Why is Heroin So Addictive? – Heroin is an illegal opioid that produces an intense high that is the primary component of its extremely addictive quality. All opioid addictions originate from the mechanism of action these drugs have on the brain.
Why is Heroin So Addictive?
Heroin is a chemically-modified version of morphine, and when the drug is used, enzymes convert it back into morphine upon reaching the brain. After this, the drug attaches to sites on the surface of neural cells known as opioid receptors, which are located in multiple areas of the brain and body. When bound with these receptors, morphine starts a chain reaction that ultimately triggers the release of dopamine.
Dopamine is a neurotransmitter that induces many of the pleasant feelings of well-being associated with heroin use. In fact, dopamine is linked to the addictive qualities of many drugs because it is responsible for the rewarding, pleasurable sensations that compel the user to engage in the behavior repeatedly.
As a person seeks to achieve and sustain their intense highs, over time, they often find themselves requiring larger amounts or more potent doses of heroin to achieve the effects – a physiological state known as tolerance.
Tolerance develops as the brain grows accustomed to a continuously elevated opioid drug influence, leading to a situation in which certain brain cells will not respond as well to opioid receptor stimulation, releasing a diminishing amount of dopamine upon repeated use.
With a physiological need for more heroin, drug-seeking behavior and compulsive use often begin. More time and effort will now be necessary to maintain this level of consumption. This behavior is largely fueled by both the desired to attain a high and to avoid the discomfort of withdrawal symptoms.
The presence of withdrawal symptoms upon cessation is a strong indication that dependency has developed. Avoidance of withdrawal symptoms keeps many users returning to drug use even when they desperately want to stop.
Methods of Use and Effects
Heroin can be smoked or snorted but is most often injected into a vein, under the skin, or into a muscle. Heroin’s effects on a user will vary depending on the quantity, quality, and method of delivery into the system.
When smoked or injected, heroin enters the bloodstream rapidly and induces near-immediate results. The high is intense but shorter in duration that snorting or swallowing.
Those that snort heroin experience a more gradual-onset high that may be less intense, but relatively long-lasting. The increased incidence and intensity of intravenous use also increases the risk of secondary problems, such as the following:
- Bruising, tissue damage, and infection at the injection site
- Blood-borne infection or diseases such as hepatitis and HIV
- Cardiovascular problems, including inflammation and/or blockage of the peripheral blood vessels, endocarditis, and multiple embolic events
The Effects of Combining Substances
According to the Centers for Disease Control and Prevention, most people that use heroin report using at least three other substances. Also, people who are addicted to alcohol, cocaine, marijuana, or opioid pain-relieving medications are at increased risk of addiction. In fact, people who are addicted to pain medications are 40 times more likely to abuse heroin.
Heroin users will often combine the drug with other substances to increase its pleasurable effects or to relieve unwanted side effects. For example, benzodiazepines may be used to reduce the discomfort of the comedown from the heroin high’s ending.
These and similar practices can increase the danger, as mixing substances can result in pronounced depressant effects including:
- Slowed heart rate
- Labored, slowed or stopped breathing
- Hypoxia, or a lack of oxygen to the brain
- Coma and death
What Does It Mean to be Dependent On Heroin?
Heroin addiction can be an all-consuming disease that wreaks havoc on a person’s physical and mental health and livelihood. Someone suffering from an opioid use disorder may experience some or all of the following:
- Spending a significant amount of resources finding and using heroin
- Using a larger amount of heroin more frequently than intended
- Exhibiting disinterest in the participation of once-enjoyed activities
- Failing to fulfill personal or professional obligations
- Struggling to stop use with repeated attempts
- Experiencing withdrawal symptoms when not using
- Using heroin under circumstances that are potentially hazardous, such as driving
- Developing a tolerance to the drug, and therefore needing increasing amounts to get the same effects
Hallmark indications of a heroin dependency are the withdrawal symptoms that manifest at some point after the last high subsides and the substance has left the body. This will onset within 12 hours of last use and persist for a period that will depend on the user’s frequency and severity of use.
Heroin withdrawal can be very unpleasant. Its presentation may include symptoms such as:
- Nausea and vomiting
- Muscle pain
- Inability to sleep
- Irritability and agitation
- Increased anxiety and stress
- Drug cravings
Due to the discomfort of symptoms and the duration of withdrawal, many people end up turning to the use of more heroin or other substances to relieve symptoms. This behavior only restarts the process, however, and only delays withdrawal symptoms by a few more hours.
How to Get Treatment for Addiction
It is critically important that those who are addicted to heroin receive professional treatment to begin the process of recovery. Treatment usually begins with detox. In many formal treatment programs, the detox process is completed during a period of around-the-clock medical supervision.
The purpose of medically-supervised detox is to maximize the client’s comfort while the body clears itself of heroin naturally. During a medically-managed detox, medications may be administered to reduce discomfort and withdrawal symptoms, such as the following:
- Runny nose
- Nausea and vomiting
- Body aches and pains
In many programs, following detox, medical management will continue with the use of specific medications designed to aid someone in recovery from heroin addiction. These pharmaceutical agents may include:
Methadone – This is a longer-acting and less potent opioid. Because it is long-acting, the high produced will be considerably less intense than that of heroin when used as directed and not misused.
Buprenorphine – When used appropriately, this partial opioid agonist offers relief from cravings without inducing a high. Buprenorphine is available as Suboxone or Subutex.
Naloxone – This drug prevents heroin from producing a high. This medication can also be used to reverse an opioid overdose.
In conjunction with medication-assisted treatment, behavioral therapies have been clinically shown to be helpful in discontinuing drug use, establishing a period of sobriety, and preventing future use through relapse prevention plans.
Also, support programs and groups offer a level of informal treatment that allows a person in recovery to access new ideas and knowledge and share their experiences with others who have achieved extended abstinence from heroin.
How We Can Help
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