Common Questions About Heroin
Using heroin one time will not cause dependency. However, trying it once can lead to subsequent heroin usage, which can then lead to addiction. To become physically dependent on a drug (meaning that a body needs the drug to function), drug use would need to be repeated over a period of time. Using heroin one time will neither cause physical dependence on the drug nor will it lead to addiction. Data shows that approximately 80% of people who try heroin do not become dependent on it.
According to the 2018 National Survey on Drug Use and Health, approximately 808,000 people over the age of 12 used heroin at some point during 2018.2 Broken down into age groups, approximately 10,000 of these people were adolescents ages 12 to 17. 157,000 were young adults aged 18 to 25, and 641,000 were adults over the age of 26.2 While there are many drugs that tend to be used mainly by adolescents and young adults, heroin tends to be used primarily by adults.
While it’s use was steadily increasing during the 2000s, heroin use has been decreasing since 2016. In 2015, approximately 828,000 people over the age of 12 had used heroin. In 2016, this number grew to 948,000.3 It decreased in 2017 to approximately 886,000 users and dropped to 808,000 people in 2019.4
Effects of Heroin
What are the Short-term Effects?
The instant effect of taking heroin is a pleasurable feeling that is often referred to as a ‘rush.’ Some of the common short-term effects include:
•Falling in and out of consciousness and semi-consciousness
•Heavy feeling in the arms and legs
•Impaired mental functioning
•Warm flushing of the skin
Long-term use can lead to experiencing the following effects:
•Changes in the physiology of the brain
•HIV (from sharing needles)
Infection of the heart lining and valves
•Irregular menstrual cycles
•Antisocial personality disorder
•Collapsed veins (from injecting heroin)
•Damaged tissue inside the nose (from sniffing or snorting heroin)
•Hepatitis (from sharing needles)
•Imbalances in neuronal and hormonal systems
•Liver and kidney disease
One of the risks of heroin use that is unique to injecting it is the potential to contract HIV and hepatitis C through the sharing of unclean needles or other paraphernalia. Individuals who use inject oftentimes share needles, increasing the risk of spreading HIV and hepatitis C. Hepatitis C is the most common blood-borne infection in the United States.
What are the Effects of Using Heroin During Pregnancy?
Heroin is not safe to use during pregnancy as it can result in neonatal abstinence syndrome (NAS). NAS occurs as a result of heroin passing through the placenta to the fetus during pregnancy, causing the baby to become dependent on it.
Common Side Effects of Using Heroin During Pregnancy Consist of:
•Slow weight gain
NAS requires hospitalization and treatment with medication such as morphine to relieve the symptoms. The medication is gradually lowered in dose until the baby can adjust to being opioid-free.
If heroin has been used repeatedly over a long period of time, a dependency has likely been developed on the drug. If its use suddenly stops, it is likely to cause withdrawal symptoms. Withdrawal symptoms occur when the body has gotten used to the presence of a substance and has become dependent on it. The body responds to the absence of the substance with various symptoms. Symptoms of heroin withdrawal include:
•Cold flashes with goosebumps (“cold turkey”)
•Uncontrollable leg movements (“kicking the habit”)
Can You Overdose On Heroin?
Yes, it is possible to overdose. An overdose occurs when too much heroin enters the body, causing a life-threatening reaction or death. Taking a large amount of it at once can slow down or stop breathing, decreasing the amount of oxygen in the brain. This condition is called hypoxia, and it can have short and long term mental effects and effects on the nervous system, such as a coma or permanent brain damage.
How to Treat an Overdose
If a person is experiencing an overdose, it is important to be treated with naloxone right away to reverse the effects of the overdose. Naloxone is a medication that is used to treat opioid overdoses by blocking the effects of heroin and other opioids on the brain. Naloxone helps normalize breathing, but more than one dosage might be necessary. After administering naloxone, it is important to go to the emergency room immediately in case further treatment is needed.
Naloxone is administered as an injectable liquid or as a nasal spray. Naloxone can be administered by family or friends (not just medical personnel), and in some states, pharmacists can provide naloxone without a prescription.
What Happens if Heroin is Mixed with Alcohol or Other Drugs?
Based on the interactions of these two drugs with one another, there are some specific physical and mental effects that occur when mixing them. For example, generally, when a stimulant drug is added to an opioid analgesic, the painkilling effect can be enhanced while the individual will not feel quite as much fatigue as would occur with the painkiller alone. Effects include but are not limited to:
•Intense euphoria rush
•Normal to increased respiratory rate
•Increased heart rate
•Relaxation and release of inhibitions
What Happens During a Heroin Detox?
A detox is the first step of treatment for heroin addiction. A detox stops the drug use, and then other treatments can tackle the underlying issues that may have led to addiction. This would include building better habits and developing a healthy lifestyle that will help a person recover and avoid relapse.
A heroin detox typically involves being medically monitored while stopping the use of the drug while monitoring and controlling withdrawal symptoms. While it is possible to detox without assistance, it is very difficult and unpleasant, particularly without medical help.
Often times, a medical detox will include the use of medication to reduce the negative physical or psychological effects of withdrawal. Medications such as methadone or buprenorphine can help to decrease the severity of withdrawal symptoms and can help to avoid a relapse. Because it is difficult to avoid using heroin to stop the unpleasant withdrawal symptoms, medically supervised detoxes are recommended for long term recovery.
Medication Assisted Therapy (MAT)
While medications might be introduced during the detox stage, they will often still be used as part of a treatment plan to manage withdrawal symptoms, cravings, and to avoid a risk of relapse. Medications that might be used for the treatment of heroin are:
In most cases, addiction treatment involves more than just stopping the use of a certain substance or substances. There are usually underlying reasons for why substance use began, or there are co-occurring disorders such as depression or anxiety that may play a role in addiction. For that reason, it is important to address each issue that plays a role in addiction rather than just focusing on the substance itself.
Behavioral therapies include individual therapy, group therapy, or family therapy. Examples are cognitive behavioral therapy, which can occur on a one-to-one basis with a psychotherapist or in a group setting. Cognitive-behavioral therapy focuses on thought patterns and behaviors surrounding drug use and ways that an individual can adapt their thinking and behavior to reflect recovery.
Another group therapy option is Heroin Anonymous, which is based on the principles of Alcoholics Anonymous and revolves around the peer support of people going through the same process. There are a variety of treatment facilities where behavioral therapy can occur. They include:
Outpatient Treatment Facilities
Outpatient treatment facilities are the most popular treatment option in the United States. In an outpatient treatment facility, the patient lives at home and travels to the facility for treatment. This can take place over a period of weeks, months, or even years.
Inpatient Treatment Facilities
Inpatient treatment facilities are used less than outpatient facilities because they require the patient to stay overnight for up to 28 days. Inpatient treatment facilities offer more structure and support for individuals and are typically located in hospitals or other medical facilities where patients receive more care. After about a month, patients might be transferred to outpatient treatment facilities or residential treatment facilities.
Residential Treatment Facilities
Residential substance use treatment facilities are facilities where people live full-time for a longer period of time because they require more intensive structure and support for recovery. These treatment facilities offer assistance for co-occurring problems outside of just substance use.
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