Many people who do not suffer the affliction of addiction assume that drug addicts or abusers are immoral, weak, dirty, and criminal. These people believe that to stop doing drugs one only needs to abstain from them. Just make the choice to no longer take drugs. Simple. These people would be wrong.
The Reality of Heroin Addiction
Heroin is an opioid drug and is derived from morphine. It can be a powder, (brown or white) or it can be in the form of a black, sticky tar-like substance known as “black tar heroin. The National Institute on Drug Abuse states that 4.2 Americans over age 12 had used heroin at least once and about 23 percent of people who use heroin become addicted to it.
Heroin addicts are not the thin, pasty people with sunken black eyes as seen in the movies. In reality, it is unlikely you would spot a person addicted to heroin if you passed them on the street. People suffer from many illnesses with overlapping symptoms and many heroin addicts are actually overweight with a bloated appearance. Some addicts may look and act “normal” with no signs of drug use and are capable of functioning in everyday life. Your reality is not their reality. For them, every minute is another minute to figure out how to get their next fix before the receptors in their brain run out of the drug.
Heroin changes the brain and those receptors. Once heroin enters the brain, it is converted back to morphine and attaches to the brain receptors associated with pleasure. Receptors are also in the brain stem and affect processes such as blood pressure, respiration (breathing) and arousal.
The brain is not the only part of the body that is affected by heroin. Chronic heroin use can lead to permanent damage or failure of vital organs such as lungs, kidneys, and liver. (National Institute on Drug Abuse: Drug Facts: Heroin. Oct 2014.)
The Pain of Heroin Addiction
With the habitual use of heroin comes physical dependence. The body has become used to the drug’s presence and abruptly stopping the drug will result in severe withdrawal symptoms.
These symptoms can begin within a few hours of the last dose and include,
- Muscle and bone pain
- Cold flashes with goose bumps
- Craving for the drug
This last symptom is one of the main reasons that continued use or relapse occurs. Combined with the physical pain of withdrawal, heroin is an extremely difficult addiction to overcome. Especially when another dose is all that is necessary to stop the painful withdrawal symptoms.
An individual addicted to heroin needs to detox in a facility capable of easing the withdrawal symptoms with support from professionals who understand addiction.
Medical Detox – Easing the Pain
Heroin is one of the most dangerous and addictive drugs on the street. It is also one of the hardest addictions to overcome. Detoxing without professional assistance is dangerous and seldom successful. Medical detoxification eases the symptoms of withdrawal as the brain recovers from the dependence of the drug. The purpose of detoxification is to treat the physical symptoms of withdrawal and remove the toxins left behind in the body.
- Medical Detoxification – Medical detoxification allows individuals to withdraw from heroin safely. Generally, the process is medically supervised in a hospital or other treatment center that has a unit for detoxification which allows the patient to be monitored closely throughout the process. Medication is given to prevent the withdrawal symptoms from becoming severe. The medication is usually a related drug type that is gradually tapered over a period of days.
- Rapid Detoxification – This type of detoxification happens while the patient sleeps under general anesthesia. Opiate blocker injections are given to the patient which will prevent the action of the heroin. Other medications that aid in reducing physical symptoms are also given by injection. The process of rapid detox allows for the rapid withdrawal from the effects of heroin within 4 to 8 hours. This procedure occurs in an intensive care unit in a hospital and patients are generally discharged within two days. (The Online Addiction Recovery Guide.)
- Stepped Rapid Detoxification – This is an alternative to the rapid detoxification by which a patient receives small doses of Naloxone which is injected under the skin as well as Naltrexone about every hour. This method allows the patient to withdraw at a slower more controlled pace. It also allows for the medical professional to treat any withdrawal symptoms quickly and thus there is less need for withdrawal medications. Naltrexone Maintenance Therapy can stabilize the patient and aid in the long-term goal of recovery. While a person is on Naltrexone they would feel no effect were they to take any type of opiate.
- Ultra Rapid Detoxification – This method also requires the patient to be under general anesthesia. The patient is then given the drug Naltrexone which will block the endorphin receptors and put them into complete detoxification within a 30 minute period.
- Outpatient Detoxification – For patients with less severe withdrawal symptoms this method is usually both safe and effective. A physician has a variety of medications at his/her disposal and outpatient detox takes anywhere from 7 to 14 days.
- Methadone – This is the most common form of opiate detox and largely unsuccessful. The patient is given methadone and is then tapered from it over the next 21 days. This method still causes withdrawal to be uncomfortable and often the patients will use drugs during this withdrawal period.
Detoxification can either be in an outpatient setting such as a mental health center or addiction clinic, or in an inpatient setting like a hospital or residential treatment center.
Whether a patient utilizes inpatient or outpatient treatment will be determined by factors such as amount and history of heroin abuse, patient’s age, and any co-existing physical or mental health issues.