Signs of Heroin Use, Abuse and Addiction

Heroin quickly passes through the bloodstream into the brain. It works by binding to natural opioid receptors in many areas of the brain, particularly those that regulate pleasure, pain, heart rate, and respiratory activity. It causes the release of mood-affecting chemicals like serotonin and alters many body functions.

Drug abuse, or substance abuse, arises when drugs are taken in a way other than a medical professional prescribes them. Drug abuse also occurs when heroin is taken for recreational purposes.

As noted above, heroin is a Schedule I illicit drug with no medical value, meaning that it is illegal for doctors to prescribe heroin in the United States. This also concludes that any use of heroin is a form of heroin abuse.

How Widespread Is Heroin Abuse in the United States?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 902,000 people reported using heroin in 2019, representing about 0.3% of the population. In the same year, approximately 14,019 people died from a heroin overdose.

What Is the Link Between Prescription Opioid Abuse and Heroin Abuse?

In recent decades, the United States has been in the grip of an opioid crisis. Millions of people have become addicted to prescription drugs containing opioid painkillers, leading to long-term health problems, social issues, and premature death.

Social studies have investigated the link between prescription opioid abuse and heroin. Research from 2011 found that up to 6% of people misusing other drugs, such as prescription drugs, switched to heroin. However, recent data suggests that heroin is often the first opiate that people use. Within a group of people entering treatment for heroin use disorder, one in three people said heroin was the first opiate they had taken to get high.

As reported by the National Institute on Drug Abuse, this evidence suggests that prescription drug abuse is only one of the factors contributing to heroin use.

Heroin addiction is when an individual compulsively uses heroin despite its negative consequences. It is characterized by physical changes in the brain that cause strong urges to seek the substance, especially in response to specific triggers.

Heroin is a highly addictive drug regardless of the method of administration. However, routes of ingestion that allow heroin to cross the blood-brain barrier fastest, such as smoking or injecting, increase the risk of developing a heroin use disorder.

What Is the Difference Between Physical Dependence and Addiction?

Physical dependence happens when a person repeatedly uses heroin over some time. Upon doing so, the body becomes accustomed to the presence of heroin and adjusts its natural opioid – endorphin – production to compensate. Following this, many people develop a tolerance to heroin and begin to depend on it to feel normal. If someone suddenly stops using heroin, they often experience a range of withdrawal symptoms.

While physical dependence often leads to addiction, the two are distinct conditions. Addiction refers to the psychological and behavioral phenomenon of compulsively seeking the drug. It is possible to be physically dependent on heroin without being addicted, and vice-versa.

Heroin is a powerful opiate drug that comes from the seeds of the opium poppy plant. A natural substance usually found in a white or brown powder, heroin can produce feelings of euphoria and relaxation in the user and acts as a potent painkiller when injected, snorted, or smoked.

Due to its euphoric high, heroin has a high potential for abuse. For this reason, the United States Drugs Enforcement Administration (DEA) classifies heroin as a Schedule I substance.

Heroin is a powerful substance with a high risk of overdose – fatal overdose is possible with only one use. It also comes with several short-term and long-term risk factors that can impair a user’s health, including heroin addiction.

What Are the Short-Term Effects of Heroin Use?

Heroin users often take heroin to experience a rush of pleasure or euphoric high. But heroin can have other short-term effects, including:

• Skin flushing
• Heavy arms and legs
• Dry mouth
• Vomiting and/or nausea
• Inhibited mental functioning
• Drifting between consciousness and semi-consciousness
• Heroin overdose, which may lead to coma or death
• Infectious diseases due to sharing of needles

What Are the Long-Term Dangers of Heroin Use?

Research has shown that repeatedly using heroin changes the structure of the brain, creating hormonal and neurological imbalances that are difficult to reverse. It may cause partial deterioration of the brain’s white matter, which could affect decision-making skills and responses to stressful situations.

Some other long-term risks of heroin use include:

• Insomnia
• Collapsed veins
• Damaged tissue inside the nose
• Infected valve linings in the heart
• Abscesses
• Constipation and stomach cramps
• Liver and kidney disease
• Lung diseases such as pneumonia
• Lung complications including pulmonary embolism
• Mental illnesses including major depression and antisocial personality disorder
• Sexual dysfunction
• Irregular menstrual cycles
• Physical dependence
• Heroin addiction

What Happens in a Heroin Overdose?

Heroin is a central nervous system depressant that works by slowing down activity in the brain. During a heroin overdose, the heart and respiratory system slow down to dangerous levels. Here, breathing and heart rate depress to a level that cannot be survived without immediate medical support.

If someone has overdosed on heroin, emergency medical care should be sought immediately. Medics can prescribe a drug called naloxone that quickly binds to opioid receptors, preventing heroin from activating them. It can stop all signs of opioid intoxication and reverse a heroin overdose.

Preventing Heroin Overdose

In response to rising rates of opioid overdose from prescription opioid abuse, medical and governmental institutions have heightened preventative measures against heroin overdose. In 2021, the Food and Drug Administration (FDA) approved a higher-dose naloxone nasal spray that families and caregivers can use to reverse an opioid overdose in loved ones.

If someone lives with a heroin use disorder, it’s normal to feel scared. Recovery may seem difficult or even impossible, especially as many people do not know where to start.

The good news is that addiction is treatable, and no matter how severe the problem, anyone can benefit from drug rehabilitation programs. According to the National Institute on Drug Abuse, effective treatment combines a range of treatment approaches tailored to each client’s unique needs. Programs should be continuously evaluated and adapted as each client progresses along their recovery journey.

Heroin recovery programs may involve:

• Inpatient medical detox, where clients are consistently monitored to ensure their safety throughout the process
• Talk therapies, including cognitive-behavioral therapy
• Group programming
• Support groups
• Family therapy
• Complementary or alternative treatment methods, like yoga or meditation
• Experiential therapies such as creative arts therapies
• Medication-assisted treatment (MAT)

In response to the current pandemic, addiction treatment centers typically offer proper infection prevention procedures and controls so that all clients are safe throughout their treatment experience. Staff maintain proper distance, use personal protective equipment items, and follow symptom screening protocols according to Centers for Disease Control and Prevention (CDC) guidelines.

Recovery programs can be inpatient or outpatient. Inpatient programs involve residential stays in a center, offering a safe and trigger-free environment to help clients engage in treatment. Outpatient treatment involves regular visits to a treatment center for recovery sessions while allowing clients to continue fulfilling their work and home responsibilities. Clients often begin in inpatient programs before moving to outpatient as they continue their recovery journey.

Recovery from addiction is a lifelong process that requires commitment and support long after leaving a treatment center. Many rehab facilities offer continued care or alumni programs so those in recovery can remain connected in the years ahead. Support groups are also available, enabling many to benefit from the shared experience of others in recovery.

If you think that a loved one may be using heroin, it is normal to want to support them and recognize the problem. Though help is available, those struggling with a heroin addiction need to be committed to recovery first.

Having an open conversation with your loved one about their heroin use and the options for treatment is recommended. In doing so, try to listen to what they have to say and avoid being judgmental.

If this is unsuccessful or you don’t feel comfortable having the conversation yourself, you could stage an intervention with the help of an addiction professional. The interventionist may help your loved one accept that they have a problem and recognize the need for recovery and treatment.

Living with a loved one in recovery can be difficult and tiring. You must remember to care for yourself throughout the process. Make sure that you practice good self-care, eat well, exercise, and engage in hobbies you enjoy.

You can also seek professional help and advice on how to support a loved one and care for yourself. Support groups like Al-Anon are a place where families of people in recovery can meet, share their experiences, and provide mutual encouragement and support. You may also want to receive therapy and other mental health support to help you cope with the emotional toll of addiction.