In 2005, according to the Department of Health and Human Services, 254,000 people were admitted into heroin addiction treatment programs. It’s reasonable to assume that most of these people never thought they would develop an addiction. Most people don’t strive to become addicts. When people experiment with heroin, however, they’re experimenting with an incredibly powerful drug that has an extremely high risk of addiction. Some simply can’t resist the pull of heroin, and they need professional help in order to recover.
A Heroin Primer
Heroin is one of the oldest drugs available on the market today. It is synthesized from the seeds of the poppy plant, and it’s been used as a method of pain control for hundreds of years. In the past, users often smoked forms of heroin in water-based pipes. Now, users often heat up heroin and inject it directly into their veins.
Normally, the body likes to keep the bloodstream and the brain completely separate. In fact, no blood ever reaches the brain. Heroin can, however, jump right over this barrier. Once the drug hits the bloodstream, it reaches right over to the brain and begins its work. The brain is duped into believing that heroin is actual a natural chemical called dopamine that belongs in the brain, and it begins releasing an entire series of chemicals in response. Mere seconds after injecting the drug, the user feels:
- Warm and tingling
- Relaxed, with heavy extremities
The brain doesn’t like to be overwhelmed in this manner, and it begins to go on the offensive to stop these floods of feelings from occurring. The brain might shut off a few dopamine receptors, for example, or the brain might require higher levels of dopamine in order to release chemicals. Sometimes, the brain even stops making its own dopamine, in the hopes of stopping another reaction. The user must then take higher and higher doses of heroin in order to feel any sort of rush.
High doses come with big risks. Often, heroin sold on the street is far from pure. It may be laced with other chemicals that can augment the efficacy of the heroin or it may contain inert additives that don’t have any effect on the user whatsoever. It can be very hard for users to know the strength of the drugs they’re taking, and when new dealers come on the scene, many people can die if the heroin they sell is different from the heroin the buyers are used to. For example, according to the United States Drug Enforcement Administration, 57 people died in St. Louis between January and September of 2011, when a new dealer came to the area.
In addition, according to the Partnership for a Drug-Free America, some heroin is sold with tiny particulates that don’t dissolve when they hit the body. People who inject this tainted heroin could be injecting tiny missiles that head to the heart or other organs and cause deadly blockages. The more the user injects, the higher the risk.
The Story of Addiction
As people develop a tolerance for heroin, they may discover that they experience unpleasant side effects between hits. They may feel cold and sweaty, nauseated, shaky and agitated. These problems subside when they take another bolt of heroin. These unpleasant side effects may last for weeks, or they can stop immediately when the person uses the drug once more. These cravings, and the nasty withdrawal side effects, lie underneath many cases of heroin addition and they may explain why the addiction is so hard to kick without help. During the withdrawal stages, the addict may be in such pain that using the drug again seems both reasonable and necessary.
In addition, many people with addiction have behavioral habits they’ve developed through the years of their addiction. They may have various friends who also use heroin, and they may spend a significant amount of their social life using heroin. Without the drug, they may have difficulty relating to those friends, and they may be at loose ends during the day. Also, heroin addicts may rely on the drug during times of stress and loss. It’s almost impossible to live life without encountering some sort of emotional upheaval, and those stresses can lead right back to addiction. According to the National Institute on Drug Abuse (NIDA), these cravings can persist for years after treatment programs end. It’s clear that the mental component of addiction must be addressed in order for the person to heal.
Since the person has endured physical changes in the brain as a result of addition, some aspects of heroin addiction treatment focus on the physical. In many cases, the heroin addict is given a drug known as buprenorphine, which acts on the same dopamine receptors and blocks nasty withdrawal side effects. Some heroin addicts are given high doses of buprenorphine when they enter treatment programs, and then they take smaller and smaller doses until they are taking no drugs at all.
Some other heroin addicts have such a strong addiction that they cannot deal with a drug-free life. These people may take buprenorphine or another drug much like it for the rest of their lives. The goal of this replacement therapy is to keep the drug user from engaging in dangerous addiction habits. As mentioned, buying off the street is dangerous as the addict might overdose or take in a tainted batch of drugs. It’s also illegal. Taking a synthetic form of the drug keeps the user from engaging in these behaviors. Some current research even suggests that providing heroin users with actual heroin on a low dose might also be an effective therapy. As reported by the National Institute for a Drug-Free America, two-thirds of those who participated in this therapy used no street drugs at all during treatment, and they were able to reconnect with family and friends and reenter society. More research needs to be done on this controversial therapy, but it does demonstrate the fact that some people have such strong addictions that innovative treatments must be given.
Heroin addiction is often closely linked to mental illness. According to a study published in the Annals of General Psychiatry, 42.6 percent of heroin addicts displayed a form of depression, and 14.9 percent showed a form of psychosis. Experts disagree about why the link between mental illness and heroin addiction exists. It could be that people use heroin in order to self-medicate and deal with mental illness issues they already have. Or, it could be that people develop mental illnesses as a result of their addictions, as their isolation grows and their coping skills decrease.
No matter whether addiction or mental illness comes first, both conditions must be treated in order for the person to truly heal. Sometimes, the addict must be given medications to help deal with the underlying condition. Other times, the addict must learn how the two conditions interact and come up with real-world solutions that can help the addict deal with mental illness and addiction triggers.
It’s almost impossible to place too much stress on the importance of mental health treatments for heroin addicts. Often, families are keen to simply treat the addiction and they may neglect to deal with the mental illness issue lurking in the wings. For example, a study by Informa Healthcare found that, of 189 people receiving ongoing medications for heroin addiction, 59 percent had a mental illness. In other words, they were getting help for their addiction, but not for their mental well-being.
The missing piece of the puzzle that can link mental illness and addiction is talk therapy. Often, heroin addicts need to meet with an addiction counselor on a one-on-one basis to learn more about the impact of addiction. In counseling sessions, the addict might learn:
What You Learn in Therapy
- What situations seem to bring on heroin cravings
- How mental illness might trigger a craving
- What can be done to block a craving
- Why relapses are common, and how they can be avoided
- When to call for help
These lessons can be put to good use when formal therapies end and the addict must reenter life in the “real world.” Addicts who know themselves and have real coping skills can identify a trigger with ease, and they’ll know just what to do to keep a relapse from occurring.
Often, heroin addicts begin these talk therapy sessions during inpatient programs. They’re receiving medications to help them cope with withdrawal symptoms, and they’re heading to multiple talk sessions to deal with their mental health. When these formal inpatient programs end, the addict continues to work with the counselor in private sessions multiple times per month.
Some heroin addicts benefit from participating in 12-step meetings such as Narcotics Anonymous. Here, they can meet other heroin addicts in recovery and they can begin to develop a network of friends who are also working toward sobriety. This newfound sense of community can be quite powerful, as members work to motivate one another to stay clean. It can also help reduce the sense of isolation that is so commonly found with addiction.