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How to Tell If You’re Having Hallucinations from Heroin Use

Heroin is not ordinarily thought of like a drug that causes hallucinations. In fact, there is a whole class of drugs that levies this kind of effect on users, altering perceptions and inducing sensations that are not real. 

The most widely known of these hallucinogens are LSD (lysergic acid diethylamide), mescaline, ketamine, PCP, psilocybin (mushrooms), and salvia. The illicit stimulant methamphetamine also causes users to experience sensations that aren’t real either. For example, someone on meth can feel as if something is crawling underneath his or her skin. Heroin typically inflicts other damages.

Heroin is more known for its ruinous effects on the brain, circulatory and respiratory systems — particularly in overdose. Yet, one underreported effect of heroin is its ability to induce hallucinations, senses such as visions, smells, or sounds that appear real to a user but are, in fact, not.

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A woman, who wrote about overdosing on heroin nine times, recalled her first time when she thought her mother was there:

“I couldn’t see anything, but I could hear my mom chattering on the phone. Quick, Cuban Spanish broken by an occasional burst of laughter…I couldn’t feel my body, either.  I don’t know how long I spent in that noisy blackness, but when my vision returned, I was not with my mom…I’d been hallucinating because I overdosed on heroin.”

Hallucination from heroin is a severe but underreported effect that indicates advanced dependency or addiction. Yet, there are telltale signs of what a heroin hallucination looks like. Read on to find out more about heroin and the hallucinations that it and other opioids can cause.

What Heroin Does to the Body

When heroin use declines into addiction, a user’s brain chemistry is profoundly altered. The opioid receptors and limbic system, which governs the pleasure and reward centers of the brain, respectively, are impacted to such a degree that users quickly develop an addiction. 

Heroin achieves this by mimicking the opioids that the body naturally produces. Opioids are the neurotransmitters that are created by the brain and body to block pain signals from reaching the brain, among other things. It is also responsible for modifying stress levels.

Heroin rapidly binds to opioid receptors. This action leads to an overproduction of opioids, which ultimately floods the brain. When this occurs, users feel an intense rush of sedation, pain relief, and euphoria. 

The influx of opioids affects the following areas:

  • Brainstem: Heroin and other opioids create blocks around the brainstem. This action keeps pain signals from reaching the brain, but it also slows down breathing. This is why opioids, in general, have cough-suppressant effects.
  • Spinal cord: Heroin also produces blocks around the spinal cord to keep pain signals in check and blunt the moderate-to-severe pain caused by injuries. 
  • Limbic system: The limbic system is stimulated by dopamine, the neurotransmitter that governs emotion, cognition, and pleasure. It also regulates how humans process feelings of motivation and reward. Heroin boosts dopamine levels, which causes the spike of euphoria that comes with use. 

What endows heroin with its addictive quality is how it impacts the body, particularly the production of dopamine. With repeated use, the brain begins to produce less of the opioid chemical on its own. This will cause users to experience intense cravings for heroin because they need it to feel “normal.”

This is also how heroin dependency develops. When the body relies on heroin for opioids and dopamine, it will build up a tolerance to the drug, requiring someone to use more of it to experience the same effects from previous dosages. When someone stops using heroin, especially after becoming dependent, the system crashes in response to the loss of dopamine and opioids. That ‘crash’ results in a litany of withdrawal symptoms that range from mild to severe.

When someone experiences a hallucination from heroin use, it is usually an indication that they are at the severe end of withdrawal.  

The range of symptoms include:

Mild

  • Muscle aches and pains
  • Fever and chills
  • Excessive sweating
  • A runny nose
  • Uncontrollable crying
  • Restlessness
  • Difficulty concentrating
  • Abdominal pain

Moderate

  • Nausea and vomiting
  • Diarrhea
  • Insomnia
  • Extreme fatigue
  • Depression
  • Anxiety
  • Agitation and mood swings
  • Intense heroin cravings

Severe

  • Hallucinations
  • Tremors
  • Irregular heartbeat
  • Elevated blood pressure
  • Impaired breathing
  • Panic attacks
  • Suicidal thoughts

What Morphine Has to Do With Heroin Hallucinations 

Morphine, one of the oldest pain medications in existence, is typically derived from the dried latex that is culled from the unripe seed pods from the opium poppy. Morphine is further refined to form heroin.

When heroin enters the body, it turns into morphine. Why is this important? Because morphine is the one opioid most responsible for producing hallucinatory effects. The more common effects of opioids include constipation, nausea, vomiting, and slow breathing. Still, opioid-induced hallucination is a possible, underreported outcome.

What Opioid-Induced Hallucination Feels Like

Renowned poet Samuel Taylor Coleridge published “Kubla Khan” in the early 1800s, yet it would go on to become one of the most anthologized poems in the English language. He wrote the poem after he experienced an opium-influenced dream. Musicians, writers, and other creatives have chronicled experiencing vivid details and images that are dreamlike as a result of their opium, morphine, or heroin use.

They reported that the hallucinations can feel like being in a sort of “waking dream” where they were able to see objects or hear voices that did not exist, like the aforementioned woman who thought she heard her mother while in overdose. During that same experience, she also thought she heard a television blaring in the background.

When she came to, the woman discovered that not only was her mother not there, but her boyfriend was kneeling over her instead. Only when she emerged from her overdose was she aware of her surroundings: “I could see our empty apartment behind him, the one we’d lived in for months but had never furnished. There was no TV…”

Multiple studies describe opioid-induced hallucination as an adverse side effect of opioid treatment, particularly in end-of-life and cancer pain settings. They also indicate something else about a heroin user.

What Heroin Hallucinations Also Indicate

The belief is that hallucinations from opioids are rare. However, they represent a toxic side effect of advanced substance abuse or addiction, as hallucination remains a severe side effect of heroin use.

This means that a user has developed a heroin dependency and a likely addiction, where use continues despite the adverse circumstances. While heroin withdrawal is not deadly, it can still compel a user to continue their cycle of abuse and addiction. In this instance, the only viable solution to breaking that course is professional addiction treatment

What’s more, street heroin is often cut with adulterants, additives designed to help the product meet weight expectations while allowing a dealer to “stretch” the product. Sometimes, the use of adulterated heroin can produce hallucinatory effects. It is not unusual for users to ingest heroin that has been cut with methamphetamine or used in combination with hallucinogens like PCP (phencyclidine) or LSD.  

Treatment for Heroin Withdrawal

The first step in treating heroin addiction is medical detox via medical maintenance therapy. You will be slowly weaned off the heroin in favor of weaker and less dangerous substances.

Medications that are used during heroin detox are listed below.

  • Methadone is a synthetic opioid that is longer-acting than heroin. It works by lessening cravings and blocking heroin’s euphoric effects by taking up space in the brain’s opioid receptors. Methadone itself can be addictive, and maintenance treatment of this kind requires careful monitoring.
  • Buprenorphine acts on the same neurotransmitters as heroin but, as a partial opioid, it is much weaker. Buprenorphine is like methadone but has much lower addiction potential.
  • Suboxone, the brand name for a combination of buprenorphine and naloxone, is used in emergency overdose situations. It works by binding to opioid receptors and blocking them.
  • Naltrexone completely blocks the effects of opioids and is nonaddictive. It can be taken once a day in pill form or once a month in the form of an extended-release injection under the brand name Vivitrol.

Once the heroin is removed from your body, and you are medically stabilized, the next treatment step is inpatient or outpatient care, depending on the severity of your addiction. Heroin withdrawal isn’t life-threatening, but treatment can be obtained on an outpatient basis, which allows you to attend to your daily obligations while undergoing therapy.

However, the relapse rates associated with heroin are relatively high compared to other substances. Thus, intensive, residential treatment is seen as the most effective inpatient plan for acute heroin addictions. In inpatient, you will live at the treatment center while receiving comprehensive therapy and counseling and around-the-clock supervision. 

Treatment length is also going to depend on the specific needs of a given individual, but according to the National Institute on Drug Abuse (NIDA), the minimum length for effective treatment is at least 90 days. In many cases, people will need anywhere from six months to a year in long-term residential treatment.

You also will have access to a number of treatment approaches that have been proven effective. Such methods and therapies include:

  • Cognitive behavioral therapy
  • Motivational interviewing
  • Medication management
  • Stress management
  • Relapse prevention planning
  • 12-step programs

After treatment, you can also be connected to aftercare programs such as alumni programs, support groups, and sober living communities to provide you with the necessary support.

Sources

Brico, E. (2017, August 15). This Is What it's Like to Overdose on Heroin Nine Times. from https://tonic.vice.com/en_us/article/d33v9x/this-is-what-its-like-to-overdose-on-heroin-nine-times

National Institute on Drug Abuse. (n.d.). Hallucinogens. from https://www.drugabuse.gov/publications/drugfacts/hallucinogens

National Institute on Drug Abuse. (n.d.). Heroin. from https://www.drugabuse.gov/publications/drugfacts/heroin

Opioid-Induced Hallucination: Distressful or Sought After? : Anesthesia & Analgesia. (n.d.). from https://journals.lww.com/anesthesia-analgesia/fulltext/2016/10000/Opioid_Induced_Hallucination___Distressful_or.7.aspx

What is Heroin? How is Heroin Made? What is Heroin Made of? – Drug-Free World. (n.d.). from https://www.drugfreeworld.org/drugfacts/heroin.html

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