When Philip Seymour Hoffman died of a heroin overdose in 2014, the president of Drugfree.org took the opportunity to remind everyone that while Hoffman obviously knew that taking heroin was a bad idea, “his brain was constantly telling him that taking some heroin would be a very good idea.”
Many people use heroin – in fact, 669,000 in the United States do, according to a 2012 survey by the National Survey on Drug Use and Health. The National Institute on Drug Abuse says that heroin abuse is the most, or one of the most, important drug issues across the United States, and a month before Hoffman’s death, the governor of Vermont claimed that heroin use in his state increased by 250 percent since 2000.
Some of the people who use heroin may be fully aware of the dangers posed by the drug, but their dependence on the substance robs them of any control or inhibition. Fortunately, there is light at the end of the tunnel; rehabilitation and therapy programs have not only saved lives, but also turned those lives around for a better future.
Who Needs Treatment for a Heroin Addiction?
The obvious answer for the question of who needs treatment for a heroin addiction is “heroin addicts,” but how do people get into that situation? The negative effects of heroin take a while to manifest, leading many users to believe that they have mastered their habit. On his list of “5 Unexpected Things I Learned from Being a Heroin Addict,” a writer at Cracked.com lists the delayed addiction as being what makes the addiction to heroin worse. In the first few weeks of usage, there are no withdrawal symptoms, and users emerge from their heroin-induced stupors “clear as a bell,” without any cravings. This clean, seemingly harmless period is what encourages users to continue taking heroin, since there is nothing to suggest that a problem is brewing.
But what drives users to keep taking heroin? To answer that question, we have to understand how the human brain works.
In a Frontline report, PBS compares the effect of heroin and other similar opiates on the brain to that of endorphins. Endorphins are natural, opiate-like chemicals that the body produces in response to stress, pain or fear. If you’ve ever gotten a rush from watching a horror movie or engaging in a solid workout, your endorphins are hard at work.
In the same way that endorphins are the body’s own opiates, chemical or plant-based opiates (like opium, morphine or heroin) can supersede the function of your own endorphins. They are more powerful than the chemicals your body produces, giving you even stronger rushes than what you’re used to experiencing from thrills, exercise, sex, etc., and often within mere seconds of administration.
Since we are all pleasure-seeking organisms, Frontline says, it comes as no surprise that users are motivated to seek out another hit. But that is where the addictiveness of a heroin habit comes from. Because the heroin introduces you to stronger rushes, any regular, drug-free experiences don’t cut it anymore. You can try to experience those again, but why would you, when the heroin provides such a vastly improved alternative with seemingly no consequences?
But then, after weeks and weeks of using, you may try to go without using. By this point, the brain’s chemistry has been completely rewired due to the frequency and potency of the heroin. Now suddenly deprived of the drug, the brain overreacts and floods the body with its own chemicals that have long been suppressed. You are flung into withdrawal, and it seems the only respite from the symptoms of shivering, cramping and nausea is another hit.
A paper published in the US National Library of Medicine discusses how drug addiction affects the neurotransmitters in the brains of drug-abusing individuals. In the case of heroin, long-term use modifies the brain’s dopamine systems, which are the parts of the brain that are responsible for the neurochemicals that make you feel rewarded when you indulge in something pleasurable, and they are particularly susceptible to manipulation and contamination by addictive substances. The prolonged use of heroin eventually leads the brain to become dependent on heroin, and thus addicted to the substance.
What Are the Signs of Heroin Use?
Heroin has different effects on a person when it is present in their body, and when it is no longer in their body but still has them trapped. If a person is high, they will display some of the following symptoms:
- Feelings of extreme confidence or invulnerability
- Fatigue and drowsiness
- Difficulty breathing
- Dilated pupils
- Dry mouth
- Flushed skin
As the heroin starts to leave the user’s body, they will experience withdrawal effects, such as the following:
- Increased heart rate
- Agitation and anxiety
- Nausea and vomiting
- Abdominal cramping
While injecting heroin intravenously is a commonly depicted form of abusing the drug, many users start with the seemingly benign form of snorting powdered heroin. The powder is usually white, but it can appear brown as well. With heroin today being much purer in concentration than it used to be (50 to 60 percent pure, according to a story in US News & World Report), users are enticed to seek out even stronger hits. For a more powerful dosage, they will probably turn to injecting the heroin (now dissolved into a liquid state) directly into their blood. They may use paraphernalia such as spoons to mix and convert the powdered heroin into a liquid, syringes to inject it, and belts to enlarge the veins in their body where the heroin is being administered.
What Is Treatment for Heroin Addiction Like?
Treating a substance addiction involves two fronts: combating the user’s physical need for the drug and addressing the psychological reasons they turned to the heroin. Why were they not satisfied with the natural rushes of life’s experiences? Was there something missing in their life that they tried to replace with the sensations that came from abusing heroin?
To reduce a chemical dependency on heroin, users are often given drugs like methadone and Suboxone. In profiling drugs that are used to treat opioid addictions, PsychCentral describes methadone as one of the standards of “medication-assisted treatment” for the past three decades. The profile cites studies that show enrollment in methadone programs improves mental and physical health, and reduces the mortality rate from opioid addictions. Crucially, the proper administration of methadone in a treatment program can subdue withdrawal symptoms and reduce a user’s cravings for more heroin.
Withdrawal from heroin can be a tough process, often making many addicts wish they could shoot up again just to stop the nausea, cramping and discomfort of their physical addiction to heroin being broken. Guided detoxification, supervised by consulting health care professionals with the prescription of methadone and Suboxone (and similar drugs where applicable), can help ease the former user into the first steps of their post-heroin life.
Psychotherapy and Cognitive Behavioral Therapy
The next stage of treatment for a heroin addiction involves addressing the psychological reasons that drove the addict to substance abuse. Through private, group and/or family therapy, the recovering addict will begin understand how to identify and eliminate the causes that led to the need to seek heroin, and the user will learn how to control the thoughts or behaviors that may have once led to the craving for a hit.
This style of treatment is known as Cognitive Behavioral Therapy, or CBT. It is a very popular form of psychotherapy that helps people deal with the mental reasons behind a drug habit. As part of CBT, therapists teach their patients a variety of skills to deal with the challenges, temptations and frustrations of being clean and sober after knowing what it’s like to be high. It empowers patients to take responsibility for their lives and decisions, and it shows them newer, healthier ways of approaching the problems that they used to flee by indulging in their heroin habit.
Getting Treatment for a Heroin Addiction
Because of its slow-acting, insidious nature, heroin is one of the most dangerous illicit substances out there. The first step to treatment is really just a phone call away. We can answer your questions and give you the help you need to get checked into a safe, healthy and positive place where you can break free of your mental and physical addiction, and learn how to live with clarity and focus. Our admissions coordinators are standing by to talk with you about how we can help. Please call now.
Further Reading About Treatment for Heroin Addiction
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton