[Major points]

1. Heroin is a highly toxic and addictive drug.

2. Excessive use can be life-threatening, and withdrawal symptoms may occur if use is suddenly stopped .

3. Establishing family and social support is important to help prevent relapse.
   

What is Heroin?

"Heroin" is a white powder that is no longer used in medical treatment because it is very toxic, highly addictive, and causes drug tolerance. In Taiwan, heroin is a commonly abused Class I drug. Taking too much can be life-threatening.

What are the common symptoms?

1. Weakness, lethargy, poor appetite, weight loss, and slow gastrointestinal motility (such as constipation, abdominal distension, and vomiting), bile duct spasm (causing abdominal pain), and difficulty urinating.
2. Bronchial constriction, respiratory depression, and pulmonary edema.
3. Pupil constriction, chronic brain damage, loss of balance, trance-like state, irritability, and hallucinations (seeing or hearing things that do not exist, or holding unreasonable beliefs).
4. Hypotension, hypoxemia, and hypothermia may cause convulsions and coma, which can lead to respiratory arrest and even death.
5. Infections caused by injection, such as wound collapse, phlebitis, endocarditis, damage to heart valves, and infectious diseases such as hepatitis, syphilis, and HIV (human immunodeficiency virus).
6. Heroin can pass from the mother’s blood to the fetus through the placenta, causing fetal addiction. During pregnancy, heroin use increases the risk of stillbirth and premature delivery. About 60–90% of newborns will show withdrawal symptoms (such as irritability, restlessness, and nervous system development damage).
   

What are heroin withdrawal symptoms?

How to treat heroin poisoning?

1. Monitor vital signs and manage withdrawal symptoms.
2. Administer antidotes according to the doctor’s orders.
3. Provide nutritional support (fluids and electrolytes) to maintain optimal body function.
4. Reduce external stimuli, create a comfortable and safe environment, and minimize risks of injury so that patients can rest fully.
5. Protect patients, prevent self-harm or harm others, and closely monitor for drug hiding or signs of re-use.

1. Develop a support system: Strengthen family and social support, and treat substance abuse as a health issue rather than a crime, to reduce social discrimination against this population.
2. Psychotherapy: Use interdisciplinary care resources, such as psychiatrists, psychotherapists, social workers, religious organizations, and support groups, to assist with psychosocial rehabilitation.
3. School education: Promote drug hazard education and adopt diverse drug prevention-related courses.
4. Government policy: The government continues to educate the public about the dangers of drugs. A drug consultation hotline (02-28757525 ext. 85500) and the Taiwan Poison Control Center are available to provide advice and help. These services encourage everyone to say no to drugs and stay away from them.

References

1. Aljefri, A. A., Nahhs, S. F., Kheimi, R. M., Alhamdan, A. Y., Alharbi, T. S., Alkahtani, S. S., Alajmi, S. T., Alotaibi, F. N., AlJardan, B. A., & Alsalmi, R. S. (2024). An overview of acute drug overdose and poisoning in emergency medicine. Journal of Healthcare Sciences, 04(10), 455–462. https://doi.org/10.52533/johs.2024.41003
2. Ceceli, A. O., King, S. G., McClain, N., Alia-Klein, N., & Goldstein, R. Z. (2022). The neural signature of impaired inhibitory control in individuals with heroin use disorder. The Journal of Neuroscience, 43(1), 173–182. https://doi.org/10.1523/jneurosci.1237-22.2022
3. Choi, N. G., Choi, B. Y., DiNitto, D. M., Marti, C. N., & Baker, S. D. (2022). Heroin and fentanyl overdose deaths among cases age 50+ in the National Poison Data System, 2015–2020. Clinical Toxicology, 60(5), 639–646. https://doi.org/10.1080/15563650.2021.2016798