Heroin is a highly addictive opioid with a great potential for abuse due to the intense pleasurable “rush” it produces in the user. Over time, users crave increasingly greater amounts of the drug to achieve the same effect. This dynamic elevates the risk of physical dependency, addiction, and accidental drug overdose. Exploring effective treatments for opioid use disorder (OUD) is a crucial step for those seeking recovery from heroin dependence and addiction.
What Is Heroin?
Heroin is an illicit opioid derived from morphine, which itself is derived from the opium poppy plant. Classified as a Schedule I controlled substance, heroin has no approved medical use in the U.S.1 Furthermore, it is widely considered a dangerous drug due to its high potential for abuse and risk of overdose and addiction.
Heroin typically comes in two forms: a white or brown powder or a black sticky substance known as “black tar.” Heroin can be snorted, smoked, or injected directly into the bloodstream. All these methods carry significant risks, including addiction, overdose, respiratory failure, and other health complications.2 Heroin is referred to by various slang terms like smack, junk, horse, or H.
Heroin Addiction & Dependence
People can quickly become addicted to heroin due to the way it interacts with the brain’s reward system. As heroin enters the bloodstream, the brain quickly converts it to morphine, which binds to the brain’s opioid receptors to instill feelings of euphoria and relaxation. These feelings can be highly reinforcing, meaning users will seek out and use heroin again and again to experience its effects.3
As people use heroin repeatedly, they develop tolerance, meaning they need larger and larger amounts of the drug to achieve the desired effect. Tolerance can lead to dependence, where the body requires heroin simply to function normally. Dependence also practically guarantees that the user will experience withdrawal symptoms like nausea, muscle pain, anxiety, and intense drug cravings when they stop using.
Dependence typically leads to addiction and OUD. Opioid use disorder differs from heroin dependence in that dependence refers to the physical need for the drug while addiction includes both physical and psychological symptoms.4
As the brain adapts to the regular presence of heroin in the body, users will find it increasingly difficult to take pleasure in activities that do not involve heroin. This dynamic drives the user to engage in compulsive drug-seeking behavior, a key characteristic of OUD.
Signs of Heroin Addiction
Heroin addiction, or OUD, is recognized by several physical and behavioral signs. Based on criteria outlined in the DSM-5 for OUD, these signs can identify if and when someone is struggling with heroin addiction. The signs of OUD include:5
- Craving or strong desire to use opioids such as heroin
- A persistent desire or unsuccessful efforts to cut down or control opioid use
- Spending significant time seeking opioids, using opioids, or recovering from their effects
- Neglecting important social, occupational, or recreational activities because of opioid use
- Undergoing withdrawal symptoms when not using opioids
- Continuing to use opioids despite their negative consequences, including legal, social, or physical health consequences
Effects of Using Heroin
Aside from relaxation and euphoria, heroin can have numerous short-term and long-term side effects on the user. While many of these effects are common among all types of heroin users, others are exclusive to the method in which the heroin is taken. Some of the common effects of heroin include:6
- Dry mouth
- Flushed skin
- A heavy feeling in the arms and legs
- Itching
- Nausea and vomiting
- Drowsiness
- Slowed breathing
- Abscesses
- Bacterial infections of the heart (endocarditis), skin, and bloodstream
- Collapsed veins
Risk of Heroin Overdose
As with other opioids, users of heroin have a high risk of overdose, particularly when combined with other substances. Combining heroin with respiratory depressants like alcohol or benzodiazepines, or stimulants like cocaine or methamphetamine, heightens the risk of overdose significantly. The risk of overdose is also heightened when the user lives with a chronic health condition such as lung disease, hepatitis, or HIV.7 Heroin overdose symptoms include:8
- Slowed or shallow breathing
- Dilated pupils
- Discoloration of the tongue
- Weak pulse
- Bluish-colored nails and lips (cyanosis)
- Confusion and disorientation
- Drowsiness
- Uncontrolled muscle movements
- Coma
If you suspect someone is overdosing on heroin or other opioids, it’s important to act quickly. Administer Narcan (naloxone) if available and call 911 right away for emergency medical assistance. It’s important to stay with the person, monitor their breathing, and be ready to administer a second dose of Narcan if necessary until help arrives.
Heroin Withdrawal & Detox
Users of heroin can experience uncomfortable, sometimes intense withdrawal symptoms when they stop using. As a result, people attempting to quit using heroin can have a difficult time staying sober.
A medically supervised detox program can help patients safely quit and manage their withdrawal symptoms with the help of prescription medications. Medical detox provides a safe and supportive environment for those looking to quit heroin for good. Some common heroin withdrawal symptoms include:9
- Intense cravings for heroin
- Restlessness
- Sweating and hypertension
- Anxiety
- Irritability
- Diarrhea
- Nausea or vomiting
- Muscle pain, stomach cramps, and bone pain
- Insomnia
The Importance of Detox for Heroin Addiction
Detoxification is a critical first step in the treatment of heroin addiction, as it addresses the physical dependency on the drug. The importance of detox in this process cannot be overstated for several reasons:
Safety: Heroin withdrawal can be physically and psychologically intense, even medically dangerous. Detox in a supervised medical setting ensures that the individual’s health is closely monitored and any complications are promptly addressed.
Easing Withdrawal Symptoms: Medically supervised detox often involves medication-assisted treatment (MAT) to help alleviate withdrawal symptoms. Therefore, making the process more bearable. This can significantly reduce the discomfort and pain associated with heroin withdrawal.
Preventing Immediate Relapse: The severity of withdrawal symptoms can often lead to immediate relapse if not properly managed. Detox provides a controlled environment where relapse is not an option, thereby setting the stage for a more successful long-term recovery process.
Transition to Further Treatment: Detox is typically the first phase in a comprehensive treatment plan. Completing detox can psychologically prepare individuals for the next steps in their recovery journey, such as inpatient or outpatient rehab and therapy for heroin addiction.
Building a Foundation for Long-Term Recovery: Detox provides individuals with a clearer state of mind and a physically stabilized condition, which are essential for effectively engaging in further treatment and recovery efforts.
Detox is an indispensable part of the journey towards recovery from heroin addiction. It provides a safe and supportive environment to begin the challenging process of withdrawal, setting a solid foundation for the subsequent steps in the treatment and recovery process.
How is Heroin Addiction Treated?
Heroin addiction can be treated in a variety of settings, beginning with detox and moving through inpatient treatment, outpatient treatment, and aftercare.
Effective heroin addiction treatment programs typically include a research-based behavioral therapy, medications for addiction treatment (MAT) to help reduce cravings, and dual diagnosis treatment. Dual diagnosis treatment is a therapeutic approach that addresses both the addiction as well as any existing co-occurring mental health disorders such as depression, anxiety, or bipolar.10
The various settings for treatment of heroin addiction include:
- Detox is the process of ridding substances from the body while managing any withdrawal symptoms that might occur. The time it takes to detox from heroin can vary, but most medically supervised detox programs last three to seven days. Medically supervised heroin detox programs provide a safe, supportive environment for those who want to quit heroin. Many prescribe medications that have been approved by the U.S. Food & Drug Administration to manage the more intense heroin withdrawal symptoms.
- Inpatient treatment requires the patient to temporarily reside in a rehab facility to receive structured, individualized therapy or counseling, education, and support. The treatment helps patients manage their addiction over the long term and develop tools to enable them to live a healthier and more productive life. Inpatient treatment can last from 15 to 90 or more days, depending on the patient’s needs.11
- Partial Hospitalization Programs (PHP) represent a “step down” from inpatient treatment by offering comprehensive addiction treatment without a residential stay. During PHP, you attend a program for several hours a day, for three to five days per week. PHP programs enable patients to manage their long-term withdrawal symptoms while honing their life and coping skills. PHP typically lasts up to 30 days.
- Intensive Outpatient (IOP) typically includes multiple therapy sessions per week, such as individual counseling, group therapy, and educational workshops, all designed to address various aspects of recovery. IOP programs are ideal for those who require more support than standard outpatient programs but less intensive treatment than what is offered under PHP or inpatient treatment.
- Outpatient (OP) programs offer flexible treatment options that enable patients to live in their own homes and attend to their everyday duties at work or school while receiving care. OP is ideal as a standalone treatment option for people with mild or moderate substance use disorders and no co-occurring mental health disorders.
- Aftercare is the stage of addiction treatment that follows more intensive care, including inpatient and outpatient treatment. It is provided in a variety of formats and modalities, including individual therapy, group counseling, and self-help meetings.12
The Importance of Therapy for Heroin Addiction
Therapies vary based on each patient’s unique treatment plan. Addressing various aspects of addiction and recovery, therapy plays an important role in ongoing recovery. Examples of therapies that may be used during treatment include:
- Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and change negative thought patterns and behaviors related to addiction. It teaches coping skills to handle triggers and cravings.
- Dialectical Behavior Therapy (DBT): DBT teaches patients skills to manage painful emotions and decrease conflict in relationships. It’s particularly effective in treating individuals with dual diagnoses, such as addiction and mental health disorders.
- Individual Therapy: This one-on-one approach is crucial for heroin addiction treatment. It provides a personalized space for individuals to explore the root causes of their addiction, address personal challenges, and develop tailored coping strategies.
- Group Therapy: Led by a therapist, group sessions provide a supportive environment where individuals can share experiences and learn from others in recovery.
- Family Therapy: Addiction affects not just the individual but the entire family. Family therapy involves family members in the treatment process to improve communication and heal relationships.
- Trauma Therapy: Trauma therapy helps individuals process and heal from past traumatic experiences that often underlie and fuel their addictive behaviors. Addressing these deep-rooted issues is essential for breaking the cycle of addiction and paving the way for lasting recovery.
- Experiential Therapies: Experiential therapies play a key role in heroin addiction treatment by engaging individuals in hands-on activities, such as art or music therapy, to foster emotional expression, self-discovery, and healing in ways that traditional talk therapy may not reach.
- Holistic Therapies: These may include yoga, meditation, art therapy, or acupuncture, aimed at treating the whole person, not just the addiction.
How to Help a Loved One Addicted to Heroin
Helping a loved one who is addicted to heroin can be challenging, but there are effective steps you can take:
Educate Yourself: Learn about addiction, the effects of heroin addiction, and the recovery process. Understanding what your loved one is going through is crucial for providing appropriate support.
Communicate Openly: Approach your loved one with empathy and without judgment. Express your concerns about their heroin use and its impact on their life and your relationship.
Encourage Treatment: Gently encourage them to seek professional help. Offer to help them find a suitable treatment program.
Support, Don’t Enable: Be supportive but avoid enabling their addiction. This means not covering up for their behaviors, not providing financial support for drugs, and setting healthy boundaries.
Intervention: If direct conversation is not effective, consider organizing an intervention with the help of a professional. Interventions help the person realize the extent of their problem and the need for help.
Take Care of Yourself: Dealing with a loved one’s addiction can be emotionally draining. Make sure to take care of your own mental and emotional health. Consider seeking support for yourself.
Stay Involved During Treatment: If your loved one agrees to treatment, stay involved and supportive throughout the process.
Plan for Recovery: Recovery from heroin addiction is a long-term process. Help your loved one plan for ongoing support after treatment, such as therapy, support groups, or sober living environments.
Be Patient and Hopeful: Recovery is a journey with ups and downs. Stay patient and maintain hope. Celebrate small victories and be there for your loved one during setbacks.
Remember, while you can offer support and encourage treatment, ultimately the decision to seek help and stay in recovery lies with your loved one.
Heroin Addiction Treatment in Atlanta
At Empowered Recovery Center in Atlanta, we understand that overcoming heroin addiction is far more complex than just breaking the habit. It’s about finding the courage to embrace a new way of living. Our recovery center in Atlanta is designed to help you find that courage and move toward a healthier future.
We offer a variety of rehab programs tailored to fit your needs as well as one full year of recovery coaching to keep you feeling supported once you’ve returned to everyday life. Our admissions team can answer any questions you might have about programs, insurance, or how to pay for rehab. We can verify your benefits and assist you with out-of-network coverage plans.
If you’re ready to learn more about our comprehensive heroin addiction treatment program, reach out today.
References
- Department of Justice/U.S. Drug Enforcement Administration. (n.d.). Drug Fact Sheet: Heroin. U.S. Drug Enforcement Administration. Retrieved September 27, 2024, from https://www.dea.gov/sites/default/files/2020-06/Heroin-2020.pdf
- National Institute on Drug Abuse. (n.d.). Heroin Research Report: What is heroin and how is it used? National Institutes of Health. Retrieved September 27, 2024, from https://nida.nih.gov/publications/research-reports/heroin/what-heroin
- National Institute on Drug Abuse. (n.d.). Heroin Research Report: What are the immediate (short-term) effects of heroin use? National Institutes of Health. Retrieved September 27, 2024 https://nida.nih.gov/publications/research-reports/heroin/what-are-immediate-short-term-effects-heroin-use
- National Institute on Drug Abuse. (n.d.). Heroin Research Report: What are the long-term) effects of heroin use? National Institutes of Health. Retrieved September 27, 2024, from https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use
- American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association. Retrieved October 1, 2024, from https://www.asam.org/docs/default-source/education-docs/dsm-5-dx-oud-8-28-2017.pdf
- MedLine Plus. (n.d.). Heroin. National Library of Medicine. Retrieved September 29, 2024, from https://medlineplus.gov/heroin.html
- Mass.gov (n.d.). Opioid Overdose Risk Factors. Commonwealth of Massachusetts. Retrieved October 1, 2024, from https://www.mass.gov/info-details/opioid-overdose-risk-factors
- Mount Sinai (n.d.). Heroin overdose. Mount Sinai. Retrieved October 1, 2024, from https://www.mountsinai.org/health-library/poison/heroin-overdose
- U.S. National Library of Medicine. (n.d.). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. National Institutes of Health. Retrieved September 30, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK310652/#part4.s3
- National Institute on Drug Abuse. (n.d.). Heroin Research Report: What are the treatments for heroin use disorder? National Institutes of Health. Retrieved September 30, 2024, from https://nida.nih.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder#:~:text=A%20variety%20of%20effective%20treatments%20are%20available%20for%20heroin%20use
- Cleveland Clinic. (n.d.). Diseases and Conditions: Addiction. Cleveland Clinic. Retrieved September 29, 2024, from https://my.clevelandclinic.org/health/diseases/6407-addiction
- U.S. National Library of Medicine. (n.d.). Continuing Care Research: What We’ve Learned and Where We’re Going. National Institutes of Health. Retrieved October 1, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670779/
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