If you are on this page at this moment, it is possibly because of one of two reasons. The first is that you have a loved one who is currently struggling with an addiction and is a serious source of concern to you and the second, which I consider more heartbreaking, is that you are the one battling in every dark corner of your soul to break away from the shackles of addiction. Whichever scenario it is, I am very glad that you have taken the very first step towards a lasting solution: seeking help. Let’s dive in and get you the help you need.
What is an addiction?
In the simplest of terms, addiction is an inability to stop using a substance or engaging in a behavior even though it is causing psychological and physical harm and in which an attempt to quit the said behavior or substance is accompanied by withdrawal symptoms. From the above, it can be made out that addictions are not necessarily limited to drugs but cut across several facets of our living. If an activity or substance has the potential to stimulate the pleasure centers of the brain, then it is a likely candidate for addiction. However, the scope of this article will be narrowed to substance abuse, particularly heroin abuse. Drug addiction differs from drug misuse (which is the use of drugs without a doctor’s prescription or inappropriate situations and at high doses) in the sense that not every drug misuse is a result of addiction while every case of drug addiction amounts to drug misuse.
Can a person become addicted to a prescribed drug?
The simple answer is yes, a person can get hooked on a drug prescribed to him by a qualified medical practitioner. This is particularly true for opioid analgesics used in the management of chronic pain. However, treatment regimens with Opioids are fashioned in such a manner that the benefits outweigh the risks and the risks of addiction are minimized. So, if an individual adheres to the laid down principle of therapy, his chance of addiction is significantly reduced.
Is there a difference between drug addiction and drug dependence?
While addiction is characterized by compulsive drug use despite harmful consequences and inability to stop using a drug with its attendant strained work, social, or family relationship, dependence refers to the physical dependence on the drug to maintain some level of functionality as evidenced by the onset of withdrawal symptoms in the absence of the drug. Addiction usually coexists with dependence, but an individual may be dependent on a drug but not necessarily addicted to it. This is the case with individuals taking a certain prescribed drug for the management of a chronic disease state.
How does heroin addiction occur?
Just like every other form of addiction, the underlying mechanism in the addiction to heroin lies in its effects on the central nervous system. These processes are quite complex and involve areas of the brain that are concerned with reward and motivation, memory and learning, and inhibition of impulses and behavior. Different individuals have varying tendencies of getting hitched on a substance like heroin and one’s vulnerability is determined by the interplay of genetics, age before exposure, duration of exposure, and several other environmental factors.
Initially, the decision to start taking the drug is guided by reason until following prolonged exposure, when the individual’s ability to choose is compromised by uncontrollable compulsion to seek out and consume the drug of interest. At this stage, the agent has successfully redesigned the neuronal circuits within the reward and motivation centers of the brain.
Signs that one may be addicted to heroin
It is usually very difficult for people to accept their addiction and even more difficult for family members to know when their own are using it. A person is likely hooked on a substance when the need to get a “fix” overrides his or her better judgment such that nothing else matters until they have gotten it. So, the primary sign of addiction is the compulsive desire to obtain and utilize the substance. Others include needle marks on body parts, flattening of the nasal bridge, aggressiveness or emotional lability when in need of a fix, recurrent infection, loss of appetite with attendant malnourishment, etc. The signs are not pegged on a wall and therefore, can vary with individuals. It is important to note changes in the individual’s lifestyle and query it as appropriate.
Treatment of heroin addiction versus relapse
Heroin, also known as diamorphine, is one of the most abused drugs in history books. The most important hurdle faced in the management of addiction is relapse. Addiction is a slippery slope and its management is a very delicate process requiring a multi-step, individualized, and evidence-based treatment approach. Because drug addiction usually co-occurs with other mental and underlying medical disorders, the best treatment plan is one that is tailored to the peculiarities of the individual and his changing need throughout treatment. For every relapse, heroin addiction gets more difficult to manage. Hence, the pressure is on getting it right the first time.
To prevent relapse, treatment options should include a combination of pharmacotherapy and behavioral therapy. Centers that utilize this combined approach to the management of addiction have been known to be associated with lesser relapse rates.
The use of drugs in the management of heroin addiction is based mainly on the pharmacological principles of antagonism and drug substitution. Detoxification centers employ these principles to minimize the incidence of severe withdrawal symptoms and de-escalate the negative events that accompany it. The detoxification process (a process by which the body rids itself of the object of addiction) is a very messy one if managed poorly and is associated with significant medical adverse events like hysteria, anxiety, seizures, vomiting, pain, etc. According to Gallus Detox, rehab centers that utilize top-notch medical principles with patient-focused treatment regimens usually have the best outcomes. These centers offer comfort during the period of treatment with evidence-based intravenous and oral medication regimens.
While pharmacotherapy is the first-line therapy for managing cases of heroin addiction, behavioral therapy is required to maintain treatment and prevent relapse. Research has it that methadone therapy for the treatment of Opioid addiction when combined with behavioral therapy had better patient outcomes. Pharmacotherapy alone can not address the psychological, social, and behavioral components of addiction. Behavioral therapy can take the form of individualized drug counseling or group counseling. Individualized counseling offers the advantage of addressing the individual’s illegal activity, employment status, and family and social relationships. Group counseling on the other hand is advantageous because it focuses on social reinforcement from peers or individuals with similar problems.
Heroin addiction is real. The negative consequences cut across the social, economic, psychological, and physical aspects of an individual. Treatment options vary depending on the specific needs of the individual and involve medical therapy in detox centers and behavioral therapies. Medical therapy is usually the first line and while effective, requires augmentation with behavioral therapy.