What should you know about heroin addiction?

What is heroin?

Heroin is an opioid drug made from morphine derived from the seed pod of opium poppy plants cultivated in Mexico, Colombia and Southeast and Southwest Asia. The chemical name for heroin is diacetylmorphine. It is the fastest-acting opiate in the world.

It was first produced in 1898 and was hailed a wonder drug initially for its morphine-like properties. It was used as a powerful treatment for pain relief and analgesic medicine.
In the 1910s, the ‘wonder drug’ abuse was growing rapidly, and heroin addiction was a serious problem. Heroin was declared a narcotic drug, and restrictions were placed on its production, distribution and use. By 1924, legislation imposed a total ban on heroin production for commercial supply. This has not stopped the drug underworld from producing the illicit street drug in clandestine jungle kitchens or laboratories.

Heroin is produced as a white or brownish powder. It is also sold as a sticky black substance called black tar heroin. Street names for heroin include smack, skag, skunk, brown sugar, hell dust or white horse. Heroin mixed with night-time cold and flu medicine is called Cheese, and A-bomb when mixed with marijuana. People mix heroin with crack cocaine, known as speedballing.

How is heroin used?

Heroin users sniff, snort, smoke or inject the drug. It is a highly addictive opioid. Tolerance builds rapidly, and people are at risk of becoming ‘hooked’ on heroin within days or weeks of the first time it is used.

Heroin rapidly enters your central nervous system and binds to opioid receptors found in parts of your brain that regulate feelings of pleasure and pain, control your heart rate, breathing and sleeping, and regulate your behaviour and decision-making abilities.

Signs and symptoms of heroin use disorder?

Repeated heroin use causes uncomfortable short-term side effects as well as life-threatening long-term side effects. The way heroin rapidly binds to opioid receptors in your brain eventually changes your brain’s chemistry structure and function. These brain changes are not easily reversed and can result in permanent brain damage.

People who inject heroin into their veins with needles several times a day develop needle marks, known as tracks. This can cause permanent scarring.

Heroin users are at risk of contracting Hepatitis B, Hepatitis C or HIV if they share dirty needles.

Physical signs and symptoms of heroin use

• warm, flushed skin
• dry mouth, cracked lips
• constricted, pinpoint pupils
• extreme itching
• bruising or track marks at injection sites
• acne, weeping facial sores
• scabs from itching
• skin necrosis, open sores
• extreme weight loss
• slurred, slow or forced speech
• breathing difficulties, shortness of breath
• needle track marks on legs, feet, arms
• poor personal hygiene, dirty hair and body odour
• aggressive, defensive, hostile to others
• agitated, irritable, restless
• anti-social, avoid loved family, friends and social activities
• manipulative, deceitful, lie about drug use and behaviour
• hyperactive, restless
• drowsy, listless, exhausted, nod off easily
• poor work performance, drop school grades
• apathetic, lack motivation
• drug use paraphernalia inc. burned spoons, needles, syringes, glass pipes
• wear long-sleeved shirts and pants in hot weather
• damaged nasal tissue
• collapsed veins at injection sites
• constipation, stomach cramps
• frequent respiratory infections, pneumonia
• liver, heart and kidney disease
• sexual dysfunction
• irregular or ceased menstrual cycles

Psychotherapy

Psychotherapy – talk therapy – forms part of an integrated treatment programme for heroin use disorder, either at an inpatient or outpatient addiction care facility.

Cognitive behavioural therapy (CBT) is one of the most popular talk therapy methods used to treat substance use disorders. It focuses on a person’s behaviour and how they think, feel and view themselves relative to the world around them. CBT explores the relationship between your beliefs, thoughts, feelings and behaviour, and the divide between what you want to do and what you actually do in certain circumstances (trigger moments).

Other popular psychotherapy methods include:

Psychodynamic therapy
Psychodynamic therapy focuses on how certain relationships and life events affect your current feelings, choices and behaviour. The aim is to help you understand and acknowledge repressed emotions and negative feelings and resolve internal mental conflicts to improve your self-esteem, relationships and quality of life.

Dialectical behaviour therapy (DBT)
DBT is similar to CBT, but the goal is to provide people with coping skills to regulate their emotions, make better choices, handle stress, improve relationships and improve their quality of life. DBT was developed initially to treat borderline personality disorder and is now used to treat various mental illnesses, including substance use disorder.

Humanistic/experiential therapy
Humanistic therapy focuses on the whole person and their nature rather than their behaviour. The aim is to identify positive attributes and boost your ability to heal, grow, and self-actualise through self-exploration. Humanistic therapy is effective for people with depression, anxiety, panic disorders, low self-esteem and self-harming tendencies.