Heroin is one of the most dangerous illicit opioids because of its high risk for tolerance and dependence. This also makes it one of the hardest addictions to treat. Structured addiction treatment can help.
What is heroin?
Heroin is a potent opioid that is synthesized from morphine. Though morphine is derived directly from the poppy plant, heroin is semi-synthetic since it is made from morphine through a chemical process. It is administered by snorting, smoking, or injected in its different forms which include a powder or sticky tar. When used, it affects opioid receptors in the nervous system, leading to an increase in pleasure-producing dopamine. It also has a depressant effect, slowing down the activity of the nervous system.
These effects on the brain and nervous system reduce the perception of pain and create a feeling of deep euphoria. These potent reactions underlie its high potential for abuse. In fact, heroin is classified as a Schedule I drug according to the US Drug Enforcement Administration (DEA). This means it has no medical use and has a high likelihood of abuse and addiction. The dangers of heroin are further compounded by its illicit manufacture, which may see the drug cut with other substances like fentanyl that can increase its potency.
Why heroin is so addictive
Heroin’s extremely addictive nature comes from the mechanism by which it works in the brain. Opioid receptors are responsible for many important cognitive and emotional functions including the regulation of pain, release of dopamine and other hormones, and the sensation of pleasure. Since users get such an intense pleasurable sensation as a result of its use, heroin creates faster and stronger physical dependence than other drugs.
Repeated heroin use also increases the potential for tolerance. This means that the same amount of heroin will no longer have the same stimulating effect. Tolerance usually precedes individuals taking higher or more frequent doses to achieve the same high. Tolerance is one of the cornerstones of addiction, and once tolerance and physical dependence have been created, it can be difficult to break the addiction in part because of dangerous withdrawal symptoms that will develop if heroin use is reduced.
There are different physical and behavioral symptoms of heroin addiction that may help addiction professionals determine whether heroin addiction has been established. These include:
- Attempting and failing to quit using heroin
- Using greater doses of heroin or taking it more frequently
- Increased time spent trying to obtain, use, or recover from heroin
- Continued use of heroin when it has direct and serious consequences to one’s health and well-being
- Neglecting personal or professional duties
- Less interest in hobbies and other activities because of heroin use
- Using heroin in dangerous or risky situations
- Tolerance
- Withdrawal symptoms if heroin use is reduced
Heroin is particularly dangerous because of the long-term effects it can have on the brain and health. Detrimental effects include the direct effects of heroin as well as health problems that arise from different methods of administration. These long-term effects may include:
- Severe constipation
- Deterioration of white matter in the brain
- Impaired decision making
- Loss of behavioral regulation
- Impaired stress response
- Collapsed blood vessels due to injections
- Skin infections
- Bacterial infections in the circulatory system
- Insomnia
- Mental health problems
- Sexual dysfunction
- Nasal tissue damage due to snorting heroin
- Irregular menstruation
- HIV or other blood-borne infections due to sharing needles with other users
- Risk of accidents, injury, or death while using heroin
Heroin overdose
Like any drug that has a depressive effect on the nervous system, heroin users are particularly susceptible to overdose. In addition to creating euphoria and dulling the sensation of pain, this depressant effect also affects important bodily functions such as respiration and heart rate. When taken at high doses, breathing may be dangerously slowed, cutting off oxygen to the brain.
Since heroin overdose can easily be fatal, it’s important to look for clear signs of overdose and seek immediate medical attention. These signs may include:
- Shallow breaths
- Cold clammy skin
- Nausea
- Vomiting
- Blue lips or fingernails
- Disorientation
- Extreme drowsiness
- Weak pulse
- Low blood pressure
- Loss of consciousness
Heroin Withdrawal
Physical dependence is established when the body becomes accustomed to the chemical changes in the body due to repeated heroin use. When a person is physically dependent on heroin, they may experience unpleasant or even dangerous withdrawal symptoms when they attempt to quit. This occurs as the body struggles to adjust to normal function without heroin.
Heroin withdrawal symptoms may be severe and can create a roadblock to recovery. These symptoms include:
- Nausea
- Vomiting
- Diarrhea
- Muscle pain
- Chills
- Fever
Overcoming these symptoms may necessitate medical detox to help users safely recover and manage these withdrawal symptoms.
Understanding Heroin Withdrawal Symptoms
Facing heroin withdrawal can feel overwhelming, but you’re not alone. Learning about the symptoms and timeline can help you prepare for a safer, more manageable recovery.
Heroin Addiction Treatment
Medical detox is the first step in a comprehensive addiction treatment program. During detox, medical professionals help individuals eliminate heroin from their system while monitoring their vitals around the clock and providing care and treatment to alleviate withdrawal symptoms. In some severe cases, addiction professionals may choose to provide medications to help reduce withdrawal severity.
After medical detox, addiction treatment turns to psychological and physical motivations that underlie heroin use. This treatment includes a combination of individual and group therapy, education, and other counseling that can help teach relapse prevention, coping strategies, and other psychotherapy as needed. This part of addiction treatment is heavily tailored to the individual and their mental health history. Comprehensive treatment also encourages healthier overall well-being including instilling habits such as regular exercise, meditation, and better nutrition.
Opioids such as heroin have an intense effect on the brain and can be difficult to stop using safely. Because of this, there are several approved medications that have been approved by the FDA to treat heroin addiction. They may negate the effects of opioids or may be safer alternatives to heroin that can be used to taper off opioid use with fewer withdrawal symptoms.
Methadone
Methadone is a synthetic opioid that binds to opioid receptors in the brain in a similar way as heroin. However, it does not create the addictive high of heroin. By administering methadone to recovering addicts, withdrawal symptoms are reduced while opioid use is tapered off without the euphoric sensations that make heroin so addictive.
Buprenorphine
Buprenorphine is another less potent opioid agonist that partially activates opioid receptors, which has a less intense effect than methadone and is a much safer alternative to heroin. It can also be prescribed by medical professionals to help withdrawal symptoms during the detox period.
Naltrexone
Unlike methadone and buprenorphine, naltrexone is an opioid antagonist, which blocks substances from binding to opioid receptors. This can prevent heroin from having such a significant effect by blunting its euphoric effects. Naltrexone can be administered as an injection or pill to inhibit the effects of heroin in recovery or during an overdose.
Heroin FAQs
How long does a heroin high last?
A heroin high comes on quickly after its use but doesn’t last very long. Its effects may peak within 15-30 minutes, with less powerful sensations persisting for a couple of hours wherein the user might feel lethargic or drowsy.
Can I quit using heroin at home?
Because of the severity of withdrawal symptoms, heroin detox can be difficult to overcome without professional help. Withdrawal can last for at least a week and medically supervised detox can help alleviate symptoms during that time.
How long is treatment for heroin addiction?
Heroin addiction treatment is not one-size-fits-all. Treatment duration depends on individual factors including duration and severity of addiction, co-occurring disorders or addictions, and other physical or psychological factors. Generally speaking, heroin requires inpatient addiction treatment that can last 30 to 90 days.
