Last updated: 04/18/2018
Author: Addictions.com Medical Review
Reading Time: 4 minutes
Heroin is one of the most addictive drugs on the planet and no longer predominates solely in urban areas. Heroin is trafficked from a larger variety of sources that have modified the synthesizing process from morphine adding to the potency of the heroin found on the street today and lowering its cost.
In comparison to prescription opioid drugs which have been a primary target for abuse and diversion reductions in the United States, heroin is, now, making a comeback as a preferred, cheap, easily available, and potent alternative to those drugs.
There is no way of predicting who will have a heroin relapse after attempting to cease use of the drug, but, during the first 3 months after detox, the heroin relapse rate has been estimated to be above 90 % in some studies and at least 50 % in others when a long-term treatment such as methadone or buprenorphine maintenance therapy is not used.
Why Are the Heroin Relapse Rates So High?
The heroin relapse rate is significantly high due to heroin’s powerful euphoria-producing abilities and the short half-life that potentiates dangerously abusive behaviors and reinforces continued use. Because heroin is typically snorted or injected, its influential effects are rapid and intense activating specific receptors in the brain called mu-opioid receptors (MORs). These receptors regulate pain and pleasure, but, also appear to be the most important for the reinforcing effects of heroin and morphine.
Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed.” The adverse consequences many heroin addicts suffer leaves them with little hope for a better quality of life long after they stop using the drug and the profound tolerance and dependence produced in heroin abusers contributes to the high relapse rate. Cravings conditioned reminders, and stress can overpower the recovering heroin addict in an instant while other relapse processes may begin long before the physical resumption of heroin use.
Influential Factors in the Heroin Relapse Rate
The major problem in the treatment of opioid dependence still remains the occurrence of relapse, to which stressful life events, renewed use of heroin, and exposure to drug-associated environmental cues are all positively correlated.” People, places, things, emotions, isolation, stress, celebrations, being overly confident, and not doing what you need to do to stay in control of your heroin recovery are the most common factors that lead to heroin relapse.
Since the long-term effects of heroin interplay with many physiological, psychological, social, and environmental factors, a heroin-dependent is likely to relapse, eventually. Knowing what to do when heroin relapse occurs and having a strategic plan in place can mean all the difference in preventing the person from returning to a full-blown addictive state.
Increases in Heroin Access and Potencies
Increases in heroin access and potencies are influential factors in the relapse rates of a person who is addicted to heroin and can remain long-term associated risks for returning to a full-blown addiction. Heroin is often used as a cheap alternative to prescription opioids when accesses to those drugs become limited or too costly or it may be preferred for addicts with a high opiate tolerance. A bag of heroin that is purchased on the streets today, can be up to 15X greater in potency than what was found back in the 1970’s and 80’s and a heroin “high” can be found for as little as $5 in some places versus the $30 to $80 a pill for prescriptions opioids.
While there are many countries overlapping in their distributions of heroin worldwide, an alarming trend in America is the increased trafficking of black tar heroin from Mexico. Many of these heroin sources have been found to have higher levels of the psychoactive opium derivatives 6-MAM (6-monoacetylmorphine) and 3-MAM (3-monoacetylmorphine) because of the way the heroin is synthesized, stored, and distributed in base-line forms.
Heroin Relapse Vulnerabilities
Although abstinence is essential to relapse prevention, it is not the only issue. Recovery can be achieved only when patients change their attitudes and behaviors that led to and/or were associated with drug use. Patients must learn: (1) that relapse begins long before drug use occurs, (2) to anticipate high-risk situations, and (3) to develop alternative coping skills to manage the stress and frustration of daily life.”
Studies have proven that heroin use is on the rise in urban areas as well as many suburban communities among young adults aged 18-25. Individuals in this age group seeking treatment for heroin abuse increased from 11 percent of total admissions in 2008 to 26 percent in the first half of 2012.” In another study by the Research Society on Alcoholism social anxiety disorder (SAD) has been found to be associated with “earlier age of first use, greater lifetime use of heroin, incarceration history, and lifetime trauma.”
Detox from heroin has long been proven insufficient in maintaining abstinence and researchers have found that psychiatric and behavioral treatments frequently fail to help heroin addicts sustain abstinence, thereby, advocating a comprehensive approach using methadone or buprenorphine. According to the University of California,” Over the long term, …among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids.