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Author Archive: aenriquez

Why 12 Steps Programs Aren’t a Magic Bullet

Modern medicine has tricked us into thinking fixing the human body is easy. The advent of antibiotics has to lead us to believe that there is a one-stop shop for every ailment or disease process. You’ve probably had grandparents complaining of a chesty cough diagnosed with a chest infection. Antibiotics are given and it clears up. Or if you’re a woman – you might have felt a sting when passing urine that quickly passed when your family doctor prescribed a 3-day course of antibiotics. Perhaps you even know somebody who had an early stage cancer that was swiftly trolleyed off to an operating room only to make a full recovery. Regardless of who the patient is, where the patient has come from and what they have done in the past is irrelevant – everybody gets the same treatment. But this isn’t the case with mental health and addiction. If you yourself are reading this looking for a cure for an addiction take a moment to think to yourself why you are here. What happened along your own complex journey that led you or somebody you love to addiction. Each patient, each person, has an individual story that directly affects why they are there and how they can recover. Why then does the United States rely so heavily on one treatment, 12 step recovery programs, for addiction treatment?

Dual Diagnoses

A significant proportion of people who have a substance abuse issue also have a mental health diagnosis. Called a dual diagnosis, this is just one example of the ways in which the status quo is hindered addiction recovery in the United States. Whilst a 12 step programme can be useful for these patients – a whole host of other mental health treatments are also needed.

Treatment Options for Addiction

Whilst 12 step programs do provide an excellent option for addiction recovery – they aren’t for everyone. They also aren’t the be all and end all of the addiction treatment. Take the PacificBayRecoverycentre for instance which offers the following list of treatments:

● Inpatient recovery
● Intensive outpatient recovery
● Cognitive Behavioural therapy
● Medical detox

These different types of treatment programmes are tailored to the individual – providing a far more holistic care for the patient. What we mean by holistic is that the programmes are built around the patient’s own personal journeys and stories. They are tailored and personalized to that patient.

There Will Never Be A Magic Bullet

For incredibly complex diseases like an addiction – there will never be a magic bullet, an antibiotic or drug that can be given quickly and easily and give the patient immediate and lifetime relief. A multitude of treatments and need to be tailored to that individual patient to aid in their recovery. An interesting blog post (that I recommend you read) on DopeMagazine.com explored this very issue this week. In the article a clinician notes:

“Without guidance to other methods, a person with an addiction can stay stuck in the belief that nothing will work for them,” says CT, a Seattle-based CDP who wished to remain anonymous. “12 Steps does not encourage getting help for mental health issues, nor convey how common dual disorders are.”

And therein lies the issue. Not that 12 step programs don’t work. For many they do. It is just the word is not getting out about the different options available that specialist centers like the Pacific Bay Recovery Centre can provide.

Signs to Look for in an Alcoholic

People across the western world are certainly fond of a drink. In fact almost 27% of the American population over 18 binge drink every single month according to the National Institute on Alcohol Abuse and Alcoholism. Almost 70% of American adults had a drink in the past year and almost 56% in the past month. This will come as no surprise to many – and it’s no secret that lots of us need to cut down in one form or another. But the majority of Americans aren’t alcoholics. How can you differentiate between somebody that likes a drink and a problem drinker that potentially needs professional help? The simple steps below should help.

Doctors across the world use a tool developed by the World Health Organization called the AUDIT. It helps doctors identify people that might be at risk of alcohol abuse. Whilst it isn’t 100%, and scoring highly on it is not a diagnosis of alcoholism (you should always visit a licensed doctor for a diagnosis), it can give a good indicator to problem drinking. It acts as a good tool to have in mind if you suspect you or somebody you know may suffer from alcoholism.

The questionnaire includes 10 questions each with an answer scoring between 0 and 4. The maximum score is therefore 40, and any score over 20 indicates potential dependence. You can download the questionnaire for yourself at the following link but the questions include things such as:

● How often during the last year have you found that you were not able to stop drinking once you had started?
● How often during the last year have you failed to do what was normally expected from you because of your drinking?
● How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session? (This is often known as an “eye opener” and it a big sign of alcoholism).
● How often during the last year have you had a feeling of guilt or remorse after drinking?
● Has a relative, friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

Getting Help For a drinking problem

If you or somebody you love scored highly on the World Health Organization’s AUDIT score, it may indicate they have a dependence to alcohol. There are lots of treatment options available for those who do, and there are a number of specialist services available across the United States that can provide tailor made plans to help an individual overcome their drinking problem. Their treatment options include:

● Inpatient recovery facilities (where a patient will stay on site to break their habit).
● Intensive outpatient treatment (where the patient come sin for regular meetings to discuss and get help).
● Pharmacotherapy – sometimes drugs may be prescribed to overcome withdrawal.
● CBT (cognitive behavioral therapy can be very helpful for people that have a dual diagnosis of alcoholism and a mental health condition).

Substance Abuse and Inpatient Rehabilitation Services

Substance abuse is a difficult and challenging problem for affected individuals to manage and overcome. Factors such as the environment one lives in or is exposed to contribute to continued substance abuse. Increased stressors and being known as mental health conditions are also problems that can lead to alcohol and drug abuse and this may lead to further mental and physical complications.

Recognizing that one may have a problem with substance abuse can be quite difficult because most individuals who face this problem are either ignorant of the problem or are in denial of being affected. The following are symptoms that may help one identify if they have a problem with substance abuse:

  • Overcoming Substance AbuseThere’s a lack of control when using the abused substance.
  • Family members and friends express concern over the substance abuse.
  • Questioning whether the use of the substance is actually a problem or not.
  • Only the user knows the extent of their substance use.
  • The user is isolating themselves from friends and loved ones.
  • The performance of the user at school or at work is suffering.

Those individuals who continue with the behavior to abuse substances despite facing negative consequences such as poor health or getting into trouble with the law are considered to be addicted to the substance in question.

Inpatient Rehabilitation Services

 

Inpatient rehabilitation is a treatment program where addicted individuals spend between one and three months at a designated and licensed facility aimed at helping those with substance abuse problems.

The following services are offered at these inpatient facilities:

  • Medical detoxification, where patients are withdrawn from their respective abused substances in a safe environment and where there is access to a healthcare professional who helps them go through the withdrawal process.
  • Access to primary care doctors and psychiatrists to address any physical and mental health issues which may arise or already be present and need addressing. Many patients who abuse substances are either diagnosed with or have underlying mental health issues which, as mentioned, may trigger abusing the use of alcohol and drugs.
  • Psychologists are also available to discuss mental health conditions and any underlying and unresolved stressors at home or at work. Psychotherapy aims at helping the patient have a positive outlook on life and teaches them coping skills to better deal with stressors outside of the rehab facility.
  • Occupational therapists are involved with motivating affected individuals to help improve their drive and their mood by incorporating appropriate activities for patients to perform. Relaxation techniques are also taught by these allied healthcare workers.
  • Physical therapists may also be involved to help with any musculoskeletal conditions or just help reduce tension in affected individuals by working on tense areas of the body. Massage therapy, for example, is one of the clinically proven methods for helping with stress reduction.
  • The program is beneficial in monitoring the medication intake of patients which improves their compliance, such as where treatment is prescribed for certain individuals like methadone for heroin addicts.

The biggest benefit of an inpatient rehabilitation facility though is that the patient is taken out of their environment where exposure to the addictive substance is a problem. Here, they are able to focus on the important aspects such as overcoming their addiction with the right help in order to get back on track with their lives.

How To Identify Alcoholism

People across the western world are certainly fond of a drink. In fact, almost 27% of the American population over 18 binge drink every single month according to the National Institute on Alcohol Abuse and Alcoholism. Almost 70% of Americans had a drink in the past year and almost 56% in the past month. This will come as no surprise to many – and it’s no secret that lots of us need to cut down in one form or another. But the majority of Americans aren’t alcoholics. How can you differentiate between somebody that likes a drink and a problem drinker that potentially needs professional help? The simple steps below should help.

Identifying Alcoholism

Doctors across the world use a tool developed by the World Health Organisation called the AUDIT. It helps doctors identify people that might be at risk of alcohol abuse. Whilst it isn’t 100%, and scoring highly on it is not a diagnosis of alcoholism (you should always visit a licensed doctor for a diagnosis), it can give a good indicator of problem drinking and it’s a good tool to have in mind if you suspect you yourself or somebody you know may suffer from alcoholism.

The questionnaire includes 10 questions each with an answer scoring between 0 and 4. The maximum score is therefore 40, and any score over 20 indicates potential dependence. You can download the questionnaire for yourself at the following link but the questions include things such as:

  • How often during the last year have you found that you were not able to stop drinking once you had started?
  • How often during the last year have you failed to do what was normally expected from you because of your drinking?
  • How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session? (This is often known as an “eye opener” and it a big sign of alcoholism)
  • How often during the last year have you had a feeling of guilt or remorse after drinking?
  • Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

 

Getting Help For a Drinking Problem

 

If you or somebody you love scored highly on the World Health Organisations AUDIT score, it may indicate they have a dependence on alcohol. There are lots of treatment options available for those who do, and there are a number of specialist services available across the united states that can provide tailor-made plans to help an individual overcome their drinking problem. Their treatment options include:

  • Inpatient recovery facilities (where a patient will stay on site to break their habit)
  • Intensive outpatient treatment (where the patient come in for regular meetings to discuss and get help)
  • Pharmacotherapy – sometimes drugs may be prescribed to overcome withdrawal
  • CBT (cognitive behavioral therapy can be very helpful for people that have a dual diagnosis of alcoholism and a mental health condition).

Specialized Outpatient Programs for Patients with Substance Abuse Disorders

Intensive outpatient treatment programs are developed for individuals with addictions to substances such as opiates/narcotic and are available for affected individuals of all ages and backgrounds. The programs provide a supportive, structural, and educational setting for those who need assistance with the recovery process.

The benefits of an outpatient addiction treatment facility include:

  • Reinforcing helpful and healthy ways of interacting with a safe and supportive environment.
  • Assisting with the development of communication and socialization skills.
  • Guiding, where necessary, patients in structuring their new lifestyles.
  • Helping patients to get assistance from other group members during their recovery process.

The following are specialized outpatient programs that have been shown to be effective and beneficial in those patients affected by substance abuse disorders:

Aquatic therapy

  • Performing exercises in water help with relaxation have a physical therapeutic benefit.
  • Warm water is used to help facilitate muscle relaxation and increase peripheral circulation.
  • Can help to detoxify the patient faster from the drug they used.

Counseling

  • This service offers a forum for patients to receive support with their life stressors, as well as school, work, and any family-related issues.
  • Traditional counseling allows the addiction specialists to help addicts resolve anxiety, stress, emotional concerns, and interpersonal conflicts.
  • Counseling also includes group therapy sessions which focus on improving strategies to remain sober, develop a supportive environment needed for recovery, and avoiding relapses.

Hypnotherapy

  • Regarded as a relaxation technique in terms of helping to reduce addictive behaviors in affected individuals.
  • Used to put the patient in between a sleep state in order to induce suggestions into the unconscious mind.
  • Studies have shown that this therapy is more effective than placebos or simple therapies when dealing with substance abuse disorders.

Physical restorative therapy

  • Exercise and physical practices such as yoga are incorporated to help improve the strength of the body.
  • This is especially effective in those patients who have experienced physical complications such as muscle loss, arthritis, balance disorders, and generalized weakness due to their addictive behaviors.
  • This therapy helps to recondition the body to its optimal state.

Psychoeducation

  • Here, education and information regarding substance abuse, addictive behaviors, mental health disorders and what to expect on the journey to recovery are discussed and given to the patient.
  • The goal of this therapy is to help the patients and their family members understand how addictive behaviors develop, what events may trigger these issues, and what can be done to overcome the pathology.
  • A better understanding of the addictive process allows for better understanding of the causes of the problem which in turn means a better understanding of what situations to try and avoid from the patient’s side and what family members and friends can do to support them.

Spiritual Therapy

  • This involves the process of helping to relieve physical and emotional problems through meditation and prayer.
  • Spiritual therapy may involve the transference of spiritual energy from the person administering the therapy by touching or laying hands on the patient.
  • Even in those who are not spiritual, the act itself is one of grace and compassion that some benefit may be derived from this therapy.

Opioids Now a Bigger Killer Than Cancer: Here’s How We Fix That

Opioids Kill More than CancerA recent CNN report identified a devastating truth about the current opioid epidemic: opioids are now a bigger killer of Americans than cancer. In 2016 there were 42 000 overdoses of opioids (which include codeine, fentanyl, and heroin). Only 41 000 Americans die from breast cancer each year. The news that opioids are a bigger killer than breast cancer is no surprise for some, and much has been made about the national opioid crisis. In October the President Donald Trump announced from the White House that the opioid crisis was a “National Emergency” and needs to be dealt with immediately.

 

You might be forgiven for thinking that opioid addiction means heroin addiction. But increasingly that is not the case. Many people afflicted by this were actually prescribed these drugs for their chronic pain conditions by Doctors. When a clamp down on opioid prescriptions swept across America, many were left in the dark, addicted and alone. Talking to the Guardian, Cassie from Cleveland talked about the first time she used opioids for her back pain

 

“I felt like that’s how I wanted to feel for the rest of my life…I had energy, I was happy, nothing hurt, and it also took away those feelings of feeling, like, out of place. It just numbed me.”

 

Now 31, Cassie has overcome her addiction and says it was an uphill battle, but she is happy she can help people in a similar situation.

 

Prescription drug addiction affects thousands of Americans every year and isn’t just limited to opioids. The following drugs can be addictive and may require treatment:

 

  • Opiates – Also called narcotics and prescribed for severe or chronic pain.
  • Stimulants – Used to treat attention deficit hyperactivity disorder (ADHD).
  • Sedatives – Benzodiazepines used for sleep and to treat anxiety disorders.

 

The Solution: More Emphasis on Rehabilitation

 

It might seem like the landscape is dire, or that there is little hope for thousands of patients with prescription drug addiction from the way news outlets have been reporting the issue. But this isn’t true. With better support and a better understanding of the problem, we can make significant inroads into the problem.

 

A major issue has been the patients who were being prescribed drugs that have the “rug pulled out from under them” so to speak. These patients were taken off prescriptions and had no help to overcome their addiction. The CDC has made this a priority for Doctors, who are now being trained a lot more on how to wean their patients off the drugs.

 

There are also options for patients who do not have a prescription. Specialist rehabilitation services across the united states do fantastic work with both inpatient and outpatient services. They can take patients on an outpatient basis, where they prescribe a number of different drugs that can help wean addicts off the drugs. They also offer inpatient services, where the person stays at a residential facility with staff for a period of time. The clinician in charge of each patient will make a decision as to what treatment is appropriate for the patient.

 

With services like these, the opioid epidemic is sure to pass and patients will be free to live addiction-free lives.

 

Withdrawal Symptoms Caused by Stopping Addictive Substances and How to Manage Them

Substance dependence occurs when an individual who is using addictive substances such as alcohol, narcotics, prescription medications, or other illegal drugs experiences withdrawal symptoms if they stop using the product. The body becomes used to the substance to the point that it needs the product in order to function adequately.

Drug Addict Going Through Addiction CrisisOnce the substance is discontinued, the body will experience the following general signs and symptoms within a few hours:

  • Excessive yawning.
  • Increased sweating.
  • Muscles aches and pains.
  • Increased agitation or anxiety.
  • Mood swings.
  • A runny nose and teary eyes as well as other flu-like symptoms.
  • Cravings for the addictive product.
  • Difficulty with getting to sleep (insomnia).

These are not life-threatening issues but they can make the affected individual very uncomfortable which is why they rather choose to continue using the addictive substance.

Certain withdrawal symptoms may also specifically occur when discontinuation the following substances:

  • Depressants such as benzodiazepines and alcohol – agitation, anxiety, tremors, hallucinations, and seizures.
  • Narcotics such as opioid pain medications and heroin – Bone, joint, and muscle aches, gastrointestinal issues, and increased pain sensitivity.
  • Stimulants such as the amphetamines and cocaine – anxiety, aggression, depression, sweating, fevers, stomach aches, and tremors.
  • Bath salts – paranoia, tremors, depression, and sleeping difficulties.

The duration, intensity, and severity of withdrawal symptoms will depend on the following factors:

  • The length of the addiction to the substance.
  • How much of the substance is in the individual’s body when they discontinue the product.
  • How many different substances are used by the individual at the same time.
  • If there are any physical or mental disorders present.
  • How long it takes the substance to be eliminated from the body (half-life of the product).

Medical detox

  • Medical detoxification (detox) is a therapy used to help addicts to go through the withdrawal process with as little discomfort as possible.
  • Alcohol and drug rehabilitation programs use applicable medications with appropriate dosing regimens to help reduce the duration and severity of withdrawal symptoms when the offending substance is discontinued.
  • This is performed on an inpatient basis so that the patient can be monitored by healthcare personnel in order to provide the correct level of care to the patient and so that any emergency situations may be dealt with properly.
  • Admission to inpatient substance rehabilitation centers is the safest way to detox, especially when co-morbid mental health disorders affect the patient. Psychological counseling and psychiatric consultations are offered to these patients to help address mental health problems.
  • There are various methods of medical detox including the “cold-turkey” method (meaning stopping the medication with only medical supervision), short-term medicated detox, and long-term medicated detox.

The following medications are prescribed for patients to help reduce withdrawal symptoms associated with the respective addictive substances:

 

  • Short–acting benzodiazepines – used in those who use stimulants such as alcohol as well as in marijuana users.
  • Desipramine – used in long-term stimulant users.
  • Disulfiram – prescribed for users to prevent them from using alcohol. The medication causes a metabolite of alcohol to build up in the body causing moderate to severe gastrointestinal symptoms.
  • Methadone or buprenorphine – used in addicts of narcotics such as heroin and opioid pain medications.

Outpatient Rehab – Is it Right for Me?

For those whose lives still remain functional, outpatient rehab may be an option to consider. With this type of program, you see a counselor locally and work with therapy groups, attend AA/NA meetings, and complete assignments to help you with becoming drug- and/or alcohol-free. While you do have the freedom to live your life, random drug/alcohol tests are likely with this type of program, and you must be willing to submit to them, especially if it is court ordered outpatient care.

Addictive Medications and Minor AddictionsMinor Addictions

If you have trouble removing drugs and/or alcohol from your life, outpatient treatment may be right for you. This is especially the case if your life does not revolve solely around drinking and using drugs.  When you blow off friends, family, or general adult responsibilities to bar hop, consume an entire 12-pack of beer or bottle of alcohol, it’s time to get help. If you’d rather sit and completely lose your mind to get high instead of cleaning the house, grocery shopping, or spending time with your kids, it’s time to get help. This might be the right situation for you since you’re still able to function in daily life.

Remain in your Own Home

When attending outpatient rehab, you don’t have to deal with the stress of being in a strange place with conflicting personalities or those that are near death from their addictions. Being able to stay home with your family or in transitional housing while getting treatment has proven higher success rates. You have to take this program just as seriously as you would an inpatient center.

The transitional housing idea is to keep you in a dry household with others that are also in recovery. You still go to work, pay your bills, and have some freedom. There are curfews and some house rules to adhere to while seeing your counselor, participating in maintaining the home, and attending group sessions.

Live Normal Life without Drugs or Alcohol

In an outpatient program, you learn how to live life and make use of the extra time that you’d normally spend drinking or getting high. Some counselors suggest taking night college courses, painting, cooking, or taking up a hobby. It’s also an open invitation to get more involved with your spouse and children. Taking a more active role in your family is healing in itself and has plenty of benefits. You’re treating the addiction with your family, rather than being separated from them and feeling awkward returning home in a sober state.

Outpatient programs don’t work for everyone. This is the case with addicts where the only method of detection is by a blood sample or spinal tap. These expensive procedures have to be paid for by the patient and most cannot afford them. For those that recognize their problem and cannot afford inpatient care, this is a good place to start. It can be considered as temporary treatment while you look for financial aid or “scholarship” funds to get clean and live a healthy, substance-free lifestyle again.

Why Oxycodone is Being Used Recreationally

is oxycodone addictiveOxycodone is a synthetic opioid drug that is produced from thebaine which is found in the Persian poppy plant. The drug is used as a pain relieving medication and is found to be up to 1.5 times more potent than morphine.

Oxycodone is indicated for providing pain relief in patients with moderate to severe pain and is used in situations such as:

  • Post-surgical pain relief.
  • Severe spinal pathologies.
  • Pain caused by certain cancers.

Effects

Effects of oxycodone other than pain relief include:

  • Feelings of euphoria.
  • Reduced anxiety.

The reason why this happens is that the drug works on the opioid receptors in the brain that are involved with the reward system of the organ. Unfortunately, prolonged use of medications such as oxycodone can lead to other problematic behaviors such as:

  • Tolerance – where the user starts to use more of the medication because it doesn’t seem to provide the desired effect, be it pain relief or the mentioned euphoria associated with its use.
  • Recreational use – the pain may no longer be present but the individual may still be using the medication because of the mentioned effects it has on the body.
  • Dependence – this occurs when one stops using the drug and begins to experience withdrawal symptoms thereby causing the individual to continue using oxycodone to prevent these issues from occurring.
  • Addiction – is oxycodone addictive? Yes, it is because continued use of the medication may result in health-related problems, issues with school or work performance, and even getting into trouble with the law. Continued behaviors such as these without taking into consideration the negative consequences associated with it are regarded as addictive behaviors.

In one literature review, multiple studies demonstrated that oxycodone had an elevated abuse liability compared to other similar drugs such as morphine and hydrocodone-based on its high likability scores and relatively reduced amount of subjective effects.1

 

Adverse effects

Oxycodone use in high dosages can lead to problems such as:

  • Suppressed and shallow respiration.
  • Slowed heart rate.
  • Low blood pressure.
  • Circulatory collapse.
  • Respiratory arrest.
  • Spinal cord infarction, strokes, and heart attacks due to reduced blood flow and oxygen transport to the involved organs.
  • Liver and/or kidney damage if oxycodone combined with medications such as acetaminophen or ibuprofen are consumed.

Legal status in the United States

Oxycodone is a Schedule II controlled substance under the Controlled Substance Act that was enacted in 1971. This includes formulations of the medication where other drugs are included with the oxycodone, such as those mentioned already.

Despite this legislation, oxycodone is still one of the most commonly abused pharmaceutical drugs in the United States and has given rise to the current opioid epidemic which has resulted in the death of over 180,000 people from 2009 to 2015 with nearly 35,000 of those fatalities coming from the latter mentioned the year.

Management

The primary focus of prevention is at the level of the physicians who prescribe these medications. Caution needs to be exercised when patients are prescribed oxycodone. Their needs and unique circumstances should be factors that must be considered when deciding who is prescribed these kinds of medications.

Where addictive behaviors are suspected in individuals using these medications, the services of local substance abuse rehabilitation facilities should be made use of.

Heroin – Dangers Associated with the Drug and its Addictive Factor

Heroin – Dangers Heroin is classified as an opioid drug because it acts on the opioid receptors in the brain. The drug is mostly used recreationally to produce euphoria in the user and also results in relaxation, drowsiness, and reduces any pain experienced by the individual.

In the United States, heroin is not accepted as medically useful whereas in countries such as the United Kingdom it may be prescribed as a strong pain reliever for the following situations:

  • Severe trauma.
  • Post-surgical pain control.
  • Myocardial infarction (heart attack)
  • Chronic pain caused by terminal illnesses and end-stage cancer.
  • Maintenance therapy for those who are addicted to heroin, even being considered more useful than methadone. This is somewhat of a controversial use of the drug though.

Does heroin cause have any adverse effects?    

 

The use of heroin as a recreational drug is extremely problematic and there are major adverse effects associated with its use such as:

  • Contracting blood-borne diseases such as hepatitis and HIV due to sharing infected needles and syringes to administer the drug intravenously (into the bloodstream through a vein).
  • Developing fungal or bacterial endocarditis (infection of the inner lining of the heart).
  • Formation of abscesses at the injection sites due to the introduction of harmful bacteria into the soft tissue when injecting the drug.
  • Accidentally becoming poisoned with products used to “cut” the drug.
  • Overdosing on the drug which can suppress the central nervous and respiratory systems enough to result in death.

How addictive is heroin?

Heroin is an extremely addictive drug because of the way it works on the brain. The mentioned opioid receptors are involved in the reward system of the brain and when they are stimulated, the result is a relaxed state, or a “high”, that makes the user feel pleasant.

The steps to full-on addiction to the drug are as follows:

  • Frequent and regular use of heroin leads to tolerance to the drug which means the individual needs to use more of the product to reach its desired effect.
  • Dependence develops when stopping the drug causes withdrawal symptoms such as restlessness, agitation, cold flashes, nausea and vomiting, diarrhea, muscles aches and pains, insomnia, and severe cravings for heroin. This results in the continued use of the drug to avoid these symptoms from occurring.
  • Continued use of heroin then leads to issues such as health-related problems, failure to meet responsibilities at school or work, and even getting into trouble with the law. This is termed as the user having a substance use disorder and the most severe form of it being referred to as an addiction to the drug.

Long-term effects

Individuals who use heroin over the long term may develop problems such as:

  • The collapse of veins that are used to inject the drug into.
  • Sleep disturbances that are difficult to manage.
  • Damage to the mucous membranes in the noses of those who snort the drug.
  • Damage to the valves of the heart due to endocarditis.
  • Liver and kidney disease usually caused by the additives in the drug.
  • Development or worsening of mental health disorders such as depression.
  • Irregular menstrual cycles in women.
  • Sexual dysfunction in men.