Heroin is an illegal drug that is classified as an opioid. The Drug Enforcement Administration (DEA) classifies heroin as a Schedule I drug, which means it is highly addictive and does not have a legitimate medical use.1 Heroin has a high potential for abuse and addiction. The drug functions by attaching to opioid receptors in the brain, leading to feelings of relaxation and euphoria. Such feelings cause the user to want to experience the high again and again.2
According to the 2019 National Survey on Drug Use and Health an estimated 438,000 people age 12 and over struggle with a heroin use disorder.3 Heroin use is a growing problem not just among the general populations, but also amongst veteran populations. Roughly 10% of veterans entering substance abuse treatment were for heroin.4 It’s important for veterans to understand what heroin is, how it can be abused, and what avenues for treatment are available to them.
Table of Contents
- What is Heroin?
- Why Do Veterans Abuse Heroin?
- Signs of Heroin Addiction
- Side Effects of Heroin Use
- Symptoms of Heroin Withdrawal
- Heroin Rehab and Treatment Options
- Finding Heroin Rehab for Veterans
- Do the VA and Veteran Benefits Cover Heroin Rehab?
- Can Rehab for Heroin Use Affect My Veteran Benefits?
- Does Heroin Rehab Go On My Record?
What is Heroin?
Heroin is an opioid drug made from certain poppy plants that are grown mainly in Southeast and Southwest Asia, as well as Colombia and Mexico. Heroin is extracted from morphine that is taken from the plant and then made into a powder form that can be smoked, snorted, or injected when mixed with water. Heroin can also be in the form of a sticky substance known as black tar. Street names for heroin include smack, H, horse, and hell dust.1 Heroin acts rapidly once it is ingested, causing the user to experience an intense rush. Heroin also leads to slowed respiration, a warm flushing of the skin, and drowsiness. Nausea, vomiting, and severe itching often also occur.2
Heroin is highly addictive and comes with a high risk of overdose, which can be fatal, and other potentially serious effects.5
Why Do Veterans Abuse Heroin?
There are a variety of reasons why veterans might abuse heroin, but post-traumatic stress disorder (PTSD) may play a significant role in any type of substance use. When some people suffer from PTSD, they will oftentimes turn to substance use to deal with their symptoms. The Department of Veterans Affairs (VA) notes that 1 in 3 veterans seeking treatment for substance use disorder has PTSD.6
Impacts of Heroin Use on Veterans
The impacts of heroin use in veterans have not been studied extensively. However, veterans with any type of substance use disorder are twice as likely to commit suicide as non-veterans. This outcome was even more pronounced in female veterans, who were 5 times more likely to complete suicide than non-veteran females.7
Homelessness is another growing problem amongst veterans with a substance abuse disorder. According to a 2014 study, nearly 70% of homeless veterans were actively struggling with a substance use disorder.4
Signs of Heroin Addiction
Those who use heroin may quickly become physically dependent upon the drug. Heroin users may experience intense withdrawal symptoms after they stop taking the drug. The unpleasant feelings caused by withdrawal often lead people to keep using heroin to alleviate the withdrawal symptoms. Some of the common signs of heroin addiction include:8
- Strong cravings to use heroin.
- Taking more heroin than you originally intended.
- Developing tolerance, which means you have to take more heroin to feel the same effects from using it.
- Being unable to manage your family and/or work responsibilities as a result of heroin use.
- Attempting to stop using or cut back on heroin use but unable to do so.
- Experiencing interpersonal conflict with people over your use of heroin.
- No longer engaging in hobbies you once enjoyed in order to use heroin.
- Spending a lot of time and resources looking for, using, and getting over the effects of heroin.
- Taking heroin in high-risk situations, such as when driving.
- Continuing to take heroin even though it makes a medical condition worse.
Side Effects of Heroin Use
If you use heroin, you can experience several short-term side effects after the initial “rush” of euphoria, such as:5
- Dry mouth.
- Nausea and vomiting.
- Severe itching.
- Heavy feeling in the extremities.
When you use heroin long-term, you may also experience:5
- Liver and kidney disorder.
- Sexual dysfunction in men.
- Impaired menstrual cycle in women.
- Mental health disorders.
- Pneumonia and other respiratory disorders.
- Abscesses and/or collapsed veins in those who inject heroin.
- Infections of the heart lining or valves.
Symptoms of Heroin Withdrawal
When you become dependent on heroin, you may experience withdrawal after you cease taking the drug. Symptoms of heroin withdrawal typically begin about 8 to 12 hours after the last dose and can include:5
- Vomiting and diarrhea.
- Severe cravings for heroin.
- Uncontrollable muscle movements.
- Agitation and restlessness.
- Muscle and bone pain.
The severity of physical withdrawal can make it difficult for a person to stop using heroin on their own. Most people who try to quit on their own start using again to alleviate the symptoms of physical withdrawal. Therefore, the Substance Abuse and Mental Health Services Administration suggests that medically supervised withdrawal management for those detoxing from heroin or other opioids. Medically supervised detox can ensure that trained professionals are nearby in case you experience complications.9 Veterans considering detoxing from heroin should contact a medical professional or their VA representative for more information.
Heroin Rehab and Treatment Options
Heroin addiction is a serious condition, but effective treatments exist. In particular, veterans seeking treatment for heroin dependence or addiction have access to the VA health network. The VA can connect veterans with heroin rehab both internally and externally through the Community Care program. Many VA and private facilities also offer veterans-specific treatment tracks, which can help address addiction and co-occurring mental health disorders that commonly afflict veterans, such as depression, anxiety, and post-traumatic stress disorder (PTSD).
After you enter a heroin rehab center, an intake counselor will complete a medical assessment to better understand your medical needs. They will then create a tailored treatment plan specifically for you to address your individualized needs. While the treatment program can differ from person to person, the general process of heroin rehab may involve one or several of the following treatment tracks:10
- Detox, which gets heroin out of your system in a safe and comfortable way.
- Inpatient or residential treatment, which requires that you live at the facility and receive 24/7 care. You will usually attend counseling sessions, in some combination of individual and group therapy, throughout the day. Some programs offer family therapy as well. You will also be assessed frequently by medical staff.
- Outpatient treatment, which involves getting treatment 2-3 hours a day, 2-3 times per week (up to 20 hours per week). It allows you to go home every evening and potentially continue your daily responsibilities, including attending school or going to work.
In a heroin rehab program, you may attend inpatient treatment first and then step down into outpatient treatment. Some people with a less severe addiction might not require inpatient treatment and can attend outpatient treatment. Overall, everybody has different treatment needs; multiple factors determine what is best for your particular situation.9(p.21)
In both inpatient and outpatient rehab centers, you will usually receive some form of behavioral therapy. The most common type of therapy for any substance use disorder, including heroin abuse, is cognitive behavioral therapy (CBT). This therapy will aim to help you change the thought and behavioral patterns that lead to heroin use. In CBT, you can also learn coping skills to avoid relapsing and recognize triggers.11
Heroin Addiction Medications
In addition to behavioral therapy, medication-assisted treatment (MAT) is often used for treating heroin addiction. MAT can help control cravings for heroin and lessen the symptoms of heroin withdrawal. The three FDA-approved medications used in MAT for heroin addiction are:9
- Buprenorphine, which helps to manage heroin withdrawal symptoms, including cravings. Buprenorphine can be taken longer-term to help people maintain their recovery from heroin abuse. In addition, it can be used for long-term maintenance to help people stay in recovery from heroin addiction. Buprenorphine is also marketed under the brand names Subutex and Suboxone. Suboxone also contains naltrexone, which helps to deter abuse of buprenorphine.
- Naltrexone, which can block the effects of heroin. If you use heroin while you are on naltrexone, you will not feel high or experience any of the other effects of heroin.
- Methadone, which can help with heroin withdrawal symptoms and support long-term maintenance to prevent relapse into heroin addiction.
Is Rehab Effective?
Heroin rehab can be effective in helping people maintain long-term recovery from heroin addiction. Overall, rehab success rates for all types of substance abuse disorders range from 40-60%. A significant number of people do relapse, but relapse rates are roughly the same for drug treatment as the relapse rate for treating other chronic diseases such as high blood pressure and asthma.12
Finding Heroin Rehab for Veterans
If you feel that you have a need for heroin addiction treatment, you can start your search for a heroin rehab program by reaching out to the VA. The VA, aside from being one of the largest healthcare networks in the United States, is a vital resource for veterans seeking any kind of treatment. VA insurance programs can help drastically reduce the cost of treatment. Additionally, VA facilities have staff who are highly trained in addressing veterans’ issues, such as the treatment of PTSD, the stresses faced by those who see combat, and the difficulties of reintegrating into civilian life.
If you do not live near a VA that offers the appropriate treatment for your heroin use disorder, or if the programs close to you are full, you may be able to get approval by the VA to get into a rehab program offered by a private provider. Through the Community Care program, private providers contract with the VA to offer services such as heroin addiction rehab. Many private providers can offer veteran-specific tracks for treatment, using their expertise in treating veterans with substance use disorders including heroin addiction.
Do the VA and Veteran Benefits Cover Heroin Rehab?
The VA offers comprehensive heroin rehab options. The VA has many substance abuse treatment programs, which include inpatient and outpatient options. In addition, if you have Medicaid or Medicare coverage, both types of coverage also offer benefits for heroin treatment.
Can Rehab for Heroin Use Affect My Veteran Benefits?
Health insurance coverage, whether through the VA or other insurance plans, will vary depending on one’s situation. The VA covers most mental health services, especially those that directly result from service-related injuries. For example, if a veteran is struggling with PTSD caused by a traumatic event experienced while in combat, and consequently turned to heroin abuse to try and cope, that heroin abuse and resulting addiction will be considered a result of a service-related condition. As such, the VA will likely provide some kind of coverage. However, coverage will vary, so it’s best to reach out to your VA representative.
Insurance providers, including TRICARE, Medicare, and Medicaid, cannot take away your benefits if you use heroin. Medicare and Medicaid both offer heroin addiction treatment and rehab options as part of the coverage provided by these plans. If you have Medicare or Medicaid in addition to VA benefits, the VA will coordinate with these insurance programs regarding the payment for your treatment.
VA disability benefits are a bit more of a gray area. VA disability benefits are regular disability payments for veterans who struggle with injuries caused during military service. Whether heroin addiction is considered covered by VA disability benefits will depend on whether willful misconduct can be established. Willful misconduct is when a veteran knowingly engages in risky behavior, despite knowing of potential negative consequences.13 So, if a veteran knowingly takes heroin and sustains injuries, the VA disability would likely consider this willful misconduct and not allocate disability funds. It’s important to contact your VA disability benefits to establish what conditions your disability benefits apply to.
Does Heroin Rehab Go On My Record?
You do not have to worry that going to heroin rehab treatment will be on any records or be publicly known to anyone. Due to the sensitive nature of substance abuse, the rights of individuals who seek help for addiction are protected by several laws that guarantee privacy. For example, HIPAA is a set of federal laws and standards that forbid a treatment program from releasing information about your heroin addiction treatment without your express consent. So know that you can get confidential help for heroin addiction without the worry of any information becoming public.
- DEA. (2020). Heroin.
- NIDA. (2021). What are the immediate (short term) effects of heroin on the brain?
- NIDA. (2021). What is the scope of heroin use in the United States?
- NIDA. (2019). Substance use and military life drugfacts.
- NIDA. (2021). Heroin drugfacts.
- US Department of Veterans Affairs. (2019). PTSD and substance abuse in veterans.
- University of Michigan. (2017). Drug and alcohol problems linked to increased veteran suicide risk, especially in women, long term study finds.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Pub.
- SAMHSA. (2015). Detoxification and substance abuse treatment.
- ASAM. (2015). What are the ASAM levels of care?
- NIDA. (2018). Principles of drug addiction treatment: Cognitive-behavioral therapy.
- NIDA. (2018). How effective is drug addiction treatment?
- Nolo.com. When Willful Misconduct in the Military Makes a Veteran Ineligible for Benefits.