While you won’t become addicted to heroin the first time you try it, using the drug once may lead to repeated use that escalates to addiction. Over time, heroin use can alter the way the brain functions, causing intense cravings that fuel compulsive use.
Heroin is at the center of the opioid epidemic that has ravaged the United States for more than a decade. According to the 2016 National Survey on Drug Use and Health, the number of heroin users in the United States increased by 135 percent since 2002.
Those who use heroin usually do not experience physical or psychological cravings after their first use. But the drug’s desirable effects often motivate people to try it again. This can start a dangerous cycle of compulsive use.
As heroin use escalates, the brain begins to build a tolerance to the drug. Over time, people become physically dependent on the drug, which means they need it to function normally. Many individuals don’t realize they have a problem until they’ve developed a full-blown heroin addiction.
Most first-time heroin users start by snorting or smoking the drug. After the first hit, they experience a warm, euphoric feeling that causes their pain and worries to melt away. Some heroin users say it’s the most pleasurable feeling they have ever experienced.
The drive to use heroin a second time is usually psychological. People don’t become addicted immediately, but they may be inclined to try the drug again to relive its pleasurable effects.
But as people use heroin more often, they begin to build a tolerance to the drug. The drug’s effects lessen over time, and people need to take larger and more frequent doses to achieve the same rush. Many people become dependent on heroin while attempting to counteract their rising tolerance.
Heroin dependence causes flu-like withdrawal symptoms when use of the drug suddenly stops. The symptoms, which can range from uncomfortable to painful, reinforce the psychological drive to use heroin.
Heroin users have a substance use disorder when they continue to use the drug even though it causes serious health consequences and problems at home, work or school. Addiction is the most severe form of substance use disorder.
As heroin addiction progresses, people engage in riskier behaviors. Those who initially smoked or snorted the drug may start injecting it for a faster and more potent high. Injecting heroin puts people at risk for hepatitis B and C, HIV and other illnesses.
In the early 2000s, a sharp rise in prescription opioid abuse — fueled by overprescribing practices by illegal pain management clinics known as pill mills — created a new wave of opioid abusers. Much like heroin, prescription opioids such as OxyContin and Vicodin are highly addictive.
When state and federal governments cracked down on pill mills around 2010, access to prescription opioids dramatically decreased. Those addicted to prescription painkillers were now unable to easily find the drugs they were physically dependent on. They frequently turned to street dealers to get their pills.
The street price of prescription opioids skyrocketed at this time. People were desperate to obtain opioids to avoid withdrawal, but the cost was too high to maintain.
These individuals found a cheap and convenient alternative to prescription opioids: heroin. Heroin and opioids produce similar effects. Both substances bind to opioid receptors in the body and affect the brain in the same way. People addicted to prescription opioids can easily switch to heroin to quell their withdrawal symptoms or get high.
Individuals who are dependent on heroin commonly take the drug to stave off uncomfortable withdrawal symptoms. Rather than using the drug to get high, they take it to avoid feeling sick. Taking a drug solely to prevent withdrawal is a common sign of addiction.
Heroin addiction requires immediate treatment. Evidence-based rehab facilities provide detox services that help clients through the process of withdrawal. The primary goal of detox is to rid the body of heroin while ensuring clients are safe and comfortable.
Medications such as methadone and buprenorphine can help alleviate withdrawal symptoms and reduce heroin cravings. Once detox is complete, clients can start behavioral therapy and join support groups to build a strong foundation for recovery.
Heroin addiction doesn’t happen on the first hit. However, it takes only one try to start the process of compulsive use that frequently leads to a heroin use disorder. It’s a slow process that can take hold of individuals before they realize the danger or consequences.