The following information is drawn from the NIDA Research Report Series, Heroin: Abuse and Addiction (http://www.drugabuse.gov/ResearchReports/Heroin/Heroin.html).
What is heroin?
Heroin is a member of the opiate family of drugs. Heroin is derived from morphine; in the brain, heroin is changed back into morphine. Because heroin enters the blood and reaches the brain more quickly than morphine, drug abusers and addicts often abuse heroin instead of morphine. Heroin is a white powder that is most often dissolved in saline and injected into the bloodstream, but it can also be snorted (sniffed) or smoked.
What does heroin do in the body?
After taking heroin, the abuser experiences a “rush,” the intensity of which depends on the amount of drug taken and how the abuser takes it. The rush is accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities, which can be accompanied by nausea, vomiting, and severe itching. Heroin blocks pain messages transmitted from the body. After the initial effects, abusers will be drowsy for several hours. Mental function is clouded by heroin’s effect on the nervous system. Cardiac functions slow; breathing is also severely slowed, sometimes to the point of death. Overdose is a particular risk because the amount and purity of the drug cannot be accurately known.
Treatment for heroin abuse and addiction
The first step in treatment is detoxification to rid the body of the drug. During detoxification, patients adjust to a drug-free state. This stage is short-term and needs to lead to a long-term treatment plan.
Methadone is a synthetic opiate that blocks the effects of heroin and eliminates withdrawal symptoms. Methadone binds to the same opiate receptor that morphine does (remember that heroin breaks down into morphine in the brain). Methadone, however, binds to the receptor more tightly than heroin. People usually take methadone orally one time each day to suppress cravings and withdrawal symptoms for 24-36 hours (four to six times longer than heroin). Methadone is not intoxicating or sedating, and does not produce the feelings of euphoria that heroin does, unless taken in very high doses. Individuals taking methadone do feel pain and have emotional reactions. People can take methadone continuously for many years without problems.
Other drugs used to treat heroin addiction include LAAM and naltrexone, but these are not used as extensively as methadone.
The most effective treatment combines pharmacological approaches (medications) with behavioral therapies. Behavioral therapies may be either on a residential or outpatient basis, but they need to match the needs of the patient.
In addition, the additives in street heroin often include substances that clog blood vessels that lead to the lungs, liver, kidneys, or brain. Contaminated injection equipment can lead to blood-borne viral infections including hepatitis B, hepatitis C, and HIV, which can then be passed on to other individuals through shared needles or sexual activity.