Heroin: tolerance and dependence

Drug Rehab Arizona

Heroin: tolerance and dependence

Heroin is a drug processed morphine, which is extracted poppy plants’ resin. The federal government has categorized it as Schedule 1 substance alongside cocaine and other drugs.

In most instances, victims inject heroin into their body using syringes. It can be injected into muscles, veins, or under the skin.

Heroin is mostly sold as a brownish of white powder “cut” with quinine, sugars, powdered milk, or starch. Heroin addiction is extremely dangerous.

In its purest form, heroin can be smoked or snorted and is usually more appealing to new users as it does doesn’t necessarily have to be injected, something that puts off most users.

How does Heroin Work?

Heroin affects the central nervous system, brain, and affects all other parts of the body. When you take heroin it gets into the circulatory system that transports it to the brain where it disrupts endorphin production and amount sent to the body.

This action ends up creating more intense euphoria while suppressing physical pain and this makes heroin a very effective analgesic. As well, heroin suppresses the spinal cord and central nervous system.

With this chemical, you will experience slowed motor function which explains why you feel it and so relaxed when taking heroin.

Heroin Tolerance

From available evidence, sustained use of heroin is very addictive.

If you use heroin on regular basis, you may develop tolerance and dependence on it, which means you will need to take larger amounts of it to get to the same level of high.

You may be psychologically or physically dependent on heroin, or both. If you become dependent on heroin it will take a control on your life and become far more important than any other activities in your life.

Psychological dependence means you will feel an urge to use the substance when you are socializing with users or in specific surroundings. Physical dependency means your body has adapted to the drug and is used to functioning with the heroin present.

What is Heroin Abuse?

Heroin is an illegal and very addictive substance. As much as it has a negative reputation for its adverse negative effects on the human body, it is one of the most abused drugs in the US.

No matter how heroin is used, it delivers potent effects very quickly. Because it is difficult to gauge the strength of heroin, users are always at risk getting a fatal overdose.

Heroin abuse results from the fact that it gives them immediate pleasurable feelings including a warm and calm feeling increased sense of confidence and well-being, surge of pleasant feeling commonly called the “rush,” and slowed feelings in the legs and arms.

Is Heroin Dangerous?

Heroin is one of the most dangerous illegal substances to humans. It is very addictive and with each subsequent use, the risk of dependency gets higher and higher. Users can inject, snort, or smoke it into muscles, under the skin, or veins. Whichever way you use it, you risk high psychological and physical dependence which may end up running your life.

High dependency on heroin may completely wreck your life, as you will no longer be able to do anything without taking substance.

Should I Stop Taking Heroin?

Heroin is a very addictive substance and no amount is considered safe. Even if you use heroin in the short term there are very high chances you will quickly develop tolerance to it. Heroin dependency is very easy to develop, as after each use you will need more of it to get to the same level of high.

If heroin use takes a hold on you, you will experience withdrawal symptoms within a quarter to half-day after using the drug. The withdrawal symptoms include:

– Increased heart rate and blood pressure

– Drug cravings

– Nausea and vomiting

– Moodiness

– Join paint, muscle spasms, tremors

– Stomach cramps

– Fever and chills

– Watery eyes, runny nose, sweating

– Yawning, restlessness, insomnia

– Diarrhea

Who Abuses Heroin?

Whites in their 20s that don’t live in urban areas

Heroin addiction and use is not limited to certain groups or people, but some groups appear to use it more than others. One of the biggest groups abusing heroin is whites in their 20s who do not live in large urban areas. Heroin use has moved to suburbs from inner cities as well as rural areas.

All groups of people

People with tendency to abuse drugs are ly to abuse heroin. Studies show that heroin can be abused by any person depending on factors such as environmental and company.

Quitting Heroin

Use of illegal drugs is always risky so the earlier you decide to quit the better for you. any other drug, heroin poses great health risk as well as exposing you to other risks such as infection from sharing drugs and getting arrested for possession and use of illegal substances.

If you are planning on quitting, it’s strongly recommended that you consult a specialist that can create a custom plan for you. Also, you can visit a rehab center as they specialize in helping people you.

There is no standard treatment for heroin addicts; each of them requires a treatment that suits their needs. There are various therapies for heroin addicts including dual diagnosis, group counseling, 12 step programs, inpatient treatment, and individual therapies.

By having a customized recovery you increase chances of getting a full recovery so you can lead drug-free life once again.

Heroin doesn’t have long-lasting effects as it get cleared from the system after few hours. Withdrawal symptoms for heroin last for 6-12 hours after the last dose. The severity of withdrawal on average peaks is 1-3 days.

In most cases, withdrawal symptoms will go away in 5-7 days after last dose factors such as your physiology, duration of addiction, and amount used. A person that is very addicted may be admitted to a drug rehab.

Source: https://scottsdalerecovery.com/heroin/

Understanding What the Long-Term Effects of Using Heroin Are

Heroin: tolerance and dependence

Heroin is a dangerous, illegal drug deriving from the opium poppy. The drug is related to morphine and other prescription narcotic painkillers fentanyl and oxycodone.

When people snort, smoke, or inject heroin, they will feel an intense, euphoric high when the central nervous system depressant takes effect. An estimated half a million people have used heroin in the past month.

As one of the most addictive drugs in the world, using heroin, just one time can result in tolerance, dependence, and addiction.

When people try to quit or cut back on heroin, they will experience a range of painful withdrawal symptoms, some of which can last for months or years after cessation, but getting help for heroin addiction is critical. The long-term physical and psychological effects of the drug are devastating.

What is heroin addiction?

When someone uses an addictive substance heroin, their brain and body are significantly impacted. With heroin, in particular, the body develops a physical tolerance and dependence on the drug quickly. Tolerance is what happens when someone takes a hit of heroin and gets high. But their body becomes used to that dose of heroin fast.

The next time they use heroin, they won’t get the same intense effect from the drug at the same dosage. Instead, they will need to use more of the drug. As they continue to use heroin, the brain and body become more tolerant of ever-increasing heroin levels. As a result, physical and sometimes psychological dependence on the drug emerges.

This process of tolerance and dependence with substance addiction happens when someone uses any addictive material, but with heroin, it happens more quickly and intensely.

When someone is physically dependent on a drug heroin, they will experience painful withdrawal symptoms once they attempt quitting.

These withdrawal symptoms occur because the brain and body are used to having heroin in their system.

What are the short-term impacts of heroin use?

When someone snorts, smokes, or shoots heroin, they will experience a range of short-term, intense effects and other signs of drug addiction.

  • Intense euphoria, or high
  • Sudden bursts of energy followed by extreme drowsiness
  • Pain relief
  • Dry mouth
  • Slowed breathing and lowered blood pressure
  • Constricted pupils
  • Slurred speech
  • Flushing
  • Itching

The intense euphoria produced by heroin is highly addictive on an emotional and psychological level, but this euphoria, or high, is something that lessens as heroin addiction progresses.

People addicted to heroin will continue to use increasing amounts of the drug or attempt mixing the drug with other substances as a way to experience the same level of intensity they had when they first got high on heroin.

In drug addiction, this phenomenon is called “chasing the dragon.” 

Continued, long-term and heavy use of heroin has devastating effects on the brain and body. Also, people who abuse heroin are at increased risk of other issues, infections. HIV, hepatitis, and other bloodborne illnesses can happen to those who inject drugs heroin.

What are the long-term physical effects of heroin addiction?

Mainly, the long-term impacts of heroin use affect the brain and the body in a few different ways. Physically, people who are addicted to heroin put themselves at increased risk of infections. While bloodborne infections and skin infections are a risk when people inject heroin, respiratory infections frequently occur in heroin users, no matter which way they use the drug. 

When someone uses heroin, the drug suppresses respiration. Heroin can make someone take shallow, frequent breaths and prevents the lungs from adequately clearing themselves of mucus and other irritants.

This puts someone at an increased risk of respiratory infections, such as bronchitis and even tuberculosis. Heroin can also cause problems with joint mobility.

Many long-term users of heroin will develop arthritis as well.

What is heroin use disorder?

Persistent withdrawal symptoms that occur many months or even years after quitting heroin happens to many long-term users. Distressing withdrawal symptoms, depression, anxiety, and intense cravings, increase the risk of relapse. Repeated heroin use can result in a condition called heroin use disorder. This disorder is a chronic relapsing disease.

Heroin use disorder goes beyond the physical dependence that happens with heroin addiction. Instead, heroin use disorder has more to do with the changes in brain structure and chemistry that occur with long-term heroin use. People with heroin use disorder will exhibit uncontrollable drug-seeking behavior, despite the problems it causes.

Early intervention in heroin addiction is the key to preventing this devastating disease.

Are you or a loved one exhibiting the signs of heroin addiction? Stopping heroin addiction early can prevent many of the long-term health consequences and risks associated with the disease. Please reach out to us today at Mission Harbor Behavioral Health to learn more about your treatment options.

The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help

Alcohol addiction is extremely difficult to overcome on your own.. Seek specialized help and let professionals guide you in your recovery.

Source: https://sbtreatment.com/heroin/long-term-effects/

What Does Heroin Do To Your Body?

Heroin: tolerance and dependence

Heroin is an extremely addictive opioid drug that can cause serious harm to the body. Those who use heroin can suffer from aftereffects that include addiction, brain damage, chronic medical complications, or even overdose and death. Seeking treatment for heroin addiction is the best way to prevent the long-term and potentially fatal side effects of heroin abuse.

Using heroin can severely impact your body. Just one use can cause severe complications and make it difficult to stop taking the drug. Heroin can be smoked or snorted, but most users inject it directly for the quickest high.

Smoking or injecting this drug increases the potential for addiction and overdose. Those who are addicted will have a challenging time quitting. People suffering from heroin addiction often exhibit compulsive behaviors to obtain and use the drug.

The longer a person abuses heroin, the more damage to the body he or she will experience. However, many people who abuse heroin will experience the short-term effects of the drug after just a few uses. Both short-term and long-term damage can occur as a result of heroin abuse.

Effects Of Short-Term Heroin Use On The Body

Heroin is a very fast-acting drug. Once it enters the system, it quickly creates reactions in the brain and pulses throughout the body. When injecting the drug intravenously, the effects take roughly seven to eight seconds to be felt. People who use heroin report feeling an immediate surge of pleasurable sensations. This is referred to as a rush.

While the rush happens immediately, there is also a variety of aftereffects that occur from heroin. Heroin does not only provide the user with a euphoric rush. On the heels of this rush, the drug can present a variety of uncomfortable symptoms, including:

  • alternating between drowsiness and wakefulness
  • respiratory depression
  • decreased heart rate
  • nausea and vomiting
  • dry mouth
  • intense itching
  • flushing of the skin
  • a heavy feeling in the extremities
  • clouded mental functions
  • slowed breathing
  • slurred speech
  • constricted pupils

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Effects Of Long-Term Heroin Use On The Body

Long-term heroin use can destroy the gray matter in the brain. Gray matter in the brain controls muscle movement, sight, hearing, emotions, speech, decision-making, and behavior.

All of these functions can be impaired through heroin use. The longer the use of the drug and the higher the dosage, the more stress is put on the body. Unfortunately, long-term use can create imbalances that are not easily reversed.

When the brain is impacted by heroin over an extended period of time, an individual may develop the inability to regulate behavior or fail to respond to stressful situations. Heroin also produces substantial degrees of tolerance and physical dependence that make quitting the drug extremely difficult.

In addition to the damage to the brain, other long-term effects of heroin use on the body include:

  • inflamed gums
  • chronic constipation
  • tooth decay and tooth loss
  • weakened immune system
  • respiratory problems
  • muscular weakness
  • memory loss
  • decreased sexual function

Tolerance And Dependence From Heroin Abuse

The rush from heroin use is so intense and pleasurable that the individual often experiences a desire to repeat the process. The cycle of consumption and desire becomes more frequent, and the amount of heroin a person uses increases.

Eventually, the feeling from that original high is difficult to obtain, and the person needs to use more of the drug for the desired results. This is called tolerance. Tolerance occurs when more of the drug is required to achieve the same effects. With physical heroin dependence, the body adapts to the drug, and withdrawal symptoms occur quickly if the drug is stopped.

Heroin causes physical dependency in a short period of time. When addiction happens, the body and the brain become chemically imbalanced. If heroin is not consistently introduced into a person’s body, they have a strong reaction called withdrawal.

Withdrawal From Heroin Abuse

When a physical dependence on heroin exists and the drug is stopped, a person will begin to experience withdrawal. Typically, withdrawal symptoms start within six to 12 hours of the last dose, peak in two to three days, and last up to 10 days in total.

Withdrawal from heroin may include the following symptoms:

  • cold flashes with goosebumps
  • muscle and bone pain
  • nervousness
  • restlessness
  • strong cravings
  • trouble sleeping
  • uncontrollable leg movements
  • vomiting and diarrhea

These withdrawal symptoms range in severity the level of dependence and duration of abuse. Unfortunately, many people who attempt to stop using heroin relapse or overdose in an effort to reduce the symptoms of the withdrawal.

Heroin Overdose

When tolerance is achieved, a person will begin taking larger doses of the drug to meet the high. Unfortunately, the body may not be able to handle higher doses of the drug and an individual may experience an overdose.

Heroin overdose fatalities are mainly due to respiratory failure or asphyxiation. Large doses of heroin will slow the respiratory system and cause the person to appear very drowsy or sleepy.

Leaving someone to “sleep it off” can be a hazardous or life-threatening situation. A heroin overdose can cause long-term complications in the body and brain and can even lead to death.

The following are signs and symptoms of a heroin overdose:

  • low blood pressure
  • pinpoint pupils
  • sedation
  • blue or purple nails and lips
  • delirium
  • disorientation
  • dry mouth
  • shallow or slow breathing
  • stomach and intestinal spasms
  • uncontrolled muscle movements
  • weak pulse
  • coma
  • unresponsiveness

Heroin Addiction Treatment

Physical and emotional healing from heroin needs to begin in a safe detox center while undergoing a comprehensive heroin addiction treatment program. If you believe that your loved one is abusing heroin, contact Swift River right away. Our treatment facility provides individualized programs for people struggling with heroin abuse and addiction.

At Swift River, we offer you or your loved one a variety of treatment methods and techniques. All of our programs are medically proven methods that have been tested and approved for use in addiction treatment.

Our addiction treatment methods include:

  • medically supervised detox
  • physical health monitoring
  • dual diagnosis treatment
  • recreational treatment
  • group therapy
  • behavioral adjustment techniques
  • adventure therapy
  • aftercare services

Addiction treatment is a serious commitment and requires ongoing maintenance. At Swift River, we will promise to be with you or your loved one every step of the way. If you want to learn more about heroin addiction or talk to one of our specialists, call us today.

Source: https://www.swiftriver.com/blog/heroin-effects-on-body/

High Tolerance to Alcohol and Drugs

Heroin: tolerance and dependence

Tolerance occurs when someone repeatedly uses alcohol or other drugs. Over time, the body no longer reacts to the substance the same way it did the first time the person consumed it. With increased tolerance, the brain may not feel euphoria or could experience coordination problems. The rest of the body may not suffer nausea or other side effects of substance abuse.

The level of tolerance and the length of time it takes for toleranace to develop depend on a number of factors. Genetics playa significant role in the way the body reacts to alcohol and other drugs. Some drugs cause tolerance more quickly thanothers. The environment in which a person consumes the substance also plays a large role in his or her level of intoxication.

The phenomenon forces those intent on achieving euphoria or intoxication to consume higher doses of the substances or toconsume them in riskier ways.

For example, a person who develops a high tolerance to alcohol after drinking beer overlong periods of time may begin to drink shots of liquor in short periods of time to get drunk.

A person who developsa high tolerance to heroin after smoking it may begin injecting it.

People may mix different types of drugs to achieve their desired side effects. These methods of administration drasticallyincrease a person’s risk of negative side effects, such asblacking out,contracting diseases or overdosing.

Tolerance alone is not necessarily a health problem. Patients who take opioids, such as hydrocodone, for pain relief usuallydevelop a tolerance to the drug and require increased doses to achieve the same effects.

Dr. Chris Johnson is an emergency room physician who chairs a Minnesota task force that’s developing recommendations to addressinappropriate opioid prescribing. He told DrugRehab.com that tolerance develops because of the body’s natural desirefor homeostasis.

“The body makes opiates called endorphins,” Johnson said. “When you’re taking pills, you’re flooding your body with dosesof opiates that it’s not prepared for or that aren’t needed. Your body wants stability.

It doesn’t want highs and lows.It wants constant.

When you’re bringing new opiates into your system, your body reacts by stopping production of itsown opiates and decreasing it’s receptors for opiates because it wants stability.”

When a person stops taking a drug, the body adapts back to normal. So when a patient’s injury heals and they stop takingopioids, their tolerance decreases. The next time they have a surgery or an injury, the doctor can usually prescribea low dose to achieve pain relief.

It can be dangerous, though. People inrecovery from addiction are at a high risk for overdose if they relapse because their tolerance diminishes duringdetox. The body no longer reacts to the drug the same way it did before abstinence. When a person administers the dosethat they were last used to, theirrisk of overdose is amplified.

Types of Drug Tolerance

Drug tolerance can be defined as diminished responsiveness to alcohol or another drug as a result of repeated consumptionor administration. Many people associate tolerance with a decreased ability to get high or buzzed. Those feelings arecaused by a release of a chemical called dopamine in the brain.

Dr. Kevin Wandler of Advanced Recovery Systems explains how using drugs repeatedly disrupts the brain’s ability to feel happiness.

Tolerance can be achieved in different ways, and experts have discovered three types of tolerance: pharmacodynamic tolerance,metabolic tolerance and tachyphylaxis.

Pharmacodynamic Tolerance

Feelings of intoxication are a result of a drug’s interaction with nerve receptors in the brain. Pharmacodynamic toleranceis a result of a drug’s repeated interaction with nerve receptors. The brain becomes used to the presence of the drugand requires higher doses to feel the effect previously achieved by lower doses. Opioids cause pharmacodynamic tolerance.

Metabolic Tolerance

Metabolic tolerance occurs when the body metabolizes drugs at an accelerated rate. Un pharmacodynamic tolerance, thedrug still affects the brain the same way. However, the body metabolizes — gets rid of — the drug more quickly. Thus,the same drug has a diminished effect.

Metabolic tolerance occurs when alcohol or other drugs cause metabolic enzymes to synthesize. Chronic alcohol consumptionactivates liver enzymes that contribute to metabolic tolerance.


Tachyphylaxis is a type of tolerance that occurs quickly after repeated drug use. Pharmacodynamic and metabolic toleranceusually take days or weeks to occur. Tachyphylaxis can occur within hours of administration or consumption.

Addiction to hallucinogens, such as LSD and DMT, is rare because they cause tachyphylaxis. However, the drugs aren’t harmless.People who use these drugs repeatedly sometimes need higher doses to achieve the same effects.Hallucinogens can cause long-lasting side effects, such as hallucinations and paranoia.

High Tolerance vs. Addiction

Addiction is a chronic brain disease that causes compulsive behavior despite negative consequences. Tolerance isa decreased reaction to substances of abuse. The two terms are often associated with one another, but they are not thesame.

It is possible for someone who has developed high tolerance to hallucinogens to quit using them because they can no longerachieve the desired effects of the drugs. A person addicted to tobacco cannot quit smoking cigarettes as easily. He or she usually requires some type of assistance from friends, family or health care providers.

Tolerance is one of the most common precursors and side effects of addiction. It’s also a common precursor and side effectof dependence.


Dependence is often confused with addiction and tolerance. Un addiction, dependence is not associated with compulsive,destructive behavior. A person dependent on wine may require a glass with dinner every night to avoid headaches, butthey do not necessarily seek wine compulsively or drink and drive.

Dependence occurs when the receptors in the brain become used to the presence of the drug and only operate normally whenexposed to the substance. Without the substance, the brain reacts negatively in a process called withdrawal.Withdrawal symptoms may be minor or severe depending on the substance of abuse and the severity of the dependency.

Patients receiving aggressive treatment for cancer often become dependent on painkillers, meaning they experience headachesor other withdrawal symptoms without the drugs. These patients receive opioids to treat pain and often develop a hightolerance to them, requiring higher doses to experience pain relief. But they rarely become addicted.

Most patients dependent on painkillers don’t act compulsively or perform self-destructive acts. When the pain goes away andthe doctor stops prescribing the drug, they do not seek it on the street. Dependency can lead to addiction, though. Patientswith agenetic predisposition to addiction or a history of substance abuse can relapse after being exposed to drugs in clinicalsettings.

Tolerance to Alcohol

There are several types of tolerance to alcohol, and they develop in different ways. Levels of consumption, frequency ofconsumption, environmental cues and genetic predisposition all contribute to how tolerance is developed.

Functional Tolerance

Alcohol disrupts the brain’s ability to function, but the brain adapts to alcohol exposure over time to prevent future disruption.This adaptation is called functional tolerance.

When a person repeatedly consumes low levels of alcohol, environmental cues and learning processes can promote the developmentof functional tolerance. When a person repeatedly consumes high levels of alcohol, functional tolerance can be developedwithout environmental cues.

People who have become ahigh-functioning alcoholic exhibit few signs of intoxication, even when their blood alcohol concentrationsare high. Individuals with extremely high tolerances may be able to drink levels that could be fatal to someone witha low tolerance.

Acute Tolerance

Functional tolerance takes time to develop, usually several days or weeks of repeated exposure to alcohol. However, acutetolerance can occur in a single drinking session.

Acute tolerance refers to a decreased level of impairment to alcohol later in a drinking session when compared to the levelof impairment at the beginning of the session. For example, a person who consumes four alcoholic beverages may feel lessimpaired after his or her eighth drink, even if his or her BAC remains the same.

Acute tolerance does not affect all levels of intoxication, but it can affect a person’s feeling of intoxication. Peoplemay believe they’re “sobering up” even when they aren’t. Their judgement, coordination and motor skills may still beimpaired because those are not affected by acute tolerance.

Environment-Dependent Tolerance

Environmental cues can accelerate a person’s tolerance to alcohol. Studies indicate rats develop tolerance to alcohol whenthey receive it in the same room, and humans have exhibited similar tolerances when repeatedly drinking in the same environment.

An experiment published in the Journal of Studies on Alcohol foundsocial drinkers performed hand-eye coordination tasks more effectively when they drank in a bar rather than in anoffice.

Learned Tolerance

People can learn to perform tasks more effectively when under the influence of alcohol.

In an experiment published in the journal Pharmacology Biochemistry and Behavior, people who practiced hand-eye coordinationtasks under the influence of alcohol were able to more successfully complete the tasks after being exposed to alcohola second time than people who practiced the task while sober.

Other studies have found motivation and the anticipation of a reward can contribute to more rapid tolerance development.Studies also show that people who frequently drive the same route while under the influence can develop a tolerance toalcohol, but they instantly lose the tolerance when an unexpected situation or event occurs on that route.

What Is a High Tolerance?

Anyone who consumes drugs for recreational or medical purposes needs to be aware of tolerance. Health professionals closely monitor patients’ tolerances to medications to ensure escalating doses don’t cause unwanted side effects.

Dr. Kevin Wandler of Advanced Recovery Systems defines tolerance and explains how it develops.

The brain develops a tolerance to certain medications, but other organs may not. When the risks outweigh the benefits, theperson’s tolerance may be called “too high.” In health care, the highest dose of a drug that does not cause unacceptableside effects is called the maximum tolerated dose.

Developing a high tolerance to alcohol and recreational drugs also comes with risks. Some people may be willing toabuse illicit drugs to achieve a high, but they may decide their tolerance is too high when they have to spend toomuch money on drugs to achieve the same high or when they begin to experience health-related side effects.

  • Cancer
  • Sexual difficulties
  • Vision problems
  • Bone loss
  • High blood pressure

The risk is increased because several organs, bones and other anatomical parts don’t tolerate alcohol the same way the braindoes.

  • Changes in appearance
  • Mental health problems
  • Weight loss

Because drug andalcohol use affect multiple major organ systems, increasing dosage after developing a tolerance increases the possibilityof health problems in all parts of the body.

A high tolerance also increases a person’s risk for dependence and addiction. Genetics, environmental factors and the substanceof abuse affect a person’s lihood of becoming dependent or addicted.

Some drugs are more ly to cause addiction than others, and some people are naturally more capable of resisting addictionthan others. People surrounded by peers who abuse alcohol or other drugs are more ly than those with little exposureto alcohol or drug abuse to develop a substance use disorder.

A person who has developed a high tolerance to alcohol or other drugs should be aware of the dangers associated with heavydrinking or drug use. They should speak with their health care provider about abstaining from the substance. If theyare dependent or addicted, they should seek medical detox and substance abuse treatment to learn how to live without substances of abuse.

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes.

We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment.

It should not be used in place of the advice of your physician or other qualified healthcare provider.

Source: https://www.drugrehab.com/addiction/tolerance/

Heroin Addiction and Abuse

Heroin: tolerance and dependence

Heroin is a potent opiate with an intense effect on the brain reward system.

Heroin rigs this reward system by influencing the production of feel-good chemicals in the brain, such as dopamine and endorphins.

everyone who tries heroin for the first time, nearly one in four become addicted.

In normal circumstances, the brain releases these chemicals to reward behavior necessary for survival, eating, and helping people cope with pain.

The brain quickly links heroin to the activation of these chemicals in the brain reward system. Eventually the user becomes addicted and can’t function without the drug. This, along with the withdrawal symptoms of heroin, makes it hard for users to quit on their own.

Some signs that an addiction has formed include:

  • Continuing use despite heroin-related problems
  • Trying and failing to quit or cut down use
  • Having persistent cravings
  • Building a tolerance to heroin
  • Experiencing withdrawal or feeling “junk sick”

Needing escalated doses of heroin to get high, or starting to inject the drug, are strong indications of an addiction. Once addicted, what may have once seemed a cheap way to have fun, becomes a necessary habit to function in day-to-day activities.

I ended up using heroin for about 5 years, sniffing it. But I was seeing all the people I was hanging out with who shot it totally jammed, and I was basically feeling normal [because] I now built a tolerance. I was now using heroin, a $150 a day habit, to feel normal.

– Michael D., in recovery from heroin and other drugs

Understanding Heroin

Heroin is a highly addictive painkiller synthesized from morphine, which comes from the seeds of the poppy plant. Because poppy plants are used to make opium, any drugs derived from them are considered opiates. Both heroin and morphine are opiates.

Heroin is also known by names junk, smack or “H.” Street heroin is often combined with dangerous additives morphine or the powerful pain reliever fentanyl.

Approximately four million Americans have tried heroin at least once in their lifetime. Symptoms of prolonged heroin use can include severe itchiness, depression and collapsed veins.

What Does Heroin Look ?

Not all heroin looks the same. It comes in several different forms and can be abused in several different ways, including snorting, smoking and injecting.

This is the purest form of heroin.

This form of heroin gets its color from additives and is more common than pure heroin.

This form of heroin comes as a black sticky gel.

Heroin Effects

Heroin users have described the drug’s high as an intense feeling of well-being. When someone injects heroin, they often experience a “rush” from the drug reaching the brain so quickly.

The rush from intravenous heroin use lasts about two minutes. Intravenous users have ned the rush to an orgasm in terms of pleasure. As heroin travels through the bloodstream, the high lasts for four to five hours.

The general effects of using heroin include:

  • Contentment
  • Reduced anxiety
  • Relieved tension
  • Drowsiness
  • Apathy

The effects of heroin can seem harmless to those who are experimenting with the drug. Although it may produce some dizziness and drowsiness, these effects feel enjoyable. Un substances such as alcohol or ecstasy, there generally isn’t a hangover or comedown from initial heroin use, which is an attractive benefit to new users.

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What may seem “harmless” or occasional heroin use often devolves into addiction because tolerance builds quickly. Eventually, the user cannot feel normal without taking the drug because their brain cannot produce natural amounts of dopamine on its own. As the user increases their doses, they are at a greater risk of fatal heroin overdose.

Signs of a heroin overdose include:

  • Shallow breathing
  • Dry mouth
  • Tongue discoloration
  • Very small pupils
  • Slow pulse
  • Bluish lips

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Heroin and Other Drugs

People who abuse painkillers have a higher risk of experimenting with and becoming addicted to heroin. Painkillers OxyContin are classified as opioids because they are synthetic, opiate- substances activating the same receptors in the brain as heroin.

Painkillers have similar effects to heroin, but these pills can be expensive and hard to acquire. Many people who become addicted to painkillers turn to heroin because it is cheaper and more accessible.

The way painkillers are abused can lead to future heroin abuse as well. Some people crush up painkillers to snort or inject, which introduces them to methods of administration commonly used in heroin abuse.

Close to 50 percent of young people who use heroin reported abusing painkillers before moving on to heroin. Some speculate that heroin may be easier to obtain than painkillers.

Heroin Abuse Statistics


first time users

Approximately 156,000 Americans used heroin for the first time in 2012. It is one of the most dangerous drugs, and this number of first-time users has nearly doubled over the past decade.


sought treatment

Close to half a million people received treatment for their heroin addiction in 2012.


percent of youths

20% of youths aged 12 to 17 reported that they saw either moderate, slight, or virtually no risk in using heroin.

Heroin is one of the most addictive substances in existence, and an addiction to this drug is hard to overcome without help. If you or someone you care about is suffering from a heroin addiction, find treatment and support that can help.

Source: https://www.addictioncenter.com/drugs/heroin/

Former opioid users are at a greater risk of overdosing than the newly addicted

Heroin: tolerance and dependence

Editor's note: This editorial was originally published June 3, 2016 in the Ellsworth American.

It may seem surprising that an experienced drug user is at a higher risk of overdose than a novice, but statistics show that former opioid users who have recently been released from prison or those who have already detoxed are more ly to overdose than new drug users. In order to understand this phenomenon, we must understand the neuroscience behind opioid action and the various aspects of drug abuse.

Opioids such as heroin, morphine, codeine, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) act through a distinct family of receptors in the brain, which are aptly called opioid receptors. Whether a prescription medication or an illicit street drug, the mechanisms of action are similar.

There are three members of opioid receptors (mu, delta and kappa). These are related, yet distinct binding sites for the opiates, without which the drug could not mediate its effects.

Of these three receptors, the mu-opioid receptor is the key receptor for the analgesic (pain-relieving) and rewarding properties of opioids.

Once opiates enter the body, they are circulated in the bloodstream and cross the blood-brain barrier. In the brain, the opiate is quickly metabolized into the active compound, morphine, which can bind the muopioid receptor.

The mu-opioid receptors are found in key regions of the central nervous system that control pain perception, emotional responses, reward and breathing. These receptors also exist in regions outside the central nervous system such as the skin and gut.

The activation of opioid receptors leads to a complicated set of molecular events that ultimately change the activity of individual neurons and circuits.

The consequence of receptor activation varies depending on the region of the brain in which they are located. 

Opioid receptor activation in brain regions that are responsible for pain perception, skin and spinal cord leads to pain relief. This is the reason doctors prescribe opioids.

Activation of receptors in the reward regions leads to increases in dopamine release, and is perceived as pleasurable. This pleasurable or rewarding effect is the reason why opioids are abused.

Receptor activation in the brain stem slows down breathing and decreases blood pressure. This is the primary reason for overdose deaths.

But what are the aspects of opioid use that are critical to the question posed above? This is a complex topic and I want to discuss three aspects — physical dependence, tolerance and addiction. Repeated use of opioids leads to physical dependence and tolerance in most individuals. A much smaller percentage of opioid users will become addicted.

Physical dependence and tolerance are both due to drug-induced changes in the brain (neuro-adaptations). The brain is adapting to the drug by changing the receptor’s signaling strength through several mechanisms. Physical dependence and tolerance are distinct properties of drug use that occur concurrently and should not be confused as being the same.

Tolerance leads to decrease in drug potency with repeated use. A patient who starts taking opioids for pain management will typically need to increase the dose over time to get the same effect.

The same is true for the rewarding properties of opioids; increased levels of the drug must be used in order to get the same high. Typically a chronic opioid user has developed high levels of tolerance. He or she consumes the drug in such high amounts that it would kill an opioid-naïve person.

Importantly, chronic opioid users can also develop tolerance to the life-threatening effects such as suppression of breathing.

Physical dependence occurs after chronic opioid use. It manifests itself in the form of readily observed withdrawal symptoms when the drug is not available. For opioids, withdrawal symptoms include nausea diarrhea, vomiting, muscle aches, and can last from days to weeks depending on the type and duration of opioid use.

Both tolerance and physical dependence are temporary, lasting only weeks to months after the drug is withdrawn. Tolerance may be easier to understand in the context of alcohol.

Most of us cannot consume the same amount of alcohol as our glory days in college; we have lost tolerance for the drug. The same is true for physical dependence on opioids; once a person is detoxified, the withdrawal symptoms fade.

However, a person who is no longer physically dependent can still be addicted.

Addiction occurs in a small percentage of opioid users and can manifest itself long after drug use has stopped, when tolerance is no longer present and physical dependence has subsided.

It is thought to have distinct molecular mechanisms leading to long lasting functional changes in the regions of the brain that control reward, emotion and cognition. It has a strong genetic component, and adolescents are at higher risk because of their developing brain.

Addiction is a chronic illness that can last a lifetime. Philip Seymour Hoffman was reported to have relapsed to opioid abuse after 23 years of abstinence.

Addicts meet certain criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM5). These include compulsive drug taking, obsessive thinking about the drug and escalation of drug use. Simply put, addicts take drugs despite negative consequences.

Coming back to the original question — why are people who re-initiate opiate use after quitting at higher risk of overdose? It is because they have lost their tolerance for the drug but are still addicts.

Addicts will relapse (re-initiate drug use); this is one of the characteristics of addiction.

But if the person consumes the same dose of the drug as when he or she last used opiates chronically, a time when that person had high levels of tolerance, there is a serious risk of overdose. This is because they have lost their tolerance to the respiratory suppressant effects of opiates.

Tolerance and physical dependence are temporary, but addiction is a chronic disease. Thanks to modern neuroscience and genetic methods, we have a very sophisticated and elegant understanding of opioid action. We now have a responsibility to help addicts find the treatment and prevent overdose.

Vivek Kumar, Ph.D., is an assistant professor at The Jackson Laboratory who uses mouse genetics as a platform to study behavior and behavioral abnormalities, including addiction, ADHD and depression. Follow him on at @vivekdna.

Source: https://www.jax.org/news-and-insights/jax-blog/2016/june/former-opioid-users-at-greater-risk-of-overdose-than-newly-addicted