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What Causes Heroin Addiction?

Heroin is an opioid drug composed of morphine, a natural substance extracted from the seed pod of the diverse opium poppy plants raised in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can appear as a white or brown powder, or a black sticky substance referred to as black tar heroin. Other common names for heroin include big H, horse hell dust, and smack. Heroin is either injected, sniffed, snorted, or smoked. Some users also combine heroin with crack cocaine, a mix called speedballing.

Heroin is extremely addictive and many users will develop heroin use disorder. A substance use disorder (SUD) occurs when consistent use of the drug results in behavioral and lifestyle issues, such as health problems and failure to meet responsibilities at work, school, or home. A SUD can range from mild to severe, the most severe form being addiction.

What Does Heroin Do to Your Brain

man struggling with heroin addictionHeroin enters the brain at a fast rate and rapidly binds to opioid receptors on cells located throughout the brain. Heroin specifically targets areas of the brain involved in feelings of pain and pleasure. The drug begins to alter users’ heart rates, sleeping habits, and respiratory functions.

Scientists are still studying the long-term effects of opioid addiction on the brain but the majority of studies conclude that heroin use is associated with loss of the brain’s white matter, which may affect decision-making, behavior control, and responses to stressful situations.

Due to the addictive quality of heroin, an increase in the number of individuals inhaling heroin has resulted in a higher number of users suffering from brain damage. Current research has shown that the toxicity of the drug is substantially increased when the molecules are burnt before they enter an individual’s system. The most concerning aspect of this new research is that inhaling heroin has become the fastest-growing method of using the drug.

The brain is severely altered through heroin during active addiction, as both gray and white matter of the cerebral cortex are damaged. Both brain matters are essential for optimal cognitive functioning. White matter drives the way our mind interprets spatial relationships, while gray matter covers most other functions within the brain. The complete mechanism and understanding of what happens to the different brain matters during heroin use is not fully understood by neuroscientists, but the takeaway is that regardless of the extent of the damage, the user’s brain will never be the same.

In a controlled study, scientists examined the brains of intravenous heroin and methadone users after their death. Each of the subjects died young, with an average age of all study participants of 26 years old. The results of the study displayed brain damage consistent with brains that had aged dramatically. These brains were found to show indications of early onset Alzheimer’s syndrome. Additionally, compared to individuals of similar ages, the participants who abused substances were found to be three times more likely to have brain damage. More concerning, the study findings also revealed that the participants experienced a buildup of proteins and slight inflammation in their brains. Study subjects were also found to display indications of breakdowns in nerve cells, indicating that damage from these substances goes far beyond the brain.

Why is Heroin So Addictive?

woman craving heroinHeroin rewires the mind, increasing the risk of overdose and the tendency to develop a substance use disorder. After heroin use, the brain begins to develop more opioid receptors, contributing to a cycle where users need larger amounts of the drug to have the desired effects on the newly-formed receptors. This phenomenon makes it easier for participants to develop tolerance to the drug so quickly. A loop of increasingly harmful self-dosing begins as more drug use leads to more receptor generation.

As tolerance increases, the human reward-seeking system goes haywire, especially since dopamine, the “happy hormone” and neurotransmitter, spikes with heroin use. As a result, the amount of heroin that is needed to release a significant amount of dopamine increases substantially. Dopamine is a powerful neurotransmitter that reinforces cravings and makes withdrawal and time spent without the drug painful to handle. This biological mechanism explains why users report extreme emotions and feelings of despair, emptiness, and distress when they go without the drug for less than half a day. A higher tolerance not only leads to users taking higher amounts of the drug, but also choosing riskier ways to consume the drug. For example, users may begin to use aggressive delivery methods to maintain the same high, such as IV usage or even inhaling heroin.

Not every heroin addict begins using heroin directly. Opioid pain medicines prescribed by a physician, such as OxyContin and Vicodin, have effects similar to heroin. Consistent research shows that the misuse of these drugs opens the door to heroin use. For example, data from 2011 found that an estimated four to six percent of patients who misused their prescription opioids shifted to heroin use and about eighty percent of people who used heroin first misused their prescription opioids.

However, in the most recent decade, data suggests that heroin is now frequently the first opioid people use. In a study of those starting treatment for opioid addiction, approximately one-third of participants reported heroin as the first opioid they used regularly to get high. The takeaway from this study is that prescription opioid abuse is only one factor that leads to and correlates with heroin use and inevitable addiction.

Heroin Withdrawal Symptoms

Users who are addicted to heroin and who stop using the drug abruptly will experience intense withdrawal symptoms beginning as early as a few hours after the drug was last taken. Symptoms from heroin withdrawal include but are not limited to:

  • restlessness
  • severe muscle and bone pain
  • sleep problems
  • diarrhea and vomiting
  • cold flashes with goosebumps
  • uncontrollable leg movements
  • severe heroin cravings

Heroin Addiction Treatment & Recovery

How does a heroin addict overcome their addiction? There is a multitude of treatments available, ranging from medication to behavioral and cognitive therapies. There are also medicines being created to aid in the withdrawal process.

Medications to Treat Heroin Addiction & Withdrawal

  • The FDA has approved lofexidine, a non-opioid medicine developed to reduce opioid withdrawal symptoms.
  • Buprenorphine and methadone are other medications used for heroin addiction, as well. These substances bind to the same opioid receptors in the brain as heroin, but more weakly, decreasing cravings and withdrawal symptoms.
  • Another treatment is naltrexone, which blocks opioid receptors and prevents opioid drugs from having their usual effect. A NIDA study discovered that once treatment has begun, both a buprenorphine and naloxone combination and an extended release naltrexone formulation are comparatively effective in addiction. Since thorough detoxification is essential for treatment with naloxone, starting treatment among active users was not ideal, but once detoxification was finished, both medications showed similar effectiveness.

Behavioral therapies for heroin addiction include therapeutic techniques like cognitive behavioral therapy. Cognitive behavioral therapy modifies the individual’s drug use expectations and behaviors and helps effectively approach and address triggers and stress.

At Boardwalk Recovery Center, we have a caring and expert staff that provides a safe place for heroin addicts to recover and work to overcome their addiction. Our primary concern is helping each of our clients become a healthy and happy person. Contact Boardwalk Recovery today to help you or a loved begin living their lives and heal the damage caused by heroin and opiods.

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microdosingwoman in Acceptance and Commitment Therapy session