What is heroin use?
Heroin is an illegal drug. It's highly addictive. It's an opioid, like some types of medicines that doctors prescribe to treat pain. Examples of prescribed opioids include hydromorphone, oxycodone, fentanyl, and morphine. Prescribed opioids have rules for legal use. Heroin does not. Heroin has no quality control. The strength of each dose is not known. It's often mixed (cut) with other drugs or things like powdered milk. It may also be cut with poisons, such as strychnine.
Often, heroin use starts with the misuse of a prescribed opioid. A person may then switch to heroin because it costs less, in spite of the greater danger of using it.
A person who uses heroin often will start needing bigger and bigger doses of the drug to get the same effect. This is called tolerance. If a person uses heroin regularly, the body gets used to it. This is called physical dependence. This leads to withdrawal symptoms within a few hours if the person stops using it or uses less.
Someone who uses heroin daily can become addicted to it within a few weeks. Addiction means that the person has a strong need to keep using heroin even though it causes harm to themself or to others. Heroin addiction is also called opioid use disorder.
Heroin overdose and rescue treatment
Using heroin can be dangerous. An overdose may cause trouble breathing, low blood pressure, a low heart rate, a coma, or death. It's hard to know how much heroin can cause an overdose. A lot depends on how strong the drug is and what it's cut with. And if a person starts using less heroin, they may lose tolerance to it. The person may be at a higher risk of overdose.
If you or someone you know uses heroin, talk to your doctor or pharmacist about a take-home naloxone kit. Naloxone is medicine that may help reverse the effects of heroin. A kit can help, and can even save your life, if you have taken too much heroin. You can get naloxone without a prescription at most drugstores or through a community Take Home Naloxone program.
What happens during withdrawal?
If a person who is physically dependent on heroin stops taking it or uses less, they will have withdrawal symptoms within a few hours. Symptoms can include anxiety, nausea, sweating, and chills. The person may also have diarrhea, stomach cramps, and muscle aches. These symptoms may be mild or severe. They may feel like influenza (flu).
Withdrawal can last from weeks to months. A person who has stopped using heroin will feel very ill for several days. A doctor may prescribe medicine to help relieve the symptoms.
Cravings for heroin usually go away over the next few months. But they may suddenly come back months later.
How can a person get help?
If a person decides to stop using heroin, it's safest to go through withdrawal under a doctor's care. Treatment for opioid use disorder may include medicine, group therapy, counselling, and education. The person may need to stay in a hospital or treatment centre.
Sometimes medicines are used. They can help the person take less heroin over time and then quit. Medicines can help control cravings. And they can ease withdrawal symptoms. Without medicine, people who have opioid use disorder usually go back to using heroin.
Treatment focuses on more than heroin use. It helps the person understand why they started using heroin in the first place. It also helps the person cope with the emotions that may come with trying to stop using heroin.
Counselling can also help the person's friends and family. It can provide support. And it can teach those people how to give the help that the person needs.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Where can you learn more?
Go to https://www.healthwise.net/patientEd
Enter P277 in the search box to learn more about "Learning About Heroin Use and Withdrawal".
Current as of: November 8, 2021
Author: Healthwise Staff
Medical Review:Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Michael F. Bierer MD - Internal Medicine, Addiction Medicine