Heroin, a member of the opiate family, is a pain killing drug that is made from the opium poppy. Before it is exported from its various countries of origin, it is processed from raw opium into a brown powder that is approximately 70% pure heroin. It is then mixed with several chemicals such as acetic anhydride and hydrochloric acid and is dried and sieved.
Heroin is manufactured in laboratories in remote areas using simple equipment, where it is packaged into brick form for shipment. Small amounts of this narcotic are smuggled by couriers known as “mules” who either swallow latex balloons filled with heroin or else smuggle the drug in a balloon in a body cavity in the hope that it will not be discovered. This, of course, is extremely dangerous on the part of the couriers as if the balloon were to burst, death from an overdose could occur.
When smoked or injected, this is a fast acting narcotic. Mainlining (direct injection into a vein) creates a sense of euphoria within seven to eight seconds. Injection into a muscle brings on a high within five to eight minutes. Effects of smoking heroin take a few minutes more to reach a slightly lesser high.
While the preferred means of heroin use had been either subcutaneous (skin popping), intramuscular or intravenous, a number of addicts in the United States now snort the drug due to the availability of a purer grade of heroin on the street. Heroin abusers may find themselves addicted fairly rapidly. Addiction can occur anywhere from three days to one to two weeks of constant use based upon the length of use and the size of the dose used. This drug remains popular because of the intensity of the sensation created and consequently, the habit is hard to kick.
Rarely does someone with a heroin addiction obtain the drug in its pure form which is a white, bitter-tasting powder. Heroin that is bought on the street is usually cut with any of the following: quinine, powdered milk, starch or sugar and some unscrupulous dealers resort to using brick dust as an additive. Heroin addicts are so accustomed to buying a lower grade that when a higher grade is somehow obtained, death may occur due to the increase in strength.
The reason that heroin is so addictive is because of its rapid entry into the brain. Heroin addiction provides an effect that occurs almost immediately and some users feel sick upon initial use as the drug crosses the blood-brain barrier. Once heroin enters the brain, it is converted to morphine and the user feels a “rush”, an overwhelming feeling of pleasure. Based on how much of the drug is used and at what speed the heroin enters the brain, the result is an intense feeling of warmth and calmness which spreads through the body of the user. Problems, worries and any form of physical pain are blocked from consciousness. After a “fix”, the heroin addict feels that the world and his or her life is good – until such time, of course, that the sensation wears off and the user returns to the real world and all the attendant problems. He then must concern himself with the details involved in scoring the next hit.
The first step of the treatment process for heroin addiction is detox (detoxification). This highly addictive opiate requires medical supervision. Not all drugs require medical detox. However, an abuser of heroin should never attempt to detox without his or her vital signs (heart rate and blood pressure) being closely monitored in case of complications.
A period of detox is important because until the individual’s body is purged of drugs, the craving for more heroin will cause severe withdrawal symptoms. While the heroin abuser is going through the detox process, he or she will be unable to fully concentrate on participating in rehabilitation and treatment and consequently, is not ready for recovery. Use of heroin and other opiates over a long period of time has a negative effect on the nerve cells in the brain and disrupts its normal functioning. Endorphins, which are natural painkillers, are routinely produced by these nerve cells. However, use of heroin replaces these cells in the brain’s receptors which results in a craving for continued high doses of opiates. Since the nerve cells are changed in this way, dependency on heroin – an external source of painkillers – occurs.
Research states that approximately 30% of patients who are heroin addicts attempting detox through traditional inpatient treatment are unable to complete more than three days of detox because of the intensity of withdrawal and cravings for the drug.
Heroin, which is processed from morphine, is also known by the street names of “H”, “smack”, “skag” and “junk” among other names based upon the geographical area where the drug is used. This powerful narcotic can become physically and physiologically addictive as regular use continues over time.
Consequently, regular use of heroin results in drug tolerance. What this means is that the heroin addict must use more and higher doses to achieve the results he or she previously obtained when first using the drug. This results in physical dependence on the drug because the individual’s body has become used to its presence.
If the heroin dose is reduced or use of the drug is stopped, withdrawal symptoms will occur. Regular users may experience initial symptoms of withdrawal within only a few hours after ingesting the last dose. Between 48 and 72 hours after administration of the last dose of the drug, major withdrawal symptoms will reach their peak. Heroin addicts have reported that symptoms of withdrawal can be likened to a severe case of the flu.
Some of the symptoms of heroin withdrawal include the following:
- loss of appetite
- runny nose
- muscle cramps
- goose bumps
- extreme sweating or chills
- watery eyes
- stomach cramps
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.