Heroin is a popular illegal drug in various parts of the country. The use of heroin has skyrocketed in the past five years to more than double its previous rates. However, heroin is commonly laced with a lethal dose of fentanyl. As a result, over a quarter-million people, a year-end up in the ER for heroin overdose. 

The Dangers Of A Heroin Addiction

An addiction to heroin is dangerous on a number of levels. The damage to internal organs from long-term opioid misuse is specifically dangerous. For example, heroin can cause heart infections and respiratory failure.

In addition, heroin misuse commonly co-occurs with severe depression and PTSD (post-traumatic stress disorder). While on their own, these disorders can wreak havoc on people’s lives. But, together can lead to an increase in heroin use and life-threatening overdoses. 

To fully understand the opioid epidemic, it is imperative to understand the dangers of fentanyl intoxication, smoking fentanyl, and what is a lethal dose of fentanyl.

What Is Fentanyl?

Fentanyl is a synthetic opioid prescribed to treat severe pain. Many people refer to fentanyl as “medical heroin” because it is a cousin to heroin. However, fentanyl is much deadlier. According to the Centers for Disease Control (CDC), fentanyl is 50 times more potent than heroin. Additionally, it is 100 times more potent than morphine. 

Fentanyl works by binding to opioid receptors on the brain. This action increases dopamine in the CNS or central nervous system. As a result, it increases relaxation, decreases pain perception, and creates a euphoric effect. 

Fentanyl is typically administered through transdermal patches or lozenges. While fentanyl effectively treats severe pain, its use must be monitored closely in a medical setting. Although fentanyl is proven effective, it also carries a high risk of abuse and even death.

What Is Fentanyl-Laced Heroin?

While prescribed fentanyl is extremely dangerous, the rise in fentanyl intoxication and death is primarily caused by illegally manufactured fentanyl. Moreover, it is attributed to the deadly combination of fentanyl-laced heroin. 

According to the Drug Enforcement Administration’s (DEA) 2019 National Drug Threat Assessment, both heroin, and fentanyl, disproportionately affect the Great Lakes and Northeast regions of the U.S. 

Furthermore, the majority of these drugs are smuggled across the southwest border by Mexican transnational criminal organizations. It is becoming more common for drug traffickers to lace heroin with fentanyl to produce a more potent high and make supplies last longer. 

However, this can produce a lethal dose of fentanyl since users are unaware their heroin is laced. The largest U.S. heroin markets are in larger eastern cities. Heroin in these cities is typically white powder heroin. At the same time, western cities have smaller markets and usually see black tar or brown powder heroin. 

Unfortunately, white powder markets are also the largest fentanyl markets. In eastern cities, fentanyl is mixed with heroin and sold on its own. Delaware, for example, found fentanyl was involved in 72 percent of overdose deaths in 2018. 

What Is A Lethal Dose of Fentanyl? 

A lethal dose of any opioid will vary depending on the person. However, for the typical man, 30 milligrams is generally a lethal dose of heroin. In comparison, a lethal dose of fentanyl is only 3 milligrams. 

The risk of overdose increases when someone smoking heroin doesn’t realize they are also smoking fentanyl. This also goes for anyone injecting heroin. This combination often results in an overdose and, without medical intervention, can lead to death.

How Does Heroin Laced With Fentanyl Affect The Brain And Body?

According to the National Institute on Drug Abuse (NIDA), fentanyl works by binding to opioid receptors in the brain. These receptors control a person’s emotional and pain responses. 

Although fentanyl is more potent than heroin because of different chemical structures, both drugs bind to mu-opioid receptors in the brain. But, fentanyl can easily pass through fat in the brain, unlike heroin, so it gets there faster. 

In addition, fentanyl attaches so firmly to the receptors. It takes very little to trigger its effects. Because fentanyl is a fine white powder, it easily mixes with heroin and other drugs. Unfortunately, this results in users not knowing they are smoking fentanyl or injecting fentanyl-laced heroin until it’s too late. 

Emotionally, individuals may feel very happy, confused, or drowsy, while physically, they may feel pain-free, nauseous, constipated, or have trouble breathing. Injecting or smoking fentanyl in higher doses can dangerously heighten these effects leading to fentanyl intoxication and death.

How Is Fentanyl Misused?

Fentanyl comes as a shot, a transdermal patch, and a lozenge which are all prescribed by a doctor. Illicit fentanyl is generally made in a lab and sold as a powder, dropped on blotter paper, or stored in eye droppers and nasal sprays. It can also look like pills such as OxyContin. 

Most of the illicit fentanyl in the U.S. is laced in heroin and other drugs. Unfortunately, most users are unaware their drugs contain a lethal dose of fentanyl. But, whether they know it or not, injecting, snorting, or smoking fentanyl produces immediate and intense effects.

What Are The Signs And Symptoms Of Fentanyl Intoxication?

Since it takes very little fentanyl for a person to overdose, if you or a loved one is struggling with a heroin or fentanyl addiction, it is imperative to know the signs and symptoms of fentanyl intoxication. 

Signs and symptoms of fentanyl intoxication include

• Drowsiness
• Dizziness
• Low blood pressure
• Nausea and vomiting
• Changes in pupil size
• cold and clammy skin
• Limp body
• Blue lips and fingernails
• Slowed or stopped breathing
• Slower heart rate
• Loss of consciousness
• Coma

The most common telltale signs of fentanyl intoxication are known as the “opioid overdose triad of symptoms,” which include pinpoint pupils, respiratory depression, and decreased level of consciousness. 

People who have witnessed fentanyl intoxication describe it as rapid. For example, symptoms often begin before withdrawing the needle after injecting fentanyl-laced heroin or before exhaling the smoke when smoking fentanyl. 

Fentanyl intoxication and overdose are also described as:

• Lips immediately turning blue
• Gurgling sounds when breathing
• Seizure-like activity or stiffening of the body
• Foaming at the mouth
• Confusion or bizarre behavior before losing consciousness

How Is Fentanyl Intoxication Treated?

As mentioned above, drug dealers often mix a lethal dose of fentanyl with heroin to increase their profits. This combination increases the risk of overdose. Naloxone is a medication used to reverse the effects of an opioid overdose. 

Naloxone binds to opioid receptors and blocks the effects of fentanyl and other opioids. However, it may take several doses of naloxone to reverse the effects of fentanyl. This is because it is so much stronger than other opioids. 

Because of the increase in injecting and smoking fentanyl, many states offer it without a prescription. Along with naloxone administration education, states hope to lower the overdose and death rates from fentanyl-laced heroin. While Naloxone can stop an overdose, it is only temporary, and individuals will still require medical attention at the ER. 

What Are The Signs Of Fentanyl Withdrawal?

Individuals using fentanyl-laced heroin can quickly develop an addiction to the drug. The body becomes dependent on the drug, so withdrawal symptoms can begin when a person stops or reduces their dose. 

Symptoms of withdrawal typically begin within 12 to 30 hours of the last dose and may include:

• Restlessness
• Yawning
• Sweating
• Tearing up
• Runny nose
• Stomach cramps 
• Backaches
• Chills
• Joint and muscle pain
• Muscle weakness
• Nausea/vomiting
• Increased heart rate
• Hypertension
• Increased respiratory rate
• Insomnia
• Anxiety
• Intense cravings

Withdrawal from fentanyl-laced heroin can be very uncomfortable, and sometimes withdrawal symptoms can be severe. For this reason, it is highly recommended to seek a detox program to withdraw from fentanyl safely. 

Unfortunately, suicidal thoughts are not uncommon. This is especially true for people suffering from an addiction. In a world where self-care is decreasing as stress is increasing, it can be really difficult to stay emotionally sound.

There are a few factors that increase the chances of developing intense depression and suicidal thoughts. If you or a loved one has experienced any of the following, talk to a professional about preventing or stopping these thoughts before any harm is done.

• Physical or Sexual Abuse
• Long Term Depression
• Long Term Substance Abuse 
• Family Members with Addiction 
• Family Members with Mental Health Conditions
• Personally History of Self Harm
• Poor performance in school 
• Little to no interest in hobbies, friends, or family activities
• Bullying
• Cultural/ religious beliefs such as a belief that suicide is a noble resolution of a personal problem
• Harmful or Toxic Relationships 

There are a lot of risk factors that may increase the likelihood of developing a mental health condition. Likewise, there are protective factors that can help reduce the intensity or outcome of suicidal thoughts. These include

• Healthy coping and problem-solving skills
• Cultural and religious beliefs that discourage suicide and instill positivity 
• Close relationship with friends, family, and community  
• Supportive relationships with care providers
• Access to  physical and mental health care
• Limited access to harmful substances 

Trauma And Addiction Treatment Is Necessary For Long-term Recovery 

Even when you move past suicidal thoughts, there is more healing to be done to prevent those thoughts from returning. 

The first step to healing your trauma is admitting you have it. It can be really painful to admit to others (and yourself) that you went through something hard. It can be even more difficult to admit that it caused you to have uncontrollable emotional and physical reactions. As humans, we like to pretend we always have it together. The truth is, none of us do. It is only when we can admit that we aren’t perfect, we begin to work towards a more stable life. 

It’s common for people to feel guilt surrounding their trauma, but that guilt is misplaced. If you have unhealed trauma, your side effects are not your fault. Your body was doing its job; trying to protect you. Now it’s time to let it know it’s ok to back down and begin to let go. 

Counseling is trauma’s best friend. Sometimes it just needs to be talked about. A professionally trained counselor or psychologist will be able to prompt conversation and thought patterns that will enable trauma survivors to work through their past and see how it affects their mental health and addiction. 

From there, professionals will be able to offer insight and coping skills that enable the individual to start rebuilding their brain and nervous system from a place of peace, forgiveness, and safety. 

There are some things to make a part of your daily routine if you are working on healing your trauma and addiction. Things like journaling, meditating, moderate exercise, and breathwork can all make a huge difference on your path to healing. Spending time with your thoughts in a non-judgemental way will help you release memories and physical feelings you have been holding onto.

Trauma And Addiction Treatment Options 

Today more than ever there are a ton of trauma and addiction treatment options available for people suffering from co-occurring post-traumatic stress disorders and addiction. Most rehab facilities and harm reduction services offer counseling, holistic therapy, and group therapy to assist in working through trauma. 

There may still be some stigma around mental health, but most people understand and have personally experienced mental health conditions at one point or another. Working with professionally trained mental health experts will give you insight into how you can let go of your past to build a new future. 

Typically if you are participating in a full rehab program, you will receive treatment aimed at addressing both your addiction and your mental health. Both conditions affect the other, so it’s important to keep both in mind when figuring out your treatment approach. Some services that will help address both co-occurring PTSD and Addiction include:

• Cognitive Behavioral Therapy (CBT)
• Group Therapy
• Holistic Treatments (Acupuncture, yoga, meditation)
• Mindfulness
• Life Skills 
• Nutritional Therapy 
• Long Term Counseling

Trauma And Addiction Treatment At Miracles Can Help Save Your Life

If you or a loved one is showing signs of co-occurring trauma and addiction, it’s not too late to seek help. Whether you’re ready to enter a full program, or just need someone to talk to-there are endless resources to help you resolve your past and build a bright, healthy, future. For more information on treatment for dual diagnosis of trauma and addiction, contact Miracles Recovery Center today.

Addictions don’t just appear out of nowhere. In almost every case of addiction, there are underlying emotional needs that are being self-medicated through substance use. That is not to say that addiction is not a physical addiction and disease just as much as it is an emotional one, but everything in the body is connected. 

If trauma has any place in an addiction, treating an individual without giving that trauma the attention it needs will lead to a failed or incomplete recovery. To fully heal from trauma and addiction, you need to be willing to explore the parts of your heart and mind that are painful. It won’t be easy, but it will always be worth it in the end. 

How Are Trauma And Addiction Connected?

You can have trauma and never develop an addiction. On the flip side, studies have demonstrated that the majority of addiction cases have underlying mental health concerns rooted in traumatic events. Unhealed trauma leads to anxiety, depression, and often an inability to cope with everyday life. 

Unfortunately, substance abuse is a common crutch to help people cope and function. It might start as an occasional way to numb emotional and physical pain associated with trauma but often leads to full-blown addiction. 

The Adverse Childhood Experience Study (ACE), run by the CDC, revealed some eye-opening statistics about childhood trauma and its direct correlation to substance abuse disorders. The study found:

• For each adverse/traumatic event in early life, the likelihood of early substance use increased 4 times
• People with 5-10 traumatic events in their lives are 10 times more likely to become substance abusers
• 75% of men and women who are substance abusers report having childhood trauma/abuse

These statistics alone are frightening. What’s even more eye-opening is that the ACE study reported,  “61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE, and nearly 1 in 6 reported they had experienced four or more types of ACEs”. That means out of the entire population, 61% of people are inclined to develop substance abuse problems because of unhealed trauma. 

What Does Trauma Look Like? 

Trauma is essentially a psychological and physical response to difficult events. These events triggered something in the brain that gave a message of danger, fear, and anxiety. When the events that instigated the trauma response are built up in the body and not fully healed, the body will continue to experience the trauma response even when the event is over. 

For example, people who are abused as children often develop PTSD and addiction. They live in a constant state of fear because they were forced to always be in fight or flight mode. They have tense muscles, shallow breathing, high anxiety, emotional sensitivity.

At the time, it was a defense mechanism to keep them safe. If the response lingers years later, that means they are physically and emotionally still in that trauma state even though they aren’t in any immediate danger anymore. Coping with these stressful feelings can make people feel the need to rely on external things for comfort and relaxation, like addictive substances. 

Furthermore, when these emotions and physical reactions persist for years, often people stop associating them with their trauma, and begin to think that’s just “how they are”. If this happens, it may cause people to be less inclined to seek emotional help for their addiction. 

Trauma can have symptoms that mimic a million other diseases, conditions, and mental health disorders. This is why getting to the root of the individual’s childhood and past trauma can help uncover what is stemming from it. Some symptoms of trauma include:

• Severe depression
• PTSD (Post Traumatic Stress Disorder)
• Chronic Anxiety
• Physical twitching, shaking, and restlessness
• Over or under eating
• Emotional Flashbacks
• Dissociation
• Suicidal Thoughts/Attempts 
• Chronic Pain

The list of symptoms keeps going, and it’s different for every person depending on their life experiences and coping mechanisms. The overall understanding should be that trauma can take over your life, and make it difficult to be happy in your mind and body. 

The Trauma Brain

While the initial response to trauma can be a defense mechanism and symptoms listed above, long-term response to unhealed trauma can change the chemical makeup of your body and aspects of your personality. 

Trauma can make you sick and full of disease. Being in a chronic state of fear and protection causes the body to work in overdrive in all of its systems making the brain release certain chemicals that biologically are trying to up your adrenaline (think fight or flight). Exposure to these chemical responses leads to an overall dysregulation of the brain. Hormones, nervous systems, endocrine systems, and the entire mind-body connection are thrown off. 

A trauma brain is a brain under stress. If you’re subconsciously still focused on immediate danger, you’re not giving attention to everyday things like tasks, relaxation, habits, healthy eating, etc. Instead of your body working properly to make everything run happily, its only message is “survive!”. 

The trauma brain leads to chronic illness, disease, and hormone deregulation. But, there is hope. Healing trauma can reverse a lot of negative consequences trauma survivors have endured. 

How Are Trauma, Addiction, And Suicide Connected? 

Trauma is a very complex and overwhelming experience. Trying to cope with everyday life while having an underlying history of trauma can feel nearly impossible. Sadly, a lot of people get to the point of suicidal thoughts or attempts after living with trauma. 

When addiction is also put into the picture, things get even more difficult. Addiction further dis regulates the body and mind, leading to a lot of mental health conditions and depression. Trauma and addiction combined leave little room for mental clarity, but a lot of room for overwhelming emotions. If proper help isn’t given, suicidal thoughts are likely. 

Suicide attempts have risen over the years along with addiction and mental health rates. Suicides have risen 33% and have reached 14 suicides per 100,000 people according to research conducted in 2018. It can be scary having these thoughts or hearing these from a loved one. 

Treatment For Fentanyl-Laced Heroin 

The first step in treating fentanyl-laced heroin addiction is detox. Once detox is complete, individuals can focus on treating the mental struggles of addiction. 

An addiction to opioids such as fentanyl or heroin needs long-term treatment because these drugs make significant changes in the brain. Furthermore, individuals struggling with opioid addiction often struggle with past trauma. 

Once detox is complete, therapists help individuals choose a treatment program that best fits their personal and addiction needs. Although each program has distinct benefits, treating opioid use disorder (OUD) typically includes:

• Medication-Assisted Therapy
• Psychotherapy or talk therapy
• Nutritional therapy
• Holistic therapy
• Behavioral Modification Therapy
• Relapse Prevention

If You Are Smoking Fentanyl, Get Help At Miracles Recovery

If you or someone you love is using heroin, they are at risk of also using a lethal dose of fentanyl. At Miracles Recovery, we understand many heroin addictions begin from treating chronic pain. Contact us today and find freedom from opioids and holistic ways to manage pain. 

References:

https://www.cdc.gov/opioids/basics/fentanyl.html

https://www.medicalnewstoday.com/articles/308156