Heroin is an illegal street drug that is used for the recreational high it produces. Like prescription opioids, heroin binds to the opioid receptors in the brain, which are neuron receptors normally involved in the sensation of pain and the risk/reward system. Abuse of opioid drugs like heroin dulls physical pain and produces a feeling of euphoria.
Heroin can be snorted, sniffed, smoked, or injected. Injection is the most common method of ingestion, as it induces the quickest high. Injecting drugs puts users at a greater risk for overdose and acquiring a disease, like HIV or hepatitis, related to injection drug use.
Between 2002 and 2013, the number of people who overdosed on heroin quadrupled. About 8,200 people died from a heroin overdose in 2013 alone. One estimate suggests that as many as 23 percent of people who try heroin become addicted to the drug.
Anyone can become addicted to heroin, because this drug offers a potent, quick high. There are, however, certain segments of the population that are more at risk. These demographic groups include:
- Those struggling with opioid painkiller addiction: If prescription painkiller addiction is already a factor, people are more susceptible to becoming addicted to heroin. Drugs like oxycodone and hydrocodone have a similar chemical structure to heroin, as they are derived from the same plant and work on the same receptors in the brain. In the United States, heroin is relatively easy to find and comparatively inexpensive. This means that people suffering from prescription painkiller addiction may turn to heroin when their supply of prescription painkillers is no longer accessible.
- People suffering from cocaine addiction: Although cocaine is a stimulant and heroin is a depressant, many who struggle with an addiction to one of the substances will try the other substance and often become addicted to it. In part, this is due to impulsiveness and cognitive problems associated with long-term addiction to either cocaine or heroin.
It could also be related to genetic factors that lead some individuals to
struggle with addiction more than others.
In addition, individuals who have genetic or environmental factors related to addiction are more likely to suffer from addiction to multiple substances. This is called polysubstance dependence, and there is currently little scientific research that can explain this phenomenon. However, individuals who abuse or become addicted to one substance, such as alcohol or marijuana, may be more prone to try other substances. After experimenting with a new substance, addiction to that new drug can form quickly. As a result, those who are addicted to any substance may be more likely to become addicted to heroin.
Other demographic groups that are more likely to struggle with heroin addiction include:
- Non-Hispanic Caucasian individuals
- People living in urban or metropolitan areas
- Young adults, typically 18-25 years old
Around 200,000 individuals enter inpatient treatment facilities or hospitals each year because they struggle with heroin addiction.
The term recreational user is misleading when it comes to any substance of abuse, but particularly with heroin abuse and addiction. Heroin is an extremely addictive substance, so very few individuals end up using this substance in a way that is not compulsive, dependent, and destructive.
Individuals who use heroin exclusively or primarily tend to become addicted to this drug when they are teenagers or young adults. These people may have mental health issues causing them to self-medicate, or genetic components that can lead to addiction or substance abuse problems. As teenagers or young adults, these people might be more willing to try a variety of substances, including illegal and highly addictive substances. Once people become addicted to heroin, it is incredibly difficult for them to stop using without professional help. This often leads to a cycle of poverty, serious health issues, and incarceration.
Use of heroin typically leads to overdose later in life, often around the age of 30. In too many tragic cases, overdose leads to death. Other life-threatening risks associated with heroin use include contagious diseases like HIV, hepatitis B and C; bacterial infections due to contaminated needles and unclean conditions; and lung infections. The side effects of long-term heroin abuse can be severely damaging and life-threatening as well; these include liver failure, stroke, cardiovascular issues, and respiratory distress.
When people become addicted to prescription opioid painkillers like oxycodone or hydrocodone, they become addicted to a substance that is chemically similar to heroin. The dramatic rise in prescription drug addiction over the past decade has led to a correlated spike in heroin use among Americans – particularly older, Caucasian adults. The CDC reports that between 2002 and 2013, 45 percent of those who used heroin were also addicted to prescription painkillers. A 2014 report from the CDC also showed that heroin overdoses doubled between 2010 and 2012, in large part because individuals suffering from prescription painkiller addiction turn to heroin as more states tightly regulate and control painkiller prescriptions.
Many states are cracking down on doctors’ prescribing practices, such as “pill mills,” in which doctors spend only a few minutes with patients and write prescriptions for potentially imagined pain. The Drug Enforcement Agency changed the schedule of hydrocodone-based drugs recently, so hydrocodone is now regulated in the same fashion as oxycodone. This means that individuals with hydrocodone and oxycodone prescriptions must visit their doctors for refills, so doctors can track how quickly patients consume the drug.
Statewide and even federal drug databases track painkiller prescriptions to help prevent “doctor shopping,” when a person struggling with painkiller addiction goes to multiple doctors for multiple prescriptions. Doctors are now being discouraged from widely prescribing painkillers for back pain or joint pain as well. Because so many people are addicted to painkillers, and state governments have recently passed legislation to more tightly regulate these drugs, people suffering from addiction to painkillers may turn to heroin in an effort to quell their cravings.
When people are addicted to heroin, they may display various symptoms, including:
- Feelings of euphoria or happiness just after ingestion
- Sleepiness, including alternating between wakefulness and sleepiness (like nodding off)
- Small pupils
- Track marks on the skin at injection sites
- Compulsive use of the drug, or an inability to stop using
- Lying about addiction
- Weight loss or loss of appetite
- Hiding addiction by making excuses to use the drug, which means spending time away from work, school, friends, or family
- Mood changes, including aggression or irritability
- Cold or flu-like symptoms, including fever and chills, especially if the individual has not ingested heroin for some time and begins to withdraw from the drug
- Nausea or throwing up
When a person struggles with addiction to any substance, compulsive use can easily turn into tragic overdose. This is especially true of heroin, due to the quick euphoria and harsh withdrawal symptoms associated with the drug’s use. Overdose can be deadly, and it is very important to address heroin addiction in order to prevent life-threatening complications of ongoing use.
Heroin overdose symptoms include:
- Stupor (awake but unresponsive)
- Pinpoint pupils
- Slowed breathing
- Stopped breathing
The primary, deadly symptom of heroin overdose is respiratory depression – when an individual’s breathing slows, then stops. This prevents oxygen from getting to the brain, and if untreated, the individual’s brain will shut down, leading to death.
Because of the rise in opioid addiction, there are a growing number of treatment options. Naloxone, or Narcan, is becoming more widely used by emergency medical responders and first responders to stop heroin overdoses. Naloxone can potentially stop an overdose long enough for a person to get to the hospital for further treatment.
In order to truly recover from heroin addiction, and to avoid all the damaging consequences of ongoing heroin use, comprehensive addiction treatment is needed. This care begins with medical detox and continues to therapy and aftercare. With professional help, true recovery can be within reach.