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Sober Nation

Putting Recovery On The Map

08-28-11 | By

What Is Heroin? – How Does It Affect The Body and Brain?

Heroin

Heroin Street Names

Smack, Chiva, Dope, Skag, Horse, Junk, Brown Sugar, Black Tar, Dragon, Hero, H, China White

The History of Heroin

Heroin is a powerful narcotic and is arguably one of the most addictive substances on the planet. When it is mentioned, most people often think of today’s epidemic, deadly and illegal drug. However, at one time heroin was legal and considered a highly respected remedy for numerous afflictions.

Opium plant field

Heroin’s properties are derived from the powerful narcotic and “ancestor drug”, morphine. Morphine is a naturally occurring compound that is found in the seed pods of the opium plant. Opium cultivation dates back to the ancient civilization of Mesopotamia around 3400 BC. Field that are packed with poppy plants can be extremely gorgeous, however they are also inexplicably profitable. The flower contains a sticky substance that can be extracted, cooked, and processed into opium. Opium was initially used by Egyptians and Persians. Eventually the drug spread to various parts of Europe, India, and China. In the midst of the 18th century, physicians in the United States used opium as a therapeutic agent for a multitude of purposes including pain-relief from cancer, spasms from tetanus, and pain related to menstruation and childbirth. It was primarily toward the end of the 18th century that physicians came to recognize the addictive quality of opium.

At the head of the 19th century, morphine was withdrawn from opium and used as a cure and treatment for opium addiction – at the time it’s addictive properties were not known. Morphine’s use as a treatment for opium addiction was initially well received – as morphine has about 10 times more euphoric effects than the equivalent amount of opium. Over the years, morphine abuse increased.

Heroin was first synthesized from morphine in 1874 by English chemist C.R. Alder Wright when he boiled morphine and acetic anhydride. His early testing of heroin – known as diacetylmorphine – showed unpleasant side effects such as anxiety, sleepiness and vomiting immediately after administration. Accordingly, he discontinued his research. However, it wasn’t until 1987 when alternate chemist, Felix Hoffman re-synthesized Wright’s initial formulation and the drug gained wide attention. Initially, Hoffman was suggested to re-synthesize Wright’s initial formulation to codeine which would be used in the production of cough syrup. Hoffman’s experiment resulted in the substance we know today as heroin. In 1898, the Bayer pharmaceutical company marketed “Heroin” as a cough suppressant as well as a “wonder drug” to combat tuberculosis and pneumonia – the leading causes of death during that time period.

Bayer Aspirin & Heroin Advertisement

From 1898 to 1910, Bayer touted the wonders of their new drug as a non-addictive morphine substitute. Attempts were made to use heroin in place of it to due the high abuse rate. However, it was later discovered through research that heroin metabolized into morphine at a faster rate and patients who used heroin quickly became addicted to the drug. While the high addiction potential of heroin was well-documented, heroin was still being prescribed and sold for medical reasons in the United States until 1924. By that time, the unrestricted distribution of heroin led to an astronomical number of users and resulting in a skyrocketing crime rate. Approximately 200,000 individuals in the United States were addicted to Heroin when the US Congress banned sales and importing of the drug. In 1970, the Drug Enforcement Administration (DEA) passed the Controlled Substances Act in which heroin was made a Schedule I substance.

There have been multiple heroin epidemics in the United States. The first epidemic began after World War II and the second began in the late 1960’s. Both epidemic’s subsided due to lack of purity in the heroin that was available, and the increasing cost of the drug. During the second epidemic, heroin use was prevalent among enlisted men serving in Vietnam during the Vietnam War. From 1969 to 1971 opiates were widely and cheaply available in that country. Due to most enlisted men being below the drinking age, they may have had an added incentive to try heroin as an available alternative. The most common way these men used heroin was by snorting it or mixing it with tobacco and marijuana and smoking it.

Heroin Use in the United States

Heroin is commonly sold in the illicit drug market as a white or brownish powder that is “cut” (or diluted to reduce its purity) with agents such as sugars, starch, powdered milk, fentanyl, cocaine, or quinine. In general, there are two different types of heroin that are available for purchase by users. Pure heroin is a white powder that has a bitter taste which comes from South America and Southeast Asia. Black-tar heroin, is sticky – much like roofing tar, and primarily produced in Mexico. Black tar heroin is dark in color due to impurities left behind from crude production methods used to produce the drug.

Image Courtesy of Center for Disease Control and Prevention (CDC)

Over the past few years, heroin has gained popularity in the United States. There has been a dramatic increase in the use of heroin and overdose deaths attributed to the use of the drug. The third epidemic has currently plagued the U.S. The Centers for Disease Control and Prevention (CDC) found that the average annual rates of past-year heroin use during 2011-2013 had surged 62.5% since 2002-2004. By 2013, the number of heroin overdose deaths had jumped to 8,000 – an increase of more than 286%. In an article published last year in TIME, Eliza Grey states the following:

“Heroin use has been rising since 2007, growing from 373,000 yearly users to 669,000 in 2012, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Heroin overdose deaths have also spiked, increasing 45% from 2006 to 2010, according to the most recently available data from the Drug Enforcement Administration. And the geography of the drug’s users has also expanded. Once considered a largely urban problem, law enforcement and public health officials are seeing an uptick in suburban and rural users.”

The main reasons of the drug’s increase in popularity is due to the increased market for opiates (especially prescription painkillers) and an influx of less expensive heroin from Latin America.

How Is Heroin Administered?

Heroin can be administered to the body in a variety of ways, and each method allows the drug to quickly enter the bloodstream. For first time users, the first experience isn’t always pleasant. Novice heroin users often grow nauseated when the drug takes effect, and some even vomit. Heroin can work directly on the digestive system, slowing down or stopping it all together. Experienced users can grow accustomed to these sensations, however for new users they are deeply unpleasant.

Heroin can be administered in three different ways:

bad needles
Hepatitis C is spread through blood-to-blood contact, most commonly through sharing needles used for intravenous drug use.
  • Intravenously – Injecting heroin (IV) generally have a higher rate of addiction or dependence. Shortly after injecting heroin, users report they feel a surge or “rush” of euphoria, dry mouth, a warm flushing of the skin, and a heaviness of the extremities. Injection drug users are at high risk for HIV and hepatitis – both hepatitis B and C. The process of getting heroin ready to inject can become a ritual and create an “additional high” for those who choose to mainline the drug.
  • Snorting – Although it is perceived to be safer than injecting heroin, snorting heroin is still extremely addictive and has a high overdose potential. Snorting heroin takes about five minutes for the substance to enter the bloodstream and for the high to begin. An additional problem with snorting heroin is that it will damage the mucus membranes in the nose over time. With enough use, irritation and inflammation of these sensitive membranes can occur making the individual prone to infection or other sinus problems. The tissue may become damaged and a hole can form in the nasal septum.
  • Smoking – Smoking heroin involves vaporizing the drug, inhaling the fumes, and breathing the actual smoke. Users smoke from either foil or a pipe. Smoking heroin delivers the opiate from the lungs to the arteries. It then travels through the bloodstream and goes directly to the users brain. Many first time users begin by smoking heroin because they wish to avoid social stigma.

There are additional methods that can be utilized to administer the drug. Users may engage in a process called speed-balling in which both cocaine and heroin are injected into the bloodstream. Additionally, users can also engage in a practice called shebanging in which users sniff liquefied heroin through a nasal spray bottle. While heroin users may feel that other routes of administering the drug may be less addictive, heroin is highly addictive no matter how it is taken into the body.

Short-Term Effects of Heroin

Once heroin enters the brain, it is quickly converted to morphine and binds to opioid receptors. After using the drug, users feel an intense rush or euphoria and this feeling can vary depending on the amount of heroin that is taken. The “rush” is accompanied by a warm flushing of the skin, dry mouth and a heaviness felt in the arms and legs of users. Users can also experience heavy nausea and vomiting after using the drug. After the initial high wears off, heroin users will experience a long period of drowsiness and their mental functioning, heart rate and breathing significantly slow down.

Long-Term Effects of Heroin

Cardiovascular system: Long-term heroin injectors can face high cardiovascular dangers. Each time a user pricks themselves, it does a form of damage to the veins and arteries that carry blood to and from the heart. When punctures damage this system, blood vessels can swell up, shrink down, or close up. This can lead to abscesses, infections, and death.

Digestive system: Heroin can have a deep impact on the health of the gut. Bloating and constipation can take hold when food and water move too slowly through these passages. A common issue for chronic heroin users can involve feeling off kilter and ill. It is common for heroin users to deny help for this issue, which may put them at risk for blockages and intestinal emergencies.

Respiratory system: Heroin can sedate the respiratory system. In the midst of a high individuals can breathe much slower than they would normally. If a user takes in too much, it can stop breathing all together.

Nervous system: Heroin effects the brain’s cells profoundly. Molecules of heroin fit like caps into plugs inside the brain. Once attached, these caps trigger a series of chemical releases inside the brain. Individuals who use heroin for an extended duration can show deterioration in white matter of the brain, which can lead to a reduced ability to make decisions and regulate behavior. Cells bombarded by heroin can stop producing chemical signals of pleasure, and after a period of time cells can shrink and shrivel.

Because heroin can impact physical structures of the brain, mental health concerns can be encountered with continued use. They can include depression, isolation, memory problems, anxiety regarding use, and dependency.

Additionally, an individual addicted to heroin will likely experience numerous personal consequences including but not limited to financial issues, relationship fallout, school or employment troubles, and legal turmoil.

Heroin Overdose

While heroin use involves a number of health risks, the most dangerous of them all is overdose. A heroin overdose occurs when a person uses enough of the drug to produce a life-threatening reaction or death. If not addressed overdose can be fatal. In recent years, Heroin overdoses have increased. When a person overdoses on heroin, their breathing often slows or stops. This decreases the amount of oxygen that reaches the brain. This is a condition called hypoxia. Hypoxia can have long and short term mental effects on the nervous system – including coma and/or permanent brain damage.

Heroin overdose is more likely to occur in those who have had a brief period of sobriety and relapse on heroin. This happens because taking heroin regularly results in tolerance to the drug; meaning more is required to achieve previous effects.

Overdose symptoms may include:

  • Slowed breathing or no breathing
  • Bluish nails or lips
  • Very small or pinpoint pupils in the eyes
  • Slow heartbeats
  • Extreme drowsiness – particularly if you are unable to wake the person from sleep.

A majority of states have laws that provide protection from arrest for possession of illegal drugs or paraphernalia is emergency help is sought for overdose. Do not hesitate to get help for fear of legal consequences.

If you feel that a friend or a loved one is suffering from a heroin overdose, call 911. 

Naloxone

Naloxone is a life-saving opioid overdose reversal medication that can treat an opioid overdose in an emergency situation. It is useful in both acute opioid overdose and in reducing respiratory or mental depression due to opioids. Naloxone was patented in 1961 and approved for overdose by the Food and Drug Administration (FDA) in 1971. More commonly known as Narcan or Evzio, the drug works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Naloxone is available as an inject-able solution, a handheld auto-injector, and a nasal spray. When given intravenously, the drug works within two minutes. When the drug is injected into a muscle, it reverses effects within five minutes. Naloxone may also be spayed into the nose. More than one dose may be needed to help a person start breathing again – as the duration of action of most opioids is greater than that of naloxone.

In 2014 the Food and Drug Administration approved a hand-held automatic injector product that is pocket-sized and can be used in non-medical settings. It’s use has been designed for laypersons including family members and caregivers of opioid users at-risk for an overdose. The approval process was fast-tracked as an initiative to reduce the death toll caused by opiate overdoses. At the time of approval, an estimated 16,000 annual deaths were attributed to opioid and heroin overdoses in the United States.

Do You Have A Loved One Struggling?

It is estimated that 23 percent of people who use heroin will become dependent on the substance. One of the many devastating things about a heroin addiction is that the addict himself or herself is seldom aware of the damage being done to his or her life. They may often neglect their own needs – as the acquisition of the day’s dose of heroin is far more important. The addict may not eat properly or and can often look haggard if heroin is abuse has been prolonged. If you are concerned about a loved one who seems to be abusing heroin, a crucial issue is that many drug users are seldom honest about the drugs they may be abusing. Very few heroin addicts may ask for help, but the majority who are addicted fear the pain and sickness of withdrawal. Talking to your loved one about their addiction is not an easy task, but is necessary to kick-start the recovery process.

It may be knowing signs of a loved ones heroin use that you are able to detect the addiction and and begin to make arrangements for rehabilitation.

The Importance of Treatment for Heroin Addiction

In short, heroin is very harmful. It can bring devastation to both physical and mental health, and is likely to culminate in a number of social and legal ramifications for the user. It is extremely critical for one to undergo intensive drug treatment when struggling with a heroin addiction. Treatment for heroin addiction in a professional and closely supervised setting is crucial since the symptoms associated with getting off of heroin are extremely painful and may be life-threatening. The primary objective early in the treatment process is managing heroin withdrawal through the process of medical detoxification. During a heroin detox, the person addicted is gradually eased off of heroin to minimize symptoms such as muscle aches, vomiting, abdominal cramping, diarrhea and dehydration. Additionally, those who used street-grade heroin often have additional chemicals in their system that could clog their arteries, lungs, and heart. These users will need close evaluation and medical intervention.

In order to help minimize withdrawal symptoms, addicts can be administered medications such as suboxone or naloxone. Once the addict becomes medically and psychologically stable, they can transition into formal drug treatment. There, they will undergo a comprehensive array of therapies and programming in order to uncover the underlying causes for their addiction. In this stage they will learn new life and coping skills to continue their recovery while resuming their daily lives without heroin. It is highly recommended that those new in recovery actively participate in some form of support group in order to receive the empowerment and encouragement needed to continue on their path to recovery. Long-term heroin recovery is possible.

If you feel yourself or a loved one is struggling with a heroin addiction, help is available at SoberNation at (866) 317-7050

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