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  • Writer's pictureDr. Harold Pierre

Heroin Addiction: A Dangerous Epidemic in Oklahoma and Across the US

Updated: Nov 21, 2023

Heroin Addiction: A Dangerous Epidemic Threatening Lives

Understanding the Heroin Epidemic

Syringe heroin cocaine spoon

Heroin addiction has exploded into a nationwide crisis, devastating families and communities across America. According to the National Institute on Drug Abuse, heroin use has more than doubled among young adults ages 18–25 between 2011 to 2013. The number of overdose deaths involving heroin quadrupled during this time. Heroin use increased further during the COVID-19 pandemic.

This sharp spike in heroin abuse signals a growing public health emergency. So what's behind the surge in heroin use? Several key factors have collided to drive heroin addiction rates higher than ever before:

  • Increased availability - Heroin from Mexico has been flowing into the U.S. in larger amounts. It's cheaper, more potent, and easier to obtain than ever.

  • Prescription opioid abuse - Misuse of prescription painkillers like oxycodone and hydrocodone is strongly linked to heroin addiction. As lawmakers crack down on prescription opioids, many users transition to cheaper and more accessible heroin.

  • Higher purity - Heroin purity has increased dramatically, making the drug even more addictive and lethal.

  • Economic disadvantage - The rise in heroin coincides with depressing economic trends like higher unemployment and poverty in certain regions. Heroin provides an escape for people feeling financial instability and despair.

  • Limited treatment access - Rising numbers of uninsured Americans have restricted access to substance abuse treatment and recovery services.

This perfect storm of conditions has created a heroin epidemic engulfing communities across the country. But through education, compassion, and comprehensive strategies, we can reverse these trends and overcome heroin addiction.

What is Heroin?

Heroin is an illegal and highly addictive opioid drug. It is processed from morphine, which is extracted from the seed pod of opium poppy plants. Heroin usually appears as a white or brown powder, or a black sticky substance known as black tar heroin.

Other common street names for heroin include:

  • Smack

  • Junk

  • Horse

  • Brown sugar

  • Dope

The three main methods for taking heroin are:

  • Injecting - Using a needle to inject heroin directly into the bloodstream produces the fastest, most intense high. But it also comes with severe health risks like HIV, hepatitis, and deadly infections of the heart and valves.

  • Smoking - Heating heroin and inhaling the vapors through a pipe, cigarette, or foil. This delivers the drug quickly to the brain to produce a sudden rush.

  • Snorting - Inhaling heroin powder through the nose provides a shorter yet still potent high. But snorting heroin leads to addiction just as rapidly as other methods.

No matter how it's taken, heroin wreaks havoc on the body and brain when abused regularly. Let’s examine why it’s one of the most addictive and dangerous drugs on the planet.

The Effects of Heroin on the Brain and Body

Compared to morphine, heroin enters the brain much faster. When heroin enters the brain, it is rapidly converted back into morphine. Morphine binds to molecules on cells known as opioid receptors. These receptors are located in various regions throughout the brain and body.

There are 3 main types of opioid receptors:

  • Delta receptors - Found mostly in the brain, these control pain relief and emotional responses.

  • Kappa receptors - These activate regions involved in pain transmission, mood, and addiction.

  • Mu receptors - The primary target of heroin and morphine. Mu receptors mediate euphoria, respiratory depression, and physical dependence.

By binding to mu opioid receptors, heroin mimics the brain’s natural endorphins. This overload of opioid stimulation induces an intense rush of pleasure and relaxation.

Short-term effects of using heroin include:

  • Euphoria and warm flushing of the skin

  • Dry mouth and heavy feeling in arms/legs

  • Clouded mental functioning and impaired coordination

  • Nausea, vomiting, and severe itching

  • Slowed breathing and heart rate

In addition to the temporary high, heroin addiction may also leads to:

  • Physical dependence and addiction

  • Damage to white matter in the brain impacting decision-making

  • Increased risk of HIV, hepatitis B and C from shared needles

  • Infection of the heart lining and valves

  • Abscesses, collapsed veins, and infections from repeated injection

  • Constipation, kidney and liver disease

  • Sexual dysfunction and irregular menstruation in women

  • Weakened immune system, pneumonia, tuberculosis

  • Permanent brain damage and cognitive impairment

  • Heroin during pregnancy may lead to neonatal abstinence syndrome

Clearly, heroin takes an immense toll on every organ in the body. But perhaps the most frightening effect is its tendency to produce life-threatening respiratory depression known as a heroin overdose. Heroin, like other opioids, directly slows activity in the brain’s breathing center. High doses can severely impair breathing to the point of coma or death.

This risk of overdose intensifies as people become addicted to heroin and develop tolerance over time. Seeking a more intense high, long-time users may take dangerously large amounts of heroin. Even dedicated efforts to stay safe cannot overcome the deadly dangers.

Heroin on a spoon being melted by a zippo lighter

Heroin Overdose: A Deadly Consequence

Heroin depresses breathing and heart rate. When people take high doses, the drug can slow or stop breathing entirely. This causes oxygen levels in the blood to plummet. Brain damage or death can occur within minutes without oxygen.

Many factors make heroin overdose a constant risk:

  • Heroin purity is unpredictable, making proper dosing difficult. Just a small amount of extra pure heroin can trigger an overdose.

  • Long-time users build up tolerance and take increasingly larger doses seeking a stronger high. This greatly raises overdose risk.

  • Combining heroin with alcohol or certain medications like benzodiazepines has a synergistic effect, severely amplifying respiratory depression.

  • People who have quit heroin for a period of time often relapse with a dose they previously tolerated. Their reduced tolerance makes this dose potentially lethal.

Signs of a heroin overdose include:

  • Extremely pale, cold, clammy skin

  • Blue-tinged nails and lips

  • Pinpoint pupils

  • Slow, erratic, or stopped breathing

  • Choking sounds or gurgling noises

  • Unresponsiveness to shouting or painful stimuli

Overdose requires emergency medical treatment. Police and bystanders must carry naloxone to rapidly reverse opioid overdoses. However, long-term recovery depends on treating the psychological grip of heroin addiction through evidence-based treatment.

Signs and Symptoms of Heroin Withdrawal

Along with euphoria and relaxation, regular heroin abuse also leads to tolerance, dependence, and addiction. With prolonged use, the brain adapts to the drug’s presence. It reduces production of endogenous opioids and becomes less responsive to their effects.

Over time, more heroin is needed to achieve the original high. The body experiences extremely unpleasant physical and psychological withdrawal symptoms in heroin’s absence.

For many dependent users, heroin addiction signs include withdrawal. The agony of heroin withdrawal is the driving force behind their addiction. They continue using to avoid the crushing lows of “coming down.”

Symptoms of heroin withdrawal come in two phases:

Early withdrawal phase - Begins 6 to 12 hours after last use. Includes anxiety, restlessness, muscle aches, sweating, runny nose, teary eyes, and yawning. Heroin cravings are extremely intense during this stage. These are common symptoms of withdrawal.

Late withdrawal phase - Starts 1 to 3 days after last use, peaks around days 3 to 5. Symptoms like nausea, vomiting, diarrhea, dilated pupils, rapid heartbeat, and high blood pressure emerge. Insomnia, chills, tremors, and drug cravings continue.

Heroin withdrawal timelines vary based on factors like:

  • Length of use

  • Typical dosage

  • Purity of the drug

  • Individual physiology

Overall, the acute stage of heroin withdrawal lasts about a week. But some symptoms like fatigue, insomnia, and drug cravings may drag on for months.

Going through withdrawal without professional help is extremely challenging. These unpleasant withdrawal symptoms are often unbearable. Many relapse during this agonizing process. Medical detox provides relief for the painful symptoms while guiding the brain and body toward recovery.

Behavioral Symptoms of Heroin Addiction

Heroin is considered one of the most addictive substances due to the speed and intensity of the high. With regular abuse over time, the appeal of the drug fades. But the growing dependence on heroin makes quitting increasingly difficult.

Signs of heroin addiction include:

  • Building tolerance, needing more heroin for the same effect

  • Unsuccessful attempts to cut back or quit

  • Spending significant time, energy, and money to obtain and use heroin

  • Taking the drug in larger amounts or for longer periods than planned

  • Experiencing heroin cravings and withdrawal without the drug

  • Failing to fulfill work, school, or home obligations due to heroin use

  • Continuing heroin use despite physical or mental health issues it may cause or worsen

  • Giving up social, recreational, or professional activities in favor of heroin

  • Engaging in risky behaviors like sharing needles or driving under the influence

  • Hiding heroin use from loved ones

  • Legal problems resulting from heroin possession or impaired functioning

Addiction warps the circuits in the brain that govern motivation, reward, learning, judgment, and self-control. Quitting becomes extremely difficult due to the grip heroin addiction takes over the mind and body.

But understanding how people become trapped in heroin dependence can foster greater compassion. With extensive treatment and support, recovery is possible.

Causes and Risk Factors for Heroin Addiction

Many pathways can lead people down the treacherous road of heroin abuse and addiction:

Prescription Opioid Transition - The clearest pathway starts with prescribed opioid painkillers. As tolerance builds, people misuse painkillers by taking higher doses or combining them with other substances like alcohol to enhance their effects. When access to painkillers becomes restricted or too expensive, heroin offers a cheaper and more powerful alternative.

Environmental Exposure - Growing up in environments where drug use is common and encouraged can increase heroin experimentation. People with family members or peers who use heroin face higher risk of trying it themselves.

Self-Medication - Some turn to the numbing effects of heroin to cope with untreated mental health disorders like depression, trauma, or anxiety. Heroin offers temporary relief from psychological distress. But it ultimately exacerbates underlying issues.

Thrill-Seeking Behaviors - The allure of heroin’s intense rush leads some to try it for recreational purposes. Curiosity, boredom, and pursuit of a euphoric high may motivate initial experimentation, which too often leads to physical dependence.

Economic Instability - The rise in heroin coincides with depressing economic trends like higher unemployment and poverty in certain regions. People feeling financial desperation may use the drug to escape realities of poverty and lack of opportunity.

While everyone’s path to addiction differs, the end result is nearly always the same – a destructive spiral into compulsive heroin use that devastates lives.

The Effects of Heroin Addiction

Beyond the severe physical and mental effects, heroin addiction extracts a huge toll on people’s lives in many spheres:

Health – Heroin abuse is linked to conditions like HIV, hepatitis, heart infections, kidney and liver disease, lung complications, and cognitive decline. Malnutrition and declines in self-care are also common.

Finances – Supporting an active heroin addiction is extremely costly. People may exhaust their resources buying the drug. They struggle to hold jobs or manage finances. Many turn to criminal activities like theft to get money for their next fix.

Relationships – Lying, disappearing for days on drug binges, and mood swings strain family bonds. Friends and colleagues are often alienated due to unpredictable behavior. Isolation worsens addiction.

Legal Problems – Heroin possession leads to criminal charges and jail time. Impaired functioning results in arrests for erratic behavior or drugged driving. Children may end up in foster care if parents neglect responsibilities.

Mental Health – People with heroin addiction have high rates of depression, anxiety disorders, and suicidal thoughts. Trauma is often exacerbated from the lifestyle and constant search for heroin.

Dangerous Situations – Obtaining heroin involves high-risk scenarios like interacting with criminals, frequenting unsafe areas, or sharing needles. Sex work and gang involvement may result from desperation.

Heroin dependence destroys lives in myriad ways. But the thousands who achieve long-term recovery prove people can overcome addiction with extensive treatment and support.

Barriers to Substance Abuse Treatment


As heroin addiction rates have soared in recent years, rates of people getting treatment have not kept pace. In 2018, less than 20% of people needing treatment for heroin addiction received it.

Many barriers prevent people from accessing professional treatment options:

  • Denial and stigma – Many deny or downplay their heroin addiction out of shame and guilt. Stigma fuels feelings of failure and prevents people from seeking help.

  • Unawareness of options – People may not know where to turn for substance abuse treatment or how to navigate the process.

  • Cost of treatment – The expense of addiction treatment causes many to delay getting help. Cost frequently exceeds $20,000 for a full treatment program.

  • Lack of motivation – The nature of addiction hampers motivation and willingness to get clean. People fear the difficulty of withdrawal and life without heroin.

  • Dual diagnosis – Co-occurring mental health disorders like anxiety, depression, or trauma complicate treatment. Many treatment centers do not treat dual diagnosis.

  • Responsibilities – People worry about taking time away from family, work, or school to attend treatment.

  • Availability of programs – Waitlists to get into rehab can be weeks or months long. Rural areas have limited access to addiction services.

  • Distrust of programs – Previous negative experiences make people hesitant to try treatment again.

Overcoming these barriers requires funding to improve access to affordable, evidence-based drug addiction treatment programs. For true progress against the heroin epidemic, seeking help must become less daunting.

Seeking Help for Heroin Addiction

Although heroin addiction feels hopeless and inescapable, recovery is within reach. With comprehensive treatment and ongoing support, people can reclaim their lives from heroin use disorder.

The most effective path to overcoming heroin addiction usually involves:

Medically-Assisted Detox

The first step of heroin addiction treatment is allowing the body to safely clear itself of the drug. Medications like methadone, buprenorphine, or Suboxone ease the severity of withdrawal symptoms during detox. Medical supervision protects against complications.

Inpatient or Outpatient Programs

Patients live at a rehab facility for 1-3 months of intensive treatment in an inpatient program. Outpatient programs offer similar treatment for multiple hours per week while allowing patients to live at home. Both programs provide counseling, behavioral therapies, 12-step programs, life skills classes, and peer support.

Ongoing Maintenance with Medication

Medications like methadone and buprenorphine help prevent cravings and relapse after detox by binding to opioid receptors. They allow brain chemistry to stabilize and recovery to solidify.

Aftercare Planning and Support

Ongoing aftercare helps people transition back to daily life and stick with sobriety. This includes outpatient counseling, 12-step meeting attendance, sober housing, recovery coaching, mental health services, and engaging with a community of support.

With personalized and evidence-based treatment, people can break heroin’s deadly grip, reconnect with purpose, and start fresh in recovery.

Spreading Awareness, Ending Stigma

As the heroin epidemic continues tearing through communities, awareness and education are vital to turn the tide. Oklahoma is not immune from this epidemic. During the COVID pandemic, a spike in heroin use occurred in Tulsa and throughout the state. We must speak openly about this crisis and adopt compassion for those battling heroin addiction rather than shame. Evidence shows that addiction is a disease, not a moral failing. With expanded knowledge and empathy, we can encourage people who use heroin to pursue treatment and build a fulfilling life in recovery.

On a societal level, smarter public health-focused policies are key to preventing heroin abuse before it starts. This includes:

  • Enhanced access to medication-assisted treatment

  • Regulations on over-prescribing painkillers

  • Community drug disposal programs

  • Increased availability of naloxone to reverse overdoses

  • Youth education programs

  • Treatment instead of incarceration for drug offenses

  • More recovery resources like sober housing and job training

Proactive strategies like these can curb the demand for heroin and related deaths. No single solution will instantly defeat the heroin epidemic - but by rallying our communities around this cause, we have hope for saving lives from heroin addiction.

If you are ready to end your heroin addiction, I believe you found the top doctor in Oklahoma to help you accomplish this. I lead a team with decades of experience, a commitment to providing you with comfort, care, and respect as you navigate this challenging time in your life. We also make treatment super convenient with hours of operation that extend from 0800 AM to 0900 PM.

About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.

This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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