Heroin and Opiate Addiction

In 2009, 605,000 Americans age 12 and older had abused heroin at least once in the year prior to being surveyed. Source: National Survey on Drug Use and Health (Substance Abuse and Mental Health Administration web site). The NIDA-funded 2010 Monitoring the Future Study showed that 0.8% of 8th graders, 0.8% of 10th graders, and 0.9% of 12th graders had abused heroin at least once in the year prior to being surveyed. Source: Monitoring the Future (University of Michigan web site.)


Short-term effects of heroin include a surge of euphoria and clouded thinking followed by alternately wakeful and drowsy states. Heroin depresses breathing, and therefore, overdose can be fatal. Users who inject the drug risk infectious diseases such as HIV/AIDS and hepatitis.

Nobody wants to be in pain

As human beings, there are many different kinds of pain: physical pain like aches and burns; and then there is emotional pain like heartache, painful memories, guilt, sadness, insecurity and anxiety. Most any living creature has a very instinctual drive to not hurt or to avoid pain, but it might be said that humans are subjected to many more types of pain than any other known organism.

One of the many less-than-healthy ways that some of us choose to try to remove pain and gain pleasure is by taking alcohol and other drugs. Historically, heroin and other opioids have appeared to many people as a viable means, or even as the only route, to do that very natural thing that all living organisms try to do: avoid pain and feel good.

What is heroin and how does it work?

Heroin and other opioids, like prescription pain-killers, have a very addictive quality to them due largely to how when consumed, they mimic the brain’s natural processes for seeking pleasure. Opioids access and alter the very components that are involved in producing pleasure and removing pain, i.e. the brain’s pleasure center and opioid receptors, dopamine and endorphins. This very rewarding process also affects an individual’s cognitive process – how we think and feel about pain and pleasure, adding a complicated layer to the risk of addiction.

Heroin and other opioids can be injected, smoked, used as a suppository or swallowed. They are central nervous system depressants and have several short-term effects such as: euphoria, sedation, reduction of pain and anxiety, breathing complications and nausea. In addition, there are risky physical effects associated with opiate and heroin addiction and these include: HIV/ AIDS, hepatitis, skin infections, or bacterial or viral infections, collapsed veins, lung infections and death from overdose.

Who gets addicted to heroin and why?

Can you imagine having a magical button that you could push and all of your body’s aches and pains would go away in a matter of seconds? What if your pain was suddenly replaced with a euphoric feeling? What if that same button could take away every insecurity, worry, painful memory and sadness in your life? Sounds too good to be true, right? Well, it is, because the consequences of opioid addiction are often unimaginably scary. Although, the truth is, that for many people who are struggling and even for those who are just young and confused or dealing with self-exploration, the allure of this kind of freedom, this type of reward, this access to so much pleasure, is very, very powerful.

Heroin isn’t just for bikers and homeless people anymore. Anyone can become addicted to heroin: from troubled youth in single parent families to cheerleaders and football players from affluent families; from people with mental health issues to lawyers and judges. In fact, more and more “well-adjusted” young people are becoming addicted to heroin every day. Just as there are as many paths to recovery as there are people, so are there as many reasons why a person becomes addicted to heroin.

Statistically, most people, especially youth, are introduced to heroin and other opioids in the form of prescription pain-killers such as Oxycontin, Vicodin, Percocet, Hydrocodone, Oxycodone and Fentanyl; drugs which when viewed at a molecular level are virtually identical to heroin (heroin was actually invented by the pharmaceutical company, Bayer). Many people are prescribed these medications appropriately for the purpose of relieving physical pain. This is not the only way, however, for an individual to acquire a prescribed opioid. Currently, acquiring prescription opioids is considered an easy task due to the over abundance of prescription pills in our medicine cabinets and society at large.

What this overabundance of prescription pills has done is to take the needle, and thus the stigma, out of opioid addiction and opened it up an entirely new audience to its dangers. Pills come from well-intended family and friends, they are sold to us or shared with us by our peers as a means of relaxing. For a number of people who use opioids, as prescribed or not, addiction is a marked risk and they may form maladaptive and dangerous behaviors, poor emotional and psychological patterns and unhealthy relationships with the drug. As prescription opioids become harder for them to obtain, heroin becomes more and more appealing in terms of cost and effect. Further, as many find out, the lifestyle that heroin addiction brings can be one wrought with danger and despair.

What does it mean to be addicted?

Chronic heroin and other opioid use results, in effect, in the body producing more and more opioid-receptors to meet the needs of the flood of opioids in the system. At the same time the body now believes that it no longer needs to produce its own pleasure-giving and pain-reducing chemicals. This is the point at which we say a person is physically dependent on the drug. The body can no longer function at its normal level without the drug. This dependence leads to painful and often frightening withdrawals when the drug is removed and the body begins the process of figuring out how to live without the extra opioids it has become accustomed to.

Withdrawals: Around 10 hours after a heroin-dependent person has last used heroin they begin to feel anxious or agitated, their eyes begin to tear-up and they begin yawning a lot. They also begin sweating and getting feverish, start to have stomach cramps and diarrhea, begin to have muscle cramps and spasms and experience chills. This gamut of physical and emotional pain and discomfort tends to peak at around three days but can be prolonged for nearly ten days. Many people addicted to heroin describe experiencing their “bones aching” and a feeling that they want to “crawl out of their skin”. The fear of this experience is felt by many who are addicted to be the reason that they get “stuck” in the addiction as they have convinced their mind and body on some level that to not have heroin is akin to dying.

How do I know if I have a problem and what sort of help do I need?

*This is in no way intended as a substitute for professional or medical advice!

If you are worried about your heroin or pill-form opioid use you may already qualify, clinically-speaking, for “opioid abuse”. Any behavior is technically “abusive” if it interferes in your life in any way and yet you continue with it. This could mean that the substance or any behavior that is related to its use leads to fighting with your family or friends, giving up or interfering with things that you previously enjoyed, spending too much money, feelings of guilt, feelings of being out of control, legal issues or many other things. “Abuse” is continuing a behavior despite negative consequences. Only you can decide if a substance or behavior is a problem in your life; it has to come from you, otherwise, change will be superficial and short-lived.

If you are experiencing: physical withdrawals, tolerance to the substance, an inability to cut-down or control your use, spending large amounts of time in activities related to the substance, interference with important things in your life or continued use of the substance despite severe physical or psychological consequences, this is a strong indicator of dependency. This means you may want to consider more immediate professional help and possibly medically assisted detox.

Also remember that, although you may feel like it, very few people actually die from opioid withdrawal (with the exception of Methadone).

There are various treatments and treatment combinations that may be effective for opioid abuse and dependence and these include, but are not limited to, talk therapy (e.g. Cognitive Behavioral Therapy, Motivational Interviewing and therapies which include contingency management), support groups (such as SMART Recovery), medically assisted treatment or replacement therapy (Methadone or Suboxone) and antagonist therapy (such as Vivitrol).

Above all, it is most important that you take action. Reach out. Let someone know that you want to talk. Please, know that you are not alone in this.

*Please remember that if you have not used heroin or other opioids before or have been off of them for a while due to being in jail or rehab, you are especially susceptible to overdose and, potentially, death.

How can SMART Recovery help me stop my heroin (opioid) problem?

SMART Recovery provides its members with tools and support that they can use to help themselves recover from addictions – be it alcohol, or other drugs or negative behaviors. SMART Recovery’s 4-Point Program® is designed to help you overcome your substance abuse problems and quit by:

<> 1. Building & Maintaining Motivation – Identify and keep up with your reasons for positive change. Why do you want to change – what will keep you focused on that goal?2. Coping with Urges – Dealing with urges and cravings is part of recovery. SMART has tools designed to help our members cope with urges and cravings.

3. Managing Thoughts, Feelings and Behaviours – We frequently turn to using drugs either to escape from or to avoid addressing problems. SMART Recovery participants learn problem-solving skills to help them manage challenges along the way.

4. Living a Balanced Life – Addiction can put your life out of balance – you may find yourself opting to engage in your addiction rather than going to work or to school. You may find that things you once enjoyed aren’t fun anymore. SMART helps participants build skills to balance both short and long-term goals, pleasures and needs that have become out of balance.

Where do I go from here?


