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Heroin Addiction

Heroin addiction, formally classified as opioid use disorder or heroin use disorder, can develop rapidly and with far-reaching consequences. 

A semi-synthetic opioid derived from morphine that has been processed chemically. Morphine is a substance that occurs naturally in opium poppy seed pods.

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Heroin comes in the following forms:

  • White powder
  • Brown powder
  • Black, sticky paste (Mexican tar heroin) 

When heroin is snorted, smoked, or injected, it enters the brain quickly, binding to naturally-occurring opioid receptors. 

Heroin addiction is an issue for 690,000 people in the United States, according to NSDUH 2020.

Article at a Glance:

How Does Heroin Addiction Occur?

As a semi-synthetic opioid and opioid, heroin delivers both pain-relieving and rewarding properties as it interacts with your brain’s opioid receptors. 

In your brain, you have chemical messengers called neurotransmitters. Some neurotransmitters are associated with core physiological processes while others are associated with movement and mood. Neurotransmitters typically deliver endorphins on demand. Endorphins are informally known as feel-good chemicals due to the way they relieve pain and boost happiness. 

If you use an addictive substance like heroin, your brain is flooded with endorphins. This reduces anxiety, and at the same time induces a sense of calm and euphoria. 

The sustained use of heroin will cause tolerance to swiftly build. When this occurs, you will need more heroin to achieve the same effects. Alternatively, you will need to increase the frequency of doses. 

Opioid tolerance, like opioid dependence and opioid addiction, is a manifestation of significant brain changes triggered by the chronic abuse of opioids. 

As tolerance to heroin builds and you use more of the drug, the risk of developing physical dependence heightens. By the stage of heroin dependence, you will experience intensely uncomfortable withdrawal symptoms in the absence of heroin. 

Although physical dependence is not the same as addiction, it often leads to addiction. 

When heroin addiction develops, this is diagnosed using the criteria in DSM-5-TR, the most current edition of APA’s Diagnostic and Statistical Manual of Mental Disorders. NIDA (National Institute on Drug Abuse) defines heroin addiction as a chronic and relapsing brain disorder. Like all addictions, heroin use disorder is characterized by the compulsive use of the substance despite obviously negative outcomes.

Signs of Heroin Addiction

Injecting heroin triggers almost instantaneously and intensely euphoric effects. 

Smoking the drug doesn’t produce such powerful effects as it takes longer to reach the brain than when injected intravenously. 

If you suspect a loved one is using this debilitating drug, here are some of the most common signs of heroin addiction: 

  • Suddenly nodding off
  • Continually dry mouth
  • Constricted pupils
  • Loss of self-control
  • Nausea and vomiting
  • Ongoing constipation
  • Slowed breathing
  • Poor personal hygiene
  • Neglected responsibilities
  • Track marks on arms
  • Itching the skin constantly
  • Confusion and disorientation
  • Impaired decision-making
  • Memory loss
  • Dramatic and unintentional weight loss
  • Runny nose and watering eyes
  • Lethargy and extreme exhaustion
  • Persistent flu-like symptoms
  • Bruising and scabbing of the skin
  • Shattered sleep patterns
  • Pneumonia
  • Tuberculosis
  • Damage to the liver and kidneys
  • Hepatitis C
  • HIV/AIDS

Heroin Addiction Symptoms

The symptoms of heroin addiction will vary according to many variables, such as: 

  • Duration of heroin use
  • Quantity of heroin used
  • Route of delivery 

Symptoms can be broadly grouped as follows: 

  • Psychological Symptoms
  • Physical Symptoms

Psychological Symptoms

  • Disorientation
  • Dramatic mood swings
  • Loss of interest in hobbies and activities
  • Major depressive episodes
  • Hostility
  • Irritation
  • Anxiety
  • Euphoria
  • Agitation
  • Concealing drug use
  • Lying about drug use
  • Paranoia
  • Social withdrawal
  • Hallucinations

Physical Symptoms

  • Nausea
  • Vomiting
  • Runny nose
  • Dry mouth
  • Weight loss
  • Persistent itching
  • Dilated pupils
  • Constipation
  • Stomach pains
  • Scabs and bruises on the skin
  • Problems with vision
  • Disrupted sleeping patterns
  • Slow breathing
  • Irregular breathing
  • Flushed skin
  • Falling asleep suddenly
  • Pinprick pupils
  • Slurred and incoherent speech

What Happens at Heroin Addiction Rehab?

Whether you engage with inpatient or outpatient rehab, you’ll first need to detox and address the physical aspect of heroin addiction. 

If you detox from heroin in a medical detox center like California Detox, complications are minimized, the severity of cravings reduced, and withdrawal symptoms mitigated. Withdrawal symptoms can be managed so they resemble the symptoms of a bad case of influenza and unfold over a similar timeline of a week or so. Most heroin withdrawal symptoms peak on the second and third days of detox. 

These are the most commonly encountered symptoms during heroin withdrawal: 

  • Vomiting
  • Nausea
  • Cravings for heroin
  • Diarrhea
  • Stomach pains
  • Fever
  • Aching bones and muscles
  • Mood changes
  • Excess of bodily fluids
  • Restlessness and disturbed sleep patterns 

After 7 to 10 days, you’ll be ready to engage with inpatient or outpatient treatment at a rehab center. 

Heroin use disorders and opioid use disorders usually respond positively to a combination of behavioral interventions (psychotherapy) and pharmacological interventions (medication-assisted treatment). 

Both of these approaches to treating heroin addiction help to recalibrate brain function along with behavior. Each type of treatment can work in isolation, but when MAT and psychotherapy are combined, results are improved. 

SAMHSA (Substance Abuse and Mental Health Services Administration) report that pharmacological treatment for opioid use disorder improves retention in rehab programs decreases substance use. Crucially, MAT can also help reduce the transmission of infectious diseases and incidences of criminal activity. 

After someone stops using heroin, the painful withdrawal symptoms can be eased using FDA-approved opioid medications. Lofexidine is a non-opioid alternative ideal for alleviating the symptoms of opioid withdrawal. 

The medications intended to treat opioid use disorders act on the same opioid receptors in your brain as heroin, but they are safer and less likely to trigger the harmful behaviors characterizing substance use disorder. 

There are three main types of medications used for this purpose: 

  1. Opioid agonists: These medications activate the brain’s opioid receptors.
  2. Partial opioid agonists: These medications activate the brain’s opioid receptors, but to a lesser degree.
  3. Opioid antagonists: Opioid antagonists the brain’s opioid receptors and counter the euphoric effects of opioids. 

Here are some examples of these medications: 

  • Methadone: Methadone is an opioid agonist. Ingested orally, the medication takes some time to reach your brain. This dilutes the rewarding high that can occur with other routes of delivery such as injection. Used since the 1960s to effectively treat heroin use disorder, you can only get methadone via an approved outpatient program. The medication is dispensed daily.
  • Buprenorphine: A partial opioid agonist, taking buprenorphine can alleviate the intensity of cravings for heroin. Marketed as Suboxone, this combination medication contains buprenorphine and naloxone. If someone attempts to take heroin, they would experience withdrawal symptoms due to the naloxone content. Approved by the FDA in 2002, buprenorphine is widely accessible, unlike methadone. The medication is now available in generic form. It is also available as a monthly injection, or as a six-monthly implant. This completely removes the barrier of daily dosing.
  • Naltrexone: An opioid antagonist that blocks the effects of opioids, naltrexone is neither sedating nor addictive. Taking this medication will not lead to physical dependence developing. That said, compliance with treatment is often problematic, reducing its effectiveness. This might be mitigated somewhat with the FDA-approved monthly formulation, an injectable form of naltrexone called Vivitrol.

Behavioral Therapies

Behavioral therapies for heroin use disorder can be applied in both inpatient and outpatient settings. 

CBT (cognitive behavioral therapy) and contingency management are forms of psychotherapy both proven effective for the treatment of opioid use disorder, especially in combination with medications. 

Through CBT sessions, you’ll learn to identify the people, places, and things that trigger you to use heroin. You’ll discover how to counter cravings using healthier coping strategies. 

Contingency management operates on a voucher-based system that incentivizes positive behaviors and negative drug tests. 

If you feel you would benefit from treatment for heroin addiction, we can help you here at California Detox.

Heroin Addiction Recovery at California Detox

At California Detox, we offer heroin addiction treatment programs at all levels of intensity as follows: 

  • OP (outpatient program)
  • IOP (intensive outpatient program)
  • PHP (partial hospitalization programs
  • Residential rehab (inpatient rehab) 

Even if you feel you would benefit from outpatient programming, it is advisable to undertake a medically-supervised detox. This will minimize the chances of relapse during detoxification and will streamline the process, making it as comfortable as possible. 

You will be heroin-free after a week or so and ready to engage with a personalized and evidence-based combination of the following therapies: 

  • Medication-assisted treatment
  • Psychotherapy
  • Counseling (individual and group)
  • Family therapy
  • Holistic therapies 

If you have heroin use disorder and a co-occurring mental health disorder like anxiety or depression, unpack both conditions simultaneously through one of our dual diagnosis treatment programs. 

Heroin might be one of the most addictive substances, but you can initiate long-term recovery here at California Detox. We’ll help you from detox to discharge and beyond. Call 949.567.8790 today to discuss your options.

FAQs

Heroin is so addictive because of the way in which it alters the reward system in the brain, influencing the production of endorphins and dopamine. 

Tolerance to heroin builds quickly, with physical dependence and addiction often following due to the brain changes triggered by use of this addictive substance.

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