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The downward spiral of heroin use

The terrors of heroin and other opiates
The terrors of heroin and other opiates
Photo by Jordan Silverman/Getty Images

From first use onward, using heroin creates a downward spiral in life, love and anything else important to a human being. The recent death of gifted actor Philip Seymour Hoffman and the apparent upsurge in heroin use in Anne Arundel County and other places has highlighted the need for all of us to have an increased awareness of the death trap called heroin use. This article will focus on the short and long-term effects of heroin use and how, for many, heroin use started with a legal prescription. The signs of heroin use will also be discussed.

Heroin is an opioid drug derived from morphine. Prescription opioid pain medications such as Oxycontin and Vicodin when not taken as prescribed can have effects similar to that of heroin. Oftentimes, these prescription opioid pain medications are prescribed secondary to sustaining an injury requiring pain relief. It is well known that pain relief facilitates recovery. It is difficult for the body to recover if it is coping with pain.

All is well if prescription opioid pain medications are taken strictly as prescribed and that the medication does not fall into the hands of someone taking the drug solely to get high. Once “hooked” on prescription opiates some people switch to heroin for many reasons such as the cost of heroin reportedly is less than that of prescription drugs. Research suggests that the abuse of prescription opioid medications by the patient and/or the pilfering and/or illegal purchase of such drugs are many times a first step towards heroin use. The National Institute on Drug Abuse (NIDA), a well respected and well-lead scientific institute, reported that nearly 50% of young people using heroin reported that their use of heroin started via the abuse of prescription opioids.

Following the administration of heroin into the body via injecting, snorting or smoking, it rapidly reaches the brain. In the brain, heroin is converted back to morphine and eventually binds with opioid receptors. These receptors are not only in the brain but also in the body and amongst other duties are involved with the perception of reward and pain. Importantly, some of these receptors control blood pressure and respiration. Heroin overdoses frequently suppress breathing causing death.

After ingesting heroin the short-term effects include a surge of euphoria or pleasure called a “rush” along with dry mouth, a warm flushing of the skin, heaviness in the extremities and fuzzy or clouded cognitive functioning. The experience and severity of symptoms is a function of the amount and how rapidly the drug reaches the brain. The initial euphoric state is quickly followed by a “nod” which is an alternating state of drowsiness and wakefulness. Other reported short-term effects include nausea, vomiting, depressed respiration and spontaneous abortion.

The long-term effects of heroin use include addiction/dependence, collapsed veins, bacterial infections, abscesses, arthritis and other rheumatologic conditions, infections of the lining of the heart and valves and the contracting of infectious diseases such as HIV/AIDS. Another particularly wicked long-term side effect for some users is the onset of withdrawal symptoms between using episodes. Withdrawal can begin within a few hours of last use.

The symptoms of withdrawal can include muscle and bone pain, restlessness, insomnia, diarrhea, vomiting, cold flashes inducing goose bumps and a craving to use heroin to relieve withdrawal symptoms and feel normal again. Eventually chronic users use the drug mostly to avoid withdrawal symptoms. NIDA and other researchers have reported that the physical withdrawal from heroin in otherwise healthy adults is not fatal but intensely uncomfortable and unpleasant.

What social signs can you look for in a person who is abusing heroin or prescription opioid medications? The primary observable symptom is a dramatic change in the person’s style of life. Such a change may be in performance at work or school. Are work assignments not being completed on time or done poorly? Are grades in school suddenly dropping with no apparent reason or explanation? Many times the person is not maintaining their personal hygiene compared to how they did in the past. Personal hygiene to this person is just not important or a priority anymore.

People using heroin, abusing prescription opiates such as Oxycontin or illicit drugs in general need money. Are items in the home or office coming up missing? Stealing something people value and selling it is quick money. Is the person behaving recklessly? Do they seem not to care about the consequences of their actions? Have they withdrawn from friends and family? Have they stopped enjoying activities you know they enjoyed in the past? These can all be social cues that a person is abusing heroin, prescription opioids, or other illicit drugs.

Other signs to look for include the following: • Possession of drug paraphernalia • Runny nose • Constant sniffing • Slurred speech • Needle marks on arms • Uncharacteristic displays of hostility • Lack of motivation or planning for the future

As discussed above, look for signs that suggest a dramatic change from usual behavior. It is important to note as well that some of these signs can indicate a mental illness or in some cases adolescent behavior. In any case, if you approach the person in question do so understanding that they most likely are in need of some sort of attention many times from professionals.

Heroin use leading to opiate dependence and addiction is a scientifically identified and recognized chronic brain and social disorder. Shortly after regular use begins the brain changes and will manifest in the signs discussed above. There is no cure in sight for addiction but long-term medical/pharmacological/behavioral treatment exists and is helpful in minimizing relapse, limiting the disease’s adverse effects and improving the patient’s day-to-day functioning.

A useful way of looking at and understanding opiate addiction is that it is similar to other diseases such as diabetes and hypertension. All three are medical diagnoses. The person in question needs treatment and sensitivity from all of us that he or she is in the throes of a medical disease deserving of our empathy and care. There’s no doubt that heroin use begins a downward spiral in life and the only means out, short of death, is treatment and a caring society.

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