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Heroin is perhaps the most well-known opiate. It can be injected, inhaled, or smoked, and it is world-famous for its intense addictive properties and its lethal potential. Heroin addicts experience a huge range of negative effects that impact their entire lives and can lead ultimately to death by overdose or other complications.
Heroin Addiction History and Prevalence
Heroin is part of a family of drugs called opiates. Opiates have powerful effects, primarily acting by reducing pain and producing a sense of euphoria. This family of drugs includes opium, codeine, and morphine, all of which have similar properties and are used for limited medical purposes. The first major wave of heroin use in the United States occurred after World War II, through the 1940s and ’50s. The second epidemic struck around the time of the Vietnam War and ended in the late 1970s.
Just about every 30 years, the United States experiences a boom in heroin use. Since the American public was introduced to the drug in the ’40s, it has remained more or less a constant presence in the American illicit drug market. The prevalence of heroin use over the last decade has gone off the charts. In 2002, just 1 in 1,000 people battled heroin addiction. By 2013, that number had doubled. In addition to skyrocketing numbers of heroin abuse, lethal overdoses currently reached an all-time high, demonstrating the extremely lethal implications of heroin use.
Heroin is another addiction which, perhaps surprisingly, does not tend to discriminate based on typical demographics. That having been said, most at-risk populations tend to be non-Hispanic white males between the ages of 18 and 25 who are living in large metropolitan areas. This is a large shift in the historic demographic of heroin users. Historically, black males in their 40’s and 50’s were at the greatest risk for heroin use and resultant complications, but data suggests that heroin abuse among non-whites is decreasing, while the presence of the drug increases in white suburban communities.
Many experts also attribute the resurgence of heroin to prescription drug addiction. Certain opioid pain medications like Vicodin or Oxycontin have highly addictive properties. Patients who are prescribed these drugs can easily become addicted and begin abusing them. When their prescription runs out or they find it difficult to acquire the quantities they need, they often turn to illicit street drugs like heroin, which are less expensive and easier to get. Nearly 50% of young people addicted to heroin report abusing prescription opioids before turning to heroin.
Signs of heroin abuse are distinct and appear very early on in the timeline of addiction. Some physical symptoms to look for include:
Lethargy, half-lidded eyes, falling asleep or “nodding off” without warning.
Nausea and vomiting
Loss of appetite and weight loss.
Instances of extreme euphoria or joyfulness.
The physical symptoms are highly noticeable, and the behavioral changes in an addict are equally obvious. More than other drugs, heroin will begin to affect an addict’s wardrobe. The heroin addict will frequently prefer long-sleeved, baggy clothing which serves the purpose of concealing needle marks and abscesses while also hiding weight loss. They will also be likely to neglect personal hygiene, not bathing or brushing their teeth and wearing the same clothes for several days on end. Also, be alert to any general shiftiness on the part of a potential addict. They may lie frequently about their activities, steal money or possessions to fund their habit, or spend time with questionable people.
Typical Cost to Addict
While considered to be a cheaper alternative to prescription drugs, heroin addiction is by no means inexpensive. To make things worse, the price can skyrocket as the addict develops an increasing tolerance. Like many street drugs, it can be difficult to pinpoint how much a heroin addict may spend on their habit. Factors like the progression of the addiction, availability of the drug in any given area, and personal connections can all play a significant role. On average, however, a single dose of heroin costs about $20 and an addict with a relatively advanced habit can spend upwards of $200 a day on their addiction.
To further complicate things, a heroin addict can rarely stay employed, simply given the side effects of heroin. As a result, the instances of heroin addicts turning to a life of crime are extremely high. Heroin addicts are notorious for stealing just about anything they can get their hands on, turning stolen goods over to pawn shops and immediately buying heroin with the funds. Once this cycle begins it is only a matter of time before most addicts end up in jail or prison. Once in a criminal facility, addicts are unfortunately able to continue their addiction, as the presence of heroin and other illicit drugs within the criminal justice system is rampant. Thus, the cycle becomes extremely difficult to break, without any viable respite from heroin aside from dedicated facilities like rehabs.
Effect on the Addict
Heroin takes an awful toll on the health of an addicted person. While injection is the most dangerous means of taking the drug, all mechanisms of heroin use have short- and long-term risks which range from severe to lethal.
Intravenous heroin users will cause irreparable damage to their veins in short order. Repeated injection at the same sites will lead rapidly to collapsed veins and a variety of infections. These infections can create large abscesses on the skin’s surface which can become life-threatening. The full scope of relatively minor, short-term effects include bad teeth, constipation, a weakened immune system, respiratory illnesses, muscular atrophy, reduced sexual capacity, menstrual disturbance, depression, and insomnia.
Naturally, the longer a heroin addict is active in their addiction, the worse the side effects become. Heroin addicts commonly share needles, which can lead to HIV/AIDS and Hepatitis-C. Both diseases are life-long illnesses which, left untreated, can kill the addict. Heroin addicts also run a high risk of contracting tuberculosis and arthritis, as a result of overall poor health and the drug’s action on the body.
Heroin Addiction Permanence and Relapse
Heroin is, in many ways, the “benchmark” for addiction. It’s considered by some to be the most addictive substance on Earth. The reasons for this seem to be primarily the psychological impact of a person’s first use of the drug. Most users report a feeling of euphoria matched by nothing they have ever felt before, with the only side effect being a rapidly subsiding nausea. Users will continue to chase this first experience as long as they are physically able, in most cases.
Like many other addictive substances, repeated exposure to heroin can begin to permanently alter a person’s brain chemistry. This results in long-term imbalances in neuronal and hormonal systems that can not be easily undone by simply abstaining from the drug for a time.
As a result, the rate of relapse among heroin addicts is extremely high, with early recovery posing the greatest threat to an addict’s ongoing sobriety. Studies have shown that the relapse rate among addicts during the first 3 months of abstinence is as high as 90%8. Through the use of drugs like methadone or buprenorphine, some studies report a significantly lower rate of relapse at around 50%.
Heroin Addiction Detox
Heroin detox is extremely uncomfortable and painful. In fact, for many addicts, it is fear of this withdrawal which drives their addiction as much as any other factor. Unlike some other drugs, however, the risks of quitting heroin “cold-turkey” are relatively minor. The heroin addict will likely go through severe withdrawal symptoms for about a week, but can usually go through this experience in an outpatient setting unless they are coming off of multiple drugs simultaneously. Withdrawal symptoms for heroin typically include nausea, abdominal pain, depression, muscle spasms, intense craving, shaking, and sweating. These symptoms will typically begin between 6-12 hours after the last dose and go on for up to 10 days.
Medically monitored detox from heroin has come a long way in recent years. Researchers have discovered several drugs which can mitigate the pain of withdrawal and even act to reduce cravings. Commonly prescribed drugs for heroin withdrawal, including buprenorphine, methadone, or naltrexone. These drugs act primarily by suppressing cravings, allowing the addict to complete the detox process without relapsing.
Physical/Mental Difficulty of Recovery
Heroin recovery is extremely difficult. The reasons for this are manifold but stem primarily from the extreme discomfort associated with the withdrawal and the intensity of a heroin high. For years after their first “high”, heroin addicts can still recall, with startling clarity, their first euphoric heroin experience.
Recovery from heroin addiction, therefore, is a long and challenging process. In this time, they may need the assistance of maintenance therapy, i.e. medically supervised administration of drugs like Suboxone or methadone. They may also need therapy or 12-step assistance to work through many of the underlying psychological triggers or trauma which can lead to relapse if left untreated. Typically the highest rates of successful recovery from heroin are the result of a comprehensive plan put together by medical professionals and other recovered addicts.
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