Stigma affects individuals who struggle with any form of substance use disorder (SUD) and other mental health disorders. Yet, those who struggle with heroin abuse often experience the most severe form of stigma, as heroin is often recognised as one of the “heaviest” forms of drug use. Unfortunately, stigmas of SUD, specifically those related to heroin abuse, develop from misunderstandings and assumptions about those who use drugs, which are continuously perpetuated over time. To put it simply, no one is safe from heroin abuse and its effects, which is why it is necessary to shed light on it as well as effective routes of treatment for those who are struggling.
One of the most important things to understand about heroin abuse is that it often co-occurs with other mental health disorders, complicating the treatment and recovery process. This not only makes individuals with mental health disorders especially at risk of future heroin abuse but also makes individuals who abuse heroin more vulnerable to developing severe mental health problems. Thus, effective treatment programs must consider the impact of dual diagnoses on heroin abuse recovery and treat all existing conditions simultaneously for lasting healing and recovery.
We at PCP – The Perry Clayman Project understand that heroin addiction is a very serious, life-threatening disease of the brain that only worsens with time. Further, we recognise that engaging in heroin abuse is almost always an attempt to self-medicate symptoms of other distress, such as symptoms of mental health disorders. Without professional treatment, however, those engaging in heroin abuse are vulnerable to severe health consequences, including suicidal ideation and drug overdose. Fortunately, we have several rehabilitation centres across the UK to help individuals heal from SUD, co-occurring mental health disorders, and other behavioural health disorders, providing life-saving treatment to individuals who need guidance and support.
Understanding Heroin Abuse
The National Institute on Drug Abuse (NIDA) has the following to say about heroin use and abuse:
Heroin is a highly addictive opioid drug, and its use has repercussions that extend far beyond the individual user. The medical and social consequences of drug use—such as hepatitis, HIV/AIDS, fetal effects, crime, violence, and disruptions in family, workplace, and educational environments—have a devastating impact on society and cost billions of dollars each year.
NIDA continues to explain that although the prevalence of heroin use and abuse may be rather low, the number of individuals engaging in heroin use continues to rise each year. Perhaps the rise of the opioid epidemic has played a role in this, as many individuals became addicted to prescription painkillers as a result of overprescribing, doctor shopping, and more over the last two decades.
After an addiction or SUD develops, especially as a result of a prescription, individuals may seek out more readily available or cheaper alternatives in an attempt to obtain physical and or emotional relief. Eventually, some may quickly find themselves engaging in heroin abuse.
As explained by the Drug Enforcement Administration (DEA), heroin informs an “[i]nitial surge of euphoria or ‘rush,’ followed by a twilight state of sleep and wakefulness.” Although symptoms of heroin use and abuse can differ between users and routes of administration, the most common effects of heroin include:
- Warm flushing of the skin
- Dry mouth
- Heavy feeling in extremities
- Nausea
- Vomiting
- Severe itching
- Clouded mental function
- Impaired cardiovascular health
- Slowed breathing
Furthermore, those who abuse heroin and experience these repeated effects are at risk of comas, permanent brain damage, and other life-threatening consequences.
Why Does Heroin Abuse Co-Occur with Mental Health Disorders?
As stated in a publication by Public Health England, “It is very common for people to experience problems with their mental health and alcohol/drug use (co-occurring conditions) at the same time.” Further, “Research shows that mental health problems are experienced by the majority of drug (70%) and alcohol (86%) of alcohol users in community substance misuse treatment.” Several reasons help to shed light on why various forms of substance abuse, like heroin abuse, coexist with mental health disorders. According to the National Insitute of Mental Health (NIMH), the main three possibilities to explain why co-occurring disorders exist include the following.
#1. Shared Risk Factors
First and foremost, both SUD and mental health disorders share many of the same risk factors. In the field of mental health and recovery, risk factors are factors that make an individual uniquely vulnerable to engaging in substance abuse, engaging in another maladaptive behaviour, or developing a mental health problem. For instance, individuals with family members who have struggled with substance abuse or addiction are more likely to engage in substance use or develop an addiction throughout their lifetime. The same can be said for those who have family members with mental health disorders.
In addition to genetics, environmental factors like trauma and stress can also increase an individual’s risk of developing SUD or mental health problems. More specifically, the Advisory Council on the Misuse of Drugs (ACMD) notes the following risk factors for co-occurring disorders:
- Various forms of abuse (physical, sexual, emotional)
- Child maltreatment and neglect
- Interpersonal violence
- Criminal victimisation
- Chronic physical illnesses
- Living in high-risk neighbourhoods
- Poverty
- Homelessness
- Discrimination
Because co-occurring disorders share many of the same risk factors, each condition may develop independently from one another.
#2. Self-Medicating Mental Health Disorders With Substance Use
Another possibility that highlights why SUD commonly exists alongside other mental health disorders is that many individuals with mental health disorders turn to alcohol and other drugs to self-medicate their symptoms and distress. In this case, the mental health disorder may exist first. Some individuals may engage in alcohol use to self-medicate initially, as alcohol is readily available and legal. Yet, over time, individuals may experiment with other substances or seek out other “harsher” forms of drug use in an attempt to relieve worsening physical and emotional pain.
Self-medicating practices may seem innocent, yet they only worsen an individual’s symptoms and distress with time. Over time, an individual engaging in self-medicating practices will discover an increase in tolerance to the substance they are using, which will require them to use the substance in greater quantities. Yet, what goes up must also come down. By using substances in greater quantities, an individual will also endure worsening withdrawal effects when they are not actively using.
Once self-medicating practices begin, it is only a matter of time before SUD develops. In the context of heroin abuse, heroin use disorder or opioid use disorder (OUD) would develop, triggering a host of complications for treatment and overall well-being. Moreover, it is necessary to understand that co-occurring disorders are comorbid, which means that the interactions of the conditions will worsen the course and prognosis of both. Thus, professional treatment is required to establish sobriety from self-medicating while healing from the root cause of it: the mental health disorder.
#3. Substance Use Triggering Mental Health Disorders
The last possibility that explains why co-occurring disorders exist is that chronic alcohol and drug use can contribute to the development of mental health disorders. Thus, it is true that substance abuse may exist before a mental health disorder, yet SUD may also develop while a mental health disorder develops. Simply put, repeated alcohol and drug use can trigger lasting alterations in brain structure and functioning, making individuals vulnerable to continued substance use and associated mental health problems.
For instance, NIDA highlights three main parts of the brain that are especially affected by drug use. These include:
- The basal ganglia: Responsible for motivating an individual to engage in healthy activities that inform feelings of pleasure. When impaired by substance use, this part of the brain can learn to adapt to drug use, making it difficult for an individual to feel pleasure from anything but the drug.
- The extended amygdala: Responsible for informing feelings of stress or crankiness. When impaired by substance use, this part of the brain gets sensitive, informing unpleasant drug cravings and withdrawals when substance use is ceased.
- The prefrontal cortex: Responsible for helping an individual think, make decisions, and control impulses. When impaired by substance use, this part of the brain becomes unable to make healthy judgments or halt impulsive behaviour.
As the brain becomes more and more impaired by substance use, an individual may experience uncomfortable symptoms of depression, anxiety, panic, and more, leading to the development of a mental health disorder.
Common Dual Diagnoses of Heroin Abuse and Mental Health Disorders
Research does not confirm that certain mental health disorders co-occur with heroin abuse more than others. Rather, it can be helpful to recognise that any mental health disorder can make an individual vulnerable to engaging in heroin abuse. Likewise, heroin abuse can contribute to the development of nearly any mental health disorder, triggering severe effects on an individual’s health and well-being.
Some of the mental health disorders that may co-occur with heroin abuse include, but are not limited to:
- Major depressive disorder (MDD)
- Social anxiety disorder
- Panic disorder
- Generalised anxiety disorder (GAD)
- Bipolar disorder
- Borderline personality disorder (BPD)
- Post-traumatic stress disorder (PTSD)
- Schizophrenia
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Dissociative disorders
Addressing Suicide, Self-Harm, and Overdose Risk
In addition to triggering the broad effects of mental health disorders, it is important to understand that heroin abuse can also trigger severe mental health symptoms, including suicidal ideation and self-harming behaviours. According to a publication in Addiction & Health, “The prevalence of deliberate self-harm [behaviour] is extensively observed among heroin users…The trend of increasing suicides associated with drug overdose, however, shows that suicide overdose is associated with opioid use.”
In this case, it is important to note that death by drug overdose is not always intentional. Certainly, some individuals may reach a devastating point in their lives while actively engaging in heroin abuse or another form of drug use, believing that they could never possibly be freed from the grips or controls of heroin abuse. They may feel so hopeless that they think a drug overdose is the only way to get out. For those whom this resonates, please do not lose hope. Everyone is worthy and able to achieve a successful recovery from heroin abuse and co-occurring mental health disorders with the help of professional support.
Meanwhile, anyone who abuses heroin is at risk of unintentional drug overdose as well. As heroin is an illicit drug obtained illegally, unsuspecting buyers may purchase heroin that is laced or contaminated with additives like fentanyl, which can be lethal in even the smallest of doses. Even if heroin is pure, an unintentional overdose can occur by using too much of the drug. Unfortunately, this can be especially common among individuals who detox and return to previous heroin abuse behaviour. Detox significantly decreases an individual’s tolerance to any drug, so re-engaging with heroin after an attempt to stop can immediately result in drug overdose and death.
The aforementioned article also states, “Since heroin influences the central neural system, leads to alterations in the perception, mood, consciousness, attention, and [behaviour] of abusers, and diminishes negative feelings in these individuals, the screening and clinical management of heroin-dependent individuals are among the crucial priorities of psychological services in many countries worldwide.” Individuals who struggle with co-occurring heroin abuse and other mental health disorders require professional intervention as soon as possible, as it can help restore autonomy and well-being while preventing suicide and other life-threatening behaviours.
Effective treatment for heroin abuse requires more than detoxing and establishing sobriety; rather, treatment must involve curating individual plans that are holistic and consider all aspects of an individual’s life that could otherwise trigger a return to substance use in the future.
Treatment for Heroin Abuse, Addiction, and Co-Occurring Disorders
Despite what some may believe, treatment for heroin abuse is available, and recovery is possible. Rather than recovery being an “end goal” of the treatment journey, it is important to recognise that recovery is a lifelong process, one that requires consistent engagement and prioritisation for lasting success and sobriety. To begin recovery, however, it is first necessary to identify whether or not an individual has a substance abuse problem. Some of the warning signs and symptoms of heroin abuse and addiction include:
- Experiencing withdrawal symptoms when the effects of heroin wear off
- Withdrawal symptoms are alleviated when more heroin is used
- Obsessively thinking about heroin, including when or where to obtain it, use it, or recover from it
- Willing to lie, steal, cheat, or beg to get more heroin
- Needing more heroin to achieve desired effects
- Engaging in polysubstance use (heroin and other drug use in tandem)
Detoxification and Rehabilitation
As explained by the National Health Service (NHS), those who are addicted to heroin or engaging in heroin abuse can receive help through local drug treatment services. These services are aimed at meeting an individual where they are at. Nearly every individual struggling with heroin abuse will begin recovery with detoxification. A medically-assisted detoxification programme will provide 24/7 medical and psychological support from experienced addiction professionals, helping individuals rid their bodies of the toxic remnants of heroin and other forms of drug abuse.
At PCP – The Perry Clayman Project, we provide inpatient medical detoxes that assist clients in getting sober from heroin and other drugs. All of our UK-based addiction treatment centres provide full medical detoxification alongside psychological support, ensuring that an individual feels supported and encouraged to begin their treatment journey to wellness beyond detox.
Following detox, we offer both inpatient and outpatient rehabilitation options for heroin addiction. Inpatient rehabilitation is more intensive and effective, requiring clients to reside at the facility for the duration of treatment. Meanwhile, outpatient treatment is more flexible, allowing clients to tend to personal responsibilities (like work, school, or childcare) while prioritising recovery and sobriety. For those struggling with severe heroin or other forms of drug addiction, commitment to our 12-week (90-day) rehabilitation is highly recommended.
No matter what program option one chooses, they can rest easy knowing that they will be treated for their heroin abuse and co-occurring mental health problems in tandem through a wide range of therapies and approaches. In addition to 1-2-1 counselling and support groups, individuals will have access to expressive outlets and activities to help reframe their lives in sobriety.
Contrary to what some individuals may believe, no one is safe from heroin abuse. Meanwhile, when heroin abuse co-occurs with other mental health disorders, an individual is at risk of worsening health consequences, including suicidal ideation, drug overdose, and other problematic health effects. Individuals experiencing dual diagnoses of heroin abuse and other mental health disorders must utilize professional treatment not only to establish sobriety but also to heal from the mental illness as well as other potential root causes of ongoing heroin abuse. At PCP – The Perry Clayman Project, we offer comprehensive rehabilitation clinics across the UK to treat both substance and behavioural addictions. Let us guide you on your journey to lasting healing. Call 08000 380 480 today.