Fact Sheet – Heroin

Heroin addiction

Heroin is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. As early as 3400 BC, the opium poppy flowers were grown and harvested in Mesopotamia. Various chemical and mechanical methods are used to make create the finished product which will have different appearances based on purity and will also have distinct names. Heroin usually appears as a white or brown powder or as a black sticky substance, known as “black tar heroin.”

How Is Heroin Abused?

Heroin can be injected, snorted/sniffed, or smoked—routes of administration that rapidly deliver the drug to the brain. Injecting is the use of a needle to administer the drug directly into the bloodstream. Snorting is the process of inhaling heroin powder through the nose, where it is absorbed into the bloodstream through the nasal tissues. Smoking involves inhaling heroin smoke into the lungs. All three methods of administering heroin can lead to addiction and other severe health problems.

How Does Heroin Affect the Brain?

Heroine drug quickly enters the brain and it slows down reaction time, slows memory and slows down your thought process. The effect of heroin is a sense of warmth and well-being is felt by users when a small dose of heroin is taken. Larger doses make the user feel relaxed, separated from the real world and drowsy. Heroin, being an opiate drug, is capable of directly stimulating the opiate receptors within the brain. When a person uses heroin, the drug moves through the blood brain barrier and infuses the brain with opiates. Heroin affects multiple brain regions. The receptors in these regions deal with pain but some receptors are within the brain stem which is an important area for automatic critical life processes, such as blood pressure and breathing.

Heroin affects the brain areas that produce physical dependence as well as the brain areas that produce euphoric sensations – thereby causing both physical and psychological addictions. The addictive properties of heroin are characterized by tolerance (the requirement for larger and larger amounts to get the same result), persistent cravings for the drug, and a dangerous/painful withdrawal. Heroin is highly addictive as well as extremely fast acting.

So addictive is it that even after just 3 days, it is possible for someone to experience withdrawal symptoms if they stopped taking it. As well as the physical addition, over time the psychological effects of heroin on the brain produce ‘craving’ and a strong desire to keep using the drug. Heroin enters the brain, where it is converted to morphine and binds to receptors known as opioid receptors. These receptors are located in many areas of the brain (and in the body), especially those involved in the perception of pain and in reward. Opioid receptors are also located in the brain stem—important for automatic processes critical for life, such as breathing (respiration), blood pressure, and arousal. Heroin overdoses frequently involve a suppression of respiration.

After an intravenous injection of heroin, users report feeling a surge of euphoria (“rush”) accompanied by dry mouth, a warm flushing of the skin, heaviness of the extremities, and clouded mental functioning. Following this initial euphoria, the user goes “on the nod,” an alternately wakeful and drowsy state. Users who do not inject the drug may not experience the initial rush, but other effects are the same.

With regular heroin use, tolerance develops, in which the user’s physiological (and psychological) response to the drug decreases, and more heroin is needed to achieve the same intensity of effect. Heroin users are at high risk for addiction—it is estimated that about 23 percent of individuals who use heroin become dependent on it.

Research has shown that a major proportion of individuals who just want to experiment with heroin can become addicted quickly. Addiction is measured by developing an increased tolerance towards the drug as well as a dependence on the drug. People can easily become so physically and mentally dependant that their entire existence becomes all about finding and taking the drug. An increase in tolerance level means that user must continually increase the amount of heroin taken in order to produce the same euphoric results. As a consequence of using heroin in larger quantities and more often, the potential for overdose and death almost exponentially increase.

What Other Adverse Effects Does Heroin Have on Health?

Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, and—particularly in users who inject the drug—infectious diseases, including HIV/AIDS and hepatitis. Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, and liver or kidney disease. Pulmonary complications, including various types of pneumonia, may result from the poor health of the abuser as well as from heroin’s depressing effects on respiration. In addition to the effects of the drug itself, street heroin often contains toxic contaminants or additives that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs.

Chronic use of heroin leads to physical dependence, a state in which the body has adapted to the presence of the drug. If a dependent user reduces or stops use of the drug abruptly, he or she may experience severe symptoms of withdrawal. These symptoms—which can begin as early as a few hours after the last drug administration—can include restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (“cold turkey”), and kicking movements (“kicking the habit”). Users also experience severe craving for the drug during withdrawal, which can precipitate continued abuse and/or relapse. Major withdrawal symptoms peak between 48 and 72 hours after the last dose of the drug and typically subside after about 1 week.

Some individuals, however, may show persistent withdrawal symptoms for months. Although heroin withdrawal is considered less dangerous than alcohol or barbiturate withdrawal, sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal. In addition, heroin craving can persist years after drug cessation, particularly upon exposure to triggers such as stress or people, places, and things associated with drug use.

Heroin abuse during pregnancy, together with related factors like poor nutrition and inadequate prenatal care, has been associated with adverse consequences including low birthweight, an important risk factor for later developmental delay. If the mother is regularly abusing the drug, the infant may be born physically dependent on heroin and could suffer from serious medical complications requiring hospitalization.

What Treatment Options Exist?

A range of treatments exist for heroin addiction, including medications and behavioral therapies. Science has taught us that when medication treatment is combined with other supportive services, patients are often able to stop using heroin (or other opiates) and return to stable and productive lives.

Treatment usually begins with medically assisted detoxification to help patients withdraw from the drug safely. Medications such as clonidine and buprenorphine can be used to help minimize symptoms of withdrawal. However, detoxification alone is not treatment and has not been shown to be effective in preventing relapse—it is merely the first step. Medications to help prevent relapse include the following:

  • Methadone has been used for more than 30 years to treat heroin addiction. It is a synthetic opiate medication that binds to the same receptors as heroin; but when taken orally, it has a gradual onset of action and sustained effects, reducing the desire for other opioid drugs while preventing withdrawal symptoms. Properly administered, methadone is not intoxicating or sedating, and its effects do not interfere with ordinary daily activities. Methadone maintenance treatment is usually conducted in specialized opiate treatment programs. The most effective methadone maintenance programs include individual and/or group counseling, as well as provision of or referral to other needed medical, psychological, and social services.
  • Buprenorphine is a more recently approved treatment for heroin addiction (and other opiates). Compared with methadone, buprenorphine produces less risk for overdose and withdrawal effects and produces a lower level of physical dependence, so patients who discontinue the medication generally have fewer withdrawal symptoms than those who stop taking methadone. The development of buprenorphine and its authorized use in physicians’ offices give opiate-addicted patients more medical options and extend the reach of addiction medication. Its accessibility may even prompt attempts to obtain treatment earlier. However, not all patients respond to buprenorphine—some continue to require treatment with methadone.
  • Naltrexone is approved for treating heroin addiction but has not been widely utilized due to poor patient compliance. This medication blocks opioids from binding to their receptors and thus prevents an addicted individual from feeling the effects of the drug. Naltrexone as a treatment for opioid addiction is usually prescribed in outpatient medical settings, although initiation of the treatment often begins after medical detoxification in a residential setting. To prevent withdrawal symptoms, individuals must be medically detoxified and opioid-free for several days before taking naltrexone.
  • Naloxone is a shorter-acting opioid receptor blocker, used to treat cases of overdose.
  • For pregnant heroin abusers, methadone maintenance combined with prenatal care and a comprehensive drug treatment program can improve many of the detrimental maternal and neonatal outcomes associated with untreated heroin abuse. Preliminary evidence suggests that buprenorphine may also be a safe and effective treatment during pregnancy, although infants exposed to either methadone or buprenorphine prenatally may still require treatment for withdrawal symptoms. For women who do not want or are not able to receive pharmacotherapy for their heroin addiction, detoxification from opiates during pregnancy can be accomplished with medical supervision, although potential risks to the fetus and the likelihood of relapse to heroin use should be considered.
  • There are many effective behavioral treatments available for heroin addiction—usually in combination with medication. These can be delivered in residential or outpatient settings. Examples are individual or group counseling; contingency management, which uses a voucher-based system where patients earn “points” based on negative drug tests—these points can be exchanged for items that encourage healthy living; and cognitive-behavioral therapy, designed to help modify a patient’s expectations and behaviours related to drug abuse, and to increase skills in coping with various life stressors.

Help at Eden Recovery Centre

Eden Recovery Centre, is beautifully situated in the Kyalami area, North of Gauteng. With the insight into the daily demand of substance abuse, it was a goal to open a sanctuary, where people, on every level would feel welcome and would leave with the results they came for…

A well trained, team of experts will make a significant impact in the life of a recovering addict. A multi-disciplinary approach based on abstinence, patient affirmation, intensive counselling and adherence to structured programs as outlined below: Through Behavioural treatments help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviours related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive abuse.

Through Cognitive-behavioural, therapy, which consists of a collection of strategies, intended to enhance self-control. Specific techniques include exploring the positive and negative consequences of continued use, self-monitoring to recognize drug cravings early on and to identify high-risk situations for use, and developing strategies for coping with and avoiding high-risk situations and the desire to use. A central element of this treatment is anticipating likely problems and helping patients develop effective coping strategies.

Eden Recovery Centre uses the Twelve-step program which is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups and, thus, promote abstinence. Three key aspects predominate: acceptance, which includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative; surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program; and active involvement in 12-step meetings and related activities.

At Eden Recovery Centre, we provide a safe haven for those going through addiction/s rehab. Staffed with kind; dedicated individuals that help client’s get through the withdrawal phase and move on to the rest of their recovery.

A team of highly trained professionals handpicked for Eden Recovery Centre you will find, psychiatrist on call if required, psychologists on call, medical doctors on call, counsellors and other trusted professionals. These experts form an extended family for the recovering addict as they make their way through the rehabilitation process.

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