What is heroin?
Heroin is a highly addictive illicit drug. It is the most widely abused drug of the opioid category, meaning drugs that are derived from the opioid poppy. It is typically a brown or white powder, and is most often snorted or injected in a solution directly into the blood stream.
Heroin increases pleasure and reduces pain by replacing natural endorphins with even stronger painkillers. After the initial rush, users usually experience flushed skin, a dry mouth, and a heavy feeling in their arms and legs. Symptoms may also include nausea, vomiting, severe itching, and drowsiness. Cardiac functions and breathing slow down severely, sometimes to the point of death.
Although pure heroin is becoming common, street heroin can be cut with strychnine or other poisons. Because abusers often don’t know the actual strength or contents of the heroin they are using, they are at risk of fatal overdose.
Many prescription painkillers (like OxyContin, codeine, and Vicodin) are derived from the opioid poppy as well. People who abuse prescription painkillers will often take them without a prescription, take more than prescribed, or crush and snort pills to get the rush they seek. Both heroin and related prescription drugs are called “opioids.”
What are the physical consequences of heroin use?
The American Psychiatric Association (APA) uses the term “opioid use disorder” to define a pattern of opioid use that leads to significant physical, interpersonal, medical, or work problems. Opioid use disorder is rated as mild, moderate, or severe based on how many criteria are met. A person diagnosed with opioid use disorder can also be classified as in remission, or what is commonly referred to as “in recovery.” Those with opioid use disorder should receive treatment, and those who identify themselves as addicts often find the skills and support to stay sober through peer support groups like Narcotics Anonymous.
Addiction is considered a brain-based disease characterized by abnormal drug-seeking behavior that leads to impaired control over one’s drug use. Addiction means a person will continue using alcohol or other drugs despite the harm it does to their health, family, work or school, and relationships. An addict may experience withdrawal symptoms (physical pain, fatigue, depression, trouble sleeping, irritability) if he or she stops using, and may need to keep using just to feel normal. “Curing” addiction is not a matter of willpower or moral strength any more than is curing diabetes or cancer. Like diabetes and cancer, addiction is considered a chronic disease which is beyond one’s control and fatal if left untreated.
Because heroin and prescription drugs (when abused) provide a similar high, it’s become an increasing problem for people who abuse prescription painkillers to move to heroin, as it is often cheaper and more readily available. Heroin overdoses are more common in these cases.
How does heroin use affect a co-occurring mental health disorder?
Co-occurring disorders, or dual disorders, occur when a mental health disorder, like depression or schizophrenia, is present along with addiction, alcoholism, or other substance use disorders. Screening for co-occurring disorders should be part of any good assessment or treatment plan.
Heroin affects the central nervous system and can both mask and mimic the signs of a serious mental illness. People with serious mental health issues may increasingly use heroin to quiet their thoughts and avoid dealing with their inner pain. Heroin use may also accelerate an underlying mental health issue.
How does heroin use affect the brain?
Heroin enters the brain, where it is converted to morphine and binds to receptors known as “opioid receptors.” These receptors are located in many areas of the brain (and in the body), especially those involved in the perception of pain and reward. Opioid receptors are also located in the brain stem—important for automatic processes critical for life, such as breathing (respiration), blood pressure, and arousal. Heroin overdoses frequently involve slowed or stopped breathing and cardiac arrest. Because abusers often don’t know the actual strength or contents of the heroin they are using, they risk fatal overdose.
Heroin users may experience collapsed veins, infection of the heart lining and valves, liver and kidney disease, and other problems. They are also in danger of exposure to HIV/AIDS and other blood-borne diseases through sharing needles.
Is addiction to heroin treatable?
Yes. Treatment usually begins with medically assisted detoxification to help patients withdraw from the drug safely. Medications such as clonidine and buprenorphine can be used to help minimize symptoms of withdrawal. However, detoxification alone is not treatment and has not been shown to be effective in preventing relapse—it is merely the first step. Drugs such as methadone or buprenorphine have been proven effective in reducing heroin cravings. Twelve Step groups such as Heroin Anonymous and Narcotics Anonymous have been helpful in giving recovering addicts support and motivation to stay sober.
Addiction won’t go away like a cold or the flu. It is a chronic disease, meaning you have it all your life. However, by staying sober and getting ongoing support, recovering people live normal, healthy, productive lives.
There are many resources out there. The websites for the following organizations were chosen for their usefulness and user friendliness.
National Institute on Drug Abuse (NIDA): This government organization is dedicated to addiction research and education. Through its website you can access up-to-date publications about many different drugs of abuse as well as emerging trends.
Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA is part of the U.S. Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities. Its website offers information and resources about preventing and treating addiction and mental illness.