Heroin is a powerful semi-synthetic opiate derived from morphine most often used as a recreational drug. Heroin delivers and intense “rush” and is more powerful than most opioid analgesics because it crosses the blood-brain barrier more rapidly. Use of heroin leads quickly to dependence and has a high potential for addiction.
Heroin is known to cause “blissful apathy” along with its painkilling effects.
Withdrawal symptoms can develop within three days if used regularly and stopped abruptly – much quicker than the onset of withdrawal from some other opiates including oxycodone and hydrocodone.
Heroin was first synthesized from morphine in 1874. Until 1910, heroin was marketed as a non-addictive cough suppressant and substitute for morphine. The Harrison Narcotics Tax Act, passed in 1914, was meant to control the sale of heroin and other opiates. Heroin could be prescribed for medical purposes until 1924, when Congress banned the sale, import or manufacturing of heroin in the U.S. Most of the heroin consumed in the U.S. comes from Columbia, Mexico, Canada, Afghanistan and China. Other top-producing countries include Thailand, Vietnam and Laos.
Heroin causes rapid tolerance and physical dependence. In combination with its euphoric effects, and almost immediate addiction potential, this causes many users extreme difficulties when attempting to curtail the use on their own.
Once physically dependent, one can experience extremely unpleasant withdrawal symptoms, therefore causing the heroin user to continue use to simply avoid the withdrawal syndrome. Some common street names for Heroin include chiva, dope, smack and junk.
Heroin can be taken orally, snorted, smoked or injected. Some users inhale the vapors when it is heated. Oftentimes, heroin is “cut” with other substances to dilute it or add bulk.
A mixture of heroin and cocaine, known on the street as a “speedball,” can be fatal. A heroin/fentanyl mix caused an outbreak of overdoses in several American cities in 2006.
Dangers of intravenous use include transmission of hepatitis and HIV from contaminated needles and syringes, abscesses, chronic constipation and poisoning from ingredients and other drugs used to dilute it.
Some countries provide needle exchange programs to provide users with clean supplies. While some argue this helps cut the transmission rate of infectious diseases, others say it amounts to governments’ acceptance of heroin use.
Common side effects associated with heroin use include:
- Shallow breathing
- Weak pulse
- Respiratory depression
- Lowered heart rate
- Dry mouth
- Muscle spasms
- Rash and itching
- Physical and psychological dependence
Withdrawing from heroin can be painfully intense and most often requires medically supervised detox. Withdrawal symptoms can set in within a few hours of last use and include:
- muscle spasms
- itching that leads to compulsive scratching
- cold sweats
- muscle and bone aches
- diarrhea and fever.
Methadone is most often used as a heroin substitute to help wean users from the drug. While it has shown some success, it too is an addictive opiate that may require detox. Buprenorphine is also used in substitution therapy, making it hard for users to get high, except when taken in very large doses. Opioid antagonists, which block the ability of heroin and other opiates from binding to receptor sites in the brain, include naloxone and naltrexone. Alternative detox programs, such as rapid detox through the Waismann Method, have shown promise.
The heroin drug culture is a popular theme in literature, music and the film industry. Many notable artists and musicians have overdosed on heroin, some resulting in death.
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