Heroin is one of the most dangerous types of drugs, as it causes serious issues not only on the psychological level, but its side effects extend to the health level as well, which prompted governments and international organizations to implement heroin addiction treatment and limit its spread.
Heroin is causing huge health and social disasters globally, with an estimated 61 million people using opioids, including heroin, of which 120,000 die each year from an opioid overdose, most of which are heroin-related, underscoring the critical need for heroin addiction treatment.
What is heroin?
Heroin consists of a chemical compound called (diacetylmorphine – diacetylmorphine), which is considered a dangerous drug that causes severe addiction, and its use may lead to physical and psychological dependence with a strong desire to use, belongs to the class of opioid drugs that also includes morphine and codeine, it is manufactured from the Asian poppy plant, where heroin abuse leads to a feeling of euphoria and relief from physical pain.
There are different forms of heroin use, including inhalation, smoking, and intravenous injection. Intravenous users are at high risk of contracting infectious diseases such as human immunodeficiency virus (HIV), viral hepatitis B or C, and bacterial infections of the skin, blood, and heart lining (endocarditis).
How does heroin work in the body?
After heroin enters the body, it turns into morphine in the brain, which binds to opioid receptors, resulting in pain relief and euphoria, and increases the release of dopamine in large quantities from the brain’s reward centers.
The danger of chronic heroin use lies in the development of pharmacological tolerance, where the body reduces its response to the usual dose, prompting the user to increase the dose to obtain the desired effect, and when stopping use, the addict will experience withdrawal symptoms that are severe and dangerous to their mental health.
Heroin addiction symptoms and its effects on the body
The Heroin addiction symptoms and effects vary depending on many factors, including the strength of the dose, the size of the person, the person’s health and psychological condition, in addition to any medications or drugs taken at the same time, as the effects of heroin increase when taking sleeping pills and tranquilizers or using alcohol. Drug users feel euphoria when using heroin, followed by a number of short-term effects such as:
- A wave of pleasant emotions and physical pain relief
- Heaviness in the limbs
- Low body temperature
- Pupil constriction
- Loss of libido
- Dry mouth
Heroin addiction symptoms and effects do not involve short-term use, but long-term use includes:
- Chronic constipation
- Pneumonia
- Skin abscesses
- Liver and kidney disease
- Fertility issues
- Menstrual cycle disorders
- Erectile dysfunction
In addition to the above, heroin addiction symptoms include psychiatric disorders characterized by chronic traumatic encephalopathy (CTE), such as:
- Continuing to use despite negative consequences
- Heroin use is becoming the patient’s primary life focus
- Declining job and social performance
- Impaired decision-making ability
How to perform heroin addiction treatment
There are a variety of effective heroin addiction treatment methods, these methods aim to restore normal brain functions and normal behavior of the patient, and include pharmacotherapy and psychotherapy, as both methods have proven their effectiveness in treating heroin addiction, but combining the two methods with each other has provided excellent and more effective results for many patients.
Pharmaceutical Heroin Addiction Treatment
Scientific studies have proven the effectiveness of pharmacotherapy in eliminating the symptoms of heroin addiction, as it increases the effectiveness of the treatment program and reduces heroin use, aggressive behavior and the transmission of infectious diseases, pharmacotherapy removes toxins, which is useful in reducing the desire and physical symptoms that push the patient to relapse, there are 3 types of medications used in the treatment of heroin addiction, namely:
- Agonists: Activate opioid receptors.
- Partial agonists: Partially activate the receptor.
- Antagonists: Block opioid receptors.
The following are some of the medications used in heroin addiction treatment:
- Methadone: A synthetic opioid agonist drug that blocks the effects of heroin for 24 hours, it is taken orally and reaches the brain slowly, relieving the euphoria while preventing withdrawal symptoms, Methadone is only available through approved treatment programs, where it is distributed to patients daily, Methadone has been used since the 1960s and remains an appropriate treatment option for patients who do not respond to other medications.
- Buprenorphine: A partial opioid agonist that relieves the strong desire to use without euphoria or any side effects, Suboxone is a new type of buprenorphine, taken orally or sublingually, as it contains naloxone, which is an opioid antagonist to prevent the patient from trying to inject, if he tries to inject naloxone, withdrawal symptoms will appear, which does not occur when taken orally.
- Naltrexone: An opioid antagonist that blocks the effects of opioids and does not cause addiction or sedation, nor does it lead to physical dependence.
Psychological heroin addiction treatment
A range of psychotherapies is available in heroin addiction treatment, and psychotherapy is provided either on an outpatient or residential basis, including contingency management and cognitive-behavioral therapy, which are most effective when combined with medication.
Emergency management
Emergency management relies on a voucher-based reward and incentive system, whereby for negative drug test results, the patient receives points, which can be redeemed for items that support a healthy lifestyle.
Cognitive-behavioral therapy in heroin addiction treatment
CBT modifies the patient’s expectations and behavior related to substance abuse, while enhancing skills to cope with various life stressors.
How long does it take for heroin to leave the body?
The duration of heroin’s stay in the body varies based on multiple factors, including those related to the method of use, including those related to the nature and size of the patient’s body, and the duration of its stay in the body’s systems also varies, as heroin is detected through a drug test, the following are the types of heroin detection tests:
- Blood tests: The most accurate test, used in emergencies and investigations, can detect heroin after use from a few hours to a day.
- Urine tests: Detects heroin metabolites, used in medical settings, detects heroin for up to 3 days after use
- Hair tests: Detects chronic and long-term heroin use and is able to detect heroin after 90 days of use.
The metabolic rate of heroin controls how long it remains in the patient’s body and is the main factor in understanding its addictive properties, as the metabolic rate is affected by many factors that determine how quickly the body processes the substance in order to excrete it, including the following:
- Genetic structure: Genetic makeup varies from person to person, and this difference leads to different enzyme levels between patients, which affects the rate of metabolism.
- Age: The rate of metabolism decreases with age, leading to increased longevity of heroin and its metabolites in the elderly.
- Weight and hydration level: These individual factors affect the excretion of substances from the body and thus affect the longevity of heroin.
- Health status: Liver and kidney function largely control substance metabolism, and diseases affecting these organs can slow down metabolism.
- Regular use: Leads to drug tolerance and changes the body’s ability to metabolize the drug.
Withdrawal symptoms and how to deal with them
Sometimes heroin withdrawal can be safely eliminated in the patient’s home if sufficient support is available, but home withdrawal is contraindicated in the presence of unstable medical conditions such as heart disease and unstable psychological conditions such as severe mental disorders, and there are some cases that require special precautions such as pregnancy and multiple drug addiction, there are several withdrawal symptoms when treating heroin addiction, including physical symptoms such as:
- Insomnia and headaches
- Nausea, vomiting, and loss of appetite
- sweating and chills
- diarrhea
- Rapid heartbeat and high blood pressure
- Muscle and joint pain
These include psychological symptoms such as:
- Depression
- Mood swings
- A strong desire to use
- Anxiety, stress, and nervousness
Strategies for dealing with withdrawal symptoms
One of the most important ways to treat heroin is to know how to deal with its withdrawal symptoms, as it is necessary to provide continuous care by doctors by providing information about how heroin withdrawal works and providing psychological counseling when needed, and giving the patient a complete diet by drinking enough water daily (2-3 liters) and eating regular and healthy snacks while avoiding caffeine and alcohol, in addition to medications to help relieve symptoms such as anti-vomiting, anti-diarrhea, and painkillers.
It is also important to monitor the patient on a daily basis and adjust the treatment plan according to the patient’s response.
Community and family support play a strong role in the treatment and elimination of heroin addiction, as the chance of recovery increases by 40-60% when there is a nurturing and supportive environment for the patient, and the most prominent roles include the following:
- The role of the family: Through emotional understanding, minimizing feelings of isolation, participating in treatment by attending family therapy sessions to learn how to deal with triggers and relapses, as well as providing a safe environment by removing drugs from the home and controlling access to potentially addictive medications.
- Community role: By providing support groups that offer positive role models and different experiences of the recovery process, and providing aftercare through community-based follow-up programs that prevent relapse.
The importance of interactive and community-based programs in treatment and recovery
Interactive and community-based programs play a crucial role in the treatment of heroin and drug addiction in general, especially for psychiatric disorders and for social rehabilitation:
- Strengthening social support
- Motivating adherence to treatment
- Building a Positive New Identity
- Minimizing relapse
- Empowering the individual
The patient must be fully aware of the dangers of heroin and other drug addiction and avoid factors that lead to relapse after heroin addiction treatment, as the family and community must provide assistance in the patient’s treatment and help him regain his normal life.
Sources:
- Centers for Disease Control and Prevention (2023, March 21). Heroin. U.S. Department of Health & Human Services
- National Institute on Drug Abuse (2021, April). Heroin drug facts. National Institutes of Health
- Drug Enforcement Administration (n.d.). Heroin. U.S. Department of Justice
