Heroin Addiction

Heroin is a highly addictive drug.  It the most abused of all the opiates.  Heroin is derived from morphine, which comes from certain varieties of poppy plants.  When processed it looks like a white or brown powder or a black sticky substance called "black tar heroin." 

The Risks of Heroin Use

“Pure heroin” is the term used for heroin that is not mixed with another substance. However “street heroin” is "cut" or mixed with other drugs or with white substances such as sugar, starch, or powdered milk.  Street heroin can also be mixed with strychnine or other poisons putting the drug user’s life in jeopardy.  Because heroin addicts do not know what the strength of the pure drug may be or what it may be mixed with, they are at risk of overdose or death.  Studies have shown that the average heroin user after five years of use has a 90% chance of having contracted Hepatitis C.   The transmission of HIV and other diseases that can occur from sharing non-sterile needles is a high risk for heroin addicts.

Routes of Administration

Heroin is typically injected, snorted, or smoked.  Injection provides the fastest rush and greatest intensity of the drug, usually within seconds. When heroin is snorted or smoked the effects are usually felt within 10 to 15 minutes.   Smoking and snorting heroin do not produce the rush as quickly or as intensely as injection does; yet all three forms of heroin administration are addictive.

Injection, referred to as “shooting up”, is the most popular route of heroin use among addicted users seeking treatment.  However, researchers have observed that patterns are shifting to more addicts snorting referred to as “sniffing” or smoking heroin.  The shift in heroin abuse patterns from injection to snorting/smoking is introducing the use of heroin to more diverse group of users.  Adults over the age of 30 continue to be one of the largest user groups abusing heroin.

Heroin Side Effects:

Short-term effects include:

• Physical sensation rush
• Slow shallow breathing
• Confused poor mental functioning
• Nausea/vomiting
• Dulling of pain
• Miscarriage

Long term effects include:

• Addiction
• Infectious diseases (HIV/AIDS, TB, Hepatitis B and C and other blood born illnesses)
• Collapsed veins
• Bacterial infections
• Infections and abscesses
• Damage to heart lining and valves
• Arthritis
• Rheumatologic problems

Signs of Heroin Abuse

• Constricted (small) pupils
• Vomiting
• Constipation
• Nodding Out
• Hyper, wakeful and alert before nodding out
• Loss of old, established friendships
• New, undesirable friends
• Frequent, secret phone calls
• Depression, apathy, lethargy
• Track marks on body from injecting
• Unexplained time away from home
• Sudden changes in behavior or performance
• Itching and scratching (itchy blood)
• Weight loss
• Cessation of menstrual cycle
• Finding plastic zip loc baggies and burned silver spoons
• Aluminum foil & gum wrappers with burn marks
• Missing shoelaces from shoes (used as a tie off for injecting)
• Dry mouth
• Droopy appearance, as if extremities are "heavy"
• Disorientated, cloudy mental functioning
• Infections (at injection site)
• Shallow breathing
• Euphoria or rush
• Sleepiness
• Poor hygiene
• Drug Paraphernalia discovered

Withdrawal

Withdrawal symptoms from heroin can start a few hours to one day after sustained use o the drug.   Withdrawal symptoms can include: sweating, anxiety, depression, profound sense of futility, feeling of heaviness, intense cramping in limbs, crying, insomnia, cold sweats, chills, runny nose, severe muscle and bone aches, nausea and vomiting, diarrhea, and fever.  Many heroin addicts also describe experiencing a condition referred to as “itchy blood.” This condition results in the addict compulsively scratching or picking at their skin resulting in cuts and bruises.  There is no threat of death in terminating heroin use suddenly as there is with alcohol, benzos and barbiturates.  Although clearly stopping heroin use “cold turkey” without the use of counteractive drugs to reduce the above listed symptoms is incredibly uncomfortable.

Heroin Addiction Treatment

Treatment for heroin addiction can be done inpatient, residential or outpatient.  Methadone clinics that administer the counteractive drug methadone are another option.  Suboxone is another popular counteractive drug for opioid dependence.  Medical interventions should be coupled with behavior modification work, psychotherapy, counseling, education and 12 step support groups.