Understanding Heroin Addiction

Heroin, when mentioned, elicits alarm. It’s a heavy-hitting substance in the harrowing world of illegal drugs, and many usually cower at its name. Through the lens of pop culture, we’ve seen it as the source of downfall and death of many, affecting the young, old, rich, poor, and everyone in between. The word alone brings forth images of rock-bottom depravity. Images like that of a desperate man or woman with a tourniquet of sorts around their arm, seconds away from injecting a needle into their vein.

Of course, heroin isn’t only injected; it can also be sniffed, smoked or snorted. But however you consume it, it’s one of the most addictive and dangerous substances in the world.

In 2018, The Centers for Disease Control and Prevention (CDC) reported that nearly 47,000 drug overdoses involved opioids, which included heroin. And yet approximately four million Americans have tried heroin at least once in their lifetime, with nearly one in four of them becoming addicted to it after just one use.

But what is it, really? What does it do to us? Why is it so harmful? And why is it so addictive?

Understanding Heroin

Made from morphine, heroin is a mind-altering painkiller. Morphine itself is a naturally occurring substance taken from certain poppy plants in Asia, Mexico or South America. And heroin is subsequently synthesized from that extracted morphine.

Since it is derived from the plant used to make opium, heroin is considered an opiate. It’s typically sold as either white or brown powder that is mixed with sugars, starch or powdered milk. Or, it can come in the form of a black sticky gel called “black tar.” On the street, it is often combined with other dangerous additives like fentanyl, which is a potent synthetic opioid pain reliever that is 50 to 100 times stronger than morphine, according to Addiction Center.

According to the National Institute on Drug Abuse (NIDA), heroin use and overdose deaths have dramatically increased over the last decade. And that influx can be attributed to the growing number of people misusing prescription opioid pain relievers, like OxyContin and Vicodin.

But how does this lead to heroin use?

Well, the individuals who misuse their pain pills end up developing a very expensive addiction, one that makes it financially burdensome to maintain. Heroin is cheaper and accessible, so the transition for some becomes an easy one. And while the percentage of people who switch to heroin from prescription pills is small, that number still translates to hundreds of thousands of heroin users.

Heroin Effects

Upon entering the body, heroin buys a one-way ticket to pleasure town. It quickly hops on opioid receptors, located in the part of the brain that is involved in the perception of pain and pleasure. And it creates an intense feeling of rapture. This “rush” from an intravenous use can last a couple of minutes, and as it travels through the bloodstream, the high can last for up to five hours.

But this sudden high, which has been compared to an orgasm in terms of pleasure, isn’t the only thing that can happen. Since heroin binds itself to the opioid receptors that are located not just in the brain, but also brain stem, spinal cord, lungs and intestines, a vast variety of physical problems can arise.

Short Term Effects Include:

• Dry mouth
• Warm flushing skin
• Heavy feeling in the extremities
• Vomiting or nausea
• Severe itching
• Clouded thinking
• Drowsiness, switching back and forth between being conscious and semi-conscious
• Blocked pain messages transmitted through the spinal cord
• Reinforcing drug taking behavior by altering activity in the limbic system, which controls emotions
• Depressed breathing by changing neurochemical activity in the brain stem where breathing and heart rate are controlled
• Increased risk of HIV and hepatitis (a liver disease) through shared needles

Long-Term Effects Include:

• Changes to the physical structure and physiology of the brain, creating imbalances in neuronal and hormonal systems that are not easily reversed
• Deterioration of the brain’s white matter, which may affects decision-making abilities and responses to stressful situations
• Problems sleeping
• Damages to the tissues inside the nose for those who sniff or snort it
• Painful area of tissue filled with puss (an abscess)
• Infection of the heart
• Constipation and stomach cramping
• Liver and kidney disease
• Lung problems
• Mental health problems, such as depression
• Sexual problems for men
• Changes in menstrual cycles for women

Like any other substance, repeated use can lead to tolerance. Which means, the more you take the more you’ll need. The same amount just won’t cut it, so the quantity and even frequency increases. At which point, addiction rears its ugly head.

When someone is addicted and stops using heroin, they’ll experience painful and wildly uncomfortable withdrawals.

Withdrawal Symptoms Include:

• Extreme pain in the muscles and bones
• Vomiting
• Trouble sleeping
• Cold flashes with chills
• Restlessness
• Diarrhea
• Strong craving for the drug

Heroin Overdose

So what starts out as an inviting and consequences-be-damned type of pleasurable activity, is really a pathway to a full on mental and physical breakdown. The user can no longer feel normal without the drug because the brain cannot produce dopamine on its own. Heroin hijacks all functions, and as the user increases the amount taken, they put themselves at greater risk of a fatal heroin overdose.

Heroin Overdose Signs

• Shallow breathing (even gasping)
• Pale skin
• Tongue discoloration
• Very small pupils
• Slow pulse
• Dry mouth
• Blue tint on lips and fingertips

There are, however, more warning signs to be aware of, as well. The most significant one being an unresponsive person. A person that appears to be sleeping, but they are not waking up despite being yelled at or shaken.

A person who has overdosed on heroin or heroin laced with fentanyl will commonly fall asleep in the middle of a sentence. If they happen to be sitting down and lolling their head, then that’s also a tell-tale sign of an overdose. Of course, you may not suspect heroin overdose if you don’t see drug paraphernalia nearby or even suspect its use. But just knowing that behavior is indicative of some dangerous level of inebriation, could save someone’s life.

And if you do suspect an overdose, call 911, try to rouse the person, and turn them onto their side to revive normal breathing. If you’re in position to administer naloxone, the opioid reversal agent, expect to see some severe flu-like symptoms.

Getting Help

Both treatment and medicines can help a person not only stop using but stay away from heroin use. Medicines like buprenorphine and methadone assist with cravings after the person has quit, and FDA approved medicines, including lofexidine, can help with withdrawal symptoms. So if you or someone you know is struggling with heroin addiction, don’t wait. You can get your life back today.