What Happens When
Someone Uses Heroin for the First Time?
By Dr. Fourkan Ali
Heroin users can
snort, swallow, or inject the drug. The speed with which the drug can zoom to
the brain is deeply dependent on the method the user employs when taking the
drug. For example, the Tennessee Association
of Alcohol, Drug and other Addiction Services suggests that intravenous injectors can feel
changes within 7-8 seconds, while people who inject into muscle feel changes
within 5-8 minutes.
For first-time users,
that experience isn’t always pleasant. A report from PBS suggests that novice
heroin users often grow nauseated when the drug takes effect, and some even
vomit. That’s because heroin can work directly on the digestive system, slowing
down processes or stopping them altogether. Experienced users may grow
accustomed to these sensations, but for new users, they’re deeply unpleasant.
Sometimes, novice
users choose to switch to a different drug, simply because they dislike feeling
queasy and nauseated. But those who push through the digestive woes and try the
drug again may experience deep-set brain changes that are nothing short of
transformative.
Molecules of heroin
fit like caps into plugs inside the brain. Once attached, these caps trigger a
series of chemical releases inside the brain.
A user typically feels
warm, relaxed, and deeply happy. Users often report that the sensations are
similar to those felt during a satisfying sexual episode, but they last much
longer and are much more intense.
That sensation can
drive people to use the drug again, as people may want the bliss back. The
brain cells manipulated by heroin can also be damaged by the exposure. Those
cells may be unable to produce chemical signals of pleasure in the absence of
heroin, and they may call out for a heroin correction. That’s the seed of
addiction, and it can be planted with just one hit of heroin.
When people continue
to use heroin despite its dangers, they can experience all sorts of health
consequences. Body systems impacted include the:
- Nervous system: Heroin’s impact on the brain is deep and profound.
Cells bombarded by heroin can stop producing chemical signals of pleasure,
and in time, cells can shrink and shrivel. According to NIDA,
people who use heroin over a long period of time can show deterioration in
the white matter of the brain, which could lead to a reduced ability to
make decisions and/or regulate behavior.
- Respiratory system: Opiates like heroin sedate the respiratory system.
That means people in the midst of a heroin high can breathe much slower
than they would normally. If users take in too much, they can stop
breathing altogether. This risk of respiration stoppage is the top health
risk associated with heroin use, according to an article in Anesthesiology,
and it’s a big risk for chronic users. That’s because these users tend to
take in huge amounts of drugs very often, and each big dose has the
capacity to stop their breathing.
- Cardiovascular system: Large heroin doses can also stop the heart and cause death,
but long-term heroin injectors can face even more cardiovascular dangers.
Each needle stick does a form of damage to the veins and arteries that
carry blood to and from the heart. When punctures damage this delicate
system, blood vessels can swell up, shrink down, or close up. That can
lead to abscesses, infections, and deaths. It’s a common consequence of
heroin. According to research from the CDC,
for example, about 32 percent of heroin injectors in New York had a
drug-related abscess or cellulitis. Clearly, heroin injectors take chances
with each prick of the needle.
- Digestive system: Heroin’s sedating qualities can have a deep impact on
the health of the gut. When food and water move too slowly through these
passages, constipation and bloating can take hold. As an article in Medical
Anthropology points out, this is a common part of life for chronic
heroin users, even though they might never talk about the issue. They may
always feel off kilter and ill, but they may not have anyone to talk to
about the issue. They may not get adequate help for the problem, either,
which could put them at risk for blockages and intestinal emergencies.
Leaving a
heroin addiction in place means exposing a person to mental and physical
challenges. It’s
not ideal, and thankfully, it’s not necessary. With the help of a qualified
treatment team, these addictions can be addressed. When that happens, people
can develop the skills they’ll need in order to control their addictions.
Heroin recovery begins
with medically assisted detox. Heroin’s impact can be felt long after the last
hit has worn away, and when people with longstanding addictions attempt to get
sober, they can feel flu-like symptoms that stretch on for weeks. People like
this may also feel deep cravings for heroin, and they may not have the skills
they can lean on in order to avoid a relapse.
Medically assisted
detox practitioners use specifically formulated therapies that mimic some of
the effects of heroin. These medications don’t make people with heroin
histories feel high or altered. Instead, when they take these medications,
these people tend to feel healthy, focused, and strong.
That clear mindset
allows their bodies to adjust to life without heroin, and the therapies give
them the strength and resolve they need in order to be active members of the
recovery team.
Medications used in
medically assisted detox programs are typically provided on a tapering
schedule. That means teams determine how much heroin the person has used in the
past, and teams provide an equivalent amount of replacement medication. Then,
slowly but surely, those medications are tapered until people aren’t taking
replacement medications at all.
A taper is designed to
move relatively slowly, so there are no signs of discomfort or drug cravings.
That means it can take
quite a while to move through a taper and into sobriety. Sometimes, people with
heroin addictions get anxious to make things move faster. When they do, they
can make mistakes that could jeopardize their sobriety.
As a study of 57
people published in the journal Drug and Alcohol
Dependence points out, most
people with heroin addictions want to get to sober as quickly as possible. Some
of these people amended their medication doses to get there. They didn’t
swallow all of their pills or they just didn’t take doses at all.
Unfortunately, researchers said, that meant some of these people were at risk
for relapse, because they had heroin cravings and heroin dreams. They wanted
the drug, and they didn’t have tools to help them overcome the craving.
Using medications properly with the guidance
of a treatment team is a vital part of the recovery process. People in these
programs have a lot of control. They can tell their teams when the drugs seem
to make them feel sedated and slow. They can highlight any symptoms of withdrawal
that manage to break through the drug barrier. They can point out signs of sedation that seem to indicate
that the drugs are too strong. Active communication and clear goals can help
the team provide the best level of care.
While this process is natural and beneficial,NIDA points out that
medically assisted detox is not, in and of itself, a form of heroin addiction
treatment. While people emerge from these programs with bodies that are free of
heroin, they don’t have the skills they’ll need in order to stay away from
heroin for good. They’re at high risk for relapse as a result. While medically
assisted detox is a good first step, it must be followed by other therapies
that build on the lessons that begin in detox.
Why You Should Enter a
Residential Treatment Center
The risk of heroin
relapse is high, particularly during the early part of the recovery process.
People can amend their
medications and put their health at risk, or they can run into dealers and
street hawkers with heroin to sell. Temptation can be around every single
corner when people keep living at home, but much of that disappears in a
residential program. Here, no drugs are allowed. It’s a clean environment,
filled with people who want to get better and staffers who want to help people
to do just that.
Therapy has a huge
role to play for people enrolled in a residential treatment center.
Almost every moment of the
day is devoted to talking about, learning about, and coping with a heroin
addiction. There’s no time to plan to take heroin. The day is completely filled
with tasks that have to do with healing.
Some therapy sessions
are held privately between a person and a therapist. These are coaching
sessions and insight sessions that can give people the personalized help they
need in order to recover. Group sessions are also common. As an article by Harvard Health Publications points out, group formats tap into the human
need to belong. That’s an element that may have been missing from the lives of
people with heroin addictions. They’ve become accustomed to hiding their
feelings and shying away from discussing their behaviors. In group therapy,
they’re enticed to share and connect. They can emerge feeling a lot less
isolated, and that could help them to build the communication skills that can
allow them to work with family members and friends in the future.
Therapy isn’t the only
thing offered in an inpatient program. People in these programs are also
offered other opportunities to heal, and some might seem a little unusual. For
example, some programs provide people with exercise equipment and fitness
instructors. Exercise can help people heal the cardiovascular damage heroin can
cause, but sessions can also be profoundly pleasant.
In an article in the International Journal
on Drug Policy, researchers found
that people with heroin addiction histories found exercise enjoyable. It was
something they did during the addiction (albeit sporadically), and they enjoyed
the mental boost the activity brought. During recovery, these same people
appreciated the opportunity to get reconnected with fitness, and they liked the
high the sessions could bring. To them, it was vital.
Of course, people in
outpatient programs could always exercise in their communities. Some certainly
do so. But an inpatient program makes participation just easier. There are no
coaches to hire, equipment to buy, or sessions to set up. The treatment team
makes it all accessible, and participation is encouraged. For some people in
recovery, that ease makes all the difference. When it’s easy, they’ll do it.
When they do it, they can get better.
Inpatient programs are
typically measured in months, but the risk of relapse can stretch on for years.
That means people with a history of heroin addiction often need to tap into
long-term relapse prevention programs.For some, that means participation in a
12-step group like Narcotics Anonymous. Here, people with heroin addictions
have the opportunity to meet with other people who have the same kind of
background. They form a community that’s deeply focused on getting better and
leaving an addiction behind. In each meeting, they come together to share their
ideas, their successes, and their support. They become a little like a family,
and since participation is free, people can keep going for months or even years
without feeling any kind of financial pinch.While 12-step groups can be vital
for some, there are other people in heroin recovery that need a little more
support in order to stay on the right path. These people may benefit from
moving into a sober living community when formal heroin treatment is complete.
A community like this is also sober, and there are many rules that ensure that
every person living here stays sober, but there are no therapeutic teams
involved. In a way, it’s a step between living in an inpatient facility and
living at home. For some, this slower adjustment means a safer recovery that
doesn’t involve relapse.
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