Heroin Addiction

In 2010, approximately 140,000 Americans over the age of 12 used heroin for the first time, according to the National Survey on Drug Use and Health, with an average age for first-timers at 21.3 years. This statistic has not changed much since 2002. The number of people abusing heroin has increased from 214,000 in 2002 to 359,000 in 2010. Approximately 417,000 people received treatment for heroin dependence or abuse in 2010. While more people are seeking treatment for pain reliever or tranquilizer abuse rose between 2002 and 2010, the number of individuals seeking treatment for heroin dependence or addiction remained about the same.

The National Institute on Drug Abuse estimates 23 percent of people who use heroin become dependent upon it.

The definition of addiction

Addiction is a chronic, primary disease, which means it is a long-term medical condition not caused by another other disease. Heroin addiction is a neurobiologic disorder, which means it affects the cells of the nervous system. Genetic, psychological and social factors influence the development and manifestation of heroin addiction. Heroin addiction is characterized by impair control over drug use, compulsive use of drugs, continued abuse despite awareness of the harm heroin causes, and cravings.

Addiction versus Dependency

Addiction to heroin is not the same as dependence on this powerful opioid. In layman's terms, drug dependence is a state where a person's body needs a drug in order to feel normal and addiction is the compulsive use of a drug.

The human body adjusts to the presence of certain substances, such as heroin, in its system. It can become tolerant of certain chemicals, which means it takes an ever-increasing amount of the substance to cause an effect. Sometimes the body becomes dependent on a chemical, such as heroin; the individual must maintain a certain level of this substance for the body to feel normal. If the level drops rapidly, the body struggles to maintain its chemical balance. This struggle manifests itself through withdrawal symptoms.

Both addiction and dependence cause real changes in your body and brain but addiction and dependence manifest themselves in different ways. Addiction and dependence on drugs are independent from one another: you can be addicted to something without being physically dependent on it and vice versa. For example, a person may be physically dependent on a hypertensive to keep his blood pressure low; if he were to stop taking this medication suddenly, his blood pressure would rise but he would not feel cravings for the drug. Conversely, an individual can be addicted to cocaine without physical dependence; if he were to stop taking cocaine suddenly, he may crave the drug but not suffer symptoms of withdrawal.

Addiction: What Family Members Should Know

Heroin addiction has a more profound impact on family member than other opioids because of its special health risks and its status as an illegal drug. The Drug Enforcement Agency has classified heroin as a schedule I narcotic, which means it carries a high risk for abuse and provides no medical merit. It is against federal law to possess heroin, with first time offense penalties beginning at one year in prison and a $5,000 fine. It is imperative to seek treatment for a family member before it causes far-reaching legal consequences for the family unit.

Abusers typically inject heroin. Many share needles with other users. Needle sharing is a dangerous practice that increases the risk for contracting a contagious disease, such as hepatitis or HIV. Infected individuals can then spread these diseases to sexual partners or children.

Children who grow up in households where illicit drug use is acceptable are more likely to develop addictions later on in life. While researchers are still working to establish the exact cause of drug abuse and dependence, genetics may play a role. Scientists at the American Society of Addiction Medicine state that genetic factors account for about half the likelihood that an individual will develop an addiction. Other environmental factors include peer pressure, emotional distress, and anxiety. Depression and environmental stress contribute to dependence.

Individuals prone to addiction may be hypersensitive to stress. Members of the family unit can work together to reduce the ambient level of stress within the household. This reduction in environmental stress also decreases the risk for addiction in other members of the family.

Addiction is a disease. Unlike other diseases, addiction to heroin is illegal and is socially unacceptable, complicating this already-complex medical condition. An individual suffering from addiction to heroin needs as much, or more, love and support from friends and family members than other chronic diseases.

Caring for someone who is addicted to heroin is a drain on the physical, emotional and social well-being of the family unit. Family members can improve their loved-ones chances for recovery by getting enough rest, avoiding substance abuse and decreasing ambient stress. Family counseling is extremely helpful for those struggling to help a loved one overcome heroin addiction.

Family members should strive to talk with their loved ones about heroin addiction. The addicted individual may resist communication at first, as addiction is a very personal issue. Concerned family members may encourage some form of opioid detox or opiate rehab program.

It is okay for family members to move toward treatment, even if the person with a heroin addiction resists rehabilitation. Concerned loved ones may visit websites, ask questions or seek referrals from others who have witness heroin addiction.

Heroin addiction causes physical changes to the brain that may result in feelings of betrayal or anger towards those who suggest discontinuing heroin. Family member should remember that these feelings will subside after recovery.

Heroin addiction is a disease that requires treatment. It is extremely difficult to remedy heroin addiction without professional help.

Addiction Symptoms: Physical and Psychological

Addiction to heroin manifests itself in a variety of physical and psychological ways. Most of these symptoms are typical of opioid abuse but some are specific to heroin addiction, including:

  • Constant Sniffing
  • Decreased Motivation
  • Hostility
  • Needle Marks on Arms or Legs
  • No Desire To Form Future Plans
  • Possession Of Drug Paraphernalia
  • Runny Nose
  • Slurred Speech

Physical symptoms of heroin drug addiction include:

  • A Change in Sleep Patterns
  • Bloodshot Eyes with Large or Small Pupils
  • Body or Clothing May Have an Unusual Odor
  • Deteriorating Physical Appearance - Looks Sickly
  • Diminished Hygiene Care
  • Nagging Cough
  • Slurred Speech
  • Tremors
  • Unexplained Weight Gain or Weight Loss

Psychological symptoms of addiction to heroin include:

  • Inability to Abstain from Heroin Consistently
  • Impairment in Behavioral Control
  • Cravings for Heroin or Other Intense Reward Experiences
  • Diminished Capacity to Recognize Significant Personal or Relationship Problems
  • Dysfunctional Emotional Response

Addiction to heroin causes changes in brain structure and function, especially in those areas of the brain associated with reward, including the nucleus accumbens, anterior cingulate cortex, basal forebrain and amygdala. Addiction also changes the way the brain remembers rewards

Addiction and gender: how women and men are affected differently

Women who abuse drugs are more likely to come from environments where use of illicit drugs such as heroin was acceptable. Women who are addicted to heroin and other substances are more likely to have a partner who is also addicted to a drug, whereas a male may be addicted to a drug regardless of his partner's status.

Men addicted to heroin and other drugs are more likely to exhibit social disorders and criminal activity than females. Women addicted to heroin and other opioids are more likely to experience mood disorders. Females with addictions are more likely to have body image issues than are addicted men and are therefore at higher risk for developing eating disorders. Addicted men are more likely to engage in drugs socially, whereas an addicted woman are more private about their addiction.

According to the 2002 National Survey on Drug Use and Health, men are more likely than women to report current drug abuse are. Historically, females have a lower rate for entry into drug treatment, remaining in rehabilitation and completing treatment than men. Researchers thing social stigmas, economic barriers and family responsibilities prevent women addicted to heroin from seeking or completing treatment programs.

Signs of addiction: For those around

Heroin addiction changes in a person's behavior, thinking patterns, emotions and interactions with others, such as family members, co-workers, friends and members of the community, like teachers, coaches, police and others. Addiction changes an individual's executive functioning, or the way he thinks; these changes manifest themselves in problems with perception, learning, impulse control compulsivity and judgment.

Heroin addiction affects performance and personal care. A person with an addiction to heroin can display a tendency toward recklessness, as well as a withdrawal from family and friends.

An individual in a relationship with a person who is addicted to heroin may notice:

  • Abnormal, Illegal and Anti-Social Actions
  • Arguments or Violent Outbursts
  • Excessive Drug Prescriptions for Self and/or Family
  • Frequent Emotional Crisis
  • Legal Problems
  • Neglect of Children
  • Neglect of Social Commitments
  • Prioritizing Activities Involving Substance Abuse
  • Separation or Divorce
  • Unexplained Absences from Home
  • Unpredictable Behavior such as Inappropriate Spending
  • Withdrawal from Relationships, Family or Friends

A person close to an individual struggling with heroin addiction may notice certain behavioral manifestation and complications of addition, such as the excessive use or participation in addictive behaviors, often at higher frequency or intensity than intended and frequently coupled with an expressed intent and attempts to control behavior. The person addicted to heroin may lose excessive time pursuing, using or recovering from heroin use. The individual may continue to use heroin, despite understanding the consequences of heroin abuse. The individual may seem increasing less interested in subjects other than heroin. He may seem unable or uninterested in quitting heroin use.

Heroin addiction causes cognitive changes, or alterations in the way a person thinks. Cognitive changes include preoccupation with heroin and the incorrect perception that heroin is good. She may also hold the inaccurate believe that issues other than heroin cause the problems in her life. She may seem unwilling or unable to accept the negative influence that heroin has had in her life.

Heroin addiction also causes emotional changes, including increased anxiety and emotional pain. Individuals who suffer from heroin addiction feel dysphoria, or overwhelming sadness and demoralization. A person who is addicted to heroin may have difficulty identifying or expressing his feelings to others. Researchers believe hypersensitivity to stress leads to addiction in some people. When asked about their addictions, these individuals may express sentiments such as "things seem more stressful right now."

Treatment options

Treatment is essential for individuals facing heroin addiction. The American Society of Addictive Medicine warns that addiction can cause "disability or premature death, especially when left untreated or treated inadequately." These experts go further to say, recovery from addiction is "best achieved through a combination of self-management, mutual support, and professional care provided by trained and certified professionals."

Some individuals try to quit heroin without the help of medical professionals in a procedure known as self-detoxification. The average individual calls this, "quitting cold turkey," a reference to the cold, clammy, pale and bumpy appearance the skin takes on as a person tries to quit heroin. The withdrawal symptoms associated with heroin addiction and physical dependence are overpowering, frequently driving the individual engaged in self-detox back to heroin use.

Other people try to overcome the potent symptoms of heroin addiction by concocting a home brew, designed to reduce withdrawal symptoms. One such remedy is the Thomas Recipe, which include medication to reduce anxiety and induce sleep, another to stop diarrhea, plus vitamins and supplements to ease muscle aches and increase energy levels. While home remedies such as the Thomas Recipe reduce withdrawal symptoms, they do not address the behavioral aspects of heroin addiction. The relapse rate for individuals who try to quit without the help of trained medical professionals is high.

Individuals who relapse back to heroin after detoxification abuse face an increased risk for overdose. Detoxification lowers the body's tolerance to heroin. A person may overdose on a smaller dose than he was used to taking before he tried detoxification.

Heroin manufacturers cut heroin with varying amounts of other substances, such as sugar, starch or other ingredients. Because heroin users are uncertain of the potency or contents in each dose, users are at increased risk for side effects or overdose. Acute intoxication or overdose requires emergency, sometimes lifesaving treatment. During emergency treatment for overdose, physicians administer medications to counteract the toxic effect of heroin, establish an airway, start an IV and monitor the patient for complications. After emergency treatment, persons addicted to heroin may participate in behavioral therapy to address his addiction.

Patients who are otherwise physically stable may choose drug replacement therapy to treat heroin addiction. Patients replace heroin with a weaker opioid to reduce withdrawal symptoms while the individual participates in behavior modification. After the patient has modified his behavior and no longer feels cravings for heroin, he weans himself from the replacement drug.

Rehabilitation specialists have prescribed methadone for more than 30 years. When properly prescribed, methadone is not intoxicating or sedating; the individual is able to function normally. Methadone is an oral medication that suppresses symptoms of heroin withdrawal for 24 to 36 hours. One dose of methadone lasts four to six times as long as heroin; patients take this medication only once a day. An individual may safely use methadone for ten years or more.

Buprenorphine is an attractive choice for individuals trying to break their addiction to heroin. Buprenorphine causes less opioid effects and is less likely to pose a lower risk for overdose than methadone. Furthermore, buprenorphine is less likely to cause physical dependence, so that patients experience few withdrawal symptoms when it comes time to discontinue drug replacement therapy.

Although medical treatment and behavioral modification are independently useful, addressing both the physical and behavioral aspects of heroin addiction offer the best hope for recovery. Behavioral therapy may take place at an inpatient or outpatient facility; it is important to match the type of facility to the individual's personal needs.

New behavioral therapies show particular promise in the treatment of heroin addiction. Contingency management therapy is a voucher system in which a patient earns points for negative drug tests. He may redeem these points for items that enhance a healthy lifestyle.

Cognitive-behavioral interventions modify a patient's expectations and behaviors related to heroin addiction and give him new tools to deal with stresses that may cause relapse.

Both pharmacological and behavioral treatments work to restore normalcy in brain function and behavior. These treatments also aim at increasing employment rates, reducing relapse and lowering side effects, such as a decreased risk for HIV and hepatitis.

Residential treatment programs include personal, family and group counseling. These programs include behavior modification programs and provide peer support to improve the individual's chances for a successful recovery from heroin addiction.