While the use of prescription painkillers may be one way how heroin addiction starts, there can be other gateway drugs that lead users down the path of this drug.

When someone has an addiction, particularly to something as dangerous and deadly as heroin, people around them often wonder how it got started. What are the initial warning signs of something like heroin addiction? While no two situations may be the same, there are often some similarities in how heroin addiction begins.

Of the people who try the heroin, almost one in four will become addicted. Heroin use has a high likelihood of addiction associated with it.

Prescription Opioid Use and Heroin

One of the primary ways of how heroin addiction starts is the abuse of prescription opioids. Research has shown the initial use of heroin was 19 times higher among people who used prescription opioids for nonmedical purposes.

Another study that examined young people who used injectable heroin showed that 86 percent used opioid pain relievers in an abusive way before using heroin. This represents a very different picture from what was seen decades ago.

For example, in the 1960s heroin addicts primarily started with heroin use itself. In the 2000s, 75 percent of people who said they used heroin also reported their first experience with an opioid was by a prescription drug. Eighty percent of heroin users in a national-level study of heroin data said they used prescription opioids before using heroin.

Some of the most commonly prescribed and abused prescription opioids include VicodinPercocet, and OxyContin. Drugs like heroin are classified as opioids, so if someone abuses them and becomes dependent and then addicted, they may switch to heroin because it’s cheaper and a more readily available alternative.

Heroin and Addiction

While the use of prescription painkillers may be one of how heroin addiction develops, there can be other gateway drugs that lead people to use heroin. For example, people often report using heroin as a way to come down from cocaine. Using multiple drugs at the same time is not uncommon, but the combination of different drugs can often be extremely dangerous. Regardless of how it begins, there is a scientific component to how heroin addiction starts.

Heroin, like prescription opioids, binds to specific receptors in the brain. When this happens, it triggers the release of a naturally occurring chemical called dopamine. Dopamine is naturally released when people do things they enjoy, but the amount of dopamine released with heroin is up to 10 times as much as what can occur naturally.

When the brain releases dopamine, its response is to continue to seek out the activity that produced it. As an example, if someone tastes chocolate for the first time, their brain is likely to release dopamine. Because the dopamine was released, a memory is formed to know that may cause someone to want to eat chocolate again.

It’s the same concept with heroin but in a much more amplified way. This is an example of how heroin addiction starts and why heroin is so addictive. Once someone uses a drug like heroin, the chemical functionality of the brain is altered. Dependence can develop when someone builds a tolerance to heroin and they need to take larger doses of the drug to get the same effects. The body becomes used to the presence of heroin, and without it, someone may start to feel abnormal or experience withdrawal symptoms.

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Editor – Jennifer Kopf
Jennifer Kopf is a Florida-based writer who likes to balance creative writing with helpful and informative pieces. Her passion for helping people has translated into writing about the importance of treatment for substance use and mental health disorders. Read more
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Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.