Heroin Addiction Treatment Options
Although the number of heroin users in the general population is lower compared to other drugs, heroin abuse is more deadly.1 After the spread of the opioid epidemic in the U.S., the number of new heroin users started to decrease in 2017, but the number of heroin-related deaths has continued to increase, with heroin claiming over 15,000 lives per year.2 Moreover, the percentage of people who seek treatment for heroin use is higher than for any other illicit drug, except marijuana.1
Due to its highly addictive nature and severe effects that this drug has on people’s health and lives, it is of vital importance that people who are struggling with heroin addiction enter heroin drug treatment that can help them detox and prevent relapse.
What Is Heroin?
Heroin is an illicit, highly addictive opioid drug made from morphine, which is a natural substance obtained from opium poppy plants.
Heroin usually appears as a white or brown powder that can be injected, smoked, or sniffed/snorted. Injecting the drug is the most effective way to get high from low-purity heroin, but injecting heroin also carries serious health risks. The sharing of needles leads to the spread of both HIV/AIDS and hepatitis in heroin users.
The threat from infectious diseases spread through needles has led some heroin users to snort a higher-purity form, but snorting the drug does not prevent the possibility of a fatal overdose. The National Institute on Drug Abuse researchers have confirmed that all forms of heroin are addictive.3
What Are Heroin’s Short-Term Effects?
Heroin rapidly binds to opioid receptors of the nervous system and heroin users experience the feeling of euphoria (also known as the “rush”) soon after a single dose, with the feeling disappearing a few hours later. After the rush, heroin users can experience the following short-term effects:3
- Warm flushing of the skin
- Dry mouth
- Heavy arms and legs
- Nausea and vomiting
- Slow breathing
- Clouded mental functioning
- Back-and-forth state of being conscious and semiconscious referred to as going “on the nod”
What Are Heroin’s Long-Term Effects?
Long-term, continued heroin addiction has serious health consequences. These include:3
- Vein damage in users who inject heroin.
- Nose tissue damage for people who sniff or snort heroin.
- Heart, liver, and kidney damage.
- Constipation and stomach cramping.
- Pulmonary complications, including pneumonia.
- Mental disorders.
- Reproductive system issues in both men and women.
Heroin users quickly develop tolerance, which means that a person needs to take a larger amount of drug to achieve the same effects. After the drug is used for a certain period of time, the body adapts to the presence of the drug. This means that if the person does not take the drug, they experience unpleasant withdrawal symptoms.3
When a person develops heroin use disorder, their behavior is characterized by continual drug-seeking that they cannot control. This can put them in risky and potentially life-threatening situations, which is another reason why getting treatment for heroin as soon as possible is so important.
What Does Heroin Withdrawal Look Like?
A key reason many heroin users fail in their attempts to quit is that the drug carries serious withdrawal symptoms so unpleasant that many users return to heroin just to make the feelings of sickness go away. Heroin withdrawal symptoms include:4
- Nausea and vomiting.
- Cold flashes and goosebumps.
- Muscle cramps.
- Watery eyes and nose.
These withdrawal symptoms can begin as early as a few hours after the last dose of heroin, and symptoms usually peak between 48 and 72 hours after the last dose. Symptoms often completely subside after about one week.4 Since these symptoms can be quite severe, heroin addiction treatment programs may include medication-assisted treatment (MAT) to help patients detox safely.
Heroin overdose is a condition in which the drug slows down the heart rate and breathing in such a way that the drug user cannot survive unless they get immediate medical help. The drug that is used to reverse this condition is called Naloxone. This medicine works by rapidly binding to opioid receptors in the brain and blocking the effect of the opioid drug.3
Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Sometimes more than one dose may be needed to help a person start breathing again, which is why it’s important to get the person to an emergency department or a doctor to receive additional support if needed. Read more in the Substance Abuse and Mental Health Services Administration’s Opioid Overdose Prevention Toolkit.
Overdose sometimes happens because heroin is often “cut” with other substances such as sugar, starch, powdered milk, or quinine. If a user does not know how much actual heroin is being used, this increases the likelihood of overdose. In addition, using heroin along with drugs or alcohol also increases the risk of overdose.3
Heroin and Other Drugs
Heroin is often used in combination with other drugs and alcohol. According to the heroin-related statistics of the Centers for Disease Control and Prevention, over 9 out of 10 heroin users use at least one other drug.5
A factor that may lead to heroin abuse is the misuse of prescription opioids. Opioid painkillers such as OxyCotin and Vicodin have similar effects to heroin and some people tend to switch to heroin as a cheaper and more easily obtainable alternative.3
How Does Heroin Addiction Treatment Work?
Treatment for heroin addiction usually involves medication and behavioral therapy.
The medications used in heroin addiction treatment may include lofexidine, buprenorphine, and methadone. The purpose of medicines is to reduce the need for heroin and help overcome withdrawal symptoms.
Medically-assisted detox should be seen as the first stage in heroin addiction treatment and it is hardly sufficient without behavioral counseling. In addition to medical stabilization, behavioral therapy is an important element of heroin addiction treatment. It has the potential to help the person change patterns of thinking and behavior that have resulted in heroin addiction.3 The approaches that have been reported to be effective in heroin drug treatment are contingency management and cognitive-behavioral therapy. Working on the causes of addiction and developing healthy habits prevents a former heroin user from turning to alcoholism or some other form of drug abuse.3
Additional Heroin Treatment Considerations
In some cases, a person may have some other psychological issues such as depression and anxiety. These co-occurring disorders are often connected to drug abuse and they should also be addressed in treatment for heroin addiction.
Furthermore, as heroin abuse puts people at high risk of infectious diseases, heroin drug treatment programs should test patients for the presence of HIV, hepatitis B and C, and other infections, as well as link them to treatment for these conditions if needed.6
Frequently Asked Questions
- According to the National Survey on Drug Use and Health, the number of people who have used heroin in the US has been on the rise since 2007. In 2016, 948,000 people reported using heroin during the past year. Heroin users are more common among adults aged 18-25, while the number of heroin users among teens aged 12-17 has declined.7
- Some of the signs that can indicate that a person is a heroin user are the following:8
- Small eye pupils
- Needle marks on the skin
- Unusual sleeping schedule
As heroin starts to wear off, the user may also show the following symptoms:9
- Muscle and bone pain
- Feelings of nervousness
- Itchiness across the skin
- Vomiting and getting chills
- Since not everyone has the same treatment needs, treatment plans will vary for individual patients. There are several heroin treatment options: some patients benefit from inpatient programs, while others may opt for outpatient services in order to be able to carry on with their activities during treatment.There are programs that place emphasis on spirituality and religion, and there are also those that pay special attention to gender-related issues. There are also treatment options designed for particularly vulnerable groups such as teens and pregnant women. Sessions are done in groups or individually, and in some situations, family therapy is also an important element of treatment.
- The length of heroin addiction treatment is not the same for everyone because people progress through treatment at various rates.9 However, positive treatment outcomes correlate with longer treatment, so it is recommended that the treatment program lasts for at least three months.10
- Yes. It is generally recommended that pregnant heroin users should seek professional help since using heroin, trying to quit heroin use, and experiencing withdrawal during pregnancy can harm the mother and the baby. Using heroin during pregnancy may result in poor fetal growth, birth defects, preterm labor, stillbirth, and maternal death. Babies can also become dependent on the substance during pregnancy and experience withdrawal after birth.11
- Heroin users are encouraged to enter treatment when the first signs of opioid addiction are noticed. Unfortunately, the gap among those who need substance abuse treatment and those that receive it is quite significant. In fact, only 2.3 million of individuals seeking treatment received it, out of 21.6 million persons who needed it in 2011. Because of this, it is important that individuals and their families be aware of the available heroin treatment options and encouraged to seek treatment before serious problems develop.10
- Since every person has unique treatment needs, they should always consult a professional to find the optimal treatment option that suits their individual case.
1. United States Drug Enforcement Administration. (2015). National Heroin Threat Assessment Summary.
2. Substance Abuse and Mental Health Service Administration. (2017). The National Survey on Drug Use and Health: 2017.
3. National Institute on Drug Abuse. (2020). Heroin DrugFacts.
4. World Health Organization. (2020).Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
5. Centers for Disease Control and Prevention. (2020). Today’s Heroin Epidemic.
6. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
7. National Institute on Drug Abuse. (2018). What is the scope of heroin use in the United States?
8. National Institute on Drug Abuse. Signs of Heroin Use.
9. National Institute on Drug Abuse. (2018). How long does drug addiction treatment usually last?
10. National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
11. Centers for Disease Control and Prevention. (2020). About Opioid Use During Pregnancy.