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Heroin Abuse: Tolerance, Addiction, and Withdrawal

With regular heroin abuse, tolerance develops.

This means the suffering from heroin addiction must use more heroin to achieve the same intensity of effect and avoid withdawal. As higher doses are used over time, physical dependence and addiction develop. With physical dependence, the body has adapted to the presence of the drug and withdrawal symptoms may occur if use is reduced or stopped.

Heroin Withdrawal

Heroin withdrawal, which in regular heroin abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps ("cold turkey"), kicking movements ("kicking the habit"), and other symptoms. Major heroin addiction withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week. Sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal, although heroin withdrawal is considered less dangerous than alcohol or barbiturate withdrawal.

Extent of Heroin Abuse

Monitoring the Future (MTF) Survey **
According to the 2004 MTF, rates of heroin abuse were stable among all three grades measured.


Heroin Abuse by Students, 2004:
Monitoring the Future Survey

 8th-Graders  10th-Graders  12th-Graders
Lifetime*** 1.6% 1.5% 1.5%
Annual 1.0  0.9  0.9 
30-Day 0.5  0.5  0.5 


Heroin Abuse and Addiction Reports

In December 2003, Community Epidemiology Work Group (CEWG) members reported that heroin indicators were mixed but relatively stable, continuing at higher levels in Northeastern, north-central, and mid-Atlantic areas where high-purity powder is available, and also in the Northwest where black tar heroin predominates. Heroin injection and the health risks associated with it, such as the spread of HIV/AIDS and hepatitis C, are of growing concern at several CEWG sites. In 2002, rates of heroin emergency department mentions exceeded 200 per 100,000 in Chicago, Newark, and Baltimore and exceeded 100 per 100,000 in Seattle, New York City, San Francisco, Boston, and Philadelphia. The reporting of heroin/opiate-related deaths was highest in Detroit (464) and Philadelphia (111).

Heroin Abuse Results


National Survey on Drug Use and Health (NSDUH)The 2003 NSDUH reports stability at low levels for heroin abuse among young people. In 2002, 13,000 youth between the ages of 12 and 17 had used heroin at least once in the past year ("annual" use), compared with 12,000 in 2003. Among the general population age 12 and older, 404,000 had used annually in 2002, compared with 314,000 in 2003. Obviously, heroin addiction and abuse is a huge problem and real help is needed.

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