Heroin Addiction Treatment
Learn more about heroin addiction symptoms, treatment, and recovery
What is heroin?
Heroin is an addictive painkiller derived from the opium poppy plant. Heroin is approximately twice as potent as morphine, the FDA-approved medication from which it is made.
It’s estimated that one in four first-time users of heroin becomes addicted to its effects. Every year, over 100,000 new users develop a dependency on heroin. In America, an estimated 0.3% of adults engage in heroin use, whether through snorting, injecting, or smoking.
You may hear heroin referred to as dope, smack, H, or skag. It plays a major role in the opioid epidemic in the United States. In 2019 alone, 14,019 deaths were linked to overdoses of heroin.
Like other narcotics, heroin’s habit-forming potential stems from its effects on the brain. This can produce long-term effects, and can negatively affect the daily lives of users.
Effects of heroin
Our brains naturally have what are called “opioid receptors,” which mediate the body’s response to neurotransmitters, hormones, and drugs. When the brain produces feel-good neurotransmitters like dopamine and endorphins, they stimulate the opioid receptors. Heroin binds to these receptors, prompting the release of a rush of dopamine and other neurotransmitters. The effect is an overwhelming sense of happiness and pleasure.
After encountering artificial stimulation from opioids like heroin, the brain produces fewer natural feel-good neurotransmitters on its own, including dopamine, serotonin, endorphins, and other neurotransmitters. This can lead to a lack of pleasure and joy in the times when a person has come down from heroin, which reinforces the craving to use again.
Heroin users commonly report experiencing a rush of euphoria as the drug artificially stimulates the brain. According to the National Institute on Drug Abuse (NIDA), other effects include:
- Dry mouth
- Flushed skin
- Limb heaviness
- Extreme itching
- Brain fog
- Slipping back and forth between semi-consciousness and unconsciousness
The long-term effects of heroin addiction can create severe damage to physical health. According to the NIDA, these dangers include:
- Collapsed veins (when heroin is injected)
- Damaged nasal tissue (when heroin is snorted)
- Heart lining infections
- Liver disease
- Lung complications
- Sexual dysfunction in men
- Irregular menstrual cycles in women
Heroin addiction may also cause and exacerbate mental health struggles—depression and antisocial personality disorder can develop from its use.
Symptoms of heroin addiction
Heroin addiction can affect an individual’s physical well-being, mental health, and social behavior. According to the DSM-5, a diagnosis of opioid use disorder includes the repeated occurrence (within a 12 month period) of two or more of the following eleven problems:
- Giving up or reducing important social, work, or recreational activities
- Difficulty fulfilling responsibilities at school, home, or work
- Continued use despite knowing that it is harming physical or psychological health
- Continued use despite knowing it’s creating social and interpersonal consequences
- Spending excessive time obtaining, using, or recovering from using opioids
- Taking more than intended
- Having cravings
- Being unable to stop using or to decrease the amount used
- Tolerance, which is the need to take larger amounts of opioids to get the desired effect
- Using opioids in physically dangerous situations
- Withdrawal symptoms
Heroin overdose can kill. When a person is suspected of having an opioid-related overdose, it’s vital that they receive urgent medical attention. Naloxone (brand name Narcan) is an opioid-overdose reversal medication that can and should be administered immediately to treat the symptoms. This rescue medication rapidly binds to opioid receptors in the body, blocking the effects of an opioid drug.
The most common form of naloxone is an easy-to-administer nasal spray. It’s important that a person who experiences an overdose receives medical care even if naloxone is given, so call 911. Most states have Good Samaritan laws protecting people who call emergency services in case of overdose.
Treatment for heroin addiction
The gold-standard treatment for opioid addiction is medication-assisted treatment (MAT). The Substance Abuse and Mental Health Services Administration defines MAT as “the use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.”
The core of MAT is medication that has been FDA-approved to treat opioid use disorder. Buprenorphine and methadone are medications that reduce cravings by stimulating the opioid receptors in the brain. These medications help to stabilize long-term recovery and lower the risk of relapse. Naltrexone is another medication approved by the FDA to treat opioid addiction that operates by binding to and blocking opioid receptors in the brain. Workit Health prescribes buprenorphine in formulations that combine it with naloxone to prevent diversion and misuse (like Suboxone), and also prescribes naltrexone. Workit does not prescribe methadone, which is subject to more stringent regulations and monitoring requirements.
Many people who use opioids want to stop but are afraid of going through withdrawal. To be fair, opioid withdrawal can be a miserable experience. Your healthcare provider can suggest options—prescriptions, over-the-counter medications, and self-care—to help with the discomfort.
Behavioral health support is an important component of MAT. Counseling techniques like cognitive behavioral therapy can help to navigate addiction. Talk therapy, group counseling, and therapeutic courses can help people in recovery identify and navigate their triggers, set goals, and learn to modify negative attitudes and behaviors.
Some treatment centers and rehab centers provide both options, but many do not support MAT.
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1. Kosten, T.R. & George, T.P. The neurobiology of opioid dependence: implications for treatment. Sci Pract Perspect. 2002;1(1):13-20. doi:10.1151/spp021113
2. National Institute on Drug Abuse. Heroin DrugFacts. June 2021
3. World Health Organization. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Geneva; 2009. 4, Withdrawal Management.
4. National Institutes of Health. Extended Suboxone Treatment Substantially Improves Outcomes for Opioid-Addicted Young Adults. November 4, 2008.
5. National Institute on Drug Abuse. How do medications to treat opioid use disorder work. December 2021
6. American Psychiatric Association. (2013) Diagnostic And Statistical Manual Of Mental Disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596