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What is heroin?
Where does heroin come from?
What are other names for heroin?
How is heroin used?
What are the short-term effects of taking heroin?
What are the long-term effects of taking heroin?
What are the treatments for heroin addiction?
Where can I buy a home drug test for heroin?
Where can I find
a substance abuse facility for heroin?
What is heroin? (top)
Heroin is an illegal,
highly addictive drug. It is both the most abused and the most rapidly
acting of the opiates.
Where does heroin
come from? (top)
Heroin is processed
from morphine, a naturally occurring substance extracted from the
seedpod of the Asian poppy plant.
What are other names
for heroin? (top)
Street names for
heroin include "smack," "H," "skag," and "junk." Other names may refer
to types of heroin produced in a specific geographical area, such as
"Mexican black tar."
How is heroin used?
Heroin can be
injected, smoked or snorted.
What are the
short-term effects of taking heroin? (top)
Soon after injection
(or inhalation), heroin crosses the blood-brain barrier. In the brain,
heroin is converted to morphine and binds rapidly to opioid receptors.
Abusers typically report feeling a surge of pleasurable sensation - a
"rush." The intensity of the rush is a function of how much drug is
taken and how rapidly the drug enters the brain and binds to the natural
opioid receptors. Heroin is particularly addictive because it enters the
brain so rapidly. With heroin, the rush is usually accompanied by a warm
flushing of the skin, dry mouth, and a heavy feeling in the extremities,
which may be accompanied by nausea, vomiting, and severe itching.
After the initial
effects, abusers usually will be drowsy for several hours. Mental
function is clouded by heroin's effect on the central nervous system.
Cardiac function slows. Breathing is also severely slowed, sometimes to
the point of death. Heroin overdose is a particular risk on the street,
where the amount and purity of the drug cannot be accurately known.
What are the
long-term effects of taking heroin? (top)
One of the most
detrimental long-term effects of heroin use is addiction itself.
Addiction is a
chronic, relapsing disease, characterized by compulsive drug seeking and
use, and by neuron-chemical and molecular changes in the brain. Heroin
also produces profound degrees of tolerance and physical dependence,
which are also powerful motivating factors for compulsive use and abuse.
As with abusers of any addictive drug, heroin abusers gradually spend
more and more time and energy obtaining and using the drug. Once they
are addicted, the heroin abusers' primary purpose in life becomes
seeking and using drugs. The drugs literally change their brains and
dependence develops with higher doses of the drug. With physical
dependence, the body adapts to the presence of the drug and withdrawal
symptoms occur if use is reduced abruptly. Withdrawal may occur within a
few hours after the last time the drug is taken. Symptoms of withdrawal
include restlessness, muscle and bone pain, insomnia, diarrhea,
vomiting, cold flashes with goose bumps ("cold turkey"), and leg
movements. Major withdrawal symptoms peak between 24 and 48 hours after
the last dose of heroin and subside after about a week. However, some
people have shown persistent withdrawal signs for many months. Heroin
withdrawal is never fatal to otherwise healthy adults, but it can cause
death to the fetus of a pregnant addict.
dependence and the emergence of withdrawal symptoms were once believed
to be the key features of heroin addiction. We now know this may not be
the case entirely, since craving and relapse can occur weeks and months
after withdrawal symptoms are long gone. We also know that patients with
chronic pain who need opiates to function (sometimes over extended
periods) have few if any problems leaving opiates after their pain is
resolved by other means. This may be because the patient in pain is
simply seeking relief of pain and not the rush sought by the addict.
What are the
treatments for heroin addiction? (top)
A variety of
effective treatments are available for heroin addiction. Treatment tends
to be more effective when heroin abuse is identified early. The
treatments that follow vary depending on the individual, but
methadone, a synthetic opiate that blocks the effects of heroin and
eliminates withdrawal symptoms, has a proven record of success for
people addicted to heroin. Other pharmaceutical approaches, such as
buprenorphine, and many
behavioral therapies also are used
for treating heroin addiction. Buprenorphine is a recent addition to the
array of medications now available for treating addiction to heroin and
other opiates. This medication is different from methadone in that it
offers less risk of addiction and can be prescribed in the privacy of a
doctor's office. Buprenorphine/naloxone (Suboxone) is a combination drug
product formulated to minimize abuse.
has been used for more than 30 years to effectively and safely treat
opioid addiction. Properly prescribed methadone is not intoxicating or
sedating, and its effects do not interfere with ordinary activities such
as driving a car. The medication is taken orally and it suppresses
narcotic withdrawal for 24 to 36 hours. Patients are able to perceive
pain and have emotional reactions. Most important, methadone relieves
the craving associated with heroin addiction; craving is a major reason
for relapse. Among methadone patients, it has been found that normal
street doses of heroin are ineffective at producing euphoria, thus
making the use of heroin more easily extinguishable.
Methadone's effects last four to six times as long as those of heroin,
so people in treatment need to take it only once a day. Also, methadone
is medically safe even when used continuously for 10 years or more.
Combined with behavioral therapies or counseling and other supportive
services, methadone enables patients to stop using heroin (and other
opiates) and return to more stable and productive lives. Methadone
dosages must be carefully monitored in patients who are receiving
antiviral therapy for HIV infection, to avoid potential medication
Buprenorphine and other
Buprenorphine is a particularly
attractive treatment for heroin addiction because, compared with other
medications, such as methadone, it causes weaker opiate effects and is
less likely to cause overdose problems. Buprenorphine also produces a
lower level of physical dependence, so patients who discontinue the
medication generally have fewer withdrawal symptoms than do those who
stop taking methadone. Because of these advantages, buprenorphine may be
appropriate for use in a wider variety of treatment settings than the
currently available medications. Several other medications with
potential for treating heroin overdose or addiction are currently under
investigation by NIDA.
In addition to methadone and buprenorphine, other drugs aimed at
reducing the severity of the withdrawal symptoms can be prescribed.
Clonidine is of some benefit but its use is limited due to side effects
of sedation and hypotension. Lofexidine, a centrally acting alpha-2
adrenergic agonist, was launched in 1992 specifically for symptomatic
relief in patients undergoing opiate withdrawal. Naloxone and naltrexone
are medications that also block the effects of morphine, heroin, and
other opiates. As antagonists, they are especially useful as antidotes.
Naltrexone has long-lasting effects, ranging from 1 to 3 days, depending
on the dose. Naltrexone blocks the pleasurable effects of heroin and is
useful in treating some highly motivated individuals. Naltrexone has
also been found to be successful in preventing relapse by former opiate
addicts released from prison on probation.
Although behavioral and pharmacologic
treatments can be extremely useful when employed alone, science has
taught us that integrating both types of treatments will ultimately be
the most effective approach. There are many effective behavioral
treatments available for heroin addiction. These can include residential
and outpatient approaches. An important task is to match the best
treatment approach to meet the particular needs of the patient.
Moreover, several new behavioral therapies, such as contingency
management therapy and cognitive-behavioral interventions, show
particular promise as treatments for heroin addiction, especially when
applied in concert with pharmacotherapies. Contingency management
therapy uses a voucher-based system, where patients earn "points" based
on negative drug tests, which they can exchange for items that encourage
healthy living. Cognitive-behavioral interventions are designed to help
modify the patient's expectations and behaviors related to drug use, and
to increase skills in coping with various life stressors. Both
behavioral and pharmacological treatments help to restore a degree of
normalcy to brain function and behavior, with increased employment rates
and lower risk of HIV and other diseases and criminal behavior.
programs aim to achieve safe and humane withdrawal from opiates by
minimizing the severity of withdrawal symptoms and other medical
complications. The primary objective of detoxification is to relieve
withdrawal symptoms while patients adjust to a drug-free state. Not in
itself a treatment for addiction, detoxification is a useful step only
when it leads into long-term treatment that is either drug-free
(residential or outpatient) or uses medications as part of the
treatment. The best documented drug-free treatments are the therapeutic
community residential programs lasting 3 to 6 months.
Opiate withdrawal is
rarely fatal. It is characterized by acute withdrawal symptoms which
peak 48 to 72 hours after the last opiate dose and disappear within 7 to
10 days, to be followed by a longer term abstinence syndrome of general
malaise and opioid craving.
to buy home test kits for heroin.
Where can I find
a substance abuse facility for heroin?
Click here for a
National Substance Abuse Treatment Facility Locator.