In a National Survey on Drug Use and Health from 2008, the number of current heroin users (using in the past month), who were twelve years old or older in the U.S. rose from 153,000 users the previous year to 213,000. First-time users of heroin who were twelve or older numbered 114,000 in 2008. Heroin is an opiate drug synthesized from morphine, which occurs naturally in opium plants, and is usually a white or brown powder, although it may also appear as a black substance, known as “black tar heroin.” The substance may be abused in a variety of ways: injected, snorted, sniffed, smoked, with the idea of delivering the active components of the drug as fast as possible to the brain. Once there, heroin is converted into morphine, binding with opioid receptors, which are located throughout the brain (and body), creating an effect, depending upon use, of euphoria and alternating between a wakeful and drowsy state. The more the drug is used, the more the body develops a tolerance, forcing a need to use more of the drug to create a similar effect, and leading to a physiological and psychological response. Twenty-three percent of all individuals who use heroin develop an addiction to it.
The health problems associated with heroin addiction can be severe, including fatal overdose, spontaneous abortion, and — for those who inject the drug — various infectious diseases such as hepatitis and HIV/AIDS. It can lead to collapsed veins, an infection of the lining of the heart, liver and kidney disease, and others. If a user stops abruptly, going cold turkey, then she or he might have severe withdrawal symptoms. Symptoms vary from muscle and bone pain, restlessness, insomnia, diarrhea, vomiting, and more. Major withdrawal symptoms peak around 48 to 72 hours after the last use of the drug and can subside after a week. However, withdrawal symptoms may continue for months. Usually, heroin withdrawal is thought to not be as dangerous as withdrawal from alcohol or barbiturates; however, if a heavy user is in poor condition, then the results may be fatal. No matter what the case, professional and supervised treatment is recommended.
Heroin addiction treatment can take various forms, including medications combined with behavioral therapy. There’s a greater chance for the addict to overcome his problem if he or she has support services working along with the medicine available for detox.
Generally, medications such as clonidine and buprenorphine are used to reduce the withdrawal symptoms. In this first step, other drugs which might be used in a treatment center will include methadone, used for over 30 years to treat the problem. More recently, buprenorphine has received approval for use in heroin addiction, as well as other opiates. Buprenorphine is less risky when it comes to overdosing and the effects of withdrawal. It also produces a lower level of physical dependence than methadone. However, since not everyone responds to buprehnorphine treatment, methadone is still used. Naltrexone is also used, but not widely, because patience compliance is low (it’s usually prescribed in outpatient settings). Naloxone is also a short acting opioid receptor blocker, and has been used to treat patients in overdose situations.
The drugs are often used in combination with behavioral treatments, either in residential or outpatient settings. These include group and individual counseling, contingency management, and a voucher system with patients earning points based on passing drug tests, points which are then used for items that help the patient to make healthier choices.
If you or a loved one need help with heroin addiction treatment the our list of buprenorphine service providers can help.