Heroin Addiction: Signs, Causes, Withdrawal & Treatment
As a type of opioid, heroin is a highly addictive substance that can impact decision-making, behavior, and responses to stressful situations. Users often develop a tolerance to heroin, and this means they’ll have to take more and more of the dangerous substance to feel its effects. This often leads to fatal heroin overdoses; more than 14,000 people in the U.S. died from overdoses involving heroin in 2019.
Because heroin is highly addictive, there is a very high chance that users will show signs and symptoms of having a dependency. A substance use disorder occurs when the cravings become too much and normal life activities are pushed aside in favor of the substance. Here is a little more information about heroin and the signs and symptoms of heroin addiction.
Heroin Addiction Signs
Because opioids help suppress pain and create a feeling of euphoria, addicts often neglect life activities to make more time for heroin, and can’t put it down. This is easy to say and understand, but some people may not feel like they are this dependent on heroin.
What if you’re unsure about your use or the use of a friend or family member? Maybe you’re seeing that some life activities are being reduced by heroin use, or maybe you’re getting most activities done, and you don’t know if heroin is really a problem. What are the addiction signs of heroin?
Heorin ADdiction Signs include:
• Feeling a need to use heroin daily or multiple times a day
• Intense cravings and urges that block other thoughts
• Building tolerance and needing more heroin to get high
• Always having a supply of heroin ready for use
• Spending money on heroin rather than necessities
• Not meeting life obligations on a regular basis
• Using heroin even when it becomes physically or mentally harmful
• Engaging in illegal or unethical activities in order to get more heroin
• Spending significant time getting, using, and recovering from heroin
• Inability to stop using heroin when you want to stop
These are the most common signs of addiction. An addict does not have to meet every symptom. In fact, you might be facing an addiction even if you only can check off one or two of the items here.
It’s important to know when you need treatment and many users will become addicted to heroin. In general, if you find that heroin has become a big part of your life and that you’re having trouble meeting your obligations, then the substance might be a problem.
What Is Heroin?
Nearly everyone has heard of heroin, and it’s commonly considered one of the most dangerous and addictive substances, but few people really know what it is or what it does in the body. According to the National Institute on Drug Abuse, or NIDA, heroin is an opioid that is created from morphine. Like all other opioids, both morphine and heroin are derived from the poppy plant. Morphine is a powerful painkiller whereas heroin is two to five times stronger than morphine.
People recreationally use heroin and prescription opioids for various reasons. Some people love the initial rush, which provides euphoric and happy feelings. However, this sensation quickly dissipates and leaves you feeling zoned out and unaware of your physical body. Some people love the euphoric feeling whereas others prefer being numb because it gets them away from their stressors and problems.
Much like how the brain has cannabinoid receptors that react to the use of marijuana, the human brain also has opioid receptors. According to NIDA, heroin and other opioids quickly attach to these opioid receptors. These receptors reduce feelings of pain and increase feelings of pleasure. They are also involved in sleeping, heart rate, and breathing. Therefore, as you may guess, overusing heroin can negatively impact your heart and breathing as well.
NIDA reports that there are several ways to use heroin. You can smoke, sniff, or snort it. The most addictive and dangerous route, but also the most potent, is through injection.
Heroin is highly addictive as it has “chemical hooks” by attaching to your opioid receptors. The truth is that prescription opioids are basically the same thing. In fact, many are stronger and purer than heroin because they aren’t being cut with other substances. Many dealers will cut heroin with other substances, but prescription opioids must legally be sterile, safe, and pure.
About one in four people who use heroin will become addicted. This is a very high number and it’s essential to recognize the seriousness of that. This means that a tremendous number of people who use heroin will face the consequences of addiction.
While heroin is very dangerous and we don’t want to minimize the risk, there are opioids that are even stronger.
Fentanyl is much stronger than heroin and significantly more fatal. Not only that, but sometimes dealers cut heroin with fentanyl, and this practice of mixing the two substances quickly leads to overdoses. However, many other people use fentanyl for legitimate medical purposes, and not everyone gets addicted. While some people won’t get addicted, a very large percentage will and it’s important to recognize this threat.
Heroin Withdrawal Symptoms
Many people treat heroin withdrawal as the worst thing ever and that there’s no way to get through it. The truth is that the heroin withdrawal symptoms are intensely uncomfortable, and many will return to using the drug due to this discomfort, but the withdrawal feelings are rarely fatal. We want this to be encouraging as it’s important that you know that you can get through this part of the cycle.
Some people might prevent themselves from stopping heroin as they are worried about the withdrawals. Let’s talk about them so that you know what this will be like.
The most common heroin withdrawal symptoms include:
• Runny nose
• Muscle pains
• Abdominal cramping
• Diarrhea and vomiting
• Yawning and lethargy
• Dilated pupils
The biggest risk here isn’t the withdrawal symptoms themselves but rather how vulnerable you become during this time. Many people continue using their substance of choice to avoid discomfort.
If you are feeling discomfort because you’re not using heroin, then you will likely go right back to using, and you may even use a higher dose to return to the good feeling more quickly. This puts you at risk of overdosing. That’s especially true if several days or longer have gone by without you using because your tolerance will be reduced. While the withdrawal symptoms are typically not fatal with heroin, the overdose symptoms are very dangerous.
Heroin Overdose Symptoms
While withdrawal is just uncomfortable, heroin overdose symptoms are very fatal, and there isn’t a guarantee that you will be able to survive this event. While response times have gotten better and naloxone can help if it’s immediately administered, you must seek immediate medical attention if you or if someone else has overdosed.
Heroin overdose symptoms include:
• Shallow or labored breathing
• Blue tint on toes, fingers, and lips
• Pale skin
• Inability to respond
The truth is that you likely won’t be able to seek medical attention on your own if you face an overdose because you’ll be unconscious. While it might seem difficult, it would be in your best interest to let someone know that you’re going to use more heroin than usual so that another individual is able to get medical attention should anything happen.
Common Treatment Options
One of the first treatment steps when it comes to heroin or any other opioid is a medical detox program. We connect you with a doctor who will help you discontinue the use of heroin or any other opioid in the most comfortable way possible. As we said before, heroin withdrawal can be difficult, and there is a high chance of relapse and overdose during this time.
Medication-assisted treatment, or MAT, is common during a medical detox from heroin. This is when medications are used that engage your opioid receptors without leading to a high. Many people find that this process reduces the biological cravings for heroin. Many of the medications used for MAT are opioids, but the difference is that they are weaker and can help you get off heroin. In addition, they are administered under the supervision of a medical professional.
Therapy is also highly recommended for heroin treatment. While medical detox and MAT take care of the physical side, you will likely still have thoughts of using along with cravings. Therapy is best suited for this.
Outpatient care is able to provide you with the treatment you need without hindering your daily activities. This consists of two levels of care. The first is individual sessions. You will meet weekly with your therapist to discuss issues related to use, abstinence, daily stress, and coping mechanisms. Your therapist will help you explore issues while teaching you better ways to handle stress.
The next level is called intensive outpatient, or IOP. This involves group sessions that last for a total of nine hours per week split between three-per-week sessions. You and several recovery peers will meet with a therapist and discuss your concerns and stressors. IOP and individual sessions can be combined so that you can learn from group members during IOP while exploring deeper issues with your individual therapist.
We also offer a partial hospitalization program, or PHP. This is the next level of care, and it’s best if you’re having more significant cravings or if your environment isn’t conducive to recovery.
You will come to our recovery facility for eight hours a day and for five to seven days per week. This gives you more time to focus on your needs while accessing doctors, nurses, therapists, and more. You’ll also be able to participate in more recovery activities in our PHP. This program is similar to inpatient care, but the major difference is that you can go home and sleep in your own bed.
Many people who try heroin will become addicted. Sometimes, it’s difficult to know where you stand with the substance, but the major things to pay attention to are your thoughts and behaviors. If you are having difficulty attending to regular life activities and find that you are only or mostly thinking about using heroin, then there is a good chance that you need help.
Recovery is very possible, especially when you have the right recovery center helping you. At First Recovery Center, we are here to provide you the support you need. From medical detox programs and MAT to multiple levels of care, we can get you the help you need so that you can move beyond heroin use. Contact us today, and we’ll work with you to create a customized treatment plan that meets your needs to beat heroin addiction.
Dr. Vahid Osman, MD is a psychiatry specialist in Indianapolis, IN.
Dr. Osman completed a residency at Austin State Hospital. He has over 32 years of experience in Psychiatry & Behavioral Health. He is board certified by the American Board of Psychiatry and Neurology.