The opioid epidemic has been steadily getting worse for the past decade, and in recent years, overdose death rates have spiked. Heroin is the main offender in the epidemic, killing 15,958 people in 2017 from an overdose. In the past few years, a powerful synthetic opioid called fentanyl has made its way into heroin supplies. People take the drug thinking they are just using regular heroin, but fentanyl makes it much stronger than their standard dose, causing a deadly overdose.
Heroin is powerfully addictive, but even heroin addiction can be treated. Learn more about heroin addiction and how treatment can help you achieve long-lasting sobriety.
Heroin is a powerful psychoactive drug in the opioid class of chemicals. It’s several times more powerful than morphine, and it’s primarily used as a recreational drug today. Heroin is derived from opium poppy plants, and it was first discovered by combining morphine with various acids to produce a new chemical. Also known as diamorphine, heroin was once used as pain medication.
Today, it’s rarely used in the United States, but it’s still widely used in the United Kingdom for palliative care. As an opioid, heroin works in the brain by binding to opioid receptors in the central nervous system and all over the body. The drug blocks pain signals, causes euphoria, and can be incredibly addictive. One study found that heroin and morphine had more of a psychological draw than other opioids, even more powerful ones.
Addiction is a chronic disease that’s difficult to overcome without help and professional treatment. However, addiction is considered a severe substance use disorder and usually comes after several signs and symptoms. Addressing a substance use issue early can help you avoid some of the most severe consequences of addiction. Learning to recognize addiction among loved ones can also help you to encourage them to seek treatment before they encounter serious consequences.
If you are worried that your own heroin use might be becoming a substance use disorder, there are a few telltale signs. Opioid use disorder typically develops after using several times. The first sign of a problem is usually tolerance, or the feeling that a normal dose is weaker than it used to be. This happens because your brain is getting used to the drug. If this continues, it can lead to chemical dependence. Dependence occurs when your body starts to rely on the drug to maintain normalcy. If you stop using, you may start to feel withdrawal symptoms.
If you are worried about a friend or family member, there are behavioral signs to watch for, including:
Ultimately, a substance abuse disorder becomes an addiction when a person uses compulsively, despite the serious consequences. If you lose a job, strain a relationship, or experience serious health issues and continue to use, you may be addicted
Addiction treatment is a process that guides you through withdrawal and helps you to learn how to manage triggers and stress to avoid relapse after treatment. The goal of addiction treatment is long-term sobriety and a return to productive society and a fulfilling lifestyle. Addiction is difficult to get over on your own.
It’s a complicated disease that comes with a variety of underlying issues and consequences that need to be addressed for treatment to be effective. Addiction to heroin and other opioids is notoriously difficult to overcome, but it is treatable.
Illicit heroin use has serious consequences, depending on the length of time you’ve used. It’s closely tied with the contraction of intravenously transmitted diseases, legal issues, financial problems, and social issues. This shapes treatment in two ways, according to the National Institute on Drug Abuse (NIDA).
First, it means that addiction treatment needs to be tailored to your individual needs to be effective. With so many different potential underlying causes and consequences, no one ultimate treatment plan is effective for everyone.
Second, addiction treatment needs to address more than just a substance use disorder. Because addiction can cause a variety of consequences and it can be caused by underlying issues, those issues need to be addressed for treatment to be successful.
When you first enter addiction treatment, you will go through an intake and assessment process that is intended to pinpoint your needs and determine the best level of care for you. Any pressing medical issues will be addressed and stabilized first, and as soon as you can, you may go through what is called a biopsychosocial assessment with your therapist. This questionnaire is designed to further explore your biological, psychological, and social needs and concerns.
Clinicians also use the ASAM Criteria, a six-dimensional assessment outlined by the American Society of Addiction Medicine (ASAM), to help with placement.
As an opioid, heroin causes uncomfortable symptoms during withdrawal that mimic the flu. In many cases, it can cause extreme discomfort, body aches, fever, chills, nausea, vomiting, sweating, and diarrhea. Though uncomfortable, opioid withdrawals usually aren’t life-threatening. However, vomiting, sweating, and diarrhea can cause dehydration, which can lead to life-threatening complications. So, it’s important to seek help when you want to quit.
The safest way to go through withdrawal is to seek medical detox, especially if you also used alcohol or central nervous system depressants that are more dangerous during withdrawal. However, insurance companies may not cover you for medical detox for opioid withdrawal because it’s not known to be life-threatening. However, it’s difficult to make it through withdrawal on your own without using, making withdrawal a serious barrier to treatment.
In some cases, especially when detox has been tried before, medication-assisted treatment can be used to alleviate withdrawal symptoms so that you can start treatment. Suboxone is often used to treat opioid withdrawal, and effectively staves off uncomfortable symptoms. Suboxone is a brand name for a drug that is a mixture of a “partial opioid” called buprenorphine and an opioid antagonist called naloxone.
The drug is taken by placing it under your tongue. The buprenorphine partially binds to opioid receptors, alleviating any withdrawal symptoms, without causing intoxication. The drug can be abused when it is taken intravenously, but that’s where the naloxone comes in. Naloxone has a low bioavailability when taken by mouth, which means only a fraction of it makes its way into the bloodstream, rendering it inert. When Suboxone is taken nasally or intravenously, the naloxone can take effect, causing immediate withdrawal. Together, the medication can help you avoid withdrawal, and it’s difficult to abuse.
There are a variety of addiction treatment modalities and therapy options you may encounter throughout your treatment. However, these therapies are split into two main groups: evidence-based therapy and alternative therapy.
Evidence-based treatment refers to therapies that have been proven to be effective in scientific studies. Examples include 12-step programs, certain medications, and behavioral therapies. Alternative therapies refer to treatments that may be helpful to some people but haven’t been tested or proven to be effective in a significant way. While alternative therapies can be useful in some settings to some people, they should only be supplemental to a treatment plan that’s rooted in evidence-based treatment.
After detox, you will be placed in a level of care that’s appropriate for your needs. If you have ongoing medical or psychological needs, you may be placed in inpatient care or a residential program. If you can live on your own, but you could use highly intensive clinical services, intensive outpatient or partial hospitalization may be for you. Outpatient treatment is the lowest level of care, but it works as a transitional step between more intensive treatment and independent life.
CDC. (2017, January 26). Heroin Overdose Data. from https://www.cdc.gov/drugoverdose/data/heroin.html
Darke, S., Larney, S., & Farrell, M. (n.d.). Yes, people can die from opiate withdrawal. from https://ndarc.med.unsw.edu.au/blog/yes-people-can-die-opiate-withdrawal
Martin, W. R., & Fraser, H. F. (1961, September 01). A COMPARATIVE STUDY OF PHYSIOLOGICAL AND SUBJECTIVE EFFECTS OF HEROIN AND MORPHINE ADMINISTERED INTRAVENOUSLY IN POSTADDICTS. from http://jpet.aspetjournals.org/content/133/3/388.long
National Institute on Drug Abuse. (2018, August 09). Overdose Death Rates. from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates
National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
National Institute on Drug Abuse. (2018, January). Evidence-Based Approaches to Drug Addiction Treatment. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment