Heroin is one of the most severe and stigmatized substance use disorders. The history behind why someone starts using heroin is often very complicated and can include untreated depression, unhealed trauma, chronic pain, or a mental health disorder that was identified but never properly treated. Heroin use starts as a way to get relief or numb pain. As destructive as it is, it genuinely did something for them in some way. And until that “something” is replaced with something better, healthier, and not self-destructive, stopping use can be incredibly difficult.
That is what Helios West Palm is for. We are a mental health rehabilitation facility that treats the underlying issues behind someone’s heroin use, to get to the root of the problem and achieve lasting recovery.
Heroin is an illegal opioid drug that is derived from morphine, which is extracted from the opium poppy plant.[1] When heroin is consumed, the drug binds to opioid receptors in the central nervous system, producing a powerful high and providing analgesic effects, sedation, and a profound sense of calm and well-being.[2] The effects are intense, but short-lived, and ultimately cause an increase in baseline discomfort, motivating the user to continue using.
Heroin can be found as a white powder, brown powder, or in the form of black tar heroin and can be injected, snorted, or smoked. Of the three methods, injecting increases the risk of heroin overdose, infectious disease transmission via contaminated needles, abscesses, and the transmission of bloodborne pathogens such as hepatitis and HIV.[3]
Fentanyl has drastically changed the landscape of heroin in our country, and currently, a significant portion of the heroin supply contains illicitly manufactured fentanyl mixed in without the user’s awareness, which dramatically increases the risk of accidental overdose. According to the Centers for Disease Control and Prevention (CDC) and the National Institute on Drug Abuse (NIDA), fentanyl contamination of the heroin supply has significantly increased the risk of heroin use compared to just 10 years ago.[4]
Heroin is one of the most addictive substances available, and understanding the reasons for its high addiction potential can help explain what effective treatment must address in order for someone to recover.
When someone uses heroin, the drug binds to opioid receptors in the brain, which causes the brain to release high levels of dopamine and mimic the effects of endorphins, the neurotransmitters that are responsible for pain relief, reward, and emotional well-being.[5] The euphoria that many people experience from using heroin is something the brain cannot produce naturally, providing warmth, comfort, and relief from all physical and emotional pain. But it is not without consequence.
As heroin use continues, the brain adapts to the excess stimulation by reducing its own opioid receptor activity and endorphin production.[6] This quickly leads to physical dependence, where the brain can no longer function at baseline without the drug. At this point, stopping use will result in withdrawal symptoms, which include severe physical pain and anxiety that can last days to weeks.[7]
Heroin withdrawal does not typically pose a serious medical risk; however, due to the symptoms, it is one of the most uncomfortable experiences a person can endure, and knowing what it feels like to quit is why many heroin users are reluctant to seek treatment.
Identifying the signs of heroin use or addiction is the first step in evaluating if professional assistance is needed. Signs and symptoms related to heroin use include:
Signs that heroin use has advanced into addiction include a person continuing to use the drug despite obvious harmful effects, being unable to stop using despite wanting to, experiencing substantial withdrawal symptoms when stopping, and completely reorganizing their life around getting and using the drug.[8]
Long-term consequences resulting from heroin use are severe and impact almost every aspect of the body’s functioning. Beyond other physical problems resulting from chronic heroin use, users may also experience the following:
The mental health consequences of long-term heroin use are particularly important for the Helios West Palm model of care, because for many patients who have stopped using heroin, the chronic depressive and anxiety symptoms and poor emotional control that they are left with may be untreated mental illnesses that need to be professionally managed.
The relationship between heroin addiction and mental health is one of the most significant clinical relationships found within behavioral health. Numerous studies show that the vast majority of heroin users have a co-occurring mental health disorder, and that often the mental health disorder existed prior to the heroin use, playing a direct role in someone’s vulnerability to addiction.
Depression is one of the most frequently diagnosed co-occurring mental health issues with heroin use.[9] The way heroin provides immediate and profound relief from emotional pain makes it especially appealing to depressed people who have never received comprehensive treatment for their condition. Heroin does what antidepressants are supposed to do, and that is a major reason heroin becomes so difficult to stop using.
Those with post-traumatic stress disorder (PTSD) or unresolved trauma are much more likely to use heroin, and the association between unresolved trauma and opioid use disorder is well-established.[10] Heroin use temporarily relieves the hyperarousal, flashbacks, and unresolved emotional pain commonly associated with untreated trauma.
Chronic pain is also a common predictor of heroin use.[11] When combined with depression or PTSD, it creates an extra complicated situation that requires treatment with an integrated, collaborative, psychiatric and medical treatment model, rather than just removing the substance.
Other frequently diagnosed co-occurring mental health problems include bipolar disorder, anxiety disorders, and personality disorders, all of which add additional vulnerability to the development of addiction by limiting the person’s ability to regulate their mood through other means.[12]
Many of the patients who come to Helios West Palm for treatment related to their heroin addiction have already undergone numerous different treatment options, including detox, residential and outpatient rehabilitation, and medication-assisted recovery. While these treatment options helped manage their heroin addiction, the underlying mental health disorders that led to heroin use were never diagnosed or managed.
Once the patient stopped using heroin, the depression resurfaced, the trauma remained unresolved, and the patient’s mental health disorder remained untreated, making the road back to heroin use a short one.
For these patients, to effectively address their substance use, the mental health causes of use need to first be treated. This is what Helios West Palm was built for. We offer a treatment program where the primary focus is on treating the patient’s mental health disorder.
We are not a detoxification facility or a primary addiction treatment program. However, for patients whose heroin use is secondary to a serious, untreated mental health disorder, we provide integrated, psychiatric-oriented treatment that finally addresses the root of the problem.
If you have attended treatment in the past, but ended up back where you started shortly after, or felt it was missing something, then Helios West Palm might be the missing piece of the puzzle.
Reach out today. Our admissions staff is available to answer your questions, verify your insurance, and help you determine if our program is the place where you can finally address what’s been missing.
Recovery from opioid and heroin addiction is achievable, but it is one of the most difficult substance use disorders to treat due to the level of physical dependence and the resulting neurological changes. However, the likelihood of achieving positive outcomes from a treatment program increases dramatically when patients’ co-occurring mental health disorders, especially major depression, PTSD, and anxiety, are identified and treated within the opioid use disorder treatment plan.
Quitting heroin is one of the most difficult withdrawal experiences from any opioid, and withdrawal symptoms can include severe pain, nausea, vomiting, anxiety, depression, sweating, insomnia, and extreme cravings. Typically, the detox process is not life-threatening. However, it requires medical supervision and is often facilitated through prescribed medications. Helios West Palm will refer any patient in need of medical detox prior to admission to an appropriate medical provider.
Relapse after heroin treatment occurs frequently when the underlying mental health conditions that have driven the use of heroin are not identified and treated. Having a treatment program that only treats the drug-using behavior without addressing the underlying conditions, such as depression, trauma, or other mental health disorders, does not address the underlying cause of the behavior and makes it easier for the person to return to using heroin.
A heroin overdose is a medical emergency that requires immediate action. The most important step is to call 911 right away. If available, naloxone (Narcan) should be administered to reverse the effects of the opioid. While waiting for help, try to keep the person awake, place them on their side to prevent choking, and monitor breathing. If they stop breathing, rescue breathing or CPR may be necessary until emergency responders arrive.
[1] [2] [3] [5] [8] National Institute on Drug Abuse. (2021). Heroin research report: What is heroin and how is it used? https://nida.nih.gov/publications/research-reports/heroin/what-heroin
[4] Centers for Disease Control and Prevention. (2026). Overdose prevention: Synthetic opioids. https://www.cdc.gov/overdose-prevention/about/index.html
[6] [7] [11] National Institute on Drug Abuse. (2021). What are the long-term effects of heroin use? https://nida.nih.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use
[9] Centers for Disease Control and Prevention. (2022). National Health Statistics Reports. https://www.cdc.gov/nchs/data/nhsr/nhsr173.pdf
[10] National Center for PTSD. (2019). Opioid use among individuals with posttraumatic stress disorder.https://www.ptsd.va.gov/publications/rq_docs/V30N1.pdf
[12] National Institute on Drug Abuse. (2020). Common comorbidities with substance use disorders. https://nida.nih.gov/research-topics/comorbidity
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