Heroin use no longer predominates solely in urban areas. Recently, several suburban and rural communities near Chicago and St. Louis have reported increasing amounts of heroin seized by officials as well as increasing numbers of overdose deaths due to heroin use. Heroin use is also on the rise in many urban areas among young adults aged 18-25. Individuals in this age group seeking treatment for heroin abuse increased from 11 percent of total admissions in 2008 to 26 percent in the first half of 2012.*
Heroin use increase among those seeking treatment: 18-25 yr olds in urban, suburban and rural America up from 11% (2008) to 26% (2012). Young adult use has almost tripled.
Heroin use among young adults is of particular concern. Once heroin enters the brain, it is converted to morphine and binds rapidly to opioid receptors. Abusers typically report feeling a surge of pleasurable sensation—a “rush.” The intensity of the rush is, obviously, a function of how much of the drug is taken and how rapidly the drug enters the brain and binds to the opioid receptors. In the worst instances, heroin use can be fatal, even for a first-time user. Sometimes it can result in coma, and permanent brain damage. And even in the best-case scenario, it can lead to other side-effects and complications such as cognitive-behavioral deficits and diminished self-regulation.
Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations. Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence, the body adapts to the presence of the drug and withdrawal symptoms occur if use is reduced abruptly.
Post-acute withdrawal from addictive heroin use can last months, chronic addiction exceeds physical dependence and seeking & using become a primary life purpose.
Another concern is the increasing abuse of prescription opioids and their synthetic derivatives. Unintentional poisoning deaths from prescription opioids quadrupled from 1999 to 2010 and now outnumber those from heroin and cocaine combined. People often assume prescription pain relievers are safer than illicit drugs because they are medically prescribed. However, when these drugs are taken for reasons or in ways or amounts not intended by a doctor, or taken by someone other than the person for whom they are prescribed, they can result in severe adverse health effects. Addiction, overdose, and death, especially when combined with other drugs or alcohol can result. Research now suggests that abuse of these medications may actually open the door to heroin use. Nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin. Some individuals reported switching to heroin because it is cheaper and easier to obtain than prescription opioids.
Pain avoidance is unhealthy and detrimental to young adult emotional development. Substance abuse as a result of pain avoidance can and does often begin with prescribed medications. Heroin use in many cases is a natural step in the deterioration of self-control and self-esteem that can perpetuate and increase addictive heroin use into the future.
*All Statistics from the National Institute on Drug Abuse, 2014
David Petersen, LCSW, LAC, December 1, 2015