Heroin (diamorphine) is a semi-synthetic opiate derived from morphine, found in the opium poppy. As a Schedule I narcotic in the U.S., heroin is considered to have no legitimate medical purpose, but instead is a purely recreational drug that is popular due to the euphoric effects it produces. Many users report experiencing feelings of calm satisfaction and warmth, in addition to heavy drowsiness or altering states of wakefulness and unconsciousness, commonly referred to as being “on the nod.”
The purest form of heroin presents as a fine white powder, although it can sometimes be found as a brown powder or black, tacky substance, also known as black tar heroin. Common slang or street names for heroin include dope, H, Horse, Junk, Smack, and Mexican Mud, among others.
In recent years, heroin abuse has risen to epidemic proportions, claiming the lives of tens of thousands. Heroin and other opioids and opiates are powerful depressants, and as such, can lead to life-threatening effects that include profound central nervous system depression and respiratory arrest.
It is quite uncommon to find heroin that is 100% pure. Most of it is diluted or cut with other substances, the most benign of which include talcum powder, sugar, starch, powdered milk, flour, caffeine, and quinine. More toxic ingredients added to heroin may consist of other potent drugs, such as fentanyl, which may be up to 50 times more potent than heroin itself.
How Heroin Works
When injured, nerve cells near the location of the injury send warning signals to the brain, indicating that something has occurred that could be problematic for the health and well-being of the body. In turn, the brain goes into survival mode, modulating levels of natural painkilling hormones, known as beta-endorphins, at opioid receptors throughout the body.
Opiates such as heroin also activate beta-endorphins, which mitigates pain and also leads to feelings of reward and well-being. Beta-endorphins also suppress GABA production, a neurochemical that inhibits the production of dopamine in the brain. Subsequently, heroin boosts dopamine levels and induces the good feelings and euphoria commonly associated with its use.
The region of the brain that experiences the highest amount of dopamine activity is commonly referred to as the reward center. These neural circuits are strongly associated with the pleasure experienced during rewarding activities, such as eating, having sex, securing resources, or virtually anything that we interpret as promoting our biological survival.
Effects of Heroin
Although heroin can be smoked or snorted, intravenous injection is a particularly popular method due to the rapid and intense delivery of heroin to the brain. A powerful initial “rush” is followed by a high that can last for several hours. During this time, heroin users will often be dozing and nodding in and out of sleep.
In addition to euphoria and drowsiness, heroin may induce short-term side effects, including the following:
- Dry mouth
- Flushed skin
- Heaviness in extremities
- Foggy thinking
- Impaired judgment
Unlike the steady, proportionate ebb and flow of reward chemicals that drive potentially beneficial actions in everyday life, the brain’s response to heroin is profound. Heroin produces an amount of dopamine that is disproportionate to the circumstances. In fact, some research has suggested that heroin use can increase dopamine levels as much as tenfold.
Such an oversaturation in this chemical alters otherwise normal patterns of neurotransmission, and long-term use can essentially reconfigure the entire brain. Along with this substance-induced chemical and structural transformation comes an analogous disturbance in actions and behavior.
Heroin can trigger feelings of artificial reward so powerful that the mind becomes destructively single-tracked and hell-bent on maintaining the high and sacrificing itself as a result. The self-sabotaging nature of an obsession with heroin is part of the reason why it is so incredibly tragic.
While a heroin addict is capable of rationalizing why they should quit as a matter of moral principle, the physical experience of drug cravings is often much more intense and immediate and is, therefore, prioritized accordingly.
Although heroin itself is incredibly addictive, around 80% of heroin addicts in the U.S. report first becoming dependent on prescription painkillers such as Vicodin or OxyContin. As the availability of these drugs has steadily decreased in recent years in light of the opioid epidemic, people addicted to such medications have turned to heroin use as a suitable, but likely more dangerous alternative.
Signs of Heroin Use
Through repeated heroin use, a person’s brain and body gradually becomes more tolerant of the drug. As tolerance increases, more and more of the drug is needed to produce the desired high or pain-relieving effects. Also, over time, dependence can develop, a condition in which the person’s body can no longer function correctly without the drug’s presence. When this occurs, unpleasant withdrawal symptoms manifest when the person tries to discontinue drug use.
Apart from significantly increased tolerance and dependence, there are multiple warning signs of heroin addiction, including the following:
- A loss of control over drug use
- Revolving life around heroin attainment and consumption
- Neglect of activities once enjoyed or considered important
- Avoiding social situations, family, or friends
- Continuing heroin use despite the incurrence of adverse life consequences
Some psycho-emotional warning signs that may indicate a heroin addiction include the following:
- Appearing irrationally anxious or paranoid
- Lacking motivation and seeming “spaced out” or lethargic
- Exhibiting mood instability and unexplainable personality or attitude changes
When a person terminates persistent heroin abuse, a chemical void is left behind. The body requires a significant amount of time to detox and reestablish balance, during which a myriad of unpleasant, often painful symptoms can arise, which may include the following:
- Muscle aches and pains
- Repeated yawning
- Runny nose
- Overactive tear ducts
- Abdominal cramping
- Nausea and vomiting
Side Effects of Long-term Heroin Use
Heroin use can lead to long-term effects that undermine the brain’s capacity to carry out essential bodily functions, such as the following:
- Respiration and swallowing
- Heart rhythm
- Blood pressure
Other long-term physical effects may include:
- Collapsed veins
- Liver and kidney disease
- Infected abscesses
- Infected heart valves
- Severe constipation
Furthermore, because heroin is often combined with other substances, like fentanyl, there is an unknown number of potentially adverse complications that can occur. One of the most disturbing effects of heroin abuse is associated with the deterioration of the brain’s white matter, which is partly responsible for decision-making, behavioral and impulse control, and stress management.
Intravenous heroin use also comes with an increased risk of the contraction of diseases transmitted through unsterile needles, such as hepatitis and HIV. If left untreated, hepatitis B and C can compromise liver function or cause it to fail, and HIV can develop into full-blown AIDS, which is life-threatening.
As a CNS depressant, heroin impacts the brain’s ability to regulate breathing. For this reason, hypoxia (oxygen deprivation in the brain) can occur and lead to irreversible brain damage or coma.
Signs of a life-threatening heroin overdose include the following:
- Slow, shallow, or stopped breathing
- Unresponsiveness or unconsciousness
- Bluish lips, fingertips, or other extremities (cyanosis)
- Gurgling sounds (death rattle)
Treatment for Heroin Addiction
Heroin addiction treatment usually begins with medical detox in which the patient is supervised around-the-clock and administered medication to relieve withdrawal symptoms. After detox, patients are urged to enter long-term residential rehab, followed by intensive outpatient treatment.
Just Believe Recovery offers a comprehensive, evidence-based, individualized approach to addiction treatment that includes psychotherapy, counseling, group support, aftercare planning services, and much more.
Recovery is often a lifelong endeavor, but you don’t have to do it alone. We can provide you with the tools and support you need to reclaim your life!