Heroin
Information about Heroin
Heroin is a semi-synthetic opioid synthesized from morphine, a derivative of the opium poppy. The white crystalline form is commonly the hydrochloride salt diacetylmorphine hydrochloride. Upon crossing the blood-brain barrier, which occurs soon after introduction of the drug into the bloodstream, heroin is converted into morphine, which mimics the action of endorphins, creating a sense of well-being; the characteristic euphoria has been described as an “orgasm” centered in the gut. One of the most efficient methods of heroin use is via intravenous injection.
Opioids are strong central nervous system depressants, but regular users develop physiological tolerance allowing gradually increased dosages. In combination with other central nervous system depressants, heroin may still kill even experienced users, particularly if their tolerance to the drug has reduced or the strength of their usual dose has increased.
Due to heroin’s mimicry of opiates, it is used both as a pain-killer and a recreational drug. Frequent administration has a high potential for causing addiction and may quickly lead to tolerance. If a continuous, sustained use of heroin for as little as three days is stopped abruptly, withdrawal symptoms can appear.
Internationally, heroin is illegal to manufacture, possess, or sell. However, under the name diamorphine, heroin is a legal prescription drug in the United Kingdom. Popular street names for heroin include smack, black tar, junk, dope, and others.
Heroin is used as a recreational drug for its intense euphoria, which often fades with increased tolerance. It is believed that heroin’s popularity with recreational users, compared to morphine or other opiates, comes from its somewhat different perceived effects. In studies comparing the physiological and subjective effects of heroin and morphine administered intravenously in post-addicts, subjects showed no preference for one or the other of these drugs when administered on a single injection basis. Heroin can be administered in a number of ways, including snorting and injection. It may also be smoked by inhaling the vapors produced when heated (known as “chasing the dragon”). Some users mix heroin with cocaine in a so-called “speedball” or “snowball”, which is usually injected intravenously although it can be smoked or dissolved in water and snorted. This causes a more intense rush than heroin alone but is more dangerous because the combination of the short-acting stimulant with the longer-acting depressant increases the risk of overdosing on one or both drugs.
Withdrawal
The withdrawal syndrome from heroin may begin within 6 to 24 hours of discontinuation of sustained use of the drug; however, this time frame can fluctuate with the degree of tolerance as well as the amount of the last consumed dose. Symptoms may include: sweating, malaise, anxiety, depression, persistent and intense penile erection in males (priapism), extra sensitivity of the genitals in females, general feeling of heaviness, cramp-like pains in the limbs, pandiculation (intense yawning) and lacrimation (intense “weeping”), sleep difficulties (insomnia), cold sweats, chills, severe muscle and bone aches not precipitated by any physical trauma; nausea and vomiting, diarrhoea, goose bumps, cramps, and fever. Many users also complain of a painful condition, the so-called “itchy blood”, which often results in compulsive scratching that causes bruises and sometimes ruptures the skin, leaving scabs. Abrupt termination of heroin use causes muscle spasms in the legs of the user (restless leg syndrome). Users taking the “cold turkey” approach (withdrawal without using symptom-reducing or counteractive drugs), or induced withdrawal with opiate antagonist drugs, are more likely to experience the negative effects of withdrawal in a more pronounced manner.
Health Issues
* For intravenous users of heroin (and any other substance), the use of non-sterile needles and syringes and other related equipment leads to the risk of contracting blood-borne viruses such as HIV and hepatitis, as well as the risk of contracting bacterial or fungal infections.
* Poisoning from contaminants added to “cut” or dilute heroin.
* Chronic constipation
* Addiction and constantly growing tolerance. Like all opiates and opioids, long term use can lead to addiction.
* Physical dependence can result from prolonged use of all opiate and opioids, resulting in withdrawal symptoms on cessation of use.
* Decreased kidney function.
Many countries and local governments have begun funding programs that supply sterile needles to people who inject illegal drugs in an attempt to reduce these contingent risks and especially the contraction and spread of blood-borne diseases. The Drug Policy Alliance reports that up to 75% of new AIDS cases among women and children are directly or indirectly a consequence of drug use by injection.
Depending on drug interactions and numerous other factors, death from overdose can take anywhere from several minutes to several hours due to anoxia (lack of oxygen being delivered to parts of the body) because the breathing reflex is suppressed by opiods. An overdose is immediately reversible with an opioid antagonist injection Naloxone). Heroin overdoses can occur due to an unexpected increase in the dose or purity or due to diminished opiate tolerance. However, most fatalities reported as overdoses are probably caused by interactions with other depressant drugs like alcohol or benzodiazepines.
Street heroin is of widely varying and unpredictable purity. This means that the user may prepare what they consider to be a moderate dose while actually taking far more than intended. Also, those who use the drug after a period of abstinence have tolerances below what they were during active addiction. If a dose comparable to their previous use is taken, an effect greater to what the user intended is caused, in extreme cases an overdose could result.