According to the C.D.C. or the Centers for Disease Control and Prevention, heroin use and abuse in the last decade has more than doubled in the country. In the year 2013, about 8,200 people died from overdosing on heroin. This is nearly 4 (four) times the total number of heroin-related overdose deaths reported in 2002.
Within the opioid family, heroin is immensely popular- one of the most popular. There are two main variations of the drug sold in the U.S. Powder heroin is often diluted or cut, with substances that look like it. The most preferred ones include powdered milk and sugar.
Powder heroin is typically believed to be white. However, depending on the region it comes from and the mixture, it may be off-white. People often say that the whiter the heroin is, the purer it is. This is not always true, mainly depending on the substance it is cut with.
People who use powder heroin snort or smoke it. This makes it more appealing to use, especially among newer users of the drug. For some, abuse of prescription painkillers leads to heroin use and misuse. This is because heroin is often cheaper than prescription medications and more accessible. However, turning to heroin is not the solution. The problem only gets worse. Rehab and detox are the real solutions.
Shooting heroin, commonly referred to as "shooting up" is a collective term for injecting heroin directly into the veins using a hypothermic needle. This abuse type will bring about the effects of heroin faster, as the drug promptly integrates into the bloodstream and then travels immediately to your brain.
Impure black tar heroin makes up the rest of sales. The process of manufacture leaves a great many impurities in heroin. The impurities give it a look that resembles tar. Snorting, as such, doesn't work well. This leaves the users little choice than to melt it and directly inject it in their veins. Some smoke it as well, usually on tin foil.
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Heroin works by impacting your brain's reward system. This increases your tolerance to the effects of the drug as time goes by. Eventually, you will require to use increasingly large doses of the drug to reach the same high. Once you stop using or cut down on the heroin amounts, withdrawal symptoms typically set in.
Heroin suppresses some of the C.N.S.' functions, such as respiration, blood pressure, heart rate, and regulation of temperature. Heroin also binds to opioid receptors. The result is an increase in chemicals in the brain. These chemicals are responsible for pleasurable feelings.
When you abuse heroin, a pleasure rush will also occur. During the withdrawal process, the effects of this drug are the opposites of the high. For instance, instead of euphoria, sedation, and suppressed heart rate, you may suffer from low mood, a rapid heart rate, and great anxiety.
Users start to experience withdrawal symptoms about 6-12 hours after their last heroin fix. Withdrawal symptoms will mirror those of prescription opioids. Heroin leaves the system faster than prescription opioids like OxyContin, which means that withdrawal symptoms come about faster.
Withdrawal from heroin will often feel like a severe case of the flu. The worst will pass after a week - which is about the same time frame as the flu - with the symptoms peaking on the 2nd or 3rd day.
Heroin withdrawal is not the same for all people. The longer you use the drug, the method of abuse, and how much you take each time you get your fix will all factor into just how bad your withdrawal symptoms are.
As such, the duration of withdrawal will differ as well. A person with a history of mental disorders or one who has experienced prior opioid withdrawal symptoms will likely have more severe symptoms.
Common withdrawal symptoms include:
The withdrawal length will depend on several factors. Some of the most important ones include:
Depending on the length and level of use, a recovering heroin addict is likely to suffer post-acute withdrawal symptoms (PAWS). They include poor concentration, poor sleep, increased anxiety, restlessness, panic attacks, depression, fatigue, irritability, hypersensitivity, mood swings, and memory loss.
PAWS may last anywhere from 18 to 24 months. The effects on behavior and mood may persist for several months. However, as long as you remain drug-free, the symptoms will gradually pass.
Withdrawal from heroin is not typically considered to be life-threatening. However, some of the symptoms may end up leading to complications - some of which could be fatal. This is why detox ought to be under the keen eye of a medical professional.
Depression is one of the symptoms of heroin withdrawal. It may lead one to consider suicide. You must never stop taking the drug suddenly unless you have a professional watching over you. These professionals know what to do to keep you safe and to manage withdrawal effects.
Here's what the heroin withdrawal timeline looks like:
a) Days 1-2: The symptoms may crop up as early as 6 hours after your last fix. The pain will steadily develop in the first day, especially muscle aches. The pains will intensify over the next 48 hours. Other symptoms will include panic attacks, anxiety, insomnia, shivers & shaking, and diarrhea.
b) Days 3-5: By the 3rd day, the withdrawal will be in full swing. The symptoms will include, but will not be limited to, sweating, shivering abdominal cramping and nausea.
c) Days 6-7: A week typically marks the end of acute withdrawal. During this time, joint and muscle aches and vomiting/nausea will pass. Physically, former users will begin to feel a lot more like themselves, though still ground down and exhausted.
d) Post-Acute Withdrawal Syndrome (PAWS): Withdrawal symptoms may continue inconsistently for months after the acute withdrawal phase. These will be caused by the neurological shifts which result from heroin abuse. Common long-lasting symptoms will include depression, fatigue, anxiety, insomnia, and irritability.
Heroin detox facilities will provide a safe space where withdrawal symptoms can be managed. Complications from heroin withdrawal could fatally injure a former user if detox is not done under medical professional supervision.
People suffering from heroin withdrawal may become severely dehydrated. They may even inhale contents of their vomit, which could lead to asphyxiation. Also when the withdrawal is not life-threatening, the symptoms are often so uncomfortable that the former user relapses and avoids getting clean to prevent the discomfort.
Heroin is scientifically classified a short-acting opioid. This means that you feel its effects quickly, but it also leaves your system immediately. Detox refers to the evidence-based set of interventions commonly used to manage and blunt the symptoms of withdrawal.
Typically, the acute withdrawal will be over in about seven days. However, if you are a heavier user of the drug, it may take up to 10 days for acute withdrawal symptoms to subside.
Medical detox will often incorporate therapy and medications to help your brain and body recover from the developed dependence on it.
A person in heroin recovery may be treated using buprenorphine (Suboxone), methadone, or naltrexone. Each medication may have different introduction times. However, all of them will require an in-clinic appearance and a prescription for use at home.
The Food and Drug Administration (the F.D.A.) has approved buprenorphine for opioid withdrawal and maintenance therapy. These medications will work by blunting cravings and inhibiting symptoms. As such, buprenorphine works as a measure for relapse prevention.
When used as a form of abstinence maintenance therapy, the medication has a lower probability for misuse, especially compared to the likes of methadone. Some studies report 1-year rates of sobriety for former users on buprenorphine to be between 40% and 60%. This is impressive enough.
But buprenorphine, especially Suboxone, will also be used for separate purposes than its intended use. Some abusers of heroin buy Suboxone on the street and use it recreationally. These users will use the medication to keep off the painful and debilitating symptoms that occur between heroin fixes.
This street Suboxone primarily comes from persons with legit prescriptions who choose to sell the pills. Some folks who use Suboxone between their fixes of heroin may do so as a means of chipping, which is slang for using and abusing heroin without becoming clinically addicted. Chipping is far from foolproof. It is, in fact, highly dangerous and may lead to dependence and, ultimately, addiction.
The American Society of Addiction Medicine (ASAM) approximates that at least 517,000 Americans are addicted to heroin. Heroin has also been classified as a schedule 1 drug by the Drug Enforcement Administration (D.E.A.) under the Controlled Substances Act that was passed by the federal government. Thus, it means that the drug is considered to possess a very high rate of misuse and abuse and has a high potential for addiction, all while having no medicinal uses in the country.
Heroin may also be substituted with another longer-acting opioid in a bid to relieve drug cravings and the accompanying withdrawal symptoms. Adjunct medications may be used in the treatment of specific withdrawal symptoms. Anti-nausea medications, anticonvulsants, and antidepressants are examples of functional symptom-specific drugs.
During the detox process, mental health professionals will be at hand to offer guidance and support. The National Alliance on Mental Illness (NAMI) further reports that almost half of all heroin users suffer from mental illnesses as well. This may affect the duration of treatment as well as treatment methods. It may also affect the heroin recovery.
Emotional symptoms of withdrawal, such as anxiety and depression, could be more prevalent in former users who have an ongoing history of mental health disorders or illnesses or have an underlying mood disorder.
Not only will your vital signs and the levels of anxiety spike, but ordinary things that used to be pleasurable are also no longer so. When heroin ceases to be active in your bloodstream, the individual may notice a clear dip in dopamine levels. This may result in a crash of emotions. Being in a supportive, calming environment when these withdrawal symptoms start peaking will often go a long way toward getting to the end of the process with more ease.
Methadone is among the drug that has been used for a long time as a valid treatment for heroin addiction. This medication is a long-acting opioid. As such, it is typically substituted by doctors for heroin, which is shorter-acting in nature.
Methadone will stay in the bloodstream for the whole day, in many cases. It also works to reduce withdrawal by activating opioid receptors similar to how heroin does. However, the feelings of euphoria will be considerably less compared to those that come about from using heroin.
Methadone is regulated on a national scale. It is usually prescribed as a pill that you should take once a day. Doses of methadone can be tapered down gradually over time. It is important to know that methadone use can also lead to dependency. This is especially true if it is abused or taken in more copious amounts. As such, other medications may be the right choice if you prefer.
Another product that is a partial opioid agonist as well as a long-acting opioid is buprenorphine. This drug also has the added advantage of reaching a plateau. This is especially after you have taken a certain amount of it. This greatly lowers its abuse potential and risk of addiction.
Naloxone may be mixed with other buprenorphine products in a bid to keep users from desiring more heroin in their bid to stave off withdrawal effects. Naltrexone is classified as an opioid antagonist. This means that it blocks opioid receptors in the brain. It may be used to ensure long term and ongoing abstinence from heroin abuse.