Understanding Heroin Addiction

Learn about heroin addiction and abuse

Heroin is widely known for its dangerously addictive properties. When individuals consume heroin, they are overcome with intense feelings of pleasure, euphoria, and a sense of detachment from their surroundings. These pleasurable feelings frequently cause them to continue using the substance, increasing their risk for developing an addiction to it. Despite the pleasurable feelings that the drug elicits, the detriments of its use are far more extreme. All aspects of an individual’s life can be negatively impacted when acquiring, consuming, and recovering from the use of heroin becomes his or her top priority. The longer that the abuse of this substance continues, the more likely it is that an individual will develop a tolerance to it, followed by the onset of chemical dependency, meaning that his or her body no longer knows how to function unless heroin is present in its system. Once this dependency and addiction have developed, it can be exceedingly difficult to overcome without receiving treatment.

Statistics

Heroin addiction statistics

Extensive research has provided evidence that nearly 13.5 million people around the world abuse opioids, with an estimated 9.2 million using heroin, specifically. The National Institute on Drug Abuse (NIDA) reports the 1.8% of individuals between the ages of 18 and 25 have abused heroin, and approximately 2% of individuals aged 25 and older have abused the drug.

Causes and Risk Factors

Causes and risk factors for heroin addiction

There are a number of causes and risk factors that can impact an individual’s susceptibility to becoming addicted to heroin. Such factors are discussed briefly in the following:

Genetic: Addictions have long been known to have a genetic link. Individuals who have family members who abused or were addicted to heroin are more likely to struggle with the same concerns than are individuals who do not have the same type of family history.

Environmental: Certain environmental factors can increase an individual’s vulnerability for beginning to experiment with the use of heroin. For example, people who are surrounded by other individuals, whether it be friends or family members, who abuse substances like heroin are more likely to engage in the behavior themselves than they would if they did not have such exposure. Additionally, experiencing a traumatic event or being the victim of abuse or neglect can lead individuals to seek out substances of abuse.

Risk Factors:

Possessing a novelty-seeking temperament
Possessing an impulsive personality
Associating with peers who use heroin or other substances
Family history of substance abuse
Personal history of abusing other substances
Ease of availability in obtaining heroin
Having a low self-esteem
Chronic exposure to violence, crime, and stress
Having experienced a trauma

Signs and Symptoms

Signs and symptoms of heroin addiction

The signs and symptoms that may be displayed by someone who is suffering from heroin use disorder will vary from person to person, but may include the following:

Behavioral symptoms:

Using heroin in situations where it is physically hazardous to do so, such as while operating a vehicle
Failing to put an end to the use of heroin despite frequent attempts to do so
Using heroin in greater quantities or with more frequency than one initially intended
Failing to adhere to social, familial, personal, and occupational responsibilities
No longer participating in activities that one once enjoyed
Frequent absenteeism from work
Decline in occupational performance
Social withdrawal and isolation
Wearing long-sleeved shirts or long pants, even when the weather in warm, in order to hide track marks from where the substance has been injected
Suicidal behaviors

Physical symptoms:

Constipation
Runny nose
Noticeable weight loss
Frequent bruising or scabbing of the skin
Dry mouth
Persistent flu-like symptoms

Cognitive symptoms:

Confusion
Concentration difficulties
Inability to think clearly
Inability to use sound judgment and reason
Suicidal ideation

Psychosocial symptoms:

Loss of interest in things that one once found enjoyable
Depression
Excitability
Anxiety
Hostility
Frequent mood swings

Effects

Effects of heroin addiction

When individuals fail to receive treatment for an addiction to heroin, they are placing themselves at risk for experiencing any number of detriments; detriments that have the potential to cause devastation in all facets of their lives. Examples of possible effects can include the following:

Lost friendships
Demise of marriages or partnerships
Loss of child custody
Interaction with the legal system
Incarceration
Occupational failure
Financial strife
Homelessness
Onset of self-harming behaviors

Additionally, chronic abuse of heroin can wreak havoc on the physical and mental health of those consuming it. Examples of these types of detriments can include:

Scars from injecting the substance intravenously
Contraction of viruses, such as HIV/AIDS, hepatitis, cellulitis, tuberculosis, and endocarditis
Clogged blood vessels
Perforation of the nasal septum from snorting the substance
Irreversible cognitive impairment
Organ damage
Erectile dysfunction in males
Disturbances of reproductive functioning, including irregular menses, in women
Seizures
Heart attack
Stroke
Onset of new, or worsening of current, mental illness symptoms
Chronic suicidal ideation

Dual Diagnosis

Heroin addiction and dual diagnosis

Unfortunately, it is not uncommon for individuals who are addicted to heroin to also be suffering from other mental health conditions. In clinical terms, this is known as dual diagnosis. Among people who are struggling with heroin addiction, dual diagnosis often involves the following disorders:

Posttraumatic stress disorder (PTSD)
Antisocial personality disorder
Conduct disorder
Major depressive disorder
Persistent depressive disorder
Other substance use disorders

The possible presence of additional disorders is one of the many reasons why it’s important to get care for heroin addiction at a center that offers dual diagnosis programming. Many people don’t realize they need dual diagnosis care until they enter a program. Failing to get the dual diagnosis care that you need can undermine your efforts to achieve and maintain long-term recovery from heroin addiction.

Withdrawal and Overdose

Effects of heroin withdrawal and overdose

Effects of heroin withdrawal: When chronic heroin use is suddenly ceased, there is the potential that withdrawal symptoms will arise. This state of withdrawal occurs as the body attempts to reregulate itself to the way that it functioned prior to the introduction of heroin. This withdrawal process can be extremely uncomfortable and, in some cases, even dangerous. Examples of signs and symptoms that could indicate that someone is going through heroin withdrawal may include:

Feelings of restlessness
Intense cravings for heroin
Bone pain
Abdominal cramping
Muscle pain
Watery eyes and runny nose
Diarrhea
Vomiting
Excessive sweating
Yawning
Fever
Insomnia

Effects of heroin overdose: An overdose occurs when an individual ingests more heroin than his or her body is capable of safely processing. In some circumstances, the body will try to adjust to the excessive amount of the substance by attempting to excrete it, usually by vomiting. But this attempt is not always successful, leaving the individual in a state of dire emergency. Should a person exhibit any of the following symptoms, it should be viewed as a warning sign that an overdose has occurred and that medical attention is required as soon as possible:

Extreme drowsiness
Tongue discoloration
Lips turning a bluish color
Disorientation
Weakened pulse
Hypotension
Muscle spasms
Labored breathing
Constricted pupils
Heart attack
Coma
Seizures
Stroke

Additional Information

How is heroin made?

Also called diacetylmorphine, heroin is a semi-synthetic opioid made from morphine. Morphine is made from the resin of poppy plants, which is combined with a chemical compound called acetic anhydride to form impure heroin. Heroin is then refined through a process of draining, filtering, and heating with other chemicals. This complicated process usually requires an experienced chemist and a good laboratory. In its purest form, heroin resembles a white powder, but it is more likely to be diluted with other chemicals, which turns the color gray, brown or black.

How do people get high on heroin?

Heroin can be injected, smoked or sniffed.

Smoking is one of the most common ways people abuse heroin. It is among the fastest ways to administer heroin, since heroin moves quickly from the lungs to the brain. To do this, heroin is placed on a sheet of aluminum foil, which is then placed over a lighter. A tube is held over the heroin, and the user inhales the vapor. Some prefer to use a toilet paper tube, in which a helper is needed to hold the lighter and aluminum; others prefer a solo procedure using a very small tube that can be held in the mouth. However, the direct pathway to the brain also makes smoking more dangerous, and overdosing is common.

Injecting heroin involves heating a mixture of heroin with water on a non-plastic spoon. A small cotton ball is placed in the solution, and a syringe is used to suck up the heroin from the cotton ball. The solution is usually injected in the bend of the arm. Though this method produces the greatest euphoria (“rush”), injecting heroin also carries extreme risks. A common problem occurs when the injection misses the vein and is goes into the skin instead, which leads to a “heroin blister”. The various additives found in street heroin may not fully dissolve, and may clog blood vessels. Repeated injections and reusing old needles carries the risk for infection, and sharing needles can lead to diseases such as Hepatitis and HIV.

The method for snorting heroin depends on the type of heroin you buy. Black-tar heroin is usually dissolved in a few drops of water. Crushed pills are added to absorb the liquid, which is then broken into small lines and snorted. However, it is very difficult to control how much heroin is snorted, and the rapid absorption of an unknown quantity can easily lead to overdose.

What should I not mix with heroin?

Heroin alone carries the risk for dangerous side effects. Mix it with other drugs, and the result is often lethal.

Alcohol. Heroin and Alcohol both work to increase the effects of GABA in the brain, the chemical that slows down your body system, including your breathing mechanism. Together, the drugs have a synergistic effect which can lead to respiratory arrest, or a complete cessation of breathing. Drinking alcohol can also impair the user’s judgment, leading them to take more heroin than they normally do, potentially causing an overdose. This combination has proven fatal and is the cause of many deaths involving heroin use.
Amphetamines (Ecstasy): Taking stimulants with opioids is like playing tug-of-war on your body. One tells it to speed up and the other tells it to slow down, placing the body in a dangerous state of imbalance.
Cocaine: Also called a “Speedball”, the combination of cocaine and heroin nearly doubles the effects of both drugs. While this seems attractive at first, this drug concoction suppresses the signs of overdose. A person can take fatal doses of both drugs without ever realizing the danger until it’s too late.
Depressant Drugs: GHB, benzodiazepines (Valium, Xanax) and other opioids all slow down the central nervous system. Mixing them together increases the chance of overdose.
LSD and other hallucinogens: LSD messes with the effects of opiates, making the experience unpredictable and usually unpleasant

What are the short-term effects of heroin?

Common short-term effects of heroin include:

Euphoria, or “rush”
Relaxation
Sedation and drowsiness
Slowed breathing
Clouded thinking
Hypothermia (a low body temperature)

What are the long-term effects of heroin?

Long-term effects of heroin abuse include:

Tolerance
Addiction
HIV/AIDS
Hepatitis
Skin infections
Collapsed veins
Lung infections
Constipation
Bad teeth and inflammation of the gums
Partial paralysis
Sexual dysfunction (inability to achieve orgasm and impotence in men)
Loss of memory and intellectual performance
Depression
Liver, kidney, and heart disease
Damage to vital organs from clogged blood vessels
Adverse consequences during pregnancy
Body Abscesses

What are the overdose effects of heroin?

Overdose effects include:

Stopped breathing
Weak pulse and low blood pressure
Coma
Delirium

How long does heroin stay in my system?

Once ingested, heroin is quickly metabolized and excreted. Heroin is usually detected in the urine for one to two days and can be detected in the hair for at least 90 days. As usual, the detection window for heroin depends on a person’s weight, metabolism, amount of heroin taken, and the frequency of dosing. The longer a person has taken heroin, the longer it takes to leave the body.

How long do the effects of heroin last?

Heroin is a fast acting drug. Its effects usually peak within 10 minutes and can last two to eight hours. The specific length of a high depends on a person’s dosage, weight, metabolism, tolerance, the method of ingestion, and the purity of the heroin being used. The onset of smoking or snorting heroin is faster than injecting or eating heroin. However, injecting heroin will achieve a greater high.

Since tolerance occurs rapidly, the effects of heroin will significantly decrease over time. An individual will need a higher dosage to achieve the same effects he or she used to have with smaller dosages. Sometimes users might need ten times as much drug in as little as ten days.

How much heroin can I take before I risk overdosing?

As usual, this depends on a person’s weight, metabolism, and tolerance. No two people are the same, and no two heroin dosages are the same either. Street heroin is rarely pure, and is usually “cut” (mixed) with other dangerous chemicals so a dealer can make more money. The user buying street heroin never knows the actual strength of the drug and what is actually in the drug, placing them at risk for overdose.

(For example, quinine, a commonly used additive in white powder heroin, can cause the lungs to fill up with fluid when taken in high concentrations. Quinine is one of the most common causes of heroin death.)

Additionally, heroin’s high tolerance rate forces users to consume more and more of the drug to achieve the desired effect. While “chasing the high”, users often consume dangerously high amounts of heroin. Heroin’s high tolerance rate is one of the main reasons overdose is so prevalent among users.

Can heroin kill you?

Yes. Death from heroin abuse can occur suddenly or gradually.

A lethal dose of heroin ranges from 200 mg to 500 mg, depending on the purity and the user. However, there is no safe dosage with street heroin. Street heroin is almost always mixed with other chemicals such as caffeine, lactose, starch, or other opioids.

In fact, reports show that street heroin can be and has been diluted with over 50 different substances. Herein lays the danger: a user never knows what he or she is taking. Even a little bit can be lethal.

Granted, those who have built up a tolerance to heroin can handle a larger dose than the one mentioned above. By that time, he or she is highly at risk for the long-term health effects of heroin. Although infection, addiction, or organ damage may not kill a person immediately, the long-term effects of heroin abuse are detrimental to one’s physical and social well-being.