The presented heroin-related visual cues reliably elicited heroin craving in all tested subjects. [ncbi.nlm.nih.gov]

Paper presented at the National Drug and Alcohol Annual Symposium, 8 September, Sydney Australia. [ndarc.med.unsw.edu.au]

• Congestive Heart Failure

  Lungs Aspiration pneumonia; pulmonary oedema due to direct heroin toxicity, affecting pulmonary capillaries or myocardium; hypoxic endothelial damage; congestive heart failure; central vasomotor effect (increased protein in oedema fluid); talc granulomas [medical-dictionary.thefreedictionary.com]

• Nausea

  People who are addicted to heroin are likely to show some or even all of the following signs: Fatigue, followed by patterns of alertness Shallow or laboured breathing Injection wounds Infections on the skin from injections, boils Nausea Vomiting Small [castlecraig.co.uk]

  Withdrawal symptoms of heroin can include: Intensive cravings Negative mood Stomach pain Nausea and vomiting Muscle aches and whole body pain Body weakness Joint pain Runny nose Nausea and vomiting Extreme sweating Chills Runny nose Increased blood pressure [acadianaaddiction.com]

  Medication may be used to ease the physical effects of withdrawal, which include goosebumps, cramping, body aches, nausea, and intense craving. [medicinenet.com]

  Subsequent uses result in less nausea and increase the level of withdrawal symptoms experienced when the heroin wears off. These withdrawal symptoms cause the user to turn to heroin to find relief. [addictions.com]

• Vomiting

  People who are addicted to heroin are likely to show some or even all of the following signs: Fatigue, followed by patterns of alertness Shallow or laboured breathing Injection wounds Infections on the skin from injections, boils Nausea Vomiting Small [castlecraig.co.uk]

  Withdrawal symptoms of heroin can include: Intensive cravings Negative mood Stomach pain Nausea and vomiting Muscle aches and whole body pain Body weakness Joint pain Runny nose Nausea and vomiting Extreme sweating Chills Runny nose Increased blood pressure [acadianaaddiction.com]

  Vomiting. Cold flashes with goose bumps. Uncontrolled leg movements. Flu-like symptoms. Anxiety. Dilated pupils. Sweating. Watering eyes. [projectknow.com]

• Constipation

  Side effects: Nausea, vomiting, diarrhea, constipation, headache, dizziness. For a more complete list of side effects visit this NIH page. [addictionrecoveryguide.org]

  Extreme constipation The article, ‘Therapeutic Advances in Chronic Disease’ illustrates just how prevalent constipation is in opiate drug abuse. Between 40 – 90 % of opiate users will experience constipation. [ashwoodrecovery.com]

  Chronic heroin users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease. [aegistreatmentcenters.net]

  Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease. [castlecraig.co.uk]

  Constipation or diarrhea are common in heroin addicts, as is insomnia and a generally weakened immune system. Heroin use over long periods of time can cause infection of the heart lining or heart valves, regardless of how it’s taken. [altamirarecovery.com]

• Abdominal Cramps

  Other symptoms include: Restlessness Insomnia Goosebumps Tremors Irritability Joint and muscle pain Abdominal cramps Profuse sweating Chills Runny nose Nausea Vomiting Diarrhoea Urinary incontinence Shortness of breath Involuntary muscle spasm Reactions [castlecraig.co.uk]

  Anorexia and abdominal cramps. Nausea, vomiting and diarrhoea. Tremor. Insomnia, restlessness, anxiety and irritability. Generalised aches and pains. Tachycardia, hypertension. Goose flesh (goosebumps). Dilated pupils. Increased bowel sounds. [patient.info]

  Someone who displays the below symptoms after consuming heroin should seek immediate medical attention in order to avoid a grave outcome: Slowed heart rate Abdominal cramping Blue hue around mouth or fingertips Muscle spasms Loss of consciousness Pinpoint [roserehab.com]

  They include difficulty sleeping, aggression, irritability, abdominal cramps, tremors, spasms and drug cravings lowered blood pressure, dizziness and shallow breathing, if your dose is too high tooth decay – as with heroin and other opioids, methadone [betterhealth.vic.gov.au]

• Loss of Appetite

  Some effects of heroin addiction include: Irritability Depression Loss of appetite Liver damage Respiratory depression Difficulty swallowing Circulatory problems Nausea and vomiting Intense sweating Sleep apnea Joint pain Chills Body weakness Runny nose [acadianaaddiction.com]

  […] of appetite Legs and arms that seem heavy More energy Low sex drive Nausea Muscle spasms or cramps No menstrual cycle Needle marks or “track marks” (which look like little red dots or bruises) Overstimulation Nosebleeds Psychosis Pinpoint pupils Rapid [casapalmera.com]

  Side effects: Drowsiness, weakness, nausea, constipation, headache, loss of appetite. For a more complete list of side effects visit this NIH page. Availability: Physician prescription Research: Madden LM, et al. [addictionrecoveryguide.org]

• Slow Pulse

  Signs of a heroin overdose include: Shallow breathing Dry mouth Tongue discoloration Very small pupils Slow pulse Bluish lips [addictioncenter.com]

• Hypotension

  A small proportion of patients prescribed clonidine may develop hypotension. Some patients who cease clonidine abruptly develop rebound hypertension. [nps.org.au]

• Miosis

  […] and decreased anxiety) Respiratory depression (can cause death in overdose) Decreased gastrointestinal motility (can cause constipation) Cough suppression Suppression of corticotropin-releasing factor and adrenocorticotropin hormone Pinpoint pupils (miosis [emedicine.medscape.com]

• Blurred Vision

  vision, back pain, fainting, dizziness, and sleepiness. [suboxone.com]

• Euphoria

  Heroin blocks signal to the brain that allows an individual to perceive pain, creating an overall feeling of well-being and euphoria. [riverwoodsbehavioral.com]

  Following this initial euphoria, the user alternates between a wakeful and drowsy state. Heroin has a rapid effect, beginning with euphoria and feelings of peace and contentment. [castlecraig.co.uk]

  People who take heroin might feel a temporary surge of euphoria or pleasure. [interventionsupport.com]

  Signs of heroin use include: Euphoria Drowsiness Impaired mental functioning Slowed down respiration Constricted pupils Overdose Risk The strength of heroin is unpredictable because other substances are typically added to increase volume or enhance potency [hazeldenbettyford.org]

• Denial

  The brain must be retrained and reprogrammed over time if addiction is to be defeated, and self-denial alone will not be enough to make that happen. [elementsbehavioralhealth.com]

  Denial that there is a problem at all. Nonchalant acceptance that they are indeed using heroin. The last reaction is possibly the most difficult to work with – because for many, it can signify a refusal to change. [luxury.rehabs.com]

  Denial in particular is one of the symptoms of drug addiction. Don't take it personally and avoid responding emotionally in kind. Instead, assert that you are trying to help her. [16] 8 Prepare in case the person refuses treatment. [wikihow.com]

  Depression - a raiding _party Of course, especially in the early rays cf internment, the actual denial zf freedoc was but one facet of the curious tactics used by the British — break our people. [archive.org]

• Anhedonia

  Below are some of the more common withdrawal symptoms associated with heroin: Anhedonia Dysphoria Nausea, vomiting, diarrhea Agitation Anxiety Disrupted sleep patterns Strong cravings for heroin Flu-like symptoms Effects of heroin overdose: When an individual [roserehab.com]

  Effect of extended-release naltrexone on striatal dopamine transporter availability, depression and anhedonia in heroin-dependent patients. Psychopharmacology. 2015;232(14):2597-2607. 7. [mentalhelp.net]

  A condition called anhedonia, or lack of pleasure, often develops in recovering heroin addicts. One of the primary goals of treatment is to help the addict find peace, hope and joy in a drug-free life. [dualdiagnosis.org]

• Slurred Speech

  Physical Loss or increase in appetite, change in eating habits, unexplained weight loss or gain Slowed or staggered walking, bumping into things Smell of alcohol on breath Slow or slurred speech Irregular sleep patterns, having difficulty sleeping, awake [sfad.org.uk]

  speech Lack of memory, forgetting things or not remembering important events or matters Lack of interest in the future or what comes next Unkempt self-image, lack of hygiene, loss of self discipline. [castlecraig.co.uk]

  speech Track marks Weight loss Malnutrition Constant runny nose Scabs or bruises due to skin picking Dizziness Headache Dry mouth Loss of self-control Inhibitory behavior Psychological symptoms : Emotional numbing Inability to think clearly Personality [acadianaaddiction.com]

  speech Shortness of breath Frequent respiratory infections Dry mouth Wearing long pants and shirts, even in warm weather Going “on the nod” during conversations Forced, pressured speech Track marks on arms and legs Warm, flushed skin Constricted pupils [optionsbehavioralhealthsystem.com]

• Confusion

  sores, and/or abscesses Irregular heart rate Insomnia Slowed breathing Weight loss Itchiness Lethargy and fatigue Sensation of heaviness in arms and legs Constricted pupils Cognitive Symptoms: Trouble focusing or thinking clearly Impaired judgment Confusion [roserehab.com]

  injection, smoking, snorting). 5 Aside from the initial rush, you may experience the following short-term effects: 5 Warm flushing of skin Feeling of heaviness Alternating wakeful and drowsy state Mental confusion Dry mouth Constricted pupils Nausea [projectknow.com]

  Typical heroin withdrawal symptoms include: Irritability Confusion Crying Excitability Self-harm Cravings Dilated pupils Increased heart rate Low blood pressure Severe cramping and muscle spasms Vomiting and diarrhea Seizures Tremors Anxiety The longer [recoveryconnection.com]

• Headache

  Side effects: Nausea, vomiting, diarrhea, constipation, headache, dizziness. For a more complete list of side effects visit this NIH page. [addictionrecoveryguide.org]

  […] protective measures Hiding the drug in various places Physical symptoms: Cravings Hyperactivity Fatigue Feeling disoriented Increased sleep Slurred speech Track marks Weight loss Malnutrition Constant runny nose Scabs or bruises due to skin picking Dizziness Headache [acadianaaddiction.com]

  According to the Centers for Disease Control and Prevention, the following symptoms represent possible atypical reactions to heroin: Palpitations Anxiety Shortness of breath Tremors Headache Chest pain Overdose Signs A severe reaction to heroin use will [americanaddictioncenters.org]

  […] laboratory AIDS — thanks for Prohibition and the War Against Drugs — thanks for a country where nobody is allowed to mind his own business — thanks for a nation of finks — yes, thanks for all the memories… all right, let’s see your arms… you always were a headache [tiede.fi]

  Common side effects of SUBOXONE Film include nausea, vomiting, drug withdrawal syndrome, headache, sweating, numb mouth, constipation, painful tongue, redness of the mouth, intoxication (feeling lightheaded or drunk), disturbance in attention, irregular [suboxone.com]

• Stupor

  A. heroin; is a opiate(derivative)-the other drugs in this catagory-are-morphine,codeine,heroin,dilaudid,percodan,percocet,demerol,darvon.and overdose wil cause stupor progressing to coma with respiratory depression,pupils become pinpoint and non-reactive-pulmonary [medical-dictionary.thefreedictionary.com]

  For severe overdose, patients may experience respiratory depression, stupor, and coma. A severe overdose may be fatal. [emedicine.medscape.com]

• Sexual Dysfunction

  Heroin addicts often have reproductive problems, sexual dysfunction, and menstrual irregularities. [altamirarecovery.com]

  This can be minimised with good oral hygiene menstrual changes sweating constipation sexual dysfunction (inability to reach orgasm) drowsiness heart palpitations dizziness nausea and vomiting skin rashes and itching. [betterhealth.vic.gov.au]

  Sexual dysfunctions. Mood swings – from joy and elation to apathy to depression. Constricted pupils. Negligence of responsibilities at school, work or home. Accidents or injuries from heroin-associated violence. [luxury.rehabs.com]

  Reproductive issues like sexual dysfunction and inconsistent menstrual cycles. Damage to the septum and nose tissues from snorting. [drugabuse.com]

See Workup for more detail. Management Current guidelines recommend comprehensive treatment with pharmacological agents such as methadone, buprenorphine, or buprenorphine combined with naloxone as well as psychosocial therapy. [emedicine.medscape.com]

• Torsades De Pointes

  Prolongation of the QT interval in the ECG of patients with torsade de pointes (TdP) has been reported in methadone users. [ncbi.nlm.nih.gov]

SETTING: The syringe exchange programme in Malmö, Sweden and an out-patient clinic (research treatment facility) for maintenance treatment, situated outside the hospital area and run by Malmö Addiction Centre. [ncbi.nlm.nih.gov]

Prognosis The National Drug Treatment Monitoring System reported that, for the year 2014-2015, 47% of patients attending UK drug treatment services achieved abstinence from illicit opiates when reviewed at six months. [patient.info]

This is the first study using NeuroD genetic variants to approach the etiology of heroin addiction. Of the 7 single markers we studied, NeuroD 1 rs16867467 was possibly associated with the occurrence of HD, while the other variants were not. [jneuropsychiatry.org]

Heroin addiction has a substantial heritability in its etiology; hence, identification of individuals with a high genetic propensity to heroin addiction may help prevent the occurrence and relapse of heroin addiction and its complications. [journals.lww.com]

Extramural MeSH terms Adult Alleles Analgesics, Opioid/metabolism Bulgaria/epidemiology Bulgaria/ethnology Case-Control Studies Exons Female Genotype Heroin Dependence/genetics* Heroin Dependence/physiopathology Humans Male Polymorphism, Genetic Polymorphism [ncbi.nlm.nih.gov]

Epidemiology [ 5 ] In England, there were 295,224 adults using Drug and Alcohol treatment services in 2014 to 2015. Opiates (such as heroin) were the most common substance (152,964 adults). [patient.info]

Heroin Addiction and Related Clinical Problems is particularly interested in therapies, including all aspects of translation from bench to bedside: identification of novel therapeutic targets, epidemiology, clinical trials, drug safety and meta-analyses [heroinaddictionrelatedclinicalproblems.org]

Epidemiological data indicate that having a substance use disorder increases the risk of being diagnosed with an anxiety disorder by almost 2.5 times. [mentalhelp.net]

Abstract Metabotropic glutamate receptor subtype 3 (mGluR3, encoded by GRM3) plays important roles in the pathophysiology of schizophrenia, depression, and drug dependence. [ncbi.nlm.nih.gov]

Tannu et al reported increased gamma enolase that was encoded by the ENO2 in the nucleus accumbens of cocaine overdose victims compared with control subjects, [29] suggesting the involvement of the ENO2 in the pathophysiology of cocaine dependence. [journals.lww.com]

Pathophysiology Opioids act by binding to opioid receptors on neurons distributed throughout the nervous system and immune system. Four major types of opioid receptors have been identified: mu, kappa, delta, and the more recently identified OFQ/N. [emedicine.medscape.com]

SUMMARY: Long-acting sustained release formulations of naltrexone are well tolerated and more effective for relapse prevention in heroin addicts than the oral ones. [ncbi.nlm.nih.gov]

Educating medical professional to help identify people who may be at a higher risk for opioid addiction is another prevention intervention. [michaelshouse.com]