22 Aug Study: Nearly Half of Heroin Addicts in Treatment for Over a Decade
Many people addicted to heroin will die, and large numbers of addicted users will still consume the drug more than a decade after they first enter treatment, according to newly reported findings from a team of Australian and British researchers.
Consumption of the powerful, illegal opioid drug heroin is associated with a range of highly damaging and potentially fatal problems, including addiction, overdose and exposure to infectious agents such as hepatitis C and HIV (human immunodeficiency virus). In a study published in March 2015 in the journal Addiction, researchers from an Australian institution and a British institution explored some of the long-term outcomes for people who develop heroin addictions. The researchers concluded that while some users discontinue intake over time, many die or remain actively involved in consumption of the drug more than a decade later.
Heroin is addictive because it travels to the brain and alters the chemical constituency of an area known as the pleasure center. When the pleasure center repeatedly experiences sharp increases in levels of its main chemical, dopamine, it can grow accustomed to this new “normal” and start to rely on continued heroin consumption as a condition of ongoing function. In turn, this reliance signals the onset of a physical dependence on heroin (which is, for all practical purposes, the equivalent of full-blown heroin addiction). A physically dependent or addicted heroin user typically loses his or her ability to limit consumption of the drug and experiences a range of additional symptoms that worsen the ability to maintain a productive daily routine and/or promote future instances of uncontrolled drug intake.
Recent figures compiled by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) indicate that roughly 289,000 Americans consume heroin in the average month; about 681,000 people use the drug at least once a year. SAMHSA figures also indicate that approximately 517,000 Americans meet the criteria used to diagnose opioid use disorder (a category of illness that includes heroin addiction and non-addicted heroin abuse).
Potential Addiction Consequences
All people addicted to heroin (and non-addicted heroin consumers) have clear risks for experiencing a non-fatal or fatal opioid overdose. Such an overdose occurs when the amount of heroin circulating in the bloodstream severely depresses activity in the central nervous system and disrupts the automatic function of such essential organs as the heart and lungs. In the U.S., heroin overdoses occur much less often than prescription opioid overdoses; however, heroin overdoses are on the rise and occur much more often now than before the start of the 21st century. Due to unsafe sharing of hypodermic needles and syringes, people addicted to heroin also have clearly elevated risks for developing hepatitis C, HIV and a range of other system-wide or localized infections. In addition, heroin addicts have elevated infection risks associated with unsafe sexual practices.
In the study published in Addiction, researchers from Australia’s University of New South Wales and the United Kingdom’s National Addiction Centre used data gathered from 615 heroin-dependent adults to explore what happens in the long run to people who develop heroin addictions. All of the study participants originally enrolled in a project called the Australian Treatment Outcome Study in 2001 or 2002. This project assessed factors that included basic patterns of heroin intake, level of exposure to heroin overdose and demographic background (age, gender, socioeconomic status, etc.). Over the course of three years, all of the participants answered questions regarding these and other issues on five separate occasions. They also answered questions at a sixth follow-up session conducted 11 years after the project began.
The researchers concluded that 10 percent of the initial group of 615 study participants had died by the time of the final 11-year follow-up. Roughly 25 percent of the participants were still consuming heroin, and 46.6 percent were still receiving some form of treatment for their drug use. However, the researchers also note that, for the group as a whole, the overall rate of involvement in heroin consumption fell by approximately two-thirds between the beginning of the study and the time of the three-year follow-up. The rate of involvement dropped an additional nine percentage points between the three-year follow-up and the 11-year follow-up.
The study’s authors note that addicted individuals who stop using heroin typically experience a significant decline in their involvement in criminal behavior and generally risky behavior, as well as a decline in their exposure to the damaging consequences of drug injection. They also note that addicted users affected by major depression usually have the highest chances of continuing to consume heroin over extended periods of time.