Heroin is a highly addictive drug, and its use is a serious
problem. It is both the most abused and the most rapidly acting of
the opiates. It is typically sold as a white or brownish powder or
as the black sticky substance known on the streets as "black tar
heroin."
Recent studies suggest a shift from injecting heroin to snorting
or smoking because of increased purity and the misconception that
these forms of use will not lead to addiction.
Although purer heroin is becoming more common, most street heroin
is "cut" with other drugs or with substances such as sugar, starch,
powdered milk, or quinine. Street heroin can also be cut with
strychnine or other poisons. Because heroin abusers do not know the
actual strength of the drug or its true contents, they are at risk
of overdose or death. Heroin also poses special problems because of
the transmission of HIV and other diseases that can occur from
sharing needles or other injection equipment.
Heroin
is processed from morphine, a naturally occurring substance
extracted from the seedpod of the Asian poppy plant. Heroin usually
appears as a white or brown powder. Street names for heroin include
"smack," "H," "skag," and "junk." Other names may refer to types of
heroin produced in a specific geographical area, such as "Mexican
black tar."
Heroin is usually injected, sniffed/snorted, or smoked.
Typically, a heroin abuser may inject up to four times a day.
Intravenous injection provides the greatest intensity and most rapid
onset of euphoria (7 to 8 seconds), while intramuscular injection
produces a relatively slow onset of euphoria (5 to 8 minutes). When
heroin is sniffed or smoked, peak effects are usually felt within 10
to 15 minutes. Although smoking and sniffing heroin do not produce a
"rush" as quickly or as intensely as intravenous injection, NIDA
researchers have confirmed that all three forms of heroin
administration are addictive.
Soon after injection (or inhalation), heroin crosses the
blood-brain barrier. In the brain, heroin is converted to morphine
and binds rapidly to opioid receptors. Abusers typically report
feeling a surge of pleasurable sensation, a "rush."
The intensity of the rush is a function of how much drug is taken
and how rapidly the drug enters the brain and binds to the natural
opioid receptors. Heroin is particularly addictive because it enters
the brain so rapidly. With heroin, the rush is usually accompanied
by a warm flushing of the skin, dry mouth, and a heavy feeling in
the extremities, which may be accompanied by nausea, vomiting, and
severe itching.
After the initial effects, abusers usually will be drowsy for
several hours. Mental function is clouded by heroin's effect on the
central nervous system. Cardiac functions slow. Breathing is also
severely slowed, sometimes to the point of death. Heroin overdose is
a particular risk on the street, where the amount and purity of the
drug cannot be accurately known.
Infectious diseases, for example, HIV/AIDS and hepatitis B
and C
Collapsed veins
Bacterial infections
Abscesses
Infection of heart lining and valves
Arthritis and other rheumatologic problems
One of the most detrimental long-term effects of heroin is
addiction itself. Addiction is a chronic, relapsing disease,
characterized by compulsive drug seeking and use, and by
neurochemical and molecular changes in the brain. Heroin also
produces profound degrees of tolerance and physical dependence,
which are also powerful motivating factors for compulsive use and
abuse.
As with abusers of any addictive drug, heroin abusers gradually
spend more and more time and energy obtaining and using the drug.
Once they are addicted, the heroin abusers' primary purpose in life
becomes seeking and using drugs. The drugs literally change their
brains.
Physical dependence develops with higher doses of the drug. With
physical dependence, the body adapts to the presence of the drug and
withdrawal symptoms occur if use is reduced abruptly. Withdrawal may
occur within a few hours after the last time the drug is taken.
Symptoms of withdrawal include restlessness, muscle and bone pain,
insomnia, diarrhoea, vomiting, cold sweats with goose bumps ("cold
turkey"), and leg movements. Major withdrawal symptoms peak between
24 and 48 hours after the last dose of heroin and subside after
about a week. However, some people have shown persistent withdrawal
signs for many months. Heroin withdrawal is never fatal to otherwise
healthy adults, but it can cause death to the foetus of a pregnant
addict.
At some point during continuous heroin use, a person can become
addicted to the drug. Sometimes addicted individuals will endure
many of the withdrawal symptoms to reduce their tolerance for the
drug so that they can again experience the rush.
Physical dependence and the emergence of withdrawal symptoms were
once believed to be the key features of heroin addiction. We now
know this may not be the case entirely, since craving and relapse
can occur weeks and months after withdrawal symptoms are long gone.
We also know that patients with chronic pain who need opiates to
function (sometimes over extended periods) have few if any problems
leaving opiates after their pain is resolved by other means. This
may be because the patient in pain is simply seeking relief of pain
and not the rush sought by the addict.
Medical consequences of chronic heroin abuse include scarred
and/or collapsed veins, bacterial infections of the blood vessels
and heart valves, abscesses (boils) and other soft-tissue
infections, and liver or kidney disease. Lung complications
(including various types of pneumonia and tuberculosis) may result
from the poor health condition of the abuser as well as from
heroin's depressing effects on respiration. Many of the additives in
street heroin may include substances that do not readily dissolve
and result in clogging the blood vessels that lead to the lungs,
liver, kidneys, or brain. This can cause infection or even death of
small patches of cells in vital organs. Immune reactions to these or
other contaminants can cause arthritis or other rheumatologic
problems.
Of course, sharing of injection equipment or fluids can lead to
some of the most severe consequences of heroin abuse - infections
with hepatitis B and C, HIV, and a host of other blood-borne
viruses, which drug abusers can then pass on to their sexual
partners and children.
Heroin abuse can cause serious complications during pregnancy,
including miscarriage and premature delivery. Children born to
addicted mothers are at greater risk of SIDS (sudden infant death
syndrome), as well. Pregnant women should not be detoxified from
opiates because of the increased risk of spontaneous abortion or
premature delivery; rather, treatment with methadone is strongly
advised. Although infants born to mothers taking prescribed
methadone may show signs of physical dependence, they can be treated
easily and safely in the nursery. Research has demonstrated also
that the effects of inutero exposure to methadone are relatively
benign.
Because
many heroin addicts often share needles and other injection
equipment, they are at special risk of contracting HIV and other
infectious diseases.
Infection of injection drug users with HIV is spread primarily
through reuse of contaminated syringes and needles or other
paraphernalia by more than one person, as well as through
unprotected sexual intercourse with HIV-infected individuals. For
nearly one-third of Americans infected with HIV, injection drug use
is a risk factor. In fact, drug abuse is the fastest growing vector
for the spread of HIV in the nation.
NIDA-funded research has found that drug abusers can change the
behaviours that put them at risk for contracting HIV, through drug
abuse treatment, prevention, and community-based outreach
programmes. They can eliminate drug use, drug-related risk
behaviours such as needle sharing, unsafe sexual practices, and, in
turn, the risk of exposure to HIV/AIDS and other infectious
diseases. Drug abuse prevention and treatment are highly effective
in preventing the spread of HIV.
With
regular heroin use, tolerance develops. This means the abuser must
use more heroin to achieve the same intensity or effect. As higher
doses are used over time, physical dependence and addiction develop.
With physical dependence, the body has adapted to the presence of
the drug and withdrawal symptoms may occur if use is reduced or
stopped.
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, diarrhoea and
vomiting, cold flashes with goose bumps ("cold turkey"), kicking
movements ("kicking the habit"), and other symptoms. Major
withdrawal symptoms peak between 48 and 72 hours after the last dose
and subside after about a week. Sudden withdrawal by heavily
dependent users who are in poor health is occasionally fatal,
although heroin withdrawal is considered much less dangerous than
alcohol or barbiturate withdrawal.
As withdrawal progresses, elevations in blood pressure, pulse,
respiratory rate and temperature occur. Symptoms of overdose --
which may result in death -- include shallow breathing, clammy skin,
convulsions and coma.
Heroin
can cause feelings of depression, which may last for weeks. Attempts
to stop using heroin can fail simply because the withdrawal can be
overwhelming, causing the addict to use more heroin in an attempt to
overcome these symptoms. This overpowering addiction can cause the
addict to do anything to get heroin.
If you have a problem with heroin addiction, call Narconon drug
rehab centre. We can help. Call 0800 - 169 4803 now.
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Although purer heroin is becoming more common, most street heroin
is "cut" with other drugs or with substances such as sugar, starch,
powdered milk, or quinine. Street heroin can also be cut with
strychnine or other poisons. Because heroin abusers do not know the
actual strength of the drug or its true contents, they are at risk
of overdose or death. Heroin also poses special problems because of
the transmission of HIV and other diseases that can occur from
sharing needles or other injection equipment. 
Heroin
is processed from morphine, a naturally occurring substance
extracted from the seedpod of the Asian poppy plant. Heroin usually
appears as a white or brown powder. Street names for heroin include
"smack," "H," "skag," and "junk." Other names may refer to types of
heroin produced in a specific geographical area, such as "Mexican
black tar."
Because
many heroin addicts often share needles and other injection
equipment, they are at special risk of contracting HIV and other
infectious diseases. 
With
regular heroin use, tolerance develops. This means the abuser must
use more heroin to achieve the same intensity or effect. As higher
doses are used over time, physical dependence and addiction develop.
With physical dependence, the body has adapted to the presence of
the drug and withdrawal symptoms may occur if use is reduced or
stopped.
Heroin
can cause feelings of depression, which may last for weeks. Attempts
to stop using heroin can fail simply because the withdrawal can be
overwhelming, causing the addict to use more heroin in an attempt to
overcome these symptoms. This overpowering addiction can cause the
addict to do anything to get heroin.