Heroin Addiction Treatment in Connecticut

What Are the Immediate Short-Term Effects of Heroin Use?

When heroin is introduced into the brain, it is converted into morphine, which quickly binds to opioid receptors. Users often report experiencing a strong sense of euphoria, known as a “rush.” The intensity of this rush depends on the amount of the drug consumed and the speed at which it reaches the brain and attaches to the opioid receptors. Along with the rush, heroin users commonly experience a warm flush, dry mouth, and a heavy sensation in their limbs. Nausea, vomiting, and intense itching may also occur. After these initial effects, users typically feel drowsy for several hours, with impaired mental function, slower heart rate, and significantly reduced breathing. In severe cases, this slowed breathing can be life-threatening, leading to coma or permanent brain damage.

What Are the Long-Term Effects of Heroin Use?

Frequent heroin use alters both the brain’s physical structure and its function, leading to long-lasting imbalances in neuronal and hormonal systems that are difficult to reverse. Research has shown that heroin can cause damage to the brain’s white matter, which may impair decision-making, behavior regulation, and responses to stress. Heroin also leads to significant tolerance and physical dependence. Tolerance develops as users require increasingly larger doses to achieve the same effects, while physical dependence occurs when the body adjusts to the drug’s presence, triggering withdrawal symptoms if use is abruptly reduced.

Withdrawal can begin within hours of the last dose, with symptoms including restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold sweats with goosebumps (“cold turkey”), and involuntary leg movements. The most intense withdrawal symptoms typically peak 24 to 48 hours after the last dose and start to subside within a week. However, some individuals experience withdrawal symptoms for months. Continued heroin use often leads to heroin use disorder, a chronic, relapsing condition marked by uncontrollable drug-seeking behavior regardless of the consequences. Heroin is highly addictive, regardless of how it’s consumed, though methods like injection or smoking— which deliver the drug to the brain quickly—increase the likelihood of developing heroin use disorder. Once a person develops this disorder, obtaining and using the drug becomes their main focus.

What Are the Medical Complications of Heroin Use

Chronic heroin users, regardless of how they ingest the drug, face a range of medical complications, including insomnia and constipation. Lung issues, such as various forms of pneumonia and tuberculosis, can arise from both the user’s poor health and heroin’s depressing effect on respiration. Many also suffer from mental health conditions like depression and antisocial personality disorder. Men may experience sexual dysfunction, while women often deal with irregular menstrual cycles. Different methods of heroin use also carry specific risks. For instance, individuals who frequently snort heroin can damage the mucosal tissues in their noses, and in some cases, even perforate the nasal septum (the tissue dividing the nasal passages).

Chronic injection use brings its own set of medical consequences, such as scarring or collapsing veins, bacterial infections in the blood vessels and heart valves, abscesses, and other soft-tissue infections. Some street heroin contains additives that don’t dissolve easily, leading to blockages in blood vessels that supply organs like the lungs, liver, kidneys, and brain. This can cause infections or the death of small areas of cells in these vital organs. Immune responses to these impurities or other contaminants can also lead to conditions like arthritis or other rheumatologic disorders.

Sharing needles or other injection equipment can result in some of the most serious health risks associated with heroin use, including infections with hepatitis B and C, HIV, and other bloodborne viruses. These infections can then be transmitted to sexual partners and children.

How Is Heroin Use Disorder Treated?

There are several effective treatments for heroin use disorder, including behavioral therapies and medications. Both types of treatment work to restore normal brain function and behavior, leading to improved employment prospects and a reduced risk of HIV, other diseases, and criminal activity. While both behavioral and pharmacological treatments can be highly effective on their own, research indicates that combining both approaches tends to provide the best results for many individuals which is why Waterstone offers a comprehensive Medication-Assisted Treatment program.

Pharmacological Treatment (Medications)

Research has demonstrated that pharmacological treatments for opioid use disorder can significantly improve retention in treatment programs and reduce drug use, the transmission of infectious diseases, and criminal behavior.

When individuals addicted to opioids like heroin stop using the drug, they often experience withdrawal symptoms such as pain, diarrhea, nausea, and vomiting, which can be intense. Medications can be helpful during the detoxification phase, alleviating cravings and physical symptoms that may otherwise lead to relapse. One such medication, lofexidine, is a non-opioid approved by the FDA to reduce opioid withdrawal symptoms. Although detoxification itself is not a treatment for addiction, it serves as an important first step when followed by evidence-based treatments.

Medications for opioid use disorder interact with the same opioid receptors as heroin but are safer and less likely to cause the harmful behaviors associated with substance use disorders. These medications fall into three categories: (1) agonists, which activate opioid receptors, (2) partial agonists, which also activate the receptors but with a weaker response, and (3) antagonists, which block the receptors and prevent the rewarding effects of opioids. The choice of medication is based on the individual’s specific medical needs and other factors. Some effective medications include:

• Buprenorphine (Subutex®) is a partial opioid agonist. It alleviates drug cravings without producing the “high” or dangerous side effects of full opioids. Suboxone®, a formulation of buprenorphine, is taken orally or sublingually and contains naloxone (an opioid antagonist) to prevent misuse by injection. If injected, naloxone induces withdrawal symptoms, but this is avoided when taken as prescribed. Buprenorphine was FDA-approved in 2002 as the first medication eligible to be prescribed by certified physicians under the Drug Addiction Treatment Act, expanding access to treatment. The Comprehensive Addiction and Recovery Act (CARA), signed into law in July 2016, temporarily allowed nurse practitioners and physician assistants to prescribe buprenorphine through October 2021. In 2013, the FDA approved generic versions of Suboxone to make treatment more affordable, and in 2016, it approved a 6-month subdermal buprenorphine implant and a once-monthly buprenorphine injection, eliminating the need for daily dosing.
• Naltrexone (Vivitrol®) is an opioid antagonist. It blocks the effects of opioids without causing addiction, sedation, or physical dependence. However, patient adherence to the treatment can be a challenge, limiting its effectiveness. In 2010, the FDA approved an injectable, long-acting version of naltrexone (Vivitrol®) for the prevention of opioid relapse after detoxification. Administered monthly, this formulation improves compliance by eliminating the need for daily dosing.

Behavioral Therapies

While a range of effective behavioral treatments for opioid use disorder is available in both outpatient and residential settings, Waterstone offers an outpatient solution in an atmosphere of respect, understanding and compassion. We provide individual and group therapy services which can be tailored towards the needs of each individual patient’s needs. Approaches like contingency management and cognitive-behavioral therapy have also proven effective in treating heroin use disorder, especially when combined with medication.

• Contingency management is a behavioral approach that uses a voucher-based system, rewarding patients with “points” for negative drug tests. These points can be exchanged for items that promote healthy living.
• Cognitive-behavioral therapy (CBT) aims to help patients alter their thoughts and behaviors related to drug use, enhancing their ability to cope with stress and other challenges in life.

An essential aspect of treatment is tailoring the approach to the individual’s specific needs. Combining the most appropriate treatments increases the likelihood of successful recovery.

What Can Heroin Recovery Look Like with Waterstone?

A successful heroin recovery is a gradual process that involves regaining control over one’s life, rebuilding relationships, and restoring mental and physical health. It often starts with detoxification and managing withdrawal symptoms, followed by a combination of medications and behavioral therapies to address the underlying issues of addiction. In recovery, individuals work on developing healthier coping strategies, improving self-esteem, and learning to manage stress without turning to substances. They may attend support groups, maintain regular counseling sessions, and establish a stable routine that promotes positive habits. Over time, a successful recovery is reflected in a person’s ability to remain drug-free, hold down a job or pursue education, and maintain meaningful relationships, all while making choices that align with their long-term well-being and goals.