Heroin Addiction: What You Should Know

It’s risen in recent years and doesn’t discriminate. Get the facts about heroin addiction, treatment and recovery.

Medically reviewed in January 2019

Updated on March 1, 2021

Picture in your mind a heroin addict and chances are you’re picturing him or her wrong. Anyone can be addicted to heroin. In fact, according to the Centers for Disease Control and Prevention (CDC), heroin use has risen across most age groups and all income levels in recent years—women, the privately insured and people with higher incomes are among those who have seen the greatest increase. 

“Heroin availability is a lot more widespread,” says Mark Hutchinson, a mental health counselor who specializes in addiction at St. Mark’s Hospital in Utah. “Maybe 20 or 30 years ago it was something you’d only find in a big city, but now it’s just everywhere.” 

Heroin use increased 62.5 percent between 2004 and 2013. Heroin-related overdose deaths have risen over the years, too, according to the CDC. 

So, what gives? Here’s what you need to know about heroin addiction. 

What Is heroin? 
Heroin belongs to a class of drugs called opioids. Opioids are derived from or related to substances in poppy plants and include methadone, morphine, oxycodone, hydrocodone and fentanyl. These drugs are mostly used as powerful painkillers. Heroin is synthesized from morphine and comes in the form of a white or brown powder or as a black sticky substance. It can be injected intravenously, smoked or snorted. 

Highs and lows of heroin  
Not only does heroin block out pain, it totally blocks out stress and worry, says Hutchinson. “The high is an escape that’s deep and intense,” he explains. It starts with intense euphoria that can last several minutes and users generally feel relaxed, drowsy and “out of it” for three to five hours afterward. 

After the high, though, comes the crash. Coming off a heroin high brings a severe reaction, like an intense flu, says Hutchinson. “Aches and pains, throwing up, high anxiety, the shakes. Sometimes people have hallucinations,” he says.  

The emotional and psychological effects of withdrawal follow. Users feel “a real emptiness, like a hole in their soul,” Hutchinson says. “They have no motivation or hope or thought that they can overcome these feelings.” 

A big factor in continuing to use heroin and thus becoming addicted is avoiding withdrawal symptoms, says Hutchinson. “It’s very intense and no one wants to be that sick, so the only thing in their mind is they have to use to not have those side effects,” says Hutchinson. 

Making an addict 
Reasons for trying heroin for the first time vary greatly among addicts. Because the drug temporarily relieves pain both physical and psychological, many users turn to it to escape trauma, says Hutchinson. “Or they started with marijuana or alcohol and found they needed more and more to get high. Heroin is a more efficient high,” he says. 

Prescription opioids can lead people down the path of heroin addiction as well. A person can start prescription painkillers for a legitimate reason like intense back pain or a broken femur, get addicted, and use heroin as a substitute when they can’t get a prescription. 

“Oxycontin is expensive, plus it’s in a locked safe in the pharmacy and you usually have to wait to pick it up,” explains Hutchinson. They may want Oxycontin but either can’t afford it or can’t get it without a prescription, so they turn to sources that are affordable and easily attainable, says Hutchinson. “Heroin is a lot cheaper; for $5 or $10 you can get a hit,” he says. 

Heroin addiction and the brain 
Addiction—not just drug addiction—is a medical disease and not just a human weakness, according to experts from the National Institute on Drug Abuse (NIDA). 

“There are parts of the brain that are more affected by addiction, such as the hypothalamus and the amygdala, which are connected to the frontal lobe, the judgment and responsibility area of the brain,” explains Hutchinson. “When someone is addicted to anything, the amygdala and hypothalamus start to deteriorate physically.” 

It becomes a feedback loop, explains Hutchinson. “When that happens, people will continue to use even though they know it’s high risk and will end badly,” he says. “It gets to the point where using doesn’t even bring pleasure, it just allows them to function.” 

Heroin addiction help and recovery 
If you or a loved one is using heroin, seek help as soon as possible. In the case of an overdose, call 9-1-1 right away. 

There are a variety of inpatient and outpatient programs available for those who want to recover. Hutchinson suggests starting heroin addiction treatment at an intensive inpatient program and then joining an outpatient program to stay clean. 

The first thing someone with an addiction will have to do in order to kick the habit for good is go to detox to get the heroin out of their system safely and under supervision. After detox, therapy becomes a main focus of treatment. Group therapy is particularly helpful. 

“Patients bond with one another, not just because they have people who know what they’re going through, but also in sharing what’s happened in their lives to bring them to this point,” says Hutchinson. “They trust one another and want to spend time with each other.” 

If you have a loved one with a heroin addiction, it’s absolutely essential to care for and support them in their efforts to get clean, says Hutchinson. It might not be easy, as addiction can lead people to lie, steal and generally be irresponsible or unreliable because part of the brain isn’t functioning the way it should. But Hutchinson says they simply will not get better without support. 

“If I did a sampling of 10 of my patients undergoing treatment—those with strong bonds and relationships—about 6 out of 10 will be successful,” says Hutchinson. “Probably 9 out of 10 people who don’t have those supportive relationships will go right back to addiction.”

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