Heroin is an extremely addictive and commonly abused opioid. People from all socioeconomic classes abuse heroin. The National Survey on Drug Use and Health indicates that nearly 5.1 million people used heroin in 2015. Heroin abuse is a disorder of epidemic proportions. The greatest increase in heroin use between 2001 and 2013 occurred in white Americans. Men are more likely than women to overdose and are four times more likely to overdose than women.
But heroin use has increased in women and higher income brackets.
The addiction process is considered, to begin with, the person using the drug more than once to get high. After a few uses, the individual may start developing tolerance. As a result, the person might take a higher dose for the same experience. This leads to dependence and addiction. Heroin alters the chemical pathways in the brain which leads to becoming dependent on the use of heroin. This then leads to the individual being unable to control heroin use, which is the hallmark of addiction.
Short-term effects of heroin abuse include:
- Inability to focus
- Lapsing in and out of consciousness
- Heart arrhythmia and palpitations
- Decreased respiration
- Low blood pressure
- Anxiety and depression
- Dry mouth
Long-term effects of heroin abuse include:
- Heart damage and heart disease
- Circulatory system problems
- Increased risk of developing pneumonia
- Cognitive damage and loss
- Memory loss
- Increased depression, anxiety, and moodiness
- Liver or kidney disease
The longer the drug has been used, the more damage results and the reversal becomes less likely. Brain damage and memory loss are often not reversible.
Heroin abuse is associated with other mental health conditions, due to common neurochemical pathways involved. Using heroin can cause a person to experience decreases in the ability to feel pleasure due to damage in the chemical systems that regulate reward responses. This can easily lead to depression and other anxiety and mood disorders.
Heroin overdose is another major concern. Signs of heroin overdose include:
- Shallow or stopped breathing
- Pinpoint pupils
- Dry mouth
- Bluish coloring to the fingernails and lips (cyanosis)
- Feeble pulse
- Stomach cramping
- Delirium or confusion
- Sleepiness or unconsciousness
- Coma, that can lead to death.
There are a variety of therapies available for management of Heroin use disorder. But despite them, about two-thirds of those who complete addiction treatment, relapse. Nonetheless, addiction treatment gives these individuals a solid chance of becoming and staying sober. Treatment options include:
- Medically supported detox and withdrawal
- Behavioral and motivational therapies
- Family therapy
- Peer support or 12-Step programs
- Nutritional and exercise programs
- Experiential therapy
Inpatient rehabilitation program provides patients with a structured routine that includes daily therapy, support groups, and activities. Medical management is important in helping wean individuals off heroin as it helps to reduce cravings and prevent relapses. Buprenorphine is one such medication that interacts with the same receptors as heroin but has limited effects. Methadone
is stronger than buprenorphine but essentially works in the same way. It does have an overdose potential. Naltrexone blocks opioid receptors and reverses the effects of heroin on the body. Suboxone is a combination of buprenorphine and naltrexone, and not only relieves withdrawal pain but also inhibits the effects of heroin.