Heroin is considered to be highly addictive, as nearly a quarter of all people who use it will become addicted to the drug, the American Society of Addiction Medicine (ASAM) warns. Heroin takes effect more quickly than any other opioid drug, according to the Drug Enforcement Administration (DEA), which may make it more addictive. The intense burst of euphoria can be highly desirable and extremely powerful. Addiction does not come from one-time use of heroin, as it takes regular use for addiction to form; however, one hit can rapidly lead to repeated use.

Addiction is a brain disease that occurs when brain chemistry is altered from repeated disruption of a drug like heroin. The physical changes alone are not enough to diagnose addiction, however, as behavioral manifestations must also be present.

When someone takes heroin, the drug binds to opioid receptor sites in the brain resulting in a flood of dopamine which induces the “high,” or rush of pleasure. When the drug wears off, the brain takes a time to regulate itself. With repeated use of heroin, it can take longer and longer for the brain to stabilize after the drug’s interaction. Tolerance forms, which means a person will need to take more heroin to feel its effects. With tolerance often comes drug dependence, which is what happens when the brain is no longer able to keep its chemical balance without heroin. Cravings, withdrawal symptoms, behavioral changes, and a loss of control over use of the drug may then occur – all of which are signs of addiction.

Per the National Survey on Drug Use and Health (NSDUH), more than a half-million American adults battled addiction involving heroin in 2014.

Factors Impacting Addiction Involving Heroin

While a person cannot instantly become addicted to heroin with only one use, some people may be at a higher risk for becoming addicted than others. There are many things that can play a role in the onset of addiction, such as:

  • Age of initiation: The brain is not fully formed until a person is in their mid-20s. Using drugs like heroin prior to this may increase the odds for problems surrounding substance abuse later in life, the National Institute on Drug Abuse (NIDA) warns.
  • Method and amount of use: The more heroin a person uses more often, the more likely it is that they will become addicted to it. Also, injecting or smoking the drug can send it rapidly across the blood-brain barrier and increase the risk for dependence and addiction.
  • Polydrug abuse: The Centers for Disease Control and Prevention (CDC) reports that in 2014 most people using heroin also used as many as three other drugs. Using multiple drugs at a time can increase all issues and side effects, including the rate at which addiction occurs.
  • Co-occurring disorders: Nearly 8 million American adults battled both a mental health disorder and addiction simultaneously in 2014, the Substance Abuse and Mental Health Services Administration (SAMHSA) publishes. Co-occurring mental health or medical concerns can increase the risk for addiction.
  • Biology: Things like age, metabolism, gender, race, and other biological factors can all play a role in why one person may be more susceptible to the effects of heroin, and therefore suffer from addiction more often than another person.
  • Genetics: NIDA reports that addiction is heritable between 40 percent and 60 percent of the time, meaning that there is a potential genetic predisposition for the disease. Individuals with a family history of addiction may therefore be at a higher risk for addiction than those without such history.
  • Environmental factors: Stress, trauma, low levels of support, and other negative environmental aspects can also be involved in the onset of heroin use and addiction involving heroin.

Addiction involving heroin is optimally treated with behavioral therapies, such as Cognitive Behavioral Therapy (CBT), high levels of supportive care, and often pharmacological tools.

Beginning with medical detox, which lasts around 5-7 days on average, and then moving on to a treatment program that is at least 90 days in length, addiction treatment should be comprehensive and address all factors that are involved in the onset of abuse and addiction involving heroin.