For heroin addicts and their loved ones, the prospect of achieving and maintaining sobriety can seem distant at times. Heroin exercises such powerful control over the addict that even the thought of recovery, or the earliest stages of withdrawal, can be enough of a deterrent. Even when the decision has been made to quit using heroin, there are a dizzying number of choices and options when exploring rehab facilities. In this article, we’ll discuss what heroin is, why it is so addictive, and outline the most common treatment strategies with an eye towards their effectiveness.
We’ll also discuss important things to look for in a treatment facility, which can help guide recovering addicts and their loved ones towards making an informed, calculated decision. As we will explore, the choice in treatment program has a great deal of impact on the chances of a successful recovery. Choosing the right heroin treatment program for you or the addict in your life is essential for their long-term success.
Why is Heroin so Addictive?
Most people understand that heroin is addictive and dangerous, but many don’t understand exactly why heroin users are so prone to developing an addiction. Without a proper base of knowledge regarding what heroin is and how it interacts with the body, many people wonder “is heroin addiction treatable?” This presents a unique challenge for medical professionals and staff, as some addicts may choose not to enter a recovery program because they believe that they are addicted to heroin for life.
Heroin, or diacetylmorphine, is an opiate analgesic that is currently illegal under US law. Heroin’s closest legal equivalent is morphine, an opiate analgesic that primarily sees use treating extreme pain in emergency rooms and hospital settings. Heroin is produced from liquid extracted from the poppy plant Papaver somniferum. After it is extracted, dried, and treated with chemicals, it is a morphine base. Heroin is created from this morphine base, and by the time it exits the production process, the heroin produced is roughly 75% pure.
To put the strength of heroin into perspective, morphine is one of the strongest analgesics that are currently in use in modern medicine. When heroin enters the body, it first breaks down into 6-monoacetylmorphine, which is roughly six times as powerful as morphine. On top of this, heroin is able to move more readily across lipid barriers than morphine, allowing it to enter the brain tissue of the heroin user more quickly and efficiently.
Heroin addiction is common due to a number of factors that promote the cultivation of dependence in the user. First, heroin creates a chemical dependence on the user very quickly. Heroin is an incredibly powerful drug that interacts with the central nervous system and brain rapidly. The lipid solubility of heroin helps it begin it’s interactions much more quickly than other drugs, including other opiates. Once heroin enters the body, it hijacks the parts of the central nervous system, the limbic system, which produces feelings of pleasure and pain.
This results in a profound sense of euphoria in the user shortly after taking the drug. Heroin’s pleasurable interaction with the limbic system is one factor that creates chemical dependency. A second is a rapidity that heroin is broken down, usually within less than 12 hours, and withdrawal symptoms begin to manifest. The extremely unpleasant withdrawal symptoms associated with heroin use force the user to continue taking heroin in order to avoid the unpleasant health effects of withdrawal.
How quickly a user gets an effect depends on their modality of use. The three most common ways heroin is taken are injection, snorting, and smoking. Injection produces the fastest impact, with the user feeling the effects almost instantly. Smoking heroin produces effects in around 10 seconds and snorting it will produce effects in less than 5 minutes. The euphoric feeling that heroin produces in the user only lasts a short period of time. Although most users will remain under the influence of heroin for the next 3-5 hours, they will be pushed to use again before their high has even completely worn off.
What Are the Effects of Heroin?
There are a wide variety of heroin side effects that impact both the mind and body of the user. The impact of heroin use doesn’t end there, as the lives of most long-term heroin addicts are riddled with negative outcomes that result from their drug use. Despite the fact that nearly all of the effects that heroin abuse has on the addict are negative, it still exercises an almost inescapable level of control over the heroin addict.
When heroin enters the body, it causes the release of a large amount of dopamine, the chemical responsible for producing feelings of pleasure in our brains. This flood of dopamine is responsible for the brief but overwhelming feeling of euphoria in the heroin user. Heroin users also experience a sense of calm and wellbeing while the effects of the drug are still active. Other common side effects of heroin abuse include lethargy and drowsiness, also referred to as “nodding off”, as well as slowed speech, thought, movement, and breathing. Heroin users will also experience nausea, vomiting, and constipation.
Loss of appetite is an important side effect of heroin use. Over time, heroin users will display substantial weight loss from the combination of loss of appetite while under the effects of heroin, and nausea, vomiting, chills, and diarrhea that result from withdrawal. This is far from the only effect that heroin has on the body, but it is perhaps the most visible. Long-term heroin use is extremely destructive for the body’s tissues and organs.
If the heroin user is injecting, there is a substantial risk of collapsed veins and localized tissue damage around regular injection sites. The injection can also lead to bacterial infections in the tissues of the heart. Adulterants used to cut heroin can cause irreversible damage to the body’s organs.
Heroin use has an impact on the emotional state and cognitive function of the addict as well. Heroin use tends to result in increased volatility in emotions. Heroin users are more likely to exhibit mood swings, which can range from lethargy and complacency while under the effect of the drug, to anger and irritability once withdrawal begins to take hold. Many heroin users also describe crippling levels of depression and anxiety as a result of heroin use, particularly during the withdrawal period.
Heroin use collapses down the middle of the emotional spectrum, resulting in fluctuations from one extreme to another. These fluctuations are readily apparent to those closest to the addict. For this reason, among others, another effect of heroin use is damage to the relationships of those closest to the addict.
The brain is deeply affected by heroin use, especially consistent use over a long period of time. Although much of heroin’s effect on the brain remains to be discovered, what is known is that long-term heroin use can lead to changes to the parts of our brain that regulate impulse control and decision making. In some cases, the damage caused by heroin to these parts of the brain is permanent. These factors are believed to contribute to higher crime rates among long-term heroin addicts.
Treatment for Heroin Addiction
There are many people that mistakenly believe that heroin addiction is not treatable. This is probably due to many factors, but portrayals of heroin addiction in the media through tv shows, movies, and books have partially shaped this view. In reality, heroin addiction is very treatable. That is not to say that a treatment for heroin addiction is easy. For many recovering addicts, the journey to lifelong sobriety is the most difficult challenge of their life.
Before exploring treatment options for heroin addiction recovery, it is important to first understand the different phases of recovery. Many of the most iconic depictions of heroin addiction show the addict under the effect of full withdrawal symptoms. Withdrawal from heroin can be a brutal process. Heroin withdrawal generally begins somewhere between 6-12 hours after an addict has last taken heroin.
Over the next 72 hours, an array of flu-like symptoms such as vomiting, nausea, diarrhea, excessive sweating, shaking, fever, and chills will begin to assail the addict. These symptoms are often accompanied by insomnia, panic attacks, and anxiety, or acute depression. This is generally the thing people think about when contemplating treatment for heroin addiction. While these withdrawal symptoms are real, and can even be life-threatening in some cases, they are also more typical of a heroin addict attempting to quit “cold-turkey”, or without medical assistance.
Rather than focusing solely on the withdrawal symptoms, it is important for recovering addicts or their loved ones to understand that treatment for heroin addiction encompasses roughly three phases; detox, recovery, and post-treatment care. The detox phase is where the recovering addict’s body is ridding itself of the heroin in its system. This is when the recovering addict will experience the acutest withdrawal symptoms.
After detox, recovering addicts will enter a recovery program which takes up the bulk of their time in the facility. Lastly, after an in-patient treatment program, the recovering addict continues their journey outside of the treatment facility, utilizing the skills and insights they gained while in treatment. Each of these three phases of heroin addiction treatment is crucial towards achieving lifelong sobriety. We’ll dive deeper into each of these three phases to provide a better understanding of how they help treat heroin addiction successfully.
Detox is a mandatory part of nearly every heroin addiction recovery program. During the detox process, the addict’s body will be purged of the heroin in their system. This will be accompanied by withdrawal symptoms. An inpatient facility provides two key features that help heroin addicts on their journey.
First, recovering addicts are monitored around the clock by qualified medical professionals. This not only provides peace of mind but is a necessity as there are a number of serious health complications that can arise during withdrawal. Second, health professionals can help medically manage heroin withdrawal, reducing the felt withdrawal symptoms to a manageable level. For addicts contemplating a recovering program, this can provide its own form of peace of mind.
After detoxing, the recovering addict truly begins their journey towards maintaining lifelong sobriety. From the moment a recovering addict enters a treatment facility, they should be working with medical professionals to craft a personalized treatment plan. This plan will adapt and change over the course of their recovery but serves as a blueprint for their curriculum in their program.
Treatment for heroin addiction is generally conducted in an inpatient treatment facility, with programs lasting from 30-90 days. During this time, recovering addicts will take part in a wide variety of different activities and classes. These classes are meant to create the foundation for a healthy lifestyle. In addition to classes, recovering addicts will take part in one-on-one therapy with an addiction counselor, group therapy sessions, and sometimes family counseling. The therapy sessions in a recovery program are the vehicle through which the recovering addict learns to dive into the underlying causes of their heroin addiction.
Treatment after a recovering addict has finished their inpatient program is critical to a successful recovery. For this reason, it is important that you work with an accredited rehab facility that offers a comprehensive continuum of care for recovering addicts. The level of aftercare programs should be tailored to the recovering addict’s specific situation and needs. Common aftercare programs are enrollment in a Narcotics Anonymous or similar group that operates locally to the recovering addict.
These programs are important because they continue the group therapy dynamic that was begun in the treatment facility, while also offering the opportunity for mentorship programs. Therapy resources are also made available so that recovering addicts can continue their therapy sessions outside of the facility. This is especially important for the families and loved ones of recovering addicts, as it can be difficult to navigate the trauma of the past with the desire to move forward.
This breakdown of the heroin addiction recovery process describes an inpatient recovery program. Some recovering addicts may find that choosing an outpatient treatment program is better suited for their life. Outpatient treatment programs still require a period of time in the facility to detox, but recovering addicts continue the bulk of their recovering outside of the facility. This allows recovering addicts the ability to continue their life outside of treatment, and indeed can help recovering addicts incorporate treatment into their lives for the long-term.
Throughout an outpatient program, recovering addicts are held accountable for meetings and therapy sessions. However, unlike an inpatient program, outpatient treatment for heroin addiction can carry a higher risk of relapse due to the ease with which a recovering addict can return to their habit. Each different type of treatment program has its own strengths. Addicts looking to enter recovery, or the families and loved ones of an addict, are encouraged to have an assessment with a qualified medical professional in order to determine which addiction treatment program is right for them.