Long-term Effects of Heroin

Heroin is an illicit, semi-synthetic variation of morphine with no legitimate medical use. The potent and extremely addictive opiate is at the epicenter of hard-core drug culture, where it is heavily abused and routinely hustled on the street. Heroin’s devastating long-term effect on the human body and brain—and dreaded reputation—make it both highly sought after and feared by those seeking the ultimate high.

STATISTICAL OVERVIEW

Since the late 1990s, when pharmaceutical companies falsely assured the American public that prescription painkillers were safe—the opiate epidemic has soared to record proportions.  Although increasing state and federal regulations have been implemented to ensure public safety by limiting trafficking and diversion, the abuse of legal and illicit opiates such as heroin continues to surge, frequently the end result of gateway narcotics like OxyContin or Vicodin. At present, a profitable black market utilizing the dark web and other means of smuggling   continues to thrive. To many opiate addicts, heroin represents a forbidden fruit, highly appealing and dangerously unpredictable. The following statistics are particularly relevant:

• The National Survey on Drug Use and Health (NSDUH) reports that between 2015 in 2016, approximately 950,000 Americans used heroin.
• Within that population, approximately 170,000 were first-time heroin users, the majority being emotionally, physically, and psychologically fragile young adults ages 18-25.
• According to the National Institute on Drug Abuse (NIDA), heroin abuse resulted in approximately 15,500 overdose deaths in 2017.
• According to the United Nations Office on Drugs and Crime (UNODC), approximately 500,000 Americans are currently addicted to heroin.

LONG-TERM IMPACT ON THE BODY

Although the human body is incredibly resilient by nature, it is not designed to handle the damage inflicted upon it by a drug as deadly and unpredictable as heroin. Even otherwise perfectly healthy users frequently find their physical health suffering soon after becoming addicted to the drug, and some experience debilitating and potentially lifelong complications including:

• Blood-Borne Diseases—the National Institute on Drug Abuse (NIDA) reports that the sharing of heroin needles may cause human immunodeficiency virus (HIV), hepatitis B, hepatitis C, and a variety of other blood-borne diseases. In many users, these diseases are unintentionally transmitted to sexual partners and a lifelong cause of pain and suffering.
• Poor Oral Health—heroin addiction causes a greater occurrence of oral health problems including periodontal disease and poor general hygiene. Heroin significantly reduces saliva production, resulting in decreased bone density and mass, unhealthy gums, and numbed oral sensation. This, in turn, leads to missing or decayed teeth, foul breath, and painful sores or bleeding abscesses that are difficult to treat. Poor oral health has also been linked to multiple diseases targeting other areas of the body. In fact, recent research has implicated poor oral health in memory loss and the development of Alzheimer’s disease.
• Cardiovascular Distress—impure varieties of heroin sold on the street have been implicated in serious bacterial infections of the heart lining, valves, and surrounding blood vessels. Over time, this degenerative process may cause permanent scarring, collapsed veins, and severe cardiovascular distress. In some cases, it may result in a heart attack and/or death.
• Prematurely Aged Skin—heroin’s toxic effect on skin is legendary. The rapid weight loss it triggers depletes collagen in the face, resulting in a sunken, prematurely aged appearance. Long-term users may also develop dark circles under the eyes accompanied by pale, jaundiced, or wrinkled skin. Experts frequently describe heroin-afflicted skin as sickly and diseased in both health and appearance.
• Fetal Damage—heroin addiction routinely causes fetal damage and deadly pregnancy complications. Pregnant women who abuse heroin exponentially increase the likelihood of heroin-dependence in the baby and set the stage for lifelong dysfunction. Heroin addiction may also cause the following adverse health effects:
• Loss of appetite
• Burn marks on the fingers
• Constricted pupils
• Severe constipation
• Achy limbs
• Flu-like symptoms
• Dry mouth
• Psychosis
• Disorientation
• Chronic cough
• Insomnia
• Extreme fatigue
• Coma and/or death

LONG-TERM IMPACT ON THE BRAIN

The human brain is analogous to a giant factory composed of opiate receptors, neural pathways, and fixed structures. This factory is biologically programmed to work in synchronistic harmony and provide successful daily function. However, when it is disrupted by chemical manipulation and synthetic poisons, successful function inevitably breaks down. The heroin “high”—known for its overwhelming euphoria—is the result of artificially elevated neurotransmitter levels, particularly dopamine and serotonin.  Relative to other opiates, heroin penetrates the blood-brain barrier with greater speed (when injected) and creates a higher proclivity for addiction. Over time, users require higher doses and more frequent uses of the drug in order to sustain the same fleeting benefits. The following information highlights the cumulative effects of heroin addiction on the human brain:

• Brain Structure and Neurological Damage—in long-term users, the heroin-hijacked brain becomes unstable, depleted of vital nutrients and scarred by neurological and structural damage. Although the brain is adaptable and capable of self-regeneration—a process called “neuroplasticity”—heroin destroys structural and cellular integrity. One of the initial brain structures damaged by heroin addiction is the medial temporal lobe. This brain region helps facilitate auditory perception as well as the conscious recall of facts and events. Once damaged, accelerated aging and diminished cognitive capacity become apparent.  
• The Prefrontal Cortex (PFC)—considered by neuroscientists to be a human supercomputer, the prefrontal cortex facilitates a number of key cognitive functions including logical thinking, planning, judgment, and impulse control. These capacities, known as “executive functions,” are essential for rational, responsible adult behavior. Without them, autonomous functioning becomes difficult and healthy decision-making nearly impossible. Even in mild cases, impaired executive functioning leads to cognitive deficits, impulsive behavior, and social, professional, and legal repercussions.
• Impaired Judgment and Criminality—heroin users are routinely arrested for major lapses in judgment—the result of impaired cognition. DUIs, DWIs, reckless driving, assault, battery, and related charges are all more likely to occur under the influence of heroin. Prisons, jails, and mental health institutions all across America—and the world—are filled with otherwise wonderful human beings who are suffering the lifelong consequences of heroin addiction. Even when heroin addiction doesn’t lead to legal problems, it is associated with the development of numerous neurological and personality disorders that prove equally, if not more, devastating. These disorders, including anti-social personality disorder, are extremely difficult to manage and capable of totally ruining lives.

TREATMENT METHODS

Users suffering from various stages of heroin addiction require professional substance abuse treatment and behavioral healthcare services. Without the benefit of these services, many heroin addicts become victims of increased mortality rates. The following describes popular treatment options and their respective benefits:

• Inpatient treatment—the most popular and effective medically managed treatment option is known as residential, or inpatient, The highly trained clinical staff in residential facilities provides round-the-clock monitoring and individualized client care. Inpatient programs typically last for approximately 30 – 90 days depending upon client needs. Inpatient treatment involves one-on-one as well as group therapy sessions, and medication-assisted treatment (MAT) geared toward physiological and psychological stabilization.
• Outpatient treatment—this treatment method is offered on a strictly non-residential basis in a variety of public and private settings and represents an excellent option for clients with demanding personal and/or professional schedules. As with inpatient treatment, group therapy, individual sessions, and MAT are considered the primary interventions used to treat the underlying causes of heroin addiction.
• Medication-assisted treatment (MAT)—MAT is a widely used industry term that describes the combination of Food and Drug Administration (FDA) approved pharmacological interventions with psychotherapy. In most cases, heroin addiction cannot be effectively treated using only medication or therapy and requires a comprehensive approach. Suboxone, methadone, and vivitrol are among the many evidence-based medications used to successfully treat heroin addiction. Additional medications designed to treat co-occurring mental health disorders—such as generalized anxiety disorder (GAD) and major depressive disorder (MDD)—may also be incorporated into the MAT regimen based upon individual diagnoses.

A BRIGHTER FUTURE

Heroin addiction is a chronic, relapsing disease that knows no socioeconomic boundaries. Anyone, at any time, can find themselves addicted to heroin and in need of help. If you or a loved one are struggling with heroin addiction and in need of help—call a substance abuse professional today. Delaying or avoiding treatment is considered extremely dangerous and leads to unfavorable, and sometimes deadly, outcomes. The same applies to self-guided treatment or at-home detox not managed by a team of qualified medical professionals and licensed clinicians.

And remember, heroin overdose is considered a medical emergency. In the event of an overdose, immediately call 911 or seek treatment at the nearest hospital emergency room (ER).

For more about heroin addiction and recovery, check out these related articles:

• “What is a Speedball? Cocaine and Heroin’s Deadly Combination”
• “Why Early Intervention for Addiction is Critical”
• “Heroin Detox: What You Need to Know”
• “Preventing an Opiate Overdose with Naloxone”

Sources:

1. International Journal of Drug Policy. Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study.  August, 2017
2. American Journal of Preventative Medicine. Geographic Variation in Opioid and Heroin Involved Drug Poisoning Mortality Rates. Dec, 2017
3. Harm Reduction Journal. Policy makers ignoring science and scientists ignoring policy: the medical and ethical challenges of heroin treatment. April, 2006
4. Journal of Emergency Nursing. The Heroin Epidemic and Emergency Nursing. Nov, 2014.
5. Journal of Affective Disorders. Chronology of illness in dual diagnosis heroin addicts: the role of mood disorders. July, 2015
6. Journal of Addictive Behaviors. Increased use of heroin as an initiating opioid of abuse. Nov, 2017.