Heroin addiction is a chronic, relapsing disease. Heroin is a powerful opiate drug that is one of the most abused and addictive drugs worldwide. It has been reported by the United Nations that there are between 15 -21 million regular users of heroin worldwide. Heroin works by attaching to opioid receptors in the brain, spinal cord ad gastrointestinal tract. Users report feeling an incredibly powerful euphoric rush followed by feelings of warmth, contentment and drowsiness. Many users liken the experience of heroin to being in a dream like state. Heroin can have a negative impact on cardiac and respiratory functions that can cause breathing difficulties or heart problems. In addition, regular use of the drug can lead to tolerance to the drug and addiction.
Heroin dependence is associated with a number of serious and complicated health problems. Many users will become severely constipated and suffer sexual dysfunction. Women will have irregular or no menstruation and can have problems in getting pregnant. Damage to veins, abscesses, increased risk of hepatitis or HIV and organ damage may occur. Smoking the drug can cause users to develop pneumonia, tuberculosis or cause long term damage to the lungs. Adulterant substances can cause soft tissue infections, liver and kidney disease and increase vulnerability of developing secondary health problems.
Treating heroin addiction is a difficult process due to the severe withdrawals that addicts will experience when trying to stop heroin use. Symptoms of withdrawals include severe nausea, vomiting, diarrhea, painful body aches, agitation and aggression, tremors, hallucinations, paranoia and seizures. Many of these symptoms will be experienced for many days and a large proportion of addicts will go back to using the drug as a result. Addicts who undergo detoxification with medical assistance will be administered drugs such as clondine and buprenorphine to help minimize symptoms of withdrawals.
Ongoing treatment for heroin addiction may include the use of substitution drugs such as methadone or buprenorphine. These drugs are recognized as the most effective medications in the treatment of heroin addiction. They have been found to reduce the cravings associated with heroin addiction and when taken in conjunction of other treatment programs are incredibly effective. However, these drugs do not treat all addicts with up to 10 percent not responding to these treatments.
Heroin assisted treatment is the prescribing of synthetic, injectable heroin to opiate addicts who do not benefit or tolerate other drug replacement treatments. Patients who are treated with a heroin assisted treatment are prescribed diamorphine under strict controls and regulations. In addition to the drug treatment, patients are expected to undergo psycho-social and medical care. Heroin assisted treatment is found to be beneficial for severely affected, chronically addicted individuals.
Heroin assisted treatment is part of the approved health care services in Switzerland, Germany, the Netherlands, Denmark and United Kingdom. Within each of these countries, prescribing diamorphine only one element of the harm reduction program. This treatment provides addicts access to heroin in a clinical environment where they can also get medical and welfare assistance if required. The aim of the program is to reduce illicit drug use, improve health and social outcomes and retain clients in a long term treatment program.
In many of the programs, addicts are required to attend an authorized clinic every day without negotiation to receive their diamorphine. Injection of the drug occurs under supervision of the staff, with staff watching the addict inject. The clinics do not allow the drug to be taken away under any circumstances. If an addict in the program cannot attend for a day due to other commitments or holidays, a substitution drug like methadone may be provided if given notice. Addicts are not allowed to receive their dose of the drug if they are already intoxicated and will be made to wait to receive their dose. In addition to the provision of the drug, those in the programs are often required to participate in other programs as part of their inclusion. Failure to participate means that they are excluded from the program and will no longer be allowed to continue to receive the treatment.
Substitution therapy is designed to alleviate the significant health and lifestyle problems associated with drug use. Street heroin is a substance that is made of a combination of pure heroin mixed with adulterant substances that can cause serious harm. Heroin is known to contribute to major health problems such as infectious diseases, abscesses, tetanus, cellulitis, increase in psychological distress, worsening of mental illness. It may also contribute to an increase in the risk of homelessness, involvement in criminal activities, sexual assaults or violent crimes. In addition to these issues, heroin addicts undergo painful, enduring withdrawals when they try to cease using the drug which they are chronically dependent on. By prescribing a substitution drug like diamorphine or methadone, it is anticipated that addicts are able to disengage from their drug lifestyle. The substitution drug allows them to reduce their intake of street drugs that may be cut with dangerous adulterants and gives addicts regular access to health and welfare services.
Harm reduction programs such as the heroin assisted treatment programs are often criticized for their apparent support of drug use. Many believe that by giving addicts access to clean needles, safe injection locations, drug substitutions and even health care encourages drug users to continue to use drugs. In a lot of cases, criticisms of harm reduction programs are for political reasons rather than medical or scientific reasons. Concerns about an increase in drug use, more active drug users, increases in criminal activities and infectious diseases are often unfounded. The heroin assistance treatment programs that are in place in Switzerland, United Kingdom and others have resulted in a reduction in drug use, involvement in criminal activities and associated health problems.