This detailed guide will give you all the information you need to know to truly understand your heroin addiction, grasp some of the key concepts and tools of recovery, and give you the knowledge you need to kick your heroin habit for good.
We’ve all heard about it in music, read about it in newspapers, and seen it in movies and on television shows. Some of us may even have known people close to us that have struggled with an addiction to it. Or maybe you’re struggling with it yourself.
In a nutshell, heroin is part of a class of drugs known as opioids. This class contains natural compounds like morphine, opium, and codeine as well as synthetic and semi-synthetic compounds like Fentanyl, OxyContin, and Vicodin.
Opioids like heroin, however, tend to over-stimulate these receptors, leading to a rush of pleasure-causing neurotransmitters and an intense and overwhelming wave of euphoria. In fact, the amount of these pleasure-causing chemicals can be two to ten times as high as when they’re activated naturally! This is what’s called a “high.”
But as most people know, continued use of these substances can lead to the development of both a physical and psychological addiction. And when it comes to a heroin addiction, few things can take control of and ruin your life quite as quickly.
The United States truly is in the middle of unprecedented times. Never before have we faced a drug problem so deadly and so widespread than the one we face today. In fact, the CDC, WHO, NIH, DEA, and even the President all refer to the current opioid crisis as an actual epidemic.
And when you take a look at some of the numbers behind the opioid problem, it isn’t hard to see why:
The opioid epidemic, then, has become one of the greatest health crises that our nation has ever faced, and it isn’t showing any signs of slowing down.
There are a number of factors that are contributing to an ever-worsening opioid epidemic. Part of the reason for the increasingly dangerous rise in opioid abuse has to do with how common prescription opioid painkillers have become.
The 2016 National Survey on Drug Use and Health (NSDUH) conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that in 2015 around 97.5 million Americans used pain relievers in the past year. That represents 36.4% of the total population or a bit over one-third.
And while the majority of these prescriptions are being used appropriately, use of any prescription opioid is highly linked with developing an eventual dependency. In fact, the CDC reported that even a one-day prescription of opioid painkillers came with a 6% risk of use one year later along with a 2.9% risk at three years later.
It’s no wonder, then, that almost 5% of the total population ends up abusing prescription painkillers according to the NSDUH. Chronic pain and addiction are inextricably linked.
Another cause for the opioid epidemic directly involves the quality and affordability of heroin today.
The DEA’s 2017 National Drug Threat Assessment points out that heroin has become “highly pure, inexpensive, and increasingly adulterated” in the current markets.
Availability of this dangerous drug is also on the rise. From 2010 to 2017, the number of respondents to the National Drug Threat Survey who reported high heroin availability increased by:
Heroin has actually become so widely available and cheap today that many opioid abusers actually end up turning to heroin as a less expensive way of feeling a similar high. NIDA found that the risk of heroin use among opioid painkiller abusers was actually 19 times higher than the general population.
What’s more, 80% of heroin abusers reported using prescription opioids like Fentanyl and OxyContin (two of the most addictive prescription drugs) prior to using heroin.
This shift to heroin, while cheaper, is actually much deadlier. The DEA found that while the amount of prescription painkiller abusers was ten times as high as heroin abusers, the number of overdose was only twice as high.
To put that into perspective, if the number of heroin abusers and prescription opioid abusers was the same, heroin would kill five times as many people as opioid painkillers.
Heroin is indisputably one of the most dangerous drugs on the street today. In addition to the extremely high potential for addiction as well as the especially common cases of overdose on this drug, heroin also has a number of other nasty side effects, both in the short- and long-term.
According to the National Institute on Drug Abuse (NIDA), heroin has been shown to cause the following short-term effects:
What’s more, many heroin users experience what’s called going “on the nod,” a continuous and prolonged state of drifting in and out of consciousness.
Depending on the dose, this state of semiconscious sedation can last anywhere from 1 to 5 hours. As a result, users are in an extremely vulnerable and incapacitated state during this time, making functioning normally incredibly difficult if not impossible.
The long-term effects of heroin addiction are a bit more troublesome. They include:
Researchers have also speculated on the relationship between long-term opioid abuse and permanent brain damage.
Some specialists speculate that the proven well-documented decreased respiration that results from prolonged opioid use may actually negatively affect the amount of oxygen that’s able to reach the brain.
This condition is known as hypoxia and has been linked to both short- and long-term psychological and neurological effects.
What’s more, some studies have shown that the white matter of a heroin user’s brain may be more deteriorated than a non-user. This decrease may result in an alteration of decision-making abilities, the ability to regulate behavior, and responses to stressful situations.
The full effects that continued heroin use have on the brain aren’t yet fully documented and very well may be far more damaging than we can even imagine. One thing is clear however – heroin can increase the risk of a number of both physical and psychological disorders.
Another particularly dangerous risk of continued heroin abuse and addiction comes with the fact that its most common method of abuse is through intravenous injection.
Though heroin oftentimes comes in the form of a powder, many users will dissolve that powder into a liquid, find a vein, and inject it directly into the body. This provides a significantly faster high onset (around 5 to 10 seconds) though the duration of the high may be shorter as a result.
Besides bypassing a number of the body’s natural filtering systems (making the inherent toxicity of the drug even more potent), this method of substance administration comes with a number of additional health risks as well including:
What’s more, intravenous drug users also have a much higher risk of contracting a number of blood-borne viral infections like hepatitis and HIV due to needle sharing.
In fact, the Centers for Disease Control and Prevention (CDC) reported that a whopping 10% of AIDS diagnoses in 2015 were attributed to intravenous drug use.
It seems pretty clear, then, that in addition to the numerous detrimental health effects that this dangerously toxic drug has on the body, abusing heroin can also result in a variety other problems based on the dangers of IV use alone.
Another major danger of continuous heroin abuse is the increased risk of getting a batch that’s been cut with a dangerous additive. Mixing agents, adulterants, substitutes, and more can all regularly be found in heroin.
And while some of these are added by dealers to make the drug more potent, more addictive, or cheaper to produce, these chemical compounds can actually end up being quite deadly when they enter the bloodstream.
One article published by Wired magazine listed off some of the most common compounds found in heroin today. They include:
NIDA reports that “sugars, starch, powdered milk, or quinine [a compound used to intensify the effects]” are all often found in street heroin as well.
What’s more, the Drug Enforcement Agency (DEA) found that average retail purity levels of street heroin were hovering only a bit above 30% in 2012. Now we know what the remaining 70% is…
The first step on the road to recovery from heroin addiction is acknowledging that you have a problem. And as any addict knows, this step is always the hardest to take.
Whether it’s denial of your addiction or a fear of change or facing life on your own, there are countless reasons not to quit – but there are even more reasons to get sober.
And before you can start down the road of recovery, you need to acknowledge your addiction for the disease that it really is.
One of the best tools to help you do that with is a quick online addiction quiz. For a more in-depth look, you can always see how you stack up according to the guidelines of the Diagnostic and Statistical Manual of Mental Disorders as well.
Recovery depends entirely on the individual.
For some heroin addicts, fully overcoming the persistent drive to use again is purely fantasy. Some users describe the feeling as a “devil on your shoulder” just waiting to pull you back into addiction every hour of the day.
For others, recovery may go smoothly for a year or two without any desire to return to using. But once a particularly stressful week hits them, they may slip back into full blown addiction.
And others still may drop their heroin habit without looking back or feeling the craving to use ever again.
In most cases, you won’t know what kind of person you’ll be until you actually go through the experience yourself.
But no matter where you’re at in your heroin addiction recovery, one of the most helpful things to realize is that there are thousands of others going through the exact same struggle.
The UK publication The Guardian actually collected the statements of hundreds of recovering heroin addicts and shared their stories with the world. Have a look at their collection for a bit of guidance, solidarity, and perspective.
Recovery may be tough – but it is possible with the proper treatment and support program.
One of the most common questions among heroin abusers is, “How high are relapse rates for heroin addiction?” And despite how reasonable of a concern this is, the amount of data on the matter is surprisingly sparse.
They found that drug addiction in general tends to have relapse rates that are quite similar to other chronic illnesses at around 40 to 60%.
However, one highly cited study found that these rates for heroin addiction are actually much higher. Researchers found that around 91% of heroin addicts relapsed in their study sample. Of that 91%, a whopping 59% ended up relapsing after just the first week of treatment.
And given the intensity of the withdrawal symptoms, it’s easy to see why so many people go back to using.
The symptoms of heroin withdrawal are reportedly quite intense and, at times, unbearably uncomfortable.
Mental Health Daily provides one of the most comprehensive list of these symptoms which include:
What’s more, the timeline for heroin withdrawal can be quite protracted. While the exact length of time you’ll experience these symptoms changes depending on the level of addiction, duration of substance abuse, and individual body type, many people can expect to feel the effects for a solid 4 to 6 weeks.
Reading the long list of heroin withdrawal symptoms is one thing, but having a detailed account of the exact phases of the process is much more helpful and will give you a better idea of what to expect and when to expect it.
Stage one usually begins as soon as six hours after your last heroin fix. This stage (called the acute phase) is marked by extremely severe symptoms including:
It will likely be difficult to carry on normal functioning during this phase so anyone planning on detoxing from heroin should try to recuse themselves from any responsibilities whatsoever.
These symptoms will begin to decrease in severity after about four to seven days. And while going about daily life will certainly be significantly easier after this point, many people continue to feel a variety of symptoms long afterwards. These symptoms are called Post-Acute Withdrawal Symptoms or PAWS.
PAWS is marked by a long list of symptoms which may affect addicts quite differently depending on the individual. In general, some of the most reported symptoms tend to be:
The science is still out on exactly what’s going on in the brain during PAWS. However, researchers believe it has something to do with the chronic stress response resetting after a long period of abuse.
In any case, the difficulty of heroin withdrawals doesn’t just end with detox.
Many insurance companies will cover 100% of the cost of outpatient treatment. Call today and find out if your plan qualifies. We can also help with financing. (208) 906-0782
Opioid addiction withdrawals can be intense. They’ve been described as “hellish,” “unbearable,” and “like nothing you’ve ever experienced before,” in addition to a number of descriptions with more colorful language.
Opioid addiction withdrawals can be intense. They’ve been described as “hellish,” “unbearable,” and “like nothing you’ve ever experienced before,” in addition to a number of descriptions with more colorful language.
Undoubtedly, withdrawals from heroin can be tough. But, they are not lethal.
This may come as quite a surprise. After all, even addiction to legal substances like alcohol carries with it the potentially fatal effects of withdrawal gone bad.
Even still, withdrawals from heroin (and opiates in general) are not life-threatening.
However (and this is a big however), jumping into heroin detoxification haphazardly can put your life in danger for an entirely different reason.
To explain, opiates have a tendency to build up physical tolerance quite rapidly, meaning they have to take more of the drug over time in order to feel its effects. Similarly, abstaining from using tends to drop that level of tolerance exceptionally fast.
When heroin users end up relapsing after even just a week of not touching any opioid, they typically go back to using the same amount of heroin that got them high before. However, during their week-long break from using, their body’s tolerance has already dropped significantly.
As a result, that same amount that got them high before may actually end up being a lethal dose after relapsing. What’s more, almost 3 out of 5 users who relapse do so within the first week after detoxing, putting them especially in danger of a fatal overdose.
In the end, while the withdrawals themselves aren’t exactly deadly, the severity of the withdrawals regularly leads to relapse. And that aspect of heroin recovery can be fatal.
That’s why it’s particularly important for you to seek medical help during your heroin detoxification – not doing so just may end up costing you your life.
Despite the variety of outpatient addiction treatment options available today, some heroin addicts still decide to go through detoxification without the help of addiction specialists.
As we’ve seen, although the symptoms of opioid withdrawal aren’t necessarily fatal, relapsing back into heroin use can in fact cost you your life. As such, detoxing at home is not advisable based on health concerns alone.
Added to that, shirking the expertise of qualified addiction professionals may make the entire process far more uncomfortable, much less manageable, and infinitely less likely to result in a successful recovery.
Having said that, there are a few things you can do to help someone detox from heroin at home.
One method for coping with the symptoms of heroin withdrawal that is highly regarded in the addiction community (at least among addicts themselves) is the Thomas Recipe.
Though not developed by a licensed physician or addiction specialist, this easy-to-follow process was developed by a long-time Rx opiate junkie after multiple attempts to get off the drug for good.
Again, the Thomas Recipe should not be taken as medical advice.
You can find the unabridged version at Drugs.com in the community forum.
Addiction is a complex disease that can affect nearly every single aspect (emotional, intellectual, behavioral, etc.) of an individual’s core being. It’s no wonder, then, that treatment methods today are so widely varied.
However, despite how multifaceted addiction is, there are a number of treatment methods that are scientifically proven to be effective. These are referred to as evidence-based treatments.
Evidence-based addiction treatment standards are only now beginning to replace outdated programs and, unfortunately, still aren’t being implemented in many facilities in the U.S. According to a report from the National Center on Addiction and Substance Abuse:
The vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care… Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.
But as the opioid epidemic continues to rage out of control, it will become ever more imperative that new standards are put in place to ensure that addiction treatment actually works.
And one type of therapy that has proven effective time and again is the use of medication-assisted treatments, also known as MATs. These treatment options use medications in order to reduce the intensity of withdrawal symptoms, eliminate cravings, and remove the incentives of returning to substance abuse.
They’re also highly regulated and, as such, can only be administered according to strict guidelines by qualified facilities.
Best of all, these treatment methods have been proven to work, especially when it comes to treating opioid and heroin addiction.
When it comes to heroin withdrawal, few treatment options are quite as successful as MATs. NIDA reports that when MATs are combined with treatments like CBT, counseling, and other behavioral therapies (a combination referred to as “whole patient” treatment), the likelihood of recovery is significantly higher.
One study based in Baltimore found that using MATs during treatment helped decrease heroin overdose deaths by 37%. What’s more, the study also found that MATs decreased overall opioid use, criminal activity, and the spread of infectious diseases.
Plus, Medication-Assisted Therapies have also been shown to increase social functioning and retention in treatment while improving the health outcomes for babies of opioid-dependent pregnant women.
Some of the most effective MATs being used for opioid dependence today include naltrexone, naloxone, and two Opioid Replacement Therapies (ORTs) involving buprenorphine and methadone.
When it comes to MATs, naltrexone is by far one of the most beneficial and widely used in addiction treatment today. This semi-synthetic compound is used to treat both opioid dependence and alcohol use disorders as well.
In terms of how it’s used in treating heroin addiction, naltrexone is primarily meant to take away any of the beneficial side effects of abusing opioids. Euphoria, sedation, and the all-around high that many people seek from abusing heroin are all blocked almost entirely when a person is on naltrexone.
As a result, many people abstain from falling back into patterns of abuse after they become aware of what naltrexone does to the body.
Naltrexone accomplishes this effect because it is an incredibly strong and long-lasting competitive opioid antagonist. Whereas heroin and other opioid agonists attach to the opioid receptors in the brain and activate them, naltrexone binds to and effectively blocks these receptors without stimulating them.
As such, the receptor site remains inactive and unable to be activated by any opioids.
What’s more, it also helps to reduce the cravings that many opioid abusers end up suffering through (and sometimes succumbing to).
Lastly, naltrexone can be easily administered in pill form or via injection and has zero potential for abuse given that it does not even activate the opioid receptors at all.
This is one drug that has proven instrumental in the full recovery of countless heroin addicts.
Similar to naltrexone both in structure and in name, naloxone is another opioid antagonist that has a bit of a different role in treating heroin withdrawal and addiction recovery.
As mentioned earlier, heroin and other opioids interact with the brain and body by binding to and stimulating opioid receptors. And while the stimulation of these receptors can lead to euphoria, pain relief, and a physical “high” at certain levels, over stimulation can decrease respiration to dangerous levels and cause an overdose.
That’s where naloxone comes in. This opioid antagonist not only blocks other opioids from attaching to the receptor (like naltrexone), it also actually reverses the effects of opioid stimulation.
As such, it can effectively cure a heroin overdose and bring respiration back to normal, safe levels.
What’s more, naloxone has also been developed into an easily-administrable nasal spray form. This product, called Narcan, is cheap, simple-to-use, and incredibly effective.
And given that the only prior way to administer the drug beforehand was through injection (which required past medical experience to do), this development is a big one for the addiction community. Now anyone can save a life during an opioid overdose.
Narcan is so easy to use that it’s become a common first aid medication in offices, coffee shops, and colleges across the nation.
Due to the exceptionally high risk of relapse among heroin users, naloxone is a real life-saver.
Rather than blocking or reversing the effects of opioids binding with opioid receptors, these drugs instead activate these receptors, though to a much smaller degree than drugs like heroin.
Doing so helps eliminate many of the most painful withdrawal symptoms which are typically responsible for users returning to heroin abuse during detox.
There are only two ORTs used today: Buprenorphine and Methadone.
The Opioid Replacement Therapy of choice for addiction centers for decades, methadone has long helped recovering opioid and heroin addicts reduce their cravings, diminish their withdrawals, and be able carry on a normal life throughout recovery.
As the classification as an Opioid Replacement Therapy implies, methadone helps to treat heroin addiction by binding to and activating the brain’s opioid receptors. The trick, however, is that it’s much subtler and longer-acting than other opioids.
As such, one clinical dose of methadone can help stave off cravings and withdrawal symptoms for an entire day.
According to SAMHSA, it also can block the euphoric effects of opiate drugs, thus helping to remove the incentive for turning back to drug use for struggling addicts.
However, there are a few problems with methadone treatment. In the first place, as with any ORT there is going to be a risk of abuse. The fact that methadone can only be administered at licensed clinics helps to reduce this risk but it is still possible for patients to hide and then sell doses on the street.
There’s also the problem of building up a tolerance to methadone. The longer methadone is used, the higher the doses will need to be in order to provide the same relief from cravings.
What’s more, the withdrawal symptoms from methadone can also be quite severe and could last anywhere from 2-3 weeks to 6 months.
The pharmaceutical industry has also worked to design a combination of buprenorphine and naloxone in order to reduce the risk of abuse even further.
This combination, most commonly marketed as Suboxone, allows patients to benefit from buprenorphine when taken properly but, when used illicitly (i.e. via injection), the naloxone actually launches the user into a painful state of precipitated withdrawal.
For many addicts, the threat of precipitated withdrawal is enough to dissuade them from abusing this drug entirely.
However, despite these consequences, buprenorphine has become one of the best and most successful options for recovering heroin addicts today.
Even with all of the proven benefits of using Opioid Replacement Therapies, there are still quite a few people, organizations, and even entire governments that are staunchly opposed to the idea of using drugs to treat an addiction.
Taken even further, some physicians actually prescribe drugs like methadone and Suboxone as part of a long-term maintenance plan that may last for several months or even years. It’s this approach to treatment specifically that leads many opponents of ORTs to claim that addicts are simply trading one addiction for another or even developing cross addictions altogether.
In general, most addiction specialists agree that ORTs like Suboxone should only be used in the short-term in order to reduce the severity of an addict’s detox and early recovery phases.
Extending treatment past this point, they say, will only lead to an equally addicted Suboxone user.
As such, ORTs are not a magical therapy that can cure a heroin addicted with just a few treatments. Instead, they must be combined with a variety of additional therapies in order to truly be effective.
Finding the strength to persevere through heroin recovery can be exceptionally difficult. It’s incredibly addictive, has some of the most unbearable withdrawals out of any drug, and may have one of the highest rates of relapse out of any illicit substance.