Home » Battling heroin addiction is a long and arduous journey fraught with severe psychological, emotional and physical difficulties. Perseverance is the greatest asset that an individual suffering from addiction learns to use through the course of his/her recovery. Heroin addiction is a chronic disease, and the danger of relapse is never far away; it is characterized by alterations in the brain that, in most cases, lead to cravings and impulsive behavior due to a shortage of dopamine.
Heroin comes from opium or poppy plant, and is a natural drug. Prescription opiate pain pills are made from the same stuff. Many users have reported that the first time heroin hits the body, they feel a distinct and immediate wave of pleasure, a sense of well-being, and ecstasy. These temporary changes of state, because of their intensity, leave the user craving more. That is partly why heroin addiction is such a deadly disease; the seductive quality of the transient drug experience instills in the user a deep longing for permanent pleasure. Increased tolerance levels for the drug eventually lead to full-blown addiction.
Heroin can be used in a number of ways— by injecting intravenously, inhaled in powdered form, or smoked. It affects opioid receptors in the brain. The perception of pain, pleasure, and reward is intensely affected by opioid receptors; when a user enters the drug state they feel immense joy, any sense of distress being entirely alleviated.
In the long run, the chronic use of heroin brings about irreversible changes to the structure and functioning of the brain. As the drug stimulates the brain to release huge quantities of dopamine, the brain forgets to release dopamine in response to regular stimuli, such as food, hobbies or sex. It waits for heroin to trigger the release.
Consequently, individuals addicted to heroin need heroin in order to feel normal and go about their lives. Not having it in their system leads to an out-of-body experience. Physical dependence is characterized by the almost perpetual craving for the drug in order to avoid severe and unpleasant withdrawal sensations.
Psychological dependence, on the other hand, is about the individual developing a concrete belief that he or she cannot function without consuming the drug. The user may even understand the irrationality of such a belief but may not be able to successfully pull themselves out of the vicious cycle of addiction – for complex emotional reasons associated with fear and shame. As in the case of alcohol withdrawal, individuals addicted to heroin display complex behavioral patterns owing to fear of intense withdrawal symptoms, and these become increasingly entwined with mental and physical states as the addiction goes into its deeper stages.
Understanding the Nature of Heroin Addiction
The most painful reality of heroin addiction is that, long after the individual previously addicted to the drug stops using it and attempts to move on with his or her life, the danger of relapse remains near. A research study conducted at the Beijing Institute of Medical Science showed that long-term changes in the brain is the primary contributing factor to this prolonged condition. Therefore, to help an addict stay focused through his or her recovery, it is imperative to first understand the nature of heroin addiction. Successful heroin rehabilitation should address all the core aspects of the addict’s condition.
Is addiction a disorder or a disease?
The medical community has gradually accepted the fact that addiction is a disease due to the changes that occur in the brain. Previously it was classified as a behavioral problem. Treatment for addiction followed the behavioral model and most of the treatment provided was in an inpatient setting where the patient was isolated from the real world in order to learn better behavior! Neuroscientific inquiries into the nature of addiction have brought to light the fact that heroin use causes changes in the brain, with significant dysfunction in neural pathways associated with impulse, appetitive behavior, pleasure, and reward perception.
While it may seem counter intuitive, addiction is indeed a disease and it is time the treatment community came to accept that fact and stop treating addiction as a behavioral problem. It helps us understand the disease and helps to stop stigmatizing the disease and those suffering from it. Addiction also has a genetic component.
Symptoms of Heroin Addiction
There are a set of symptoms associated with heroin addiction. Some of the most common symptoms of heroin addiction are:
● Prolonged depressive episodes
● Intense mood swings
● Feelings of euphoria and ecstasy
● Overwhelming guilt and shame
● Social isolation and antisocial behavior
● Hostility towards others
● Stress, agitation, bouts of excitement, and irritability
● Compulsive lying
● Avoiding social interaction and hurting loved ones
● Noticeable weight loss
● Delusions and magical thinking
● Paranoia, rapid thoughts, and irrational thinking
● Disorientation and dizziness
● Possession of burned spoons, needles and syringes, and glass pipes
● Keeping stash in various locations around the home or at the workplace
● Periods of manic hyperactivity followed by bouts of severe exhaustion
● Perpetual sleepiness
● Apathy and lack of interest in pleasurable activities
● Rapid decline in occupational and academic performance
● Slurred speech
● Dryness of the mouth and throat
● Pressured speech
● Intense itchiness
Long-Term Effects of Heroin Addiction
The most common and characteristic effects of heroin addiction are:
● Liver disease
● Skin disease
● Infection of valves
● Risk of Hepatitis B and C
● Risk of HIV
● Clouded cognitive functioning
● Diminished rational faculties
● Collapsed and scarred veins
● Blood clots, risk of stroke and heart attack
● Long-term depression
● Permanent damage of dopamine receptors
● Shock states
● Sudden death
Understanding Heroin Withdrawal
Heroin withdrawal is not a life-threatening condition but can be excruciating. Withdrawal occurs when a user suddenly reduces their dosage, or quits using the drug altogether (going “cold turkey”). The etiology of heroin withdrawal is complex. Studies conducted in-vivo in animal subjects have shown that withdrawal symptoms are closely related to adenylyl cyclase superactivation-based central excitation in pathways of the brain. Withdrawal is, indeed, a very painful condition, but it can be managed through close supervision and by using medication substitutes.
Heroin withdrawal symptoms may develop as soon as a few hours after sustained use. A user who is battling long-term abuse and dependence is at risk of several medical complications. Professional help to deal with addiction is imperative. Here are some of the symptoms of withdrawal:
● Intense craving for the drug
● Nausea and long periods of vomiting
● High fever
● Diarrhea and stomach ailments
● A feeling of heaviness in the body
● Uneasiness in body movements
● Death, in cases where other medical conditions develop as a result of going cold turkey
Treatment and Management of Withdrawal
When withdrawal symptoms are very severe, pharmacological treatment and management of the condition are put into practice through any of the following three methods:
● Gradual cessation of heroin, using methadone as a substitute
● Using a partial mu-opioid to diminish the dependence on heroin
● Complete detoxification using medication that fights against the opioids, like buprenorphine, naltrexone and naloxone
Why Heroin Rehabilitation is a Crucial Stage in the Journey to Recovery
Holistic heroin rehabilitation gives individuals addicted to heroin a chance to regain their life, to fulfill their potential, enrich their inner-life, and enhance their own well-being and of those around them. Everyday life stressors – what may seem like ordinary challenges to others – can be intense triggers for those in early recovery. Effective treatment involves Medication Assisted Treatment, or MAT, where methadone, buprenorphine, or naltrexone are utilized to manage withdrawal and address cravings. Psychotherapy, counseling, and behavioral therapy are also needed in order to effect lifestyle changes. Recovery is a long process, and persistence is the greatest asset in this journey.
Heroin is a highly addictive drug, on both a physical and mental level. The path to recovery is often fraught with difficulties. Those who attempt to quit have to withstand withdrawal, which is painful, unpleasant, and, sometimes, downright scary. A person in recovery may have to be conscious of their triggers for the disease, just like people suffering from other chronic conditions such as diabetes.
A successful heroin rehab program, such as those offered by the Center for Network Therapy (CNT) in New Jersey, for example, is one that is firm but flexible in its approach to treatment. The intake process involves detailed examinations of the patient’s physical and mental health, and their pattern of substance abuse. This helps the heroin rehabilitation professional determine the most suitable treatment plan for an individual.
A vital stage in a heroin rehab program is ‘detox’, where clinicians help a patient through withdrawal symptoms utilizing alternate medications that address withdrawal symptoms and cravings. Detox from heroin requires medical supervision for optimum results. CNT is the first facility in the state-licensed to offer “Medically Monitored Ambulatory Detox (MMAD) from alcohol, opiates, benzodiazepines, stimulants, anesthetics, and other substances.”
After detoxification is complete, the patient enters the next stage in their path to recovery, where they work through post-acute withdrawal symptoms and strengthen their knowledge of relapse prevention and coping skills. Most detoxification facilities provide both individual as well as group therapy to teach relapse prevention and coping skills. Family therapy can prove to be very beneficial: a patient who has an underlying mental disorder is likely to feel more open and comfortable with their loved ones present.
Staging an Intervention
Many people struggling with heroin addiction are in denial about their condition, caught in a complex web of self-deception intended to perpetuate their abuse of heroin. It is a chronic disease and it is high time that the treatment community accepted this and stopped continued stigmatization of the disease through recommendations for inpatient treatment.
Some addicts may believe that they can stop using the drug any time they wish to. Others rationalize their choice to abuse the drug through beliefs developed over time. There are also some who simply cannot accept the negative consequences of their choice and project blame onto others in their lives. No matter how the individual chooses to reflect on his or her addiction, an ‘intervention’ is a powerful way to open the eyes of the person suffering from addiction to the reality of their life and of those around them.
It helps to have a compassionate and understanding attitude when approaching a loved one instead of judging or confronting them. An individual afflicted by addiction has repositories of guilt, shame, and fear, trapped in their psyche, so confronting them in a very direct manner could cause them to become aloof or defensive. Therefore, it is really important to allow them to feel comfortable and to help them understand the negative consequences of their decisions and behavior. It is equally vital to the addict’s recovery process to have their loved ones to understand the issue from a collaborative perspective. Drug abuse is the problem, not the individual.
Rising Above Addiction
For those struggling with the disease of addiction, the most difficult step toward recovery is the first one: acknowledging the problem and deciding that he or she will make a change no matter what obstacles get in the way. True commitment to sobriety involves altering the following aspects of one’s life:
● The way one perceives and handles stress
● Close circle of friends and associates
● How one spend one’s free time, recreational habits
● How one perceives oneself, and how one feels within oneself
● Choice of prescription and over-the-counter medication
In the initial stages, feeling conflicted about giving up heroin is perfectly normal, even though the person suffering from addiction may understand the consequences of using the drug. Long-term recovery takes patience, motivation, time, perseverance, and, most importantly, the support of loved ones. By making a commitment to change, the individual finds the strength within to overcome the hurdles in the way of sobriety.
Learning to accept the support of close friends and family: A close friend, a loved one, or a family member— they form the core of the support system and will prove to be an invaluable asset in the recovery process. The indivdual suffering from addiction may feel reluctant to turn to a loved one because of an overwhelming sense of guilt or shame; in such cases, counseling or family therapy can help resolve conflicts.
Building a healthy network of friends: Many people in the throes of addiction find it difficult to even imagine quitting because it would mean leaving a circle of friends that they feel a sense of belonging within. However, a social life that revolves around drugs is toxic to begin with. It is important for a person in recovery to make new connections. Taking up a new sport, learning an instrument, swimming, yoga— these are some of the avenues they can explore to build new connections and to change their outlook toward life. Of course, self-help groups such as AA and NA are invaluable in this process as they already provide a pool of like-minded people.
Building a sober home; adopting a sober lifestyle: People in the nascent stages of recovery may have a stash of drugs in different parts of the home just to reassure themselves that heroin is never completely out of reach. One of the most noticeable results of successful heroin rehabilitation is that the patient comes to understand responsibility. A drug-free home is no longer a mere option: it is the only way forward, toward recovery. A sober lifestyle is not something that can be bought for the price of treatment at a heroin rehab facility: it is a commitment to change one’s way of thinking entirely. With a clean life flows the wisdom of a clear mind.
Disciplining oneself to attend self-help (AA/NA) meetings: An individual in recovery may come to believe that they have successfully conquered the disease and won’t require any support to tread on the straight path. A recovery support group such as the 12-step group reminds an addict of the reality of life, that everyone is emotionally vulnerable to some degree, and requiring the support and help of others is completely normal. Spending time with others who have gone through the same journey, battled the same problems in all their complexity, can be an uplifting and enriching experience. Sharing painful stories with people who understand is part of the healing process. You also get to immerse yourself in the wisdom of others who have successfully recovered and acquire new and meaningful tools to smoothen your path to sobriety.