Understanding Heroin Addiction
Heroin is a semi-synthetic opioid that has been chemically processed from the opiate morphine. Opioids are synthetic versions of the drug and opiates are natural versions. However, both have the same addictive qualities and produce similar effects on the brain and body. Heroin is only semi-synthetic as the foundation of the drug comes from the poppy plant. In more current years it is ever increasingly common that heroin purchased likely has been mixed (more commonly referred to as being cut) with other substances. Most commonly Fentanyl and at times the even more dangerous Xylazine is what the heroin is “cut” with to increase the potency of the drug, while also increasing the dangers of overdose.
When heroin is taken it rapidly binds to the opioid receptors of cells. Heroin also has effects on cells in the body and brain such as those that are in control of the feelings for pain and pleasure. The danger of heroin is that the cells it binds to also control functions such as your heart rate, breathing, and sleeping. Therefore, heroin can easily cause someone’s heart to stop or cause them to stop breathing, and occasionally both at the same time. These are common overdose symptoms of heroin. In regard to breathing, when the person’s breathing is affected, it can cause hypoxia, which is a decrease of oxygen that reaches the brain. Hypoxia can have either long- or short-term mental effects including permanent brain damage or a coma.
Other fillers commonly found in heroin can also cause side effects. Some common additives are starch, sugar, or powdered milk, which will clog blood vessels. This will lead to damage to the lungs, liver, kidneys, and/or brain. Those individuals sharing needles have a risk of contracting Hepatitis and HIV. And the additives of Fentanyl and Xylazine have greatly increased the potency of heroin and lead to alarming increases of fatal overdoses. Fentanyl is a greatly more potent opioid as Xylazine is powerful veterinary sedative, which unlike that of opioids and opiates, is not receptive to Narcan or Naloxone.
Heroin is highly addictive, as well as all other opioids and opiates are equally addictive. Individuals who regularly use heroin develop a tolerance to the drug, requiring them to need higher doses and at more frequent rates to get the desired effects. Some even report that there is a period in which the previously desired effects are just not attainable. With such an increasing tolerance comes the body’s cessation of producing the natural chemicals and neurotransmitters, which cause the individual many problems in the drug’s absence, such as pain regulation. Along with the lack of naturally occurring endorphins, the body will go through varying levels of withdrawal pending the individual’s metabolism and the level of addiction. For many it is the withdrawal symptoms that continue the addiction just to not suffer the often severe and intense withdrawal symptoms.
The Journey of Heroin Addiction Recovery
The first step to recovery is making the decision that it is time to seek treatment. This can be a hard decision to come to but is a huge and very important first step. There are various forms of treatment and not all work for each person. Many times, it makes take a few attempts at treatment to hit a stable level of recovery. With the start of treatment some form of withdrawal is almost guaranteed but does not have to be a severe level of withdrawal. At the start of treatment, you need to detoxify the body. Some avenues require full detoxification and focus on behavioral interventions and a true abstinence from any medications and substances. As other avenues of treatment require a mild detoxification in order for enough of the opioids and opiates to be out of the system so that the medications can work without causing any added discomfort. These medications can assist with withdrawal and physical cravings, such as that of Suboxone or Sublocade.
Some of the common medical interventions with heroin, or any opioid and opiate addiction, are Methadone, Suboxone (Buprenorphine), and Naltrexone. The differences are that Methadone is a full agonist medication which activates opioid receptors in the brain. Methadone has been reported by many patients to be a harder medication to come off than Buprenorphine, more commonly referred to as Suboxone. Buprenorphine is a partial agonist medication which only partially activates opioid receptors to ease cravings and withdrawal, therefore easier to titrate off then compared to other similar medications. Also, Suboxone includes the drug Naloxone which is an opioid antagonist which will reverse the effects of opioids and is a safeguard in the event of a relapse while appropriately using Suboxone. Lastly is Naltrexone, which is an opioid receptor antagonist. This prevents opioids or opiates from attaching to their receptor sites, therefore blocking their effects, but provides no support for cravings or withdrawal symptoms. There are variations of all the listed medications and names may vary some by manufacturer, but these are the three main areas of medical interventions for opioid and opiate addiction.
There are many behavioral interventions with heroin addiction as well. It is usually best to have a combination of medical intervention with behavioral interventions. The word intervention often makes people think of a room full of people talking to someone with addiction issues. As this is a type of behavioral intervention, it is not the only one. Those types of interventions can be beneficial to assist a person in seeing their addiction and how it has an effect not just on themselves but on the lives of those around them. The behavioral interventions to help with addiction are often in the form of some type of therapy, whether individual therapy, group therapy, or a combination of the two.
For behavioral therapies there are many that can be used to assist a person and for every person different therapeutic technique may work better than others. One of the most common types of behavioral therapies used is that of Cognitive Behavioral Therapy. This therapy’s main purpose is to assist a person in making positive life changes by assisting them with changing the way that they think about their life experiences and relationships. Cognitive Behavioral Therapy can also assist a person in identifying their negative and unhealthy ways of thinking, which often goes hand in hand with the rationalizations for continuing substance usage. There are other types of therapies that can also be used as interventions to assist with opioid and opiate dependency, which are, but not limited to, Rational Emotive Behavioral Therapy and Dialectical Behavioral Therapy.
In recovery it is very important to have well-established support networks. These will look different for every person but have some similarities. One of the most common support networks is that of friends and/or family members. It is important that these support networks are available to you in times of need and also do not include anyone that is a trigger for heroin (or any opioid and opiate) usage. That would include not having anyone that you associate prior usage with or individuals that cause great deals of stress in those support networks.
Another common type of support network is that of Narcotics Anonymous. The 12-step program has been greatly helpful in many individuals recovery. Often an advantage here with support groups is that you will meet others that have been in similar situations to yourself. Unlike that of other supports (and not saying other supports are not a great resource), these individuals understand what it is like to go through active addiction as well as recovery. The way that Narcotics Anonymous, more commonly referred to by its acronym N.A., is that it is a group of support groups that are anonymous as in the name. There are thousands of N.A. groups across the country and can usually find one to attend no matter where you live. Often an individual will pick a “home” group which is where they will attend most often. The individual will also pick a sponsor, which is a person they will be able to easily confide in, in times of need, as well as that sponsor will help the person work through the steps of N.A. in their recovery guide.
There are times that individuals have not agreed with the “higher power” concept embedded in the works of N.A. and/or Alcoholics Anonymous (A.A.). If this is the case for you there are agnostic versions of N.A. that are out there which remove the higher power concept but still provide all the other useful work and support that N.A. has to offer those suffering from addiction. Even without believing in all the steps of the program, the social supports provided within these organizations are an amazing and useful recovery resource for a person to have. And in turn over time and after more time in sustained recovery you get the option to help others out that are or were in similar circumstances to yourself.