Heroin Addiction and Treatment for Heroin Addiction

Introduction

Heroin addiction is one of the most destructive forms of substance dependence.

Street names in English: Dope, Smack, H, Junk, Skag, Snow, Horse, China white, Brown, Beast, Hero
Street names in Hindi : Brown sugar, Chitta, Smack,

Heroin is an opioid drug made from morphine which is derived from the seed pods of certain varieties of the poppy plant. It is pale yellow, off white, brown and black which is called as black tar heroin. It is usually cut with talcum powder, laundry detergent, rat poison, powdered milk, quinine, starch or sugars. Dangerous cutting agents currently is fentanyl which can have fatal side effects if fixed. Pure heroin is snorted like cocaine and also fixed . Black tar heroin has impurities, and is ‘fixed’ or injected into veins. Agents used to dissolve heroin before fixing can be distilled water, lime juice, vinegar etc but which can cause abscesses, ulcers and infections. Using non-sterilised neeldes and sharing needles increases the risk of transmission of diseases like HIV, Hepatitis B, Hepatitis C. Injections sites are veins, under the skin, muscles etc.

Among people aged 12 or older in 2021, 0.4% (or about 1.1 million people) reported using heroin in the past 12 months (2021 DT 1.1).
Source: 2021 National Survey on Drug Use and Health*
In 2022, an estimated 0.3% of 8^th graders, 0.2% of 10^th graders, and 0.3% of 12^th graders reported using heroin in the past 12 months.
Source: 2022 Monitoring the Future Survey
Among people aged 12 or older in 2021, an estimated 0.4% (or about 1.0 million people) had a heroin use disorder in the past 12 months (2021 DT 5.1).
Source: 2021 National Survey on Drug Use and Health*
In 2021, approximately 9,173 people died from an overdose involving heroin. Learn more about overdose death rates.
Source: CDC WONDER Database
The COVID-19 pandemic had an impact on data collection for the 2021 National Survey on Drug Use and Health (NSDUH). For more information, please see the 2021 NSDUH Frequently Asked Questions from the Substance Abuse and Mental Health Services Administration.

Short Term Effects of Heroin

A person sitting on a wooden floor with arms crossed over knees. Nearby, a used syringe and cotton suggest drug use, creating a somber, reflective mood.

Heroin converts tp morphine and binds to opioid receptors in the brain . It gives a ‘rush’ of euphoria followed by flushing of skin, dry mouthand heavy extremities. There can eb effects like nausea, vomiting and severe itching. After initial effects, the person remains very drowsy for hours, thoughts wil be clouded over, heart and respiratory fucntions slow down considerably which can prove fatal. There can be coma or permanent brain damage.

Long Term Effects

Heroin results in hormonal and neurological changes in the brain. [1-3] references. Deterioration of brain matter and white matter- the brain’s decision making abilities are affected. Huge ttolerance and extreme dependency can develop.

Withdrawals can vary depending on duration from usage

From few hours – restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and leg movements.
24-48 houts – major withdrawals peak after last dose, ,ight subsid ein a week
In some people withdrawals can last for months
Heroin use syndrome- which is the chronicn relapsing disease with obsessive compulsive use which is extremely addictive

Routes of administration

Fixing – diluting the powder with distilled water, lime juice
Chasing – keeping It on a foil paper and heating it from the bottom and inhaling the fumes
Smoking – rolling it with tobacco and smoking it
Snorting- high quality heroin or heroin ‘cut’ with fentanyl etc

Link of heroin use with prescription medication

A syringe, ampoule, plastic spoon, and two red-and-white capsules on a dark gray background, conveying a medical or pharmaceutical theme.

In the US or wherever opioid pain medication has been prescribed for pain and the person gets addicted to it, they cannot be obtained without a prescription or on the streets they are very expensive. Heroin becomes a cheaper and more easily obtainable alternative and the addiction escalates.

Medical Consequences of Chronic Heroin Use

Insomnia
Respiratory distress syndrome due to suppression of respiratory centre of the brain
Pneumonia
Low immunity resulting in Tuberculosis
In those who use the route of fixing- abscesses, ulcers on skin, clogged blood vessels
Bacterial infections, sepsis, resulting in heart and lung complications
Infarctions in brain, lungs, can result in seizures and death
Scarred and collapsed veins
Sharing of injection needles and syringes can result in HIV, Hepatitis C and other blood borne viruses etc
Snorting can damage the nasal passage can create a sinus or ulcer in the nasal septum between the nasal passages etc.
Risky sexual behaviors can occur

Heroin Use and pregnancy

A pregnant woman holds a syringe in her hand, partially illuminated against a dark background. The atmosphere conveys caution and contemplation.

Heroin use in pregnant women results result in children born with Neonatal Abstinence syndrome [NAS] in which the new born can face symptoms akin to heroin withdrawal like insomnia, crying spelles, pain, seizures , weight loss. Tremors, diarrhoea etc.

Solution – getting the mother on a buprenorphine replacement therapy with abstinance from heroin with the infant being treated with morphine on birth to deal with the NAS.

Heroin Overdose

Heroin overdose causes respiratory depression and drops heart rate. Antidotes are injections of Naltrexone.
Heroin addiction affects not only the individual, but also families, communities, and society at large. Yet recovery is possible. Heroin addiction treatment is not about quick fixes or rigid programs; it is about creating a pathway to healing that is tailored to the individual. At Anatta, we believe that every person struggling with addiction deserves dignity, compassion, and access to evidence-based care that can transform lives.

Core Principles of Effective Treatment

A group of people sit in a circle in a bright room. A man in a hoodie looks down, appearing distressed. Others offer support, one with a comforting hand on his shoulder.

Successful heroin addiction treatment is guided by a few essential principles:

Individualised plans: No two people have the same story. Treatment must be personalised to drug history, health conditions, mental well-being, and social environment.
Comprehensive care: Recovery requires more than medical treatment. Effective programs combine medication, therapy, social support, and long-term strategies for rebuilding life.
Long-term perspective: Addiction is a chronic condition. Sustainable recovery requires ongoing care, monitoring, and relapse prevention strategies.
Evidence-based methods: Interventions proven by science should always be at the core of treatment.

Medical / Pharmacological Treatments

Managing withdrawal and cravings is a critical part of heroin addiction treatment. Detoxification, when medically supervised, ensures safety and comfort during the initial phase. Medications can ease withdrawal symptoms and reduce the risk of relapse.

Key medications include:

Methadone: A full opioid agonist that stabilizes the patient, reduces cravings, and prevents withdrawal. It has a long history of helping people stay in treatment.
Buprenorphine: A partial agonist that controls cravings and withdrawal with a lower risk of overdose. Often combined with naloxone to prevent misuse.
Naltrexone: An opioid antagonist that blocks heroin’s effects, reducing the incentive to use. Injectable forms improve adherence.

These medications are most effective when combined with counseling and ongoing support, forming a comprehensive treatment plan.

Psychosocial Treatments / Therapies

Medication alone is rarely enough. Behavioural and psychological support helps individuals address the underlying triggers and rebuild life skills.

Effective therapies include:

Cognitive Behavioural Therapy (CBT): Identifies harmful thought patterns and develops healthier coping strategies.
Motivational Interviewing (MI): Enhances internal motivation to engage in recovery.
Contingency Management: Rewards positive behavior such as remaining drug-free.
Family Therapy & Community Reinforcement Approach: Involves loved ones to strengthen support networks and improve outcomes.
Peer Support Groups: Programs like Narcotics Anonymous provide shared experiences, accountability, and hope.

Combining Treatments & Stages of Care

Recovery is a process, not a single event. Heroin addiction treatment often involves multiple stages:

Inpatient / residential care – Stabilizes the patient in a safe, structured environment.
Intensive outpatient programs – Allows more independence while continuing therapy and medical support. This is after completion of long term residential rehabilitation programs.
Intensive Family Therapy Simultaneous counseling of the family- co-dependents affected by the using is done.
Outpatient care & continuing support – Focuses on maintaining recovery, preventing relapse, and reintegrating into daily life.

Transitions between stages are guided by the individual’s progress and needs. This continuum ensures support is available at every step.

What Makes a Quality Treatment Program

A doctor in a white coat, with a stethoscope, writes notes in a planner at a desk with a laptop, glasses, and an X-ray, conveying a focused, professional atmosphere.

Not all programs are equal. A high-quality heroin addiction treatment program has certain key features:

Thorough assessment and personalized planning: Every plan is tailored to the individual’s needs, history, and goals.
Evidence-based approaches: Combines medication, therapy, and psychosocial support proven to work.
Qualified and trained staff: Professionals experienced in addiction care.
Integration with medical and mental health care: Addresses co-occurring conditions like depression or anxiety.
Continuity of care and aftercare support: Ensures relapse prevention and long-term monitoring.
Family and community involvement: Encourages supportive relationships that aid recovery.

Red flags include rigid, one-size-fits-all programs, promises of “quick cures,” unproven therapies, and lack of follow-up care.

Challenges & Barriers

Even the best programs face obstacles. Some common challenges in heroin addiction treatment include:

Stigma: Fear of judgment can prevent individuals from seeking help.
Limited access: Not all regions have sufficient clinics or specialists.
Cost and insurance limitations: Treatment can be expensive and sometimes not covered.
Dropouts and nonadherence: Some individuals leave programs early or fail to follow through.
Co-occurring mental health conditions: Depression, anxiety, or trauma may complicate recovery.
Relapse: Part of chronic disease management; requires adjustment, not judgment.

What Recovery Looks Like

Recovery is more than abstaining from heroin. It encompasses rebuilding a life of health, purpose, and relationships. Key aspects include:

Physical and mental health improvement
Restored relationships and social functioning
Personal growth and purpose beyond addiction
Coping strategies and relapse prevention tools
Ongoing support and life management skills

Relapse does not equal failure. Like managing other chronic conditions, heroin addiction requires long-term care, adjustments, and support systems.

Role of Anatta in Heroin Addiction Treatment

Young man in casual attire intently talking with a therapist in an office. The therapist holds a clipboard, creating an atmosphere of attentive listening.

At Anatta in Mumbai, we provide a compassionate, evidence-based approach to heroin addiction treatment. Our programs combine medical support, counseling, and psychosocial care, tailored to each individual’s unique needs.

What sets Anatta apart:

Comprehensive care: From medically supervised detox to therapy, family support, and peer programs.
Holistic approach: Incorporating wellness practices, mindfulness, and life skills training.
Accessibility: Supportive, nonjudgmental environment designed to reduce barriers to treatment.
Ongoing guidance: Long-term follow-up and relapse prevention strategies to maintain recovery.

Our goal is to not only help individuals stop using heroin but to rebuild their lives with purpose, confidence, and resilience.

Conclusion

Heroin addiction is challenging, but recovery is achievable. Heroin addiction treatment that combines medical care, behavioral therapy, social support, and personalized planning offers the best chance for long-term success.

At Anatta, we believe in walking this journey with empathy, expertise, and dedication. Recovery is not a single moment—it is a process, a path toward health, stability, and a fulfilling life. No one has to face it alone. Help is available, and change is possible.

Wang, X.; Li, B.; Zhou, X.; Liao, Y.; Tang, J.; Liu, T.; Hu, D.; and Hao, W. Changes in brain gray matter in abstinent heroin addicts. Drug Alcohol Depend 126(3):304–308, 2012.
Ignar, D.M.; and Kuhn, C.M. Effects of specific mu and kappa opiate tolerance and abstinence on hypothalamo-pituitary-adrenal axis secretion in the rat. J Pharmacol Exp Ther 255(3):1287–1295, 1990.
Kreek, M.J.; Ragunath, J.; Plevy, S.; Hamer, D.; Schneider, B.; and Hartman, N. ACTH, cortisol and beta-endorphin response to metyrapone testing during chronic methadone maintenance treatment in humans. Neuropeptides 5(1-3):277–278, 1984.