In 2016, the National Survey on Drug Use and Health reported that 948,000 Americans had used heroin in the past year. This number has continued to climb since the report was filed in 2007. Even more concerning is the fact that the number of first-time users of heroin has risen dramatically; in 2006, about 90,000 people reported having tried heroin for the first time, but by 2016, this number had almost doubled to 170,000. Heroin is clearly becoming a bigger problem each year in the United States.
What is Heroin?
Heroin is formed from morphine, which is made from poppy seeds. It is a highly addictive drug and is illegal to make, sell, or use in the United States. Users smoke, snort, or inject heroin. The attraction to heroin is many-faceted. First, it has an unusually short half-life. Its half-life can be between eight and 30 minutes. The half-life of a drug is the amount of time it takes for half of the substance to be flushed from the body. The exact half-life for each user will vary, based on various factors such as:
- Height and weight
- Percent of body fat
- Liver and kidney health
- Quality of the heroin
- The individual’s metabolism rate
- Amount of drug taken
Even though heroin has a short half-life, its effects last longer than drugs such as cocaine and meth. Heroin produces a fast and euphoric high that is followed by sleepiness, relaxation, and contentment.
Tests for Heroin Use
There are four different lab tests approved by the FDA for testing for heroin use. These are:
- Hair follicle
Each test has different uses and is used in different situations.
The standard for short-term heroin use is the urine test. This test is generally done in a laboratory, as addicts will occasionally try to void the drug test by using another person’s or an animal’s urine. They may also try to dilute the urine with water. Sometimes, the court will order that the addict has to be supervised when giving a urine test to ensure they are not able to tamper with the sample. In most cases, the patient urinates into a cup, and the lab analyzes the liquid. Heroin can be detected in a person’s urine for up to two days after ingesting it. Some labs have even reported finding traces of heroin seven days after ingestion.
For a heroin blood test, the patient must go to a medical laboratory. There, a lab tech will draw a sample of blood out of their arm for analysis. Due to the short half-life of heroin, a blood test is generally not the first type of test ordered. Heroin is no longer detectable in a person’s blood after about five or six hours of ingesting it.
For the saliva test, the patient spits into a cup, and the liquid is analyzed. As with the blood test, the short half-life of heroin makes this test only useful if the addict has recently ingested heroin. After just a few hours, there will no longer be evidence of drug use.
Hair Follicle Test
For long term detection, a medical lab can perform a hair follicle test. This entails obtaining a hair sample from the patient. The sample must include the hair follicle, or root, of the hair. This test can detect heroin for up to three months after the last usage. Sometimes a judge may order these tests to ensure that an addict on probation is following the terms of their sentence.
Many different factors can affect a lab test for heroin use. Even a person’s metabolic rate can affect whether the lab will pick up on heroin use or not. New tests are being researched that can detect heroin for much longer. These tests look at heroin metabolites instead of the actual heroin. Metabolites stay in the system for much longer.
Heroin is more easily detected in a long-term and/or heavy user. Excessive use of the drug will cause the drug to accumulate in a person’s fatty tissues. Fat tissue holds onto the substance much longer than bodily fluids. Tests that can detect heroin in tissue are still evolving.
Effects of Heroin Use
There are both short-term and long-term effects of using heroin. Short-term effects include:
- Warm flushing of the skin
- Dry mouth
- Nausea and vomiting
- Severe itching
- Heavy feeling in the extremities
- Cloudy mind
- Slower breathing
- Slower heart rate
The lowering of a person’s heart rate and breathing can be dangerous. It can lead to a loss of consciousness, coma, and death. These effects are why users can die from an overdose so easily. First-time users who are not familiar with the effects are also more at risk of dying.
When a user has been on heroin for a while, they will start to exhibit symptoms of long-term use. These may include:
- Difficulty making decisions
- Inability to regulate behavior
- Becoming easily stressed and not having coping skills for stress
Heroin use causes actual physical and physiological changes in the brain. These changes cause an imbalance in both neuronal and hormonal systems. Once these changes occur, the physical dependence on heroin is extremely strong. Heroin is very addictive, and the reversal of this addiction can be difficult.
Treatment for Heroin Addiction
Some heroin users form a chronic relapsing disease that makes them seek heroin over everything else in life. They will seek a hit no matter what the consequences are. Aggressive treatment is the only way out for these users. Heroin addicts will need quite a bit of aftercare to help them avoid falling back into addiction.
In order to successfully treat heroin addiction, users must undergo both medical and behavioral therapies. When a user first quits using heroin, they will experience severe withdrawal symptoms. If the user is not in a safe environment when these symptoms hit, they are at risk for physical harm and the risk of relapsing.
When a heroin user is in detox, various medications will help them get through the withdrawal symptoms. While these medications do not cure the addiction itself, it helps the addict make it through the withdrawal period. These medications may include:
- Methadone: Also known as Dolophine or Methadose, methadone is one of the oldest medications used for opioid addictions. Since the 1960s, methadone has been used in the United States to treat heroin addicts. It is only available through treatment programs, where it is normally administered daily. It works by dampening the high created by heroin use and easing the symptoms of withdrawal.
- Buprenorphine: Called Subutex or Suboxone, buprenorphine helps to relieve intense drug cravings while not recreating the high. Suboxone contains naloxone, a well-known opioid antagonist. If a user were to inject Suboxone, it would immediately cause symptoms of withdrawal. However, if the user is given a controlled dose each day orally, it will ease the symptoms of withdrawal instead. Until 2016, buprenorphine was only available orally. Now, however, the FDA has approved both a six-month subdermal implant and a monthly injection. This makes it easier for the addict to receive the medication if taking it every day is difficult.
- Naltrexone: Naltrexone is another opioid antagonist that blocks the opioid from working. It is not addictive and does not cause sedation in the patient. It is formulated to take daily, however, and many patients have had trouble adhering to the daily treatment plan. In 2010, the FDA approved an injectable form of naltrexone called Vivitrol that can be injected once a month and has increased compliance.
The exact combination and dosages used to treat a heroin addiction are based on the individual’s usage and other physical and physiological traits, such as height and weight. The doctor may need to adjust dosages until they find the combination that works. Usage of these medications requires supervision by a medical provider. If an addict is in a treatment center, the doses will be regulated and given by nurses. However, some of these medications can also be taken in an outpatient setting.
- Behavioral Therapy: Research has shown over and over that any opioid addiction is best treated by using both medications and behavioral therapy. One without the other is never as effective. For initial treatment, addicts may require an inpatient program with intense therapy. Eventually, they may be able to transition to an outpatient program.
- Contingency Management: In a large study in the United States, it was shown that addicts treated with contingency management were more likely to complete their programs and maintain abstinence from their drug of choice. Contingency management is a type of positive behavior reinforcement where the patient receives an incentive for meeting certain standards.
For instance, they may earn a voucher for each negative drug test during the 12 weeks of treatment. These vouchers can then be traded in for cash or other rewards at the end of the treatment program. Some programs may choose to do prize drawings instead of cash or other rewards. Rewards may increase in size for longer periods of abstinence.
- Cognitive-Behavioral Therapy: The goals of cognitive-behavioral therapy are to teach a patient how to understand their emotions and distinguish healthy from unhealthy thoughts and feelings. A person who has become addicted to drugs often has emotional issues that need to be worked on. Sometimes these issues have been lingering from childhood, and sometimes they are more recent. Someone who has never learned coping mechanisms for grief, trauma, and stress are more likely to use drugs to dull these feelings. Cognitive-behavioral therapy helps a person identify these feelings and learn ways to deal with them. There are various ways these therapies can manifest. Group counseling and one-on-one counseling may both prove to be helpful. Both inpatient and outpatient programs use cognitive-behavioral therapies.
Inpatient vs. Outpatient Treatment
Family members of a heroin addict may wonder which type of treatment is more beneficial for their loved one: a residential program or outpatient treatment. A residential program means the addict lives in the treatment center and receives both medical and behavioral therapies. A medical professional will determine how long the addict should stay in the treatment center. A judge may also order residential treatment in some court cases.
Outpatient treatment consists of both medical and behavioral therapies as well, but the addict can continue to live at home. This is less disruptive to their life, as it enables them to continue to work and go to school. If they have a supportive family and social structure, an addict may benefit from an outpatient treatment plan. However, if they are more likely to slip up around certain people in their lives, they may need to be removed from their home for a time to receive proper treatment.
Granite Recovery Centers has been responsible for changing the lives of many alcohol and drug addicts in their state-of-the-art treatment centers. We offer a unique blend of evidence-based curriculums with a 12-step program. Both medical and behavioral therapies work together to achieve success, no matter what the patient’s backstory is. Granite Recovery Centers offers both inpatient and outpatient options, as well as extensive mental health treatments.
If you or a loved one are suffering from heroin addiction, today is the day to take the first step. Give Granite Recovery Centers a call to talk to an experienced and empathetic admissions professional. He or she can answer any questions you may have about treatment options, residential programs, and insurance. Drug addictions can have devastating effects on the user and their family. Granite Recovery Centers has been a beacon of light and hope for addicts and their loved ones for over 10 years.