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Heroin is an opioid. It is derived from morphine and used by snorting, sniffing, injecting, or smoking it. Like all opioids, heroin is highly addictive. Using it changes the brain and affects a person’s ability to function without the drug.
When someone uses an opioid, the drug binds to the brain’s receptors. There is a release of dopamine, and the person experiences a euphoric sensation. Over time, if someone continues using heroin, the brain loses its ability to function normally. The person must take larger and more frequent doses to achieve the same effect they had when they first started using. It becomes impossible for the person to experience these feelings without heroin.
Many heroin addictions begin with a person using prescription pain medications. When someone can no longer gain access to the legal opioid, they transition to heroin.
Symptoms of heroin use include:
The primary symptom of heroin abuse and addiction, or an addiction to any drug, is the inability to stop using despite the desire to do so.
An intervention is a group meeting in which people who care about someone with a heroin addiction confront that person and ask him or her to seek treatment. The intervention includes people sharing how the individual’s addiction affected them and why they want them to seek help for their addiction. Most interventions also include an addiction specialist who suggests treatment options.
Heroin addiction treatment programs almost always begin with inpatient treatment. Heroin detox is intense and is best done with medical supervision. Inpatient treatment also means the person addicted to heroin will be in a safe, drug-free environment, away from the triggers that fueled the addiction.
Heroin detox is painful and uncomfortable. It also includes intense cravings. Detox is a time when relapse risk is high. Medication eases cravings and physical withdrawal symptoms, improving the odds of successful detox and recovery. Although it’s possible to detox without medical supervision, doing so is not recommended and increases the risk of relapse.
Several medications treat heroin addiction. These medications ease withdrawal symptoms, reduce cravings, and prevent other side effects that increase the risk of relapse. They include:
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This is a generic drug intended to treat high blood pressure that is also effective for treating opioid withdrawal symptoms. It’s a sedative and reduces many of the initial symptoms of heroin withdrawal.
Methadone is a long-acting, full opioid agonist. It treats severe pain but is safer than heroin because there is no overdose risk. One approach to heroin treatment is to switch someone from heroin to methadone to lessen withdrawal symptoms and decrease cravings for heroin. Methadone doses are gradually reduced until a person is drug-free.
Buprenorphine is a partial opioid agonist. It blocks receptors in the brain that would normally be triggered by heroin. It also reduces or eliminates withdrawal symptoms and cravings by tricking the brain into thinking it’s getting what it wants.
Naltrexone is an antagonist. It causes no opioid effect and blocks full agonist opioids, such as heroin.
Medication-Assisted Treatment (MAT) for treating heroin addiction has helped many people manage their addiction. It is effective for preventing heroin overdose and reducing the risk of relapse. But many believe it to be trading one addiction for another.
Some 12-step groups look down on MAT because members believe those using it are not living the sober or clean lifestyle promoted by the programs. Additionally, taking just a single dose of heroin (or any opioid) during methadone treatment can result in a fatal overdose.
Despite the drawbacks, MAT offers benefits and is the preferred treatment method for many. Benefits include:
A variety of behavioral therapies help treat heroin and other opioid addictions, including:
These approaches help someone with a heroin addiction identify his or her drug use trigger and learn to cope with them in a healthy manner. They learn new behaviors and coping skills for dealing with cravings. Therapy also helps them develop new ways of dealing with emotional discomfort that does not involve drug use.
Counseling is an important part of recovery. In counseling, someone can explore the reasons for drug use and better understand themselves and their addiction. Counseling for heroin addiction often includes family therapy, which helps loved ones learn to support a successful recovery.
Aftercare programs are an important part of preventing relapse when a person has a heroin addiction. Most treatment centers and programs begin exploring options for aftercare from the beginning of recovery. Someone with a heroin addiction needs access to resources that support sober living.
Some of the things included in aftercare programs include:
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Herndon, Jaime. “Heroin Addiction: What You Should Know.” Healthline, Healthline Media, 24 July 2018, www.healthline.com/health/heroin-addiction.
Walsh, Lynne. “Medication and Counseling Treatment | SAMHSA - Substance Abuse and Mental Health Services Administration.” Samhsa.Gov, 15 June 2015, www.samhsa.gov/medication-assisted-treatment/treatment.