How Do You Know If You’re Addicted?

Here is a simple test to tell you: CAGE+ Questionnaire*

1. Have you ever felt you ought to cut down on your use?
2. Have people ever annoyed you by criticizing your use?
3. Have you ever felt bad or guilty about your use?
4. Have you ever used 1^st thing to steady your nerves or to keep from being "hung over" or "sick"?

If you answered yes to any of these questions, chances are you should talk to someone.

*Adapted from: Ewing J.A. Detecting Alcoholism: The Cage Questionnaire Jama; 252:1905-1907, 1984

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Physical withdrawal from heroin, is commonly known as being "sick". Symptoms can last 10 – 14 days. The symptoms can include: anxiety, chills, hot flashes, sweating, cramps, nausea, tremors, loss of appetite, insomnia, dilated pupils, watery eyes, runny nose, yawning, fit and panic attacks. Methadone withdrawal symptoms can be similar, but may also include bone aches, muscle aches, and lethargy lasting up to six months.

How is heroin used?

Heroin is used in three ways today, injection, smoking and snorting (intranasal ingestion). Heroin was primarily an injection drug until more recently when increases in levels of potency made it possible for users to get high from other types of use. When injected into a vein (most commonly the arm but any non-collapsed vein will suffice for the regular user) the onset of euphoria occurs in seven to ten seconds. The euphoria may be accompanied by nausea and vomiting and may also be associated with fainting. Regular injection users will have "tracks" in the areas of injection. (Long red lines caused by frequent injection in the same vein.) They may also have scabs and infections in the areas of frequent injection.

Snorting is the most common method today. The effects occur nearly as quickly but lack the intensity of the injection method. Risk is smaller reward is less, however many young users today feel that they won’t be taking the HIV or other infection risk if they snort and in addition many believe that if they don’t use needles they won’t become addicted…a patently untrue belief.

How long do the effects of heroin last?    

The duration of the high varies with the potency of the drug, the amount ingested and the tolerance of the individual using it. A reasonable estimated average would be 2-6 hours.

How does heroin affect the body?     

Heroin affects the body in so many ways that for the sake of space we’ll give you a few of the most glaring.

Heroin, like other opiate analgesics, causes constipation, stomach cramps and other gastrointestinal problems.

It can cause difficulties in basic perception (recognizing reality) and it can cause impairments in attention span and judgment, not to mention hallucinations, manic or hypo manic episodes.

Heroin wreaks havoc with sleep and often causes severe sleeplessness and at other times periods of over-sleeping (hypersomia). Heroin often causes severe loss of appetite creating lowered immune response and nutritional deficiencies and causes loss of sexual desire and sexual dysfunction. Heroin, because it is such a powerful depressant can easily cause respiratory depression and arrest (called O.D.)

Another physical effect of heroin is the likelihood of being beaten, shot or raped in the normally crime-ridden areas where heroin is purchased.

What are some of the dangers of heroin use?    

Besides the already mentioned effects like danger of infection, respiratory arrest, etc. opoids are extremely habituating substances. By this we mean that the user rapidly develops a tolerance to the drug’s effect. In order to achieve the same degree of euphoria, larger and larger doses must be taken.

Especially for the inexperienced user, because the tolerance changes and the window of "the high" is so small overdose becomes an exceptionally easy end. Some heroin users will abstain for long periods of time, perhaps trying to quit, only to use again, but forget that their tolerance has decrease and overdose by taking the same amount they had taken before their brief hiatus.

Crime and a crime oriented lifestyle often become part and parcel of heroin use because constant need for the drug to avoid being "sick" requires constant money. Constant money requires a good steady job which most regular users can’t keep so they have to scam and steal. Where there’s heroin there’s crime.