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Heroin Abuse and Addiction: Effects and Treatment

Heroin addiction is a terrible condition that continues claiming thousands of lives in the U.S. As a matter of fact, in recent years, nearly 80 percent of people using heroin attributed their addiction to prior prescription painkiller use.  There are many effective addiction treatment options open to those suffering from heroin addiction. However, the best detox approaches match the needs of each patient with adequate medical care and behavioral therapy. The drug works by activating molecules that interact with opioid receptors in the brain. These receptors, located throughout the brain and body, are instrumental in changing the perception of pain and rewarding behaviors. As a result, heroin addiction commonly causes compulsive and destructive drug-seeking behavior. Ultimately, it is important to understand the risk factors associated with heroin use so we can prevent destruction and overdose.


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What is Heroin?

Heroin is an illicit opioid made from natural morphine. First, morphine is derived from the seed pod of opium poppy plants. Although most of the world’s production is in Southeast and Southwest Asia, Mexico, and Colombia, the U.S. has seen a huge increase in heroin use. Heroin comes in a white or brown powder or a black sticky substance depending upon where it was made. There are a number of common nicknames for heroin in the U.S. due to it’s illegal nature. For instance, these include “big H,” “horse,” “hell dust,” and “smack.” In addition, There are many more street references often used by those who abuse drugs. For example, these names include:

  • Big H
  • Black
  • Black Eagle
  • Black Pearl
  • Black Stuff
  • Black Tar
  • Boy
  • Brown
  • Brown Crystal
  • Brown Rhine
  • Brown Sugar
  • Brown Tape
  • Chiba
  • China White
  • Chiva
  • Dope
  • Dragon
  • H
  • He
  • Hera
  • Hero
  • Heron
  • Herone
  • illnesses
  • Junk
  • Mexican Brown
  • Horse [Mexican]
  • Mud [Mexican]
  • Number 3
  • Number 4
  • Number 8
  • Sack
  • Scag
  • Scat
  • Skunk
  • Smack
  • Snow
  • Snowball
  • Tar
  • White
  • White Boy
  • White Girl
  • White Horse
  • White Lady
  • White Nurse
  • White Stuff

Signs of ACTIQ Addiction

ACTIQ addiction is progressive in nature, meaning it gets worse over time. Addiction can escalate to hazardous levels, where people will do anything to acquire and use the drug, regardless of the negative consequences.

  • Some of the most common drug-seeking behaviors are;
  • Shopping around for doctors to secure more of a supply.
  • Buying or trading them illicitly.
  • Falsification of prescriptions.
  • Seek prescriptions from multiple doctors.
  • Not use the drug correctly.
  • Continue long-term use.
  • Be unable to perform ordinary tasks of daily living.
  • Financial trouble.
  • Noticeable deficits in proper self-care.

Types of Heroin

Heroin is a highly addictive, illegal drug that is processed from morphine. It is usually found as a white or brownish powder and processed or “cut” with additives such as sugar, starch, or quinine. Even with additives, the final product remains between white and brown. Typically, white powders have a bitter taste and predominantly originate from South America and Southeast Asia. in addition, this form of heroin is nearly pure and can be snorted and smoked. This method is more appealing to new users because it eliminates the stigma associated with injecting heroin.

Next, the black tar form is as sticky as roofing tar, hard like coal, and predominantly produced in Mexico. The dark brown color is due to crude processing methods that leave behind impurities. Furthermore, this type of heroin is usually dissolved, diluted, and injected into veins, muscles, or under the skin.

Heroin was first synthesized from morphine in 1874. Until 1910, it was marketed as a non-addictive cough suppressant and substitute for morphine. However, the Harrison Narcotics Tax Act, passed in 1914, was meant to control the sale of heroin and other opiates. Heroin could be prescribed for medical purposes until 1924 when Congress banned the sale, import, or manufacturing in the U.S. Presently, most heroin consumed in the U.S. comes from Colombia, Mexico, Canada, Afghanistan, and China. Other top-producing countries include Thailand, Vietnam, and Laos.

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How is Heroin Used?

Heroin is used orally, snorted, smoked, or injected into veins, muscles, or under the skin. Some users inhale the vapors when it is heated. Often, it is “cut” with other substances to dilute it or to add bulk. Dangers of intravenous use include transmission of hepatitis and HIV from contaminated needles and syringes, abscesses, chronic constipation, and poisoning from ingredients and other drugs. Furthermore, injection poses the highest risk of overdose as this administration route allows for large amounts of heroin to enter the bloodstream immediately. However, it is possible to overdose while sniffing or smoking heroin, especially when taking large doses or combining heroin with other depressants like alcohol.

Some countries provide clean needle exchange programs because they want to decrease the harm associated with heroin use. While some argue this helps cut the transmission rate of infectious diseases, others say it amounts to governments’ acceptance of heroin use.

 The Drug Enforcement Administration (DEA) has issued an alert in response to the surge in overdose deaths caused by Fentanyl-laced heroin across the United States.

Heroin Side Effects

The addictive nature of heroin is reinforced by its powerful ability to create pleasurable feelings, also described as a rush or strong euphoric feeling. After extended use, these pleasurable effects become overshadowed by numerous unwanted physical side effects as tolerance sets in. Typically, these symptoms often mean the body is taking action to counter-balance heroin’s impact.

Heroin binds to opioid receptor sites in the body. Once a chemical interaction happens, the affected nerve cells start releasing dopamine, a molecule responsible for mediating certain pleasure or reward feelings. As the body becomes accustomed to heroin, it needs higher doses to achieve the same high. Then, users develop a dependence or heroin addiction.


Common Short Term Side Effects

In most cases, users experience some or all of the temporary side effects when using heroin. To illustrate, some of the most common, short-term side effects include:

  • The rush or euphoric feelings
  • Feelings of being warm and flushed
  • Heavy sensations in the body’s extremities.
  • Nodding (periods of being awake and asleep)
  • Reduced sensations of pain
  • Drowsiness
  • Sedation
  • Lethargy

The intense euphoric effects will only last for a few minutes, but the feeling of sedation can persist for a few hours. Furthermore, the duration and intensity of these side-effects is dependent on the purity of the drug, dose usually taken, and route of administration.

Serious Physiological Side Effects

There is a broad range of serious physiological side effects which long-term heroin users often experience. For example, these can include:

  • Dental and gum damage
  • Excoriated skin from scratching
  • Opioid-Induced Constipation (OIC)
  • Diminished immune system response
  • Susceptibility to disease
  • Poor appetite and malnutrition
  • Heart and Valve Disease
  • Sleeping issues
  • Sexual Disfunction
  • Pulmonary issues
  • Liver Damage
  • Kidney Damage
  • Infectious diseases
  • Coma or Death


Additionally, many users experience various personal consequences resulting from their addiction. For instance, financial stress due to loss of job or assets, relationship turmoil and/or divorce, child custody issues and even legal consequences, to name a few.

Heroin Dependence

With the prolonged use of heroin, tolerance develops. This means the abuser must use more and more drugs to achieve the same intensity or effect. Consequently, as higher doses are used, physical dependence develops. At this point, the body has adapted to the continuous heroin presence, and if use is reduced or discontinued, withdrawal symptoms occur.  To illustrate, these are some of the signs you might notice with heroin dependence:

  • Nausea and vomiting
  • Grogginess
  • Confusion
  • Dry mouth
  • Itchy skin
  • Constricted pupils
  • Light sensitivity
  • Lower than average body temperature
  • Slowed respiration
  • Decreased heart rate
  • Cyanotic (bluish) hands, feet, lips, etc

The euphoric effects of heroin abuse will decrease with continued use because the user becomes increasingly tolerant of the drug.

Likewise, the practice of sharing needles to inject heroin increases the risk of contracting infectious diseases, especially HIV, Hepatitis B, and Hepatitis C. Injecting heroin and exchanging needles increases the risk for other illnesses, such as endocarditis, blood clot, botulism, tetanus, and flesh-eating bacteria. Similarly, injecting heroin may also lead to painful abscesses that may result in blood poisoning.

 The Drug Enforcement Administration (DEA) has issued an alert in response to the surge in overdose deaths caused by Fentanyl-laced heroin across the United States.

Emotional Consequences of Heroin Addiction

Since heroin impacts the structure of the brain, emotional health is also compromised with continued use.  For instance, some of these emotional consequences include:

  • Depression
  • Isolation
  • Memory Problems
  • Anxiety
  • Physical Dependence and Addiction


Heroin binds to opioid receptor sites in the body. Once a chemical interaction happens, the affected nerve cells start releasing dopamine, a molecule responsible for mediating certain pleasure or reward feelings. As the body becomes accustomed to heroin, it needs higher doses to achieve the same high. Then, users develop a dependence or heroin addiction.


Heroin Abuse

Heroin is illegal, with no accepted medical use because of the risks and side effects of using it. Consequently, the use of heroin is considered recreational, so addiction is almost a certainty with repeated use.  Regular use can cause a person to develop a tolerance, requiring them to continually increase the dose so they can feel the same desirable effects. Over time, the repeated use of increasingly high doses results in a physical dependence and heroin addiction.

Once addicted, users become preoccupied with getting the drug and using it. Thus, the need to use quickly becomes overwhelming and consuming. This can lead people down a path of risky behavior in their quest to get a “fix” and because they want to avoid the sickness withdrawal creates. As a result of its intense euphoric effects and a high potential for addiction, many users find it extremely difficult to curtail use independently.

In the long run, heroin addiction can ruin relationships, destroy careers and lead to serious legal problems. Moreover, the societal impacts of heroin abuse are astounding. The fallout impacts medical establishments, criminal justice system, and even future generations because of the long standing consequences.

Signs of Heroin Addiction

Heroin addiction is described as a compulsive need to use the drug without concern for risks or adverse consequences.

Some signs of heroin addiction are signaled by paraphernalia or behaviors such as:

  • Missing shoelaces
  • Straws with burned residuals
  • Small containers with white powdery residue
  • Containers with sticky brown substance
  • Water pipes or other smoking devices
  • Aluminum foil with burn marks
  • Needles or syringes
  • Burned spoons

In addition, other signs of addiction include sudden behavioral changes such as:

  • Lying or other deceptive behavior
  • Avoiding eye contact
  • Increased sleeping
  • Slurred or incoherent speech
  • Stealing or borrowing money from loved ones and family members
  • Unexplained absence of valuables
  • Hostile behavior
  • Declining performance in school or work
  • Decreased attention to hygiene and appearance
  • Loss of motivation
  • Apathy toward future goals
  • Social withdrawal
  • Wearing long pants (even in warm weather)
  • Dressing in long sleeves (even in warm weather)

Lastly, noticeable physical symptoms may include:

  • Weight loss
  • A frequent runny nose
  • Needle track marks
  • Infections or abscesses because of IV use
  • Uncontrollable feelings of itching
  • For women, loss of menstrual cycle

Heroin Overdose

Since heroin overdose can be fatal, it’s essential to know the signs. Heroin is a central nervous system depressant and can be deadly when mixed with other substances, like Fentanyl. For this reason, purity and strength are not often guaranteed. In other words, there is no safe dose of heroin. A user’s tolerance, the amount taken, and the purity are all factors determining whether someone will have an adverse reaction to heroin. But, with every use the risks of drug overdose are incredibly high.

Like all opiates, tolerance builds with repeated heroin use, even when it’s relatively short term. Repeated use prompts users to take more and more to experience the effects they desire, whether it’s euphoria or to stave off withdrawal. Ultimately, there is no way to avoid an overdose when using heroin. An average amount for a regular user can cause a deadly overdose for a first-time user because of their level of tolerance.

Certainly, heroin is very addictive and can dramatically slow the heart rate and breathing. The signs of an overdose generally occur quickly after an individual ingests the substance. Some people may have a conversation or do other things before the symptoms appear, but others may exhibit overdose symptoms within minutes.

Likewise, other signs and symptoms of a heroin overdose can include:

  • Awake, but not able to speak
  • Limp body
  • Pinpoint pupils
  • Breathing slow, shallow or none
  • Cold and clammy skin
  • Blue or grayish lips
  • Choking sounds, or a snore-like gurgling noise
  • Weak pulse
  • Constipation
  • Low blood pressure
  • Disorientation
  • Extreme drowsiness, confusion, and delirium
  • Unresponsive to outside stimulus


Additionally, for more information on heroin abuse risks, please read SAMHSA Opioid Overdose Prevention Kit.

If you feel an overdose is occurring, you must call 911 and get medical help immediately, because death could be a serious possibility.

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