Heroin is one of the most addictive drugs in the world, and it has made a resurgence as part of the opioid epidemic. We are not experiencing the first point in history that heroin has been a popular drug of abuse. The Bayer Company started manufacturing heroin in 1898, after realizing it was more effective than codeine for treating respiratory diseases. However, it soon became apparent that the drug caused patients to develop a tolerance.
By 1910, heroin was the go-to drug for people addicted to morphine. International treaties began to restrict the production, distribution and use of heroin. The social impact of widespread heroin addiction led the United States to introduce the Harrison Narcotics Tax Act in 1914, effectively banning all illicitly obtained narcotics. Under the Act, doctors and pharmacists had to pay a tax on prescriptions. This law wasn’t enough to stem the tide of heroin addiction, and the Anti-Heroin Act of 1924 made it illegal to import opium for manufacturing heroin.
A Rising Tide of Heroin Abuse
After 1924, production and use of heroin plummeted, and remained low for most of the 20th century. With the onset of the opioid epidemic in the late 1990s and early 2000s, heroin use has been on the rise for the past couple of decades. The 2016 National Survey on Drug Use and Health revealed approximately 948,000 Americans used heroin in the last year, many of whom are young adults aged 18 to 25. This number has been growing steadily since 2007.
The number of people who used heroin for the first time in 2016 is a staggeringly high 170,000, which is almost double the number of first-time users in 2006. Additionally, the number of people who meet heroin use disorder criteria from the DSM-IV has increased from 214,000 in 2002 to 626,000 in 2016. There’s no doubt heroin use is becoming more widespread, which is one reason it’s so troubling to think about how many people don’t understand the effects of heroin.
Short-Term Side Effects of Heroin
Heroin manufacturers originally developed it as a “wonder drug” meant to replace morphine. In the years following the Civil War, morphine addiction was a severe problem among soldiers on both sides. Morphine was readily available as a painkiller due to its undeniable efficacy, and doctors did not become aware of the addictive properties until the war was over. In the early days of heroin manufacturing, people marketed it as a non-addictive substitute for morphine.
Although the non-addictive element of this claim is false, the short-term effects of heroin are similar to those of morphine. As an opioid derived from morphine, heroin works by binding to mu-opioid receptors in the brain. Once attached, heroin triggers the release of dopamine. Dopamine is a neurotransmitter, which transfers information between neurons in the brain and is responsible for the pleasurable effects of heroin.
When a person takes heroin, the immediate dopamine flood provides instant gratification. The person will feel intense pleasure and feelings of well-being. Many people report a heaviness throughout the body paired with feelings of calm, even when in a frightening or dangerous situation. Heroin also works as an analgesic to reduce pain. However, the initial feeling of pleasure also comes with physical symptoms, including:
- Dry mouth
- Flushed skin
- Nausea and vomiting
- Extreme itchiness
One of the telltale signs someone is high on heroin is a condition known as being “on the nod,” which means they’re fluctuating between being conscious and semi-conscious, and they may be impossible to communicate with.
Developing Tolerance to Heroin
The first couple of times someone uses heroin, the short-term pleasure is the overriding experience. They may feel the brief burst of euphoria makes up for the itching and nausea, and decide to do it again. When they use it repeatedly, they will find they don’t respond to heroin the way they did the first time. This effect is due to tolerance.
The definition of tolerance is a state in which an organism no longer responds to a drug, and it requires a higher dose to achieve similar effects. With frequent use, heroin’s pleasurable effects quickly diminish, and people who abuse it find themselves having to take more and more to achieve any type of euphoria. Someone may switch from smoking or snorting heroin to injecting it in higher concentrations.
Developing a tolerance to a drug does not always indicate an addiction. For example, if you get a tooth pulled and go from taking 250 mg of ibuprofen to 500 mg because of tolerance, you shouldn’t expect to get addicted. But because heroin is so potent and it has such pronounced effects, the path from tolerance to addiction is a short and extremely slippery slope.
Once someone starts building a tolerance to heroin — which can start happening within days of first use — their body craves the drug more and more. Sheer willpower is rarely enough to break the cycle. It’s crucial for anyone with a developing heroin tolerance to seek professional help for their growing addiction.
Long-Term Effects of Heroin
From a physical standpoint, heroin is exceptionally damaging. Prolonged usage over weeks, months or years leads to medical complications that affect health and quality of life. If a person continues to use this drug, the long-term physical side effects of heroin will reduce longevity.
Before & After Pictures
Brain Damage From Heroin
Heroin is a depressant, or “downer,” meaning it reduces the functionality of the central nervous system (CNS). Along with changing the body’s response to pain, heroin affects heart rate and breathing. In the case of an overdose, depression of the CNS makes the body forget how to breathe without conscious thought. But even at non-overdose levels, heroin slows breathing enough to create a severe lack of oxygen.
Growing levels of opioid abuse have given rise to a new term: toxic brain injury. It refers to two types of brain injury that occur with oxygen deprivation. Hypoxic brain injury happens to a brain that doesn’t receive enough oxygen, and anoxic brain injury occurs when the brain doesn’t receive any oxygen at all.
Hypoxic brain injury occurs in many people addicted to heroin, forcing their brains to function on limited oxygen for an extended period. Anoxic brain injury usually occurs during an overdose, but not necessarily a fatal one. For example, someone may take too much heroin and pass out for a few seconds or a minute before waking up. During that time, they may stop breathing altogether, leading to an anoxic brain injury.
Organ Damage From Heroin
There are many ways opioids damage the body, but the concentration of heroin means it causes the damage much faster than other opioids. Here are some of the ways this powerful drug can harm your body.
- Large doses of heroin cause blood pressure to drop dramatically, and an overdose can result in heart failure.
- Intravenous heroin users are 300 times likelier to die from a heart infection called infectious endocarditis.
- Heroin can cause problems with heart rate or rhythm, called arrhythmia.
- Heroin can cause pulmonary edema, a condition in which the heart can’t effectively pump blood through the body.
- Heroin increases pressure in blood vessels and causes fluid to build up in the lungs, making it difficult to breathe normally.
- Heroin may cause significant damage to the liver.
It’s also important to note that heroin dealers often cut the drug with a variety of substances from powdered milk to chalk, or combine heroin with other drugs. The effects of additives to heroin can be highly unpredictable, and cutting the drug with a highly potent substance like fentanyl can easily lead to an accidental overdose.
Appearance Changes From Heroin
Most people are aware heroin can dramatically change a person’s appearance. Once someone has become addicted to heroin, they tend to neglect personal hygiene and nutrition. They may appear dirty and unhealthily thin, with skin issues from constant itching. If they inject the heroin intravenously, they will likely have visible track marks at the point of injection.
Heroin use also leads to tooth decay and gum disease in part through persistent dry mouth. Due to a lack of proper nutrition, their skin may appear dull and sallow, and their eyes may appear sunken from weight loss. Overall, prolonged heroin use can cause people to appear run-down and generally unhealthy.
Heroin Abuse Symptoms
When someone is addicted to heroin, they may not immediately show signs you can visually identify. If you spot red track marks, you already know what’s going on, but if they hide them, you’ll need to look for other signs of heroin use. These symptoms are a reliable indicator someone is misusing opioids, including heroin.
- Loss of interest in activities
- Increased isolation and social avoidance
- Mixing with new groups of people
- Poor hygiene practices
- Strange sleeping habits
- Fluctuating appetite
- Appearing overly energetic or very depressed
- Missing appointments and meetings
- Skipping work or school
- Experiencing financial hardship
- Cycling through erratic moods
Someone abusing heroin will seem to turn into a different person to their friends and family. Sudden changes in demeanor and habits can indicate an addiction, especially if accompanied by visible cues such as frequent itching or states resembling nodding off.
Heroin Withdrawal Symptoms
When someone stops using heroin, they go through the process of withdrawal. After prolonged addiction to heroin, the brain doesn’t know how to function correctly without it. If a person quits heroin, the brain goes into panic mode and produces an array of extremely unpleasant symptoms as it adjusts to the lack of the drug. The milder symptoms include:
- Nausea and abdominal cramps
- Excessive tearing and runny nose
- Frequent yawning
- Sweats and chills
On the more acute end of the spectrum, people may experience these symptoms:
- Vomiting and diarrhea
- Extreme agitation or anxiety
- Restlessness
- Trembling and goosebumps
- Fatigue
- Trouble concentrating
In the most severe cases, someone may experience hypertension, rapid heartbeat and difficulty breathing. The severity of heroin withdrawal symptoms varies based on several factors. The longer someone has been abusing heroin, the more intense their withdrawal experience will be. The dosage taken matters as well. Someone who has been using heroin once a day for six months will likely have fewer symptoms of less severity than someone who used heroin twice a day for a year.
Heroin withdrawal is not usually life-threatening, but it creates an extreme craving for heroin. The symptoms often combine to feel like a terrible flu, and the discomfort can be bad enough to cause an immediate relapse. If someone has an underlying condition like depression or anxiety, withdrawals can feel significantly worse and even lead to suicidal ideation.
In most cases, withdrawal begins within 12 hours after the last use of heroin. The milder symptoms appear first, and the more severe symptoms usually appear within the first 24 to 48 hours. The third and fourth days of withdrawal are often the worst in terms of pain, nausea, sweating and shivers. By the end of the first week, the worst of withdrawal is usually over.
Recovery From a Heroin Addiction
Heroin addiction can be terrifying and isolating, but there are effective treatments that can help people begin a successful recovery. The National Institute on Drug Abuse (NIDA) recommends a two-pronged approach consisting of behavioral and pharmacological treatment to help restore the brain to a healthier state.
Behavioral therapies are highly versatile and can take place in both outpatient and residential settings. A variety of techniques can be effective, such as cognitive-behavioral therapy or group therapy. The goals of therapy are to give people emotional support, help them modify thoughts and behavior toward drugs and learn new methods for coping with the difficulties and stress that contributed to the addiction in the first place.
The other component of an effective program is medication-assisted treatment. In this type of program, patients receive drugs that block the worst symptoms of withdrawal. Patients usually take either buprenorphine or methadone, medications that engage opioid receptors just enough that the brain doesn’t rush into withdrawal. Instead, taking these medicines allows patients to feel healthy and stable enough to participate in behavioral therapy and go about their daily lives.
Not all people respond the same to a single type of treatment plan, so it’s vital to choose a program that takes your needs into account when designing your recovery plan.
Make Moves With MedMark
Heroin addiction is a severe health condition, but it doesn’t have to be permanent or destroy lives. With the right treatment program and support network, you or someone you love can make a successful recovery. MedMark Treatment Centers offer compassionate treatment based on the proven efficacy of medication-assisted treatment and an array of behavioral therapies.
Our treatments are medically supervised and tailored to individual needs. We offer individual and group counseling, resource referral, addiction education and discharge planning services, making MedMark a comprehensive treatment option for anyone struggling with heroin addiction.
The sooner you choose to get professional help for heroin addiction, the sooner you can halt the damage and start the healing process. If you’re ready to take the next step and get more information on heroin addiction treatment, call MedMark at 866-840-6658 to reach a clinic near to you or get in touch through our contact form.