Heroin
- What Is Heroin?
- What Is The Scope Of Heroin Use In The United States?
- How Is Heroin Used?
- What Are The Short-Term Effects Of Heroin Use?
- What Are The Long-Term Effects Of Heroin Use?
- What Are The Medical Complications Of Chronic Heroin Use?
- Why Are Heroin Users At Special Risk For Contracting HIV/AIDS & Hepatitis B & C?
- How Does Heroin Abuse Affect Pregnant Women?
- What Are The Treatments For Heroin Addiction?
Heroin is an illegal, highly addictive drug. It is both the most abused and the most rapidly acting of the opiates. Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy plants. It is typically sold as a white or brownish powder or as the black sticky substance known on the streets as “black tar heroin.”
Although purer heroin is becoming more common, most street heroin is “cut” with other drugs or with substances such as sugar, starch, powdered milk, or quinine. Street heroin can also be cut with strychnine or other poisons. Because heroin abusers do not know the actual strength of the drug or its true contents, they are at risk of overdose or death. Heroin also poses special problems because of the transmission of HIV and other diseases that can occur from sharing needles or other injection equipment.
What Is The Scope Of Heroin Use In The United States?
According to the 1996 National Household Survey on Drug Abuse, which may actually underestimate illicit opiate (heroin) use, an estimated 2.4 million people use heroin at some time in their lives, and nearly 216,000 of them reported using it within the month preceding the survey. The survey report estimates that there were 141,000 new heroin users in 1995, and that there has been an increasing trend in new heroin use since 1992. A large proportion of these recent new users were smoking, snorting, or sniffing heroin, and most were under age 26. Estimates of use for other age groups also increased, particularly among youths age 12 to 17: the incidence of first-time heroin use among this age group increased fourfold from the 1980′s to 1995.
Heroin is usually injected, sniffed/snorted, or smoked. Typically, a heroin abuser may inject up to four times a day. Intravenous injection provides the greatest intensity and most rapid onset of euphoria (7 to 8 seconds), while intramuscular injection produces a relatively slow onset of euphoria (5 to 8 minutes). When heroin is sniffed or smoked, peak effects are usually felt within 10 to 15 minutes. Although smoking and sniffing heroin do not produce a “rush” as quickly or as intensely as intravenous injection, the National Institute on Drug Abuse (NIDA) researchers have confirmed that all three forms of heroin administration are addictive.
Route of Administration Among Heroin Treatment Admissions in Selected Areas
Injection continues to be the predominant method of heroin use among addicted users seeking treatment; however, researchers have observed a shift in heroin use patterns, from injection to sniffing and smoking. In fact, sniffing/snorting heroin is now a widely reported means of taking heroin among users admitted for drug treatment.
With the shift in heroin abuse patterns comes an even more diverse group of users. Users over the age of 30 continue to be one of the largest user groups in most national data. However, several sources indicate an increase in new, young users across the country who are being lured by inexpensive, high-purity heroin that can be sniffed or smoked instead of injected. Heroin has also been appearing in more affluent communities.
What Are The Short-Term Effects Of Heroin Use?
Abusers typically report feeling a surge of pleasurable sensation, a “rush.” The intensity of the rush is a function of how much drug is taken and how rapidly the drug enters the brain and binds to the natural opioid receptors. Heroin is particularly addictive because it enters the brain so rapidly. With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities, which may be accompanied by nausea, vomiting, and severe itching. Heroin overdose is a particular risk on the street, where the amount and purity of the drug cannot be accurately known.
What Are The Long-Term Effects Of Heroin Use?
One of the most detrimental long-term effects of heroin is addiction itself. Addiction is a chronic, relapsing disease, characterized by compulsive drug seeking and use, and by neurochemical and molecular changes in the brain. Heroin also produces profound degrees of tolerance and physical dependence, which are also powerful motivating factors for compulsive use and abuse. As with abusers of any addictive drug, heroin abusers gradually spend more and more time and energy obtaining and using the drug. Once they are addicted, the heroin abusers primary purpose in life becomes seeking and using drugs. The drugs literally change their brains.
Physical dependence develops with higher doses of the drug. With physical dependence, the body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced abruptly. Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and leg movements. Major withdrawal symptoms peak between 24 and 48 hours after the last dose of heroin and subside after about a week. However, some people have shown persistent withdrawal signs for many months.
What Are The Medical Complications Of Chronic Heroin Use?
Medical consequences of chronic heroin abuse include scarred and/or collapsed veins, bacterial infections of the blood vessels and heart valves, abscesses (boils) and other soft-tissue infections, and liver or kidney disease. Lung complications (including various types of pneumonia and tuberculosis) may result from the poor health condition of the abuser as well as from heroin’s depressing effects on respiration. Many of the additives in street heroin may include substances that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs. Immune reactions to these or other contaminants can cause arthritis or other rheumatologic problems. Of course, sharing of injection equipment or fluids can lead to some of the most severe consequences of heroin abuse – infections with Hepatitis B and C, HIV, and a host of other blood-borne viruses, which drug abusers can then pass on to their sexual partners and children.
Why Are Heroin Users At Special Risk For Contracting HIV/AIDS And Hepatitis B And C?
Because many heroin addicts often share needles and other injection equipment, they are at special risk of contracting HIV and other infectious diseases. Infection of injection drug users with HIV is spread primarily through reuse of contaminated syringes and needles or other paraphernalia by more than one person, as well as through unprotected sexual intercourse with HIV-infected individuals. For nearly one-third of Americans infected with HIV, injection drug use is a risk factor. In fact, drug abuse is the fastest growing vehicle for the spread of HIV in the Nation.
How Does Heroin Abuse Affect Pregnant Women?
Heroin abuse can cause serious complications during pregnancy, including miscarriage and premature delivery. Children born to addicted mothers are at greater risk of SIDS (sudden infant death syndrome), as well. Pregnant women should not be detoxified from opiates because of the increased risk of spontaneous abortion or premature delivery; rather, treatment with methadone is strongly advised. Although infants born to mothers taking prescribed methadone may show signs of physical dependence, they can be treated easily and safely in the nursery.
What Are The Treatments For Heroin Addiction?
A variety of effective treatments are available for heroin addiction. Treatment tends to be more effective when heroin abuse is identified early. The treatments that follow vary depending on the individual, but methadone, a synthetic opiate that blocks the effects of heroin and eliminates withdrawal symptoms, has a proven record of success for people addicted to heroin.
Detoxification
The primary objective of detoxification is to relieve withdrawal symptoms while patients adjust to a drug-free state. Not in itself a treatment for addiction, detoxification is a useful step only when it leads to longer-term treatment (Inpatient or outpatient) that is either drug-free or uses medications (methadone) as part of the treatment.
Methadone programs
Methadone treatment has been used effectively and safely to treat opioid addiction for more than 30 years. Properly prescribed, methadone is not intoxicating or sedating, and its effects do not interfere with ordinary activities such as driving a car. The medication is taken orally and it suppresses narcotic withdrawal for 24 to 36 hours. Patients are able to perceive pain and have emotional reactions. Most important, methadone relieves the craving associated with heroin addiction; craving is a major reason for relapse. Among methadone patients, it has been found that normal street doses of heroin are ineffective at producing euphoria, thus making the use of heroin more easily extinguishable.
Naloxone and Naltrexone
Naloxone and naltrexone are medications that also block the effects of morphine, heroin, and other opiates. As antagonists, they are especially useful as antidotes. Naltrexone has long-lasting effects, ranging from 1 to 3 days, depending on the dose. Naltrexone blocks the pleasurable effects of heroin and is useful in treating some highly motivated individuals. Naltrexone has also been found to be successful in preventing relapse by former opiate addicts released from prison on probation.
Behavioral therapies
Although behavioral and pharmacologic treatments can be extremely useful when employed alone, science has taught us that integrating both types of treatments will ultimately be the most effective approach. There are many effective behavioral treatments available for heroin addiction. These can include Inpatient and outpatient approaches. An important task is to match the best treatment approach to meet the particular needs of the patient.
Moreover, several new behavioral therapies, such as Rimrock Foundation’s cognitive-behavioral interventions, show particular promise as treatments for heroin addiction. Cognitive-behavioral therapies are designed to help modify the patient’s thinking, expectancies, and behaviors and to increase skills in coping with various life stressors. Both behavioral and pharmacological treatments help to restore a degree of normalcy to brain function and behavior.
For further information on Rimrock Foundation’s treatment of heroin addiction, call Althea Bartlett, Admissions Supervisor at 1-800-227-3953 or 1-406-248-3175, or visit our website at rimrock.org. For more educational information on heroin addiction, contact the Rimrock Foundation Library at 1-800-227-3953 or 1-406-248-3175.
