Heroin is an opioid drug derived from morphine, a natural substance taken from the seed pod of various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. It is a highly addictive opioid drug, and its use has repercussions that extend far beyond the user.
There are severe medical and social consequences of drug use, but heroin can be much worse than other illegal substances. It is a contributor to the spread of diseases such as hepatitis, HIV/AIDS, and other problems such as fetal effects, crime, violence, and disruptions in the family, workplace, and education.
Overall, heroin use in the general population is relatively low; however, the number of people that have started to use heroin has steadily increased since 2007. Officials suspect that one of the reasons for the increase is the shift from prescription pain medication misuse to heroin, which is readily available and a much cheaper alternative.
One other reason it may be on the rise is the misperception that pure heroin is safer than less pure forms because it does not need to be injected. Unfortunately, this is false. When other methods of taking the drug start to become less effective, heroin users will shift to injecting the drug to get high.
According to the National Survey on Drug Use and Health (NSDUH) in 2016, 948,000 Americans reported using heroin in the past year. The number continues to rise, and the trend is primarily driven by young adults ages 18-25, the group in which the most substantial increases have taken place.
Unfortunately, the number of first-time heroin users is astonishingly high, with 170,000 starting to use heroin in 2016, which is close to double. The effects of heroin abuse are being felt across the United States. Heroin, an illegal substance, is identified as fueling one of the most critical drug epidemics affecting nearly the entire country. It is a problem that has moved out of urban areas and infiltrated suburban and rural communities.
No matter how heroin is ingested, chronic heroin users can experience various medical complications that range from insomnia to constipation. Lung complications also arise, such as pneumonia and tuberculosis due to a lack of personal care. There is another issue that occurs from intravenous heroin use known as track marks. Track marks are the result of injecting drugs into the vein known as “shooting up,” and they can cause severe health concerns like infections. Unfortunately, if the drug user does not take care of this, it can become fatal.
So what exactly are track marks? As we have illustrated above, heroin addiction is a disease that compromises a person’s health and destroys their body over time. Much of the physical damage does not come from the drug itself but rather from a weakened immune system combined with self-neglect and poor self-care. Track marks form when the drug user injects drugs at the same IV injection sites. When the marks are fresh, they will be raw or bloody inflamed areas. Older track marks will often be calloused and discolored.
Track marks on the arms are the most common. They are usually found in the crook of the elbow because new users will learn how to inject heroin there. Alternate injection sites may be located on the wrist or the back of a user’s hand.
Track marks on the legs are often found on the inner thigh, and some heroin users will inject into large veins on their feet or the back of their hands. It is a painful process, but often, veins disappear in the more common areas and force them to find other places on the body.
Many users have found that shooting between their toes is a good spot because they can better mask their heroin habit. Unfortunately, when users run out of options to shoot heroin into, they will go to great lengths and shoot into their neck, breasts, or penis. When a user has reached this point, it shows how deep they are into a substance use disorder and need help.
If you suspect someone is using heroin intravenously, there are many signs to identify this. Many people who use heroin will wear long sleeves no matter the temperature. If it is a sweltering hot summer day, someone will wear long sleeves to cover their track marks.
Track marks will appear bruised because blood can leak out of the vein that is causing the bruising. The darkening of veins due to scarring and toxin buildup produces tracks along the length of the veins. Arterial damage can occur at the injection site, which can rupture and potentially result in hemorrhage, distal ischemia, and gangrene.
Repeatedly injecting into the same place is going to cause scarring of the peripheral veins, which, in turn, will cause the vein to collapse eventually.
A considerable disadvantage of injecting heroin is that users tend not to sanitize or clean the injection sites, which puts them at increased risk of cellulitis and thrombophlebitis. Another threat is sharing blunt, used needles with other users. These kinds of needles increase the likelihood of causing scarring and collapsed veins and contracting iseases like HIV/AIDS, and hepatitis.
One of the most common effects of IV drug use is the appearance of collapsed veins. The damage will occur to the lining of the veins, which causes blood clots to form within. Continued use of these blunt needles, constant use of the same injection area or improper injection technique can cause the vein to become completely blocked.
The appearance of tracks mark not only is an indicator of drug use, but it carries a social stigma due to the health risks attributed to this drug subculture. Using unsanitary needles can lead to severe skin infections, which include cysts, ulcers, and abscesses.”
Over time as someone’s IV heroin use increases, the frequently used injection sites will become infected, inflamed, and too painful to shoot heroin into. Unfortunately, individuals resort to injecting the drugs into other parts of their body, which include their groin, neck, hands, or feet.
Heroin users are often aware of their track marks, and they will take extra measures to hide the signs of shooting up. Since the forearm is a visible part of their body, they will inject into more discreet areas. Intravenous (IV) heroin users seek to find sites they can easily cover.
Ongoing heroin abuse can lead to tolerance, and to achieve the same euphoric effects associated with heroin, the person will have to consume higher doses than before. As this continues, it will be harder to function normally. When heroin users get used to a specific dose, they run the risk of overdosing if they are unsure of the strength of the heroin they are using.
There is a chance the substance they are ingesting is laced with fentanyl, a highly potent opioid that is between 50 to 100 times stronger than morphine. The heroin they consume also may be much purer than what they are used to, which also can cause them to take too much and overdose. To mitigate these risks immediately, they must seek treatment. Proper treatment of a heroin addiction requires medical intervention.
Heroin withdrawal can occur anywhere from six to 12 hours after the last dose, and symptoms can include:
The first treatment phase is medical detoxification. The purpose of detox is to have a safe transition into sobriety while mitigating the risks of anything that can happen unexpectedly. There will be 24-hour access to staff who will monitor how you’re progressing and could offer medications that alleviate the symptoms.
The next step in treatment may be to enter residential treatment if such a placement is the proper fit. If you have reached the point of injecting heroin, you must stay in the most intensive levels of care to give yourself the best chance at lasting recovery.
During treatment, you will be exposed to different types of therapy that aim to change behaviors that encourage addiction and get to the root of the addiction. These include:
These all have a purpose and will help you achieve your goal of long-term sobriety. Are you ready to get help for your heroin addiction?
National Institute on Drug Abuse. (n.d.). What are the medical complications of chronic heroin use? from https://www.drugabuse.gov/publications/research-reports/heroin/what-are-medical-complications-chronic-heroin-use
HIV/AIDS. (2019, June 28). from https://www.cdc.gov/hiv/risk/idu.html
National Institute on Drug Abuse. (2015, July 29). Addiction Science. from https://www.drugabuse.gov/related-topics/addiction-science
National Institute on Drug Abuse. (n.d.). What is heroin and how is it used? from https://www.drugabuse.gov/publications/research-reports/heroin/what-heroin