Heroin Addiction Research Paper

The Ugly Truth Behind Heroin Addiction
Tiffany Lawrence
Liberty University

Abstract
This paper is to bring awareness to the addiction of heroin. It discusses the illegal, and highly addictive drug that is currently most abused most rapidly acting of the opiates. The immediate effects of heroin use, how rapid the dug enters the brain and binds to the opioid receptors will also be discussed. Heroin is very addictive because it enters the brain hastily. The abuser will show signs of drowsiness for several hours and their mental function is impaired due to heroin’s influence on the central nervous system. The most damaging long-term effect of heroin addiction is definitely the addiction itself. Heroin addiction is chronic, and
a relapsing disease characterized by compulsive drug seeking and use and the neurochemical and molecular changes of the human brain. The effect and treatment of pregnant women who are heroin users will be briefly discussed. This paper also contains information about what makes heroin users more likely to contract HIV/AIDS and hepatitis B and C. The described treatments for heroin addiction are detoxification, methadone programs, LAAM and other medications, and behavioral therapies

The Ugly Truth Behind Heroin Addiction The drug trafficking routes of Afghanistan is where heroin can be found (Bell, 2012). Heroin is not only illegal but it is also claimed to be very addictive. Heroin use affects both men and women in any age range with all types of backgrounds such as financial, social, and race. Some people say that they were addicted from their first use. Morphine is extracted of the seed pods from a variety of poppy plants which is used in the production of heroin ("Heroin," 1995-2014). Heroin is sold in different forms. It is either sold in a white or brownish powder or in a black sticky form that is known on the streets as “black tar heroin” ("Heroin," 1995-2014). The heroin that is sold on the streets normally contains sugar, starch, powdered milk or even quinine ("Heroin," 1995-2014).
Heroin can be administered in a few ways such as injection preferably intravenously, being sniffed or snorted or even smoked (Berridge, 2009). Heroin addicts prefer to use the intravenous method because this method is more intense and they get ‘high” very quickly ("Heroin," 1995-2014). Intravenous injection provides a “high” within seven to eight seconds, intramuscular is five to eight minutes and sniffing/snorting/smoking is ten to fifteen minutes ("Heroin," 1995-2014). It makes sense why heroin addicts prefer the intravenous method since it takes seconds to begin to feel anything ("Heroin," 1995-2014).
Heroin produces a "downer" effect that rapidly induces a state of relaxation and euphoria (Berridge, 2009).
Just like so many other drugs, there are signs when it comes to the use of heroin. Shortness of breath, dry mouth, constricted pupils, sudden changes in behavior or actions, disorientation, cycles of hyper alertness followed by suddenly nodding off and droopy appearance, as if extremities are heavy ("Heroin," 1995-2014). The signs of heroin addiction differ from heroin use. The possession of needles or syringes that are not being used for medical purposes, burned silver spoons, aluminum foil or gum wrappers with burn marks, missing shoelaces which are used to tie arm off for injection site, straws with burn marks, small plastic bags with white powdery residue or pipes ("Heroin," 1995-2014). There are also behavioral signs of heroin addiction such as deceptive behavior, distant field of vision, increase slurred or incoherent speech, declining performance in school or work, lack of interests in hobbies and favorite activities, hostile behaviors toward loved ones, constantly stealing or borrowing money from loved ones, withdrawal from friends and family, a tremendous increase in the time spent sleeping, and wearing clothes to cover needle marks despite the weather ("Heroin,"
1995-2014).
Some of the physical symptoms of heroin addiction are runny nose, weight loss, needle track marks on their arms or needle marks between their toes, abscesses at injection site, and cuts/bruises/stabs from picking their skin, and the loss of menstrual cycle for women (“Heroin, 1995-2014).
There are short-term and long-term side effects caused by using heroin. Right after heroin is injected it crosses the blood-brain barrier where heroin is converted into morphine and binds to opioid receptors ("Heroin," 1995-2014). This is what addicts consider a “rush.” The “rush” is determined on how much of the drug is taken and how fast it enters the brain. Heroin is so addictive because it enters the brain so fast ("Heroin," 1995-2014). Following the “rush,” a heroin addict will feel a warm flush of their skin, dry mouth, a heavy feeling in the legs and arms and even nausea, vomiting and severe itching ("Heroin," 1995-2014). Abusers will feel drowsy for several hours and their mental function will be contoured due to the effects of the heroin on the central nervous system ("Heroin," 1995-2014). The heart cannot perform its job adequately and because of this breathing is slowed down tremendously ("Heroin," 1995-2014). I remember learning in Anatomy & Physiology that the heart was the “powerhouse” of the body. With that in mind, any disturbances of the “powerhouse” can either through the body off or shut it down completely.
“The most important long-term side effect of heroin addiction is the addiction itself” ("Heroin," 1995-2014).
“Addiction is a chronic, relapsing disease, characterized by compulsive drug seeking and use, and by neurochemical and molecular changes in the brain” ("Heroin," 1995-2014). Just like any other type of abuser, heroin abusers spend more and more of their time and energy into obtaining and using the drug (Doweiko, 2014). Once they are addicted, their whole purpose in life is finding a way to get their next “rush/high” and at this point it is by any means. At this stage with the amount of heroin usage and the frequency of use the brain is changing drastically. Other side effects based on long-term use of heroin are infectious diseases such as HIV/AIDS, hepatitis B and C, bacterial infections, abscesses, infection of heart lining and valves, arthritis and even collapse veins ("Heroin,"
1995-2014). Heroin just like any other drug and alcohol suppresses the brain 's production of neurotransmitters like noradrenaline (Stobbe, 2014). When you stop using drugs or alcohol it 's like taking the weight off the spring, and your brain rebounds by producing a surge of adrenaline that causes withdrawal symptoms(Stobbe, 2014). Users and addicts of heroin feel that they need to continuing using heroin because its pain relieving effects and the fear of the symptoms of withdrawal. Heroin withdrawal symptoms can start a few hours to one day after sustained use of the drug stops (Stobbe, 2014). Some of the withdrawal symptoms are intense heroin cravings, profuse sweating, severe muscle/bone aches, nausea/vomiting, intense cramping in limbs, crying, insomnia, cold sweats, chills, runny nose, diarrhea and fever ("Heroin," 1995-2014). Someone experiencing withdrawal symptoms following long-term heroin dependence is at risk for serious medical complications, including death when other medical conditions are present. Some of the more serious symptoms of withdrawal are stroke, grand mal seizures, heart attacks and hallucinations ("Heroin," 1995-2014).
There are a few methods of treatment available for heroin addicts, some are more effective than others. The amount of effectiveness is determined on how early addiction was caught. The most common and effective treatment is the replace of heroin with methadone. Methadone is a synthetic opiate that blocks the effects of heroin and eliminate the withdrawal symptoms (Bell, 2012). Other forms of treatment are LAAM (levo-alpha-acetyl-methanol) and buprenorphine, and many behavioral therapies also are used for treating heroin addiction (Bell, 2012). Methadone has been the treatment that is effective and safe to treat opioid addiction for over thirty years (Bell, 2012). When methadone is prescribed properly, it is not intoxicating nor sedating and it does not interfere with everyday activities (Bell, 2012). The medication is administered orally and suppresses withdrawal for twenty-four to thirty-six hours (Bell, 2012). This form of treatment allows patients to have emotional reactions and perceive pain. Relapse is to due to the cravings of the drug. Methadone eliminates the cravings of heroin (Bell, 2012). Since methadone effects lasts for twenty-four hours which is four to six times longer than heroin, addicts take methadone once a day (Bell, 2012). This treatment gives recovering addicts a chance to live a normal and productive life. In combination with methadone and therapy and/or support services, an addict can regain their life. LAAM is also a form of synthetic opiate that is used to treat heroin addiction. Like methadone, LAAM is taken orally but lasts up to seventy-two hours ("Heroin," 1995-2014). LAAM was approved in 1993 by the FDA as a form of heroin addiction treatment ("Heroin," 1995-2014). Unlike methadone, LAAM is administered three times a week instead of daily because of the length of time it stays in the body. Buprenorphine is a mixture of opiate agonist-antagonist medication for the treatment of heroin addiction (Bell, 2012). Buprenorphine just like methadone causes weaker opiate effects and is less likely to cause overdose problems (Bell, 2012). Due to the low levels of dependence it produces, patients that stop taking it have fewer withdrawal symptoms compared to those taking methadone (Bell, 2012). Based on this advantage, buprenorphine may be appropriate for use in a wider variety of treatment settings than the currently available medications that are administered to heroin addicts(Bell, 2012).
Medication has helped addicts overcome their addiction but therapy is useful for support and to help avoid relapse. Behavioral therapy can either be residential or outpatient. In order to avoid relapse, it is detrimental to pair the patient with the right treatment that matches their particular needs. Contingency management therapy uses a voucher-based system, where patients earn “points” based on negative drug tests, which they can exchange for items that encourage healthy living ("Heroin," 1995-2014). On the other hand, cognitive-behavioral interventions are designed to help modify the patient’s thinking, expectancies, and behaviors and to increase skills in coping with various life stressors("Heroin," 1995-2014). Normalcy, employment and a decrease in crime and exposure to diseases is inevitable with the combination of medication and behavioral therapy.
Heroin use during pregnancy just like any other drug is very harmful to both infant and mom. The use of heroin during pregnancy will increase the risk of placental abruption, prematurity, low birth weight, and even fetal death (Jambert-Gray, Lucas, & Hall, 2009). Babies born to heroin using mothers are at a higher risk of SIDs, sudden infant death syndrome (Jambert-Gray et al., 2009). Pregnant women should not ever be detoxified from opiates due to the increased risk of spontaneous abortion or premature delivery why they are treated with methadone (Jambert-Gray et al., 2009). “Treatment with methadone has been demonstrated to reduce these adverse outcomes, to the extent that treatment suppresses use of heroin” (Bell, 2012, p.97). Methadone is another addictive drug. Methadone unlike heroin or any other drugs can be taken once a day because the “high” lasts for twenty-four hours (Jambert-Gray et al., 2009). Infants may be born addicted to methadone but they can be easily and safely treated immediately in the nursery (Jambert-Gray et al., 2009). It has been proven that the effects of utero exposure to methadone is way less of a risk than the use of heroin (Jambert-Gray et al., 2009).
Detoxification is reached only when withdrawal symptoms are absent while the addict adjusts to a drug-free environment. Detoxification is not a form of treatment but useful when long-term treatment is their preference. Long-term treatments are either residential or outpatient drug facilities or medications as a form of treatment (Bell, 2012). It was suggested that the best drug-free treatments are therapeutic community residential programs that lasts from three to six months ("Heroin," 1995-2014).
Since heroin is a “downer,” people might be taking it to suppress some sort of feelings or traumatic event. Heroin is used by some people to self-medicate instead of receiving the proper treatment. Heroin could have been a recreational drug at once but due to its addictive tendencies its now their weakness. Heroin being so easy to access on the streets and rapid effect of the “high” has to be prevalent.
In the past two years, the deaths attributed to heroin addiction has doubled (Stobbe, 2014). While in some parts of the country have declining levels of deaths induced by heroin use, other parts of the country increased drastically between 2010 and 2012 in twenty-eight states (Stobbe, 2014). It is surprising to me that heroin can contain close to anything and a person unaware of its contents will still use it. This has to be a huge factor in overdose and/or death. Besides the risk of overdose and/or death is contracting HIV due to the sharing of needles. Viral hepatitis can also be contracted through intravenous method (Bell, 2012).
References
Bell, J. (2012, June). Buprenorphine in the Treatment of heroin Addiction. The Journal of Psychiatry and Neurological Sciences, 93-100. http://dx.doi.org/10.5350/DAJPN20122502001
Berridge, V. (2009, August 20). Heroin Prescription and History. The New England Journal of Medicine, 820-821. Retrieved from search.proquest.com.ezproxy.liberty.edu:2048/docview
Doweiko, H. E. (2014). Concepts of chemical dependency (9th ed.). Stamford, CT: Cengage Learning.
Heroin: Abuse and Addiction. (1995-2014). Retrieved from www.chce.research.va.govdocs/pdfs/rrheroin.pdf
Jambert-Gray, R., Lucas, K., & Hall, V. (2009, October). Methadone-treated mothers: pregnancy and breastfeeding. British Journal of Midwifery, 17, 654-657. Retrieved from rx9vh3hy4r.search.serialssolution.com
Stobbe, M. (2014). Heroin Deaths Doubled In Much Of The Country. Retrieved from www.huffpost.com