Heroin (also known as smack, snow, powder, horse, tar, white, and more) gives users a sense of euphoria, calm, and fulfillment. Addicts describe feeling relaxed, warm and cozy, and experiencing a deep sense of satisfaction.
Heroin use has gone up dramatically in the past decade, particularly in many urban areas, and amongst those aged 18-25. The percentage of people in this age bracket who sought treatment for heroin abuse more than doubled from 2008 to 2012, rising from 11% of total admissions to 26%. (NIH)
This is, in part, due to the widespread availability of prescription opioids. Thousands of people become addicted to drugs like OxyContin, Percocet, or Vicodin, and then shift to heroin when they can no longer access the prescription drugs. Of those who began abusing opioids in the 2000s, 75% said their first opioid was a prescription drug.
Heroin Timeline: Use and Abuse
Heroin is an opium derivative. In the 1800s, opium dens were scattered all through the American “wild west,” brought into the U.S. by way of Chinese immigrants who came to work on the railroads.
In 1810, morphine, a derivative of opium, was made into a painkiller that was considered a wonder drug. It took away the extreme pain from surgery or other traumatic injuries, so by the mid 1850s, it was available widely for doctors, who considered it absolutely remarkable. However, the extremely addictive properties of the drug became apparent during the Civil War, when thousands of both Northern and Confederate soldiers became morphine addicts after consuming it for medical treatment.
In 1874, heroin was created as an “answer” to the morphine addiction problem. It was pitched to American doctors as a “safe, non-addictive” substitute for morphine -- but it ended up being just as addictive.
Until 1920, heroin, morphine and other opiates were sold legally in the U.S. The Dangerous Drug Act passed by Congress made the over-the-counter purchase of these drugs illegal, and the era of regulation began. But it was too late for many: by 1925, there were an estimated 200,000 heroin addicts in the U.S. Now, over half a million people report using heroin within the last year.
The Heroin Addiction Cycle and Withdrawal
Heroin is one of the most addictive substances in existence. It produces a “high” that feels incredibly good, flooding the brain with dopamine. Very quickly, neural pathways in the brain can become overactive due to heroin use, meaning the user will feel the need for more heroin just to feel "normal."
Repeated use of heroin (for a few weeks or more) will see a person experiencing withdrawal symptoms as the drug wears off. Withdrawal is one of the first visible signs the addiction cycle, and its physical symptoms can include fatigue, nausea/vomiting, depression, restlessness, confusion, and anxiety.
In addition to the physical discomfort, addicts experience intense cravings for the drug. The combination of the high feeling good and the withdrawal feeling so bad, makes for a very addictive cycle that is hard to break without help.
How do you know you need treatment for heroin addiction?
If you use heroin and have the following symptoms, you may be addicted:
- Tendency to nod off (fall asleep)
- Slowed breathing, flushed skin, runny nose
- Nausea, vomiting, constipation
- Feeling the need to scratch yourself
- Slurred speech
- Not eating
- Covering your arms with long sleeves
- Feeling physically sick when you aren’t using heroin
- Not being able to function without heroin
Heroin withdrawal can be physical stressful and psychologically demanding if done on your own. Research shows that it’s both safer and more effective (meaning you’re less likely to relapse) when you undergo detox with medical supervision. Inpatient rehab facilities can provide round-the-clock care throughout detox, with compassionate and skilled professionals who help minimize patients’ pain and make the process as comfortable as possible.
What is a heroin treatment center?
According to the National Survey on Drug Use and Health (NSDUH), heroin use has been on the rise since 2007, with the greatest jump in young adults. The number of people meeting psychiatric criteria for dependence or abuse of heroin doubled from 2002 to 2012.
As stated, part of the reason for the spike jump in heroin use is the increase in the use of prescription opioids. There’s a direct connection between those who started using prescription drugs like OxyContin, Vicodin, and Percocet, who then switched to heroin. When the supply of those prescription drugs went away (i.e. the person could no longer get it from a friend or family member), users switched to heroin.
Heroin rehab facilities are places specifically designed to help those addicted to heroin overcome their addiction. Heroin treatment programs are equipped to help people undergo detox from the drug itself, as well as to treat the underlying basis of addiction itself.
Why go to a heroin treatment center?
One reason to go to a heroin-specific program is to be around those going through a similar challenge. In being exposed to others with a similar background, you build connections that help support your sobriety because you really “get” them, and they get you.
The staff and therapists at heroin treatment centers are experienced in dealing with the specific issues facing heroin addicts. For example, there’s a strong correlation between opioid addiction (including heroin) and post-traumatic stress disorder (PTSD). PTSD is of the most emotionally difficult mental disorders there is, as it can bring extreme anxiety, nightmarish flashbacks, and intrusive memories that interfere with daily life.
Many people who suffer from PTSD turn to drugs like heroin to numb the pain and/or gain some control over their lives. The mental health professionals at heroin rehab facilities are aware of this, and can support it both in both individual therapy sessions as well as group therapy.
What else does a heroin-specific program offer?
Part of why to attend a heroin treatment center is to be around medical professionals and mental health professionals who are familiar with the cycle of withdrawal and addiction, and how to treat it effectively. For example, when you stop taking heroin, the drug buprenorphine can help reduce the discomfort of withdrawal symptoms (or even prevent them altogether). A number of those who were addicted to heroin stay on buprenorphine long-term, with the goal of reducing the dose and coming off it completely. It’s very important NOT to take any drugs or alcohol when you are on buprenorphine.
Methadone is another drug that can help someone stay off of heroin. Research shows that both methadone and buprenorphine can be effective -- the key is to understand what works for you specifically. For example, some people prefer buprenorphine because they report feeling more ‘clear-headed’ with it (over methadone). Going through detox and addiction recovery at a facility is helpful because you can get assistance in making decisions about what’s best for your body and mind.
What happens during treatment?
When you attend an inpatient rehab heroin treatment program, you live on site for the whole program (normally 30, 60, or 90 days). You undergo medical testing and then enter the detox process, when all drugs are slowly and safely taken out of your body. As stated, this is a critical step that is best taken with medical supervision, since detox can be painful and stressful.
After detox is over, the rest of the program begins, including therapy. Many heroin rehab treatment facilities offer both one-on-one as well as group therapy. CBT (Cognitive Behavioral Therapy) is also known to be effective in supporting sobriety and preventing relapse. CBT helps participants identify which situations are most likely to prompt them to use heroin, avoid these, and develop better coping mechanisms to handle the underlying issues (i.e. do something healthy that feels good instead of using).
The purpose of a good treatment program is to combine all the most effective therapeutic modalities (medical as well as behavioral) to set you up for success.
Once treatment is complete, most facilities offer aftercare programs to help patients integrate their newfound success in the outside world. Aftercare can include living in a halfway house, having a plan to attend 12-step program meetings, attending outpatient programs, and more.