Heroin Addiction in the United States
Most of us are aware that the United States is in the midst of a national overdose epidemic. What is the type of substance stealing the limelight of the epidemic? Opioids. Heroin is an opiate drug derived from the seedpods extracted from the poppy flower.
Nobody starts out to be a heroin addict. Many people start with an opioid pain medication prescribed by their doctor. But when the prescription runs out and the doctor won’t prescribe more refills, the cravings for the pleasure and relief begin. This is when many people turn to heroin. It is cheaper and stronger than prescription opioids and easier to get.
If you or a loved one have a substance use disorder, you are probably trying to hide it. It is common to try to avoid the stigma of drug addiction, not to mention the legal ramifications. Since you are reading this, you already suspect that you or someone close to you has a problem.
Heroin use no longer dominates exclusively in urban areas. Several suburban and rural areas communities near Chicago and St. Louis have reported increasing amounts of heroin seized by officials as well as increasing overdose deaths.
The Centers for Disease Control and Prevention (CDC) estimates that the “economic burden” of prescription opioid misuse alone is $78.5 billion a year. This includes the costs of healthcare, lost productivity, addiction treatment, and the involvement of the criminal justice system.
How Did This Happen?
In the late 1990s, drug companies assured the medical community that opioid pain relievers would not be addictive to patients. Healthcare providers began to prescribe them at increasing rates. This led to widespread misuse and diversion of these medications before it became clear that they were highly addictive.
Opioid overdose rates began to rise. In 2017, more than 47,000 Americans died from an opioid overdose, including prescription opioids, heroin, and an illegally manufactured synthetic opioid, fentanyl. Also, in 2017, an estimated 1.7 million people in the U.S. experienced substance use disorders related to prescription pain relievers and heroin use.
Signs of Addiction
In the early stages of heroin use, there may not be any signs of a disorder. This is especially true if the person is taking great measures to conceal it. The more it is used, the harder it is to hide.
Indicators of Heroin Abuse:
- Slurred speech
- Difficulty remembering things
- Marks from needles (if injecting)
- Runny nose or nose sores (if snorting)
- Obviously lacking self-care
- Secrecy or aggressive behavior
- Money issues
- School or work problems
- Dangerous or risky behavior
Anyone who uses heroin or other opioids is taking a chance of developing an opioid use disorder. But some factors increase the risk.
According to the Mayo Clinic, some of the risk factors in developing opioid abuse are:
- Personal or family history of substance addictions
- Heavy use of tobacco
- History of severe depression or anxiety
- Contact with high-risk surroundings and people
- History of risky behavior
If you or your loved one display one or many of the risk factors, it doesn’t mean that an SUD will necessarily happen or has happened. Addiction has many aspects, including genetic, psychological, and environmental factors.
What is Heroin?
It ranges from white powder, brown powder and black tar. It can be snorted, smoked, or injected. Originally made from morphine in 1874, heroin was created by a chemist at The Bayer Company of Germany in 1895 and introduced for medical use in 1898. The chemist was attempting to create a less addictive substitute for morphine and gave the new drug the name heroin for its supposed heroic qualities.
Unfortunately, the chemist later discovered that heroin is, in fact, two to three times more potent than morphine and absorbs rapidly into the brain, making it extremely easy for one to develop a heroin addiction.
How Easy is it to Develop an Addiction to Heroin?
Those addicted to heroin describe the high as feeling, “Covered in a warm blanket, where worries are gone.” (Bhandari, 2018). Heroin can be smoked, snorted, or injected directly into the user’s veins. Injecting heroin is the most popular way to take the drug since it’s the quickest way to feel the drug’s high.
Sadly, injecting heroin is the most dangerous way to use the substance. This is because the risk for overdose is greater, as well as the risk of developing an infection from using dirty needles.
It doesn’t matter how heroin gets into your body; it gets to your brain quickly. After using it only one or two times, it may be difficult to keep yourself from using it again.
Most users of heroin are aware of the deadly risks involved when using the drug yet are unable to discontinue using. Why? Heroin addiction is extremely powerful and usually requires professional medical intervention to treat and manage the addiction successfully.
How Does Heroin Work in the Brain?
Heroin binds to receptors in the brain to release the chemical called dopamine. Dopamine is then used by your nervous system to send messages between nerve cells. This plays a part in how we experience pleasure and pain. It may cause you to think and move slowly as the whole world seems to slow down around you.
Experts in the field attribute the increase in heroin use with the rising street costs of prescription painkillers such as OxyContin and Vicodin, which are also opioids. People in the market for a stronger, less expensive opioid receive both of these attributes.
Drug dealers have also been lacing heroin with a much more dangerous and potent substance called fentanyl. Fifty to one hundred times stronger than morphine, fentanyl is a synthetic opioid that is being found in more and more supplies of heroin. Heroin overdose deaths doubled between 2010 and 2012 and continue to rise at an exponential level since the introduction of fentanyl in heroin’s supply chain.
Treatment for Heroin Abuse
There is no single perfect cure for heroin addiction or any other drug. Many effective treatments can help an individual recover from heroin abuse. The types of treatment use depend on:
- The person
- The addictive substance
- Co-occurring medical conditions
- Length of addiction
- If the individual has attended a treatment facility in the past
Both behavioral (therapy) and pharmacological (medication) techniques help build some amount of normalcy to behavior and brain function. Research shows that combining both types of treatments is the most effective method if under the supervision of medical professionals.
Withdrawal symptoms for people who first quit using heroin may be quite severe. During the detoxification stage, medications are used to ease cravings and other painful symptoms that frequently cause people to relapse.
Heroin withdrawal symptoms include:
- Inability to think straight
- Stomach pain and throwing up
- Extreme aches and pains in muscles and joints
- Difficulty sleeping
Lofexidine, which has been used to treat blood pressure, is now approved for use to help with the symptoms of opioid withdrawal. It is not a treatment for addiction but is useful during detox.
Pharmacological Treatment for Heroin Use
The medications used to treat opioid addiction work through the same brain receptors as the drug but are safer and not likely to cause the same negative behaviors typical of substance use disorders. Medications are chosen based on the patient’s specific needs and other factors. There are three types of medications:
- Agonists are considered typical opioids as they activate the pleasure centers in the brain. Methadone is a slow-acting opioid agonist. It is only available through outpatient treatment programs and is dispensed daily.
- Partial agonists activate the opioid receptors but produce a limited response. Buprenorphine is a partial agonist that relieves drug cravings without the side effects of an opioid agonist.
- Antagonists block the receptor and prevent the reward effect of opioids. Naltrexone is an opioid agonist.
Behavioral Therapy for Heroin Use Treatment
There are many effective behavioral therapy techniques available for opioid use disorder. They are useful in both outpatient and residential programs.
Commonly used behavioral therapies are:
- Individual and group therapy—These types of therapies help an individual understand what was causing the addiction in the first place. In group therapy, they can discuss their experiences with other people going through similar situations. Ultimately this builds a support group that helps them grow.
- Contingency management—Contingency management uses a point system where patients earn points for clean drug tests. Points can be used to purchase things that encourage healthy living, such as nutritional meals, memberships to gyms, etc.
- Cognitive-behavioral therapy (CBT)—CBT is designed to adjust the patient’s behavior and expectations as they relate to drug use. It is a short-term therapy that helps patients learn new skills in coping with life’s stressors.
A common complication of treatment is relapse. Addiction is a complicated condition, and recovery often includes obstacles. Rates of relapse are between 40-60%, which is similar to the relapse rates with other chronic diseases such as asthma, hypertension, and Type 1 diabetes.
There are many reasons why people relapse, but the main one is that the person has the belief that the addiction is under control and wants to test himself. Other reasons are:
- “One last time can’t hurt.”
- Inability to cope with stress
- Difficulty managing physical and emotional pain
- Switching one drug for another
- Unable to address triggers
People who relapse are more susceptible to overdose. A dose of heroin you used before may now be fatal.
An overdose occurs when a person uses enough heroin to cause a life-threatening reaction or death. Heroin overdoses have risen in recent years, doubling between 2010 and 2012. Data from 2018 shows that every day, 128 people in the United States die after overdosing on opioids.
When a person overdoses, their breathing slows or stops, decreasing the oxygen to the brain. If the victim doesn’t die, this can have short- and long-term mental effects on the nervous system, including permanent brain damage.
Outlook for the Future
Although heroin addiction is a serious condition, it doesn’t have to be permanent or even long-term. It is a treatable disease. If you are seeking help for yourself or someone close to you, act now. It is not necessary or recommended to wait to “hit rock bottom.”
There is scientific evidence that combining medical and therapy-based treatments can give you the opportunity to recover and lead a healthy life. New federal rules have been enacted governing confidentiality and disclosure of substance abuse patient records.
You already know this can’t be solved at home. Harmony Ridge Recovery Center is located in the Mid-Ohio Valley in Walker, West Virginia.
Surrounded by 50 acres of lakes and forest land, it is the perfect place to begin a journey of any type. Our comprehensive treatment programs will set you up to succeed on your journey to recovery.
If you are ready to change your life, give us a call today. We have a 24-hour helpline waiting to hear from you.