Also known as: Black Eagle,Black Pearl, Black Stuff, Black Tar, Brown Crystal, Brown Sugar, Dope, Dragon, H, Horse, Junk, Scat, Skag, Smack, Tar, White Boy, White Girl, White Horse, White Nurse, White Stuff
Heroin is an opioid that is synthesized from morphine. Morphine is extracted from the seedpod of the Asian opium poppy plant. Heroin is a highly addictive, illegal drug. Millions of addicts around the world are unable to overcome the urge to continue using Heroin. Users know if they stop, they will face the horror of withdrawal.
In the 1850s, opium addiction was a major problem in the United States. The solution was to provide opium addicts with a less potent and supposedly “non-addictive” substitute. That substitute was morphine. Morphine addiction soon became a bigger problem than opium addiction. With the heroin problem came yet another non-addictive substitute — the drug now known as Methadone. Methadone was developed by German scientists in 1937. Ten years later methadone was exported to the U.S. under the trade name Dolophine. Renamed methadone, the drug was soon being widely used as a treatment for heroin addiction. Unfortunately, it proved to be even more addictive than heroin.
The mortality rate of heroin addicts was an estimated twenty times greater than the rest of the population in 1990.
The Manufacture of Heroin
Heroin was first manufactured in 1898 by Bayer, the German pharmaceutical company. It was marketed as a treatment for tuberculosis as well as a remedy for morphine addiction. Heroin usually appears as a white or brown powder or as a black sticky substance, known as “black tar heroin.”
In 2011, 4.2 million Americans aged 12 or older had used heroin at least once in their lives. It is estimated that about 23 percent of individuals who use heroin become dependent on it. It is estimated that 607,000 people per year used heroin in the years 2009-2011, compared to 374,000 during 2002-2005. The estimated number of new heroin users increased from 109,000 per year during 2002-2005 to 169,000 per year during 2009-2011.
There were 28,000 youth initiates per year in 2002-2005 and 27,000 in 2009-2011. Young adult initiates increased from 53,000 per year to 89,000 per year, and older adult initiates increased from 28,000 to 54,000 for these combined time periods. Past year use estimates for 2002-2005 and 2009-2011 showed the same pattern: for youths, estimates were 43,000 and 39,000; for young adults, the estimates were 124,000 and 208,000; and for older adults, the estimates were 207,000 and 361,000. Monitoring the Future (MTF) data indicates an increase for young adults aged 19 to 28 and a decrease for 10th graders in rates of past year heroin use between 2002 and 2011. MTF data did not indicate any changes among 8th and 12th graders between these 2 years.
How Heroin Is Used
Heroin can be injected, snorted, or smoked. All three routes of administration deliver the drug to the brain very rapidly, which contributes to its health risks and to its high risk for addiction, which is a chronic relapsing disease caused by changes in the brain and characterized by uncontrollable drug-seeking no matter the consequences.
People who inject heroin are at high risk of contracting HIV and Hepatitis C (HCV). The spread of these diseases is transmitted by contact with blood and other bodily fluids. This occurs primarily with needle sharing. (HCV is the most common blood-borne infection in the Unites States).
How Heroin Affects the Brain
When heroin enters the brain it is converted back into morphine. Morphine then binds to molecules on cells known as opioid receptors. These receptors are located in areas of the brain involved in the perception of pain and in reward. Opioid receptors also control automatic processes critical for life, such as blood pressure, arousal, and respiration.
Heroin overdoses often involve a suppression of breathing. This can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short and long-term psychological and neurological effects, including coma and permanent brain damage.
After an intravenous injection of heroin, users report feeling a surge of euphoria (“rush”) accompanied by dry mouth, a warm flushing of the skin, heaviness of the extremities, and clouded mental functioning. Following this initial euphoria, the user goes “on the nod,” an alternately wakeful and drowsy state. Users who do not inject the drug may not experience the initial rush, but the other effects are the same.
The Health Effects of Heroin
Heroin abuse is responsible for a number of serious health conditions. Chronic users of heroin may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, and liver or kidney disease. Pulmonary complications, including various types of pneumonia, may result from the poor health of the user as well as from heroin’s effects on breathing.
Side Effects of Heroin
In addition to the effects of the drug itself, street heroin often contains toxic contaminants or additives that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs. The short-term effects of heroin abuse appear soon after a single dose and disappear in a few hours.
With regular heroin use, tolerance develops where the abuser must use more heroin to achieve the same intensity or effect. Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (“cold turkey”), kicking movements and other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week. Sudden withdrawal can be fatal.