Heroin and the Brain
The human brain naturally produces “feel good” chemicals and neurotransmitters such as seratonin, dopamine and endorphins, natural opioids. Opioid receptors in the brain help control many automatic processes in a human mind, some essential for life such as respiration, control and modify the response to outside stimuli, responses to pain, hunger or thirst, and even the understanding of action and reward. Heroin use interrupts, and even replaces, these natural chemicals, attacks and binds to the opioid receptors of the brain and “highjacks” or changes the chemical processes that also control mood and temperament.
Once heroin binds to the receptors in the brain, neural activity decreases. In other words, the euphoria experienced by heroin users is actually a silencing of electrical activity in the nervous system. Among other things, it’s the beginning of a slow brain death. Like all opioids, heroin crosses the blood-brain barrier with great speed. A single dose of the drug can lead to eventual dependence and that change in brain chemistry will then require a higher dose of the drug to achieve a satisfactory high. Once a dependence or addiction has been developed for heroin, it is often easily identifiable by the need to revisit the high and go on using the drug regularly in order to avoid withdrawal symptoms.
Heroin users that regularly inject the drug report an initial “rush” or a state of euphoria that occurs immediately after the drug has been taken. Dry mouth, a feeling of heaviness, and a warm feeling or flushing of the skin might also be observed during the initial euphoric state. Users that choose not to inject often do not report this initial euphoric feeling. Once this initial rush is over, heroin users are often observed as in a wakeful but drowsy state, nodding out, where they are internally succumbing to the effects of the drug. It might appear that they are on the cusp of falling asleep, with intervals where they seemingly try to stay awake or keep themselves up. This is often referred to as being “on the nod.”
When the high wears off, neural activity jumps higher, resulting in hyperactivity and a fresh craving for that euphoria and stillness. Imagine a car going from zero to 200 miles per hour in six seconds. The need to slow down feeds on itself, requiring higher and higher doses to achieve the same effect.
The “pleasure center” of the brain is also targeted by heroin. Dopamine, a chemical in the brain, creates a feeling of well-being. This naturally occurring chemical is the “good feeling” from almost anything someone finds pleasure in. The body’s system has natural dopamine inhibitors that prevent too much of this chemical from being released. Heroin attacks these inhibitors, taking them “offline” and creating a flood of pleasure with each use.
Heroin also suppresses the central nervous system. Like morphine, it can slow breathing to the point of respiratory failure, cause changes in heartbeat and slow brain functions causing a cloudy state of mind.
Inpatient Treatment for Heroin Addiction
Opiate withdrawal is not physically fatal, but it is challenging. Heroin addiction is very difficult to beat because it changes the brain, re-wiring it to need the substance. Withdrawal is painful and almost immediate, which leads to a high relapse rate among addicts. Emotional stresses can trigger relapse as well.
Of the many methods and programs available for the treatment of heroin addiction, cognitive behavioral therapy has had encouraging results. According to NIDA, it works best in combination with pharmacotherapy such as step-down opioids that help the physical transition out of addiction. An inpatient approach offers greater control of both therapies, increasing the chances of success. It removes the addict from the social atmosphere and daily influences that caused the addictive behavior in the first place. Finally, inpatient therapy makes it easier to customize treatment to an individual’s personality, behaviors and needs.
Cognitive behavioral therapy teaches the addict ways to circumvent the “re-wiring” of heroin. Rewards and encouragement for clean drug tests and practical solutions for dealing with stresses that trigger a relapse are only two of the strategies involved, along with modification of expectations to help strengthen resolve. As small successes accumulate, the brain begins to recover its natural neural activity and dopamine levels, replacing heroin’s damage with new paths that are less disruptive to normal functioning.
Healing the body after heroin use takes only a few days. Healing the brain takes years, and many addicts report depression, lack of motivation, increased sensitivity to pain and lasting fatigue, varying in intensity by the severity and length of use.
According to the Foundation for a Drug Free World, 18 percent of drug users in rehabilitation are opioid addicts. Of the number that pursue traditional therapies, 90 percent relapse. That’s how difficult it is to kick the heroin habit.