that has been used to treat heroin addiction since the 1960s. It is designed to deliver the same effects of an opioid but at lower doses to control drug cravings until the patient can successfully wean off the substance.
This drug also suppresses drug cravings but unlike other opioids, it averts harmful side effects. Like Methadone, it is also administered orally and as such, prevents the “rush” or “high” that is produced by heroin or other opioid drugs.
Naltrexone works by blocking the opioid receptors and preventing the drug from taking an effect on the patient. It is non-addictive. Recently, the FDA approved a long-acting formulation in an injectable form called Vivitrol which is administered once a month.
As with Naltrexone, Naloxone also blocks the effects of opioids. It is used as an emergency treatment to reverse the effects of heroin overdose. It is available in injectable and nasal spray forms.
Following detoxification and withdrawal, a patient must undergo behavioral therapies that involve counseling sessions delivered individually or in group sessions. These forms of counseling are available in both inpatient and outpatient settings.
Therapists utilize a number of psychotherapy approaches to help the patients develop coping mechanisms, self-control, and new life skills, among others. The goals of behavioral therapies include strengthening the patient’s motivation and commitment to treatment, helping him sustain abstinence, and rebuilding his self-esteem to enable him to regain a normal and productive life.
The various techniques include contingency management, cognitive-behavioral therapy, motivation enhancement therapy, 12-step facilitation therapy, and family counseling.
In addition to group support programs, specialized treatment facility centers also offer various outdoor, sports, and recreational activities to help patients utilize exercise as a stress-coping technique.
Other forms of therapies include journalizing, art, drama, music, yoga, and meditation.
The Bottom Line
It is possible to recover from heroin abuse and to regain a normal life. However, in order to find the light at the end of the tunnel, an addict must first confront the problem head on and seek professional help. Sadly, most users are unaware of their deteriorating conditions and the inception of their treatment often lies in the hands of their family members, friends, and loved ones who must initiate intervention mechanisms.
As government agencies, state authorities, and private sectors contribute various efforts to combat this national epidemic, private individuals in the home, school, or workplace must also rise to join the battle. Anyone who suspects a loved one to be in danger of heroin abuse must strive to help address the issue by reaching out to the proper rehabilitation centers and health professionals for assistance.
If every person and sector in society is actively involved in this fight, the crisis can be conquered by saving one life at a time.