Heroin is an illegal and highly addictive Schedule I substance (according to the Controlled Substances Act of 1970), and more specifically an opiate (meaning it is derived from opium), processed from the sap of the poppy plant. From a physiological perspective, heroin is a central nervous system depressant that relieves pain and induces sleep.
Heroin is usually sold as a white (or brownish) powder, or as the sticky substance known on the streets as “black tar.” Heroin has a variety of street names, e.g., smack, thunder, horse, hell dust, big H, nose drops, etc. Heroin distributors often give brand names to their products to highlight their potency (Death Wish, DOA) or effects (Evening’s Delight, Magic).
Addicts sometimes gather in places called “shooting galleries,” often located in vacant buildings. Dealers or fellow addicts supply the necessary paraphernalia for ingesting the drug, e.g., hypodermic needle and spoon to heat and liquefy the heroin. Sharing of heroin needles greatly increases the risk of acquiring AIDS or other infection diseases.
Some heroin users combine the drug with cocaine in the form of Speedballs (when injected) or “moonrocks” (when smoked). This can be a fatal combination.
Heroin can be injected, smoked, sniffed, or snorted. The fear of infection through sharing needles has made snorting and smoking a more favored way of getting high from heroin.
Where does heroin come from?
Most heroin originates from opium poppy farms in Southwest Asia aka the Golden Crescent, i.e., Pakistan and Afghanistan (according to a 2004 U.N. sponsored survey, [update] Afghanistan accounted for production of 87 percent of the world’s heroin at that time), Southeast Asia aka the Golden Triangle, i.e., Myanmar , Thailand, Vietnam, Laos”, as well as Latin America, primarily Colombia and Mexico. The majority of the heroin consumed in the United States comes from the latter two countries.
Effects of heroin on the user:
– Initial onset
– Dreamlike state of warmth and well-being
– Intravenous users typically experience a rush within 7 to 8 seconds after injection
– Intramuscular users typically experience a euphoric feeling within 5 to 8 minutes
– Users who snort or smoke heroin experience the peak effects within 10 to 15 minutes
– The user goes “on the nod,” an alternately wakeful and drowsy state
– Mental functioning becomes clouded
– Physical signs and symptoms of heroin use:
– Constricted pupils
– Respiratory depression
– Warm flushing of the skin
– Dry mouth
– Heavy extremities
Adverse physical effects:
– Fatal overdose
– Spontaneous abortion
– Infectious diseases, e.g., HIV/AIDS and hepatitis
– Collapsed veins
– Damage to the heart lining and valves
– Liver disease
– Urinary retention
– Poisoning from Contaminants Cutting agent
If a dependent user reduces, or stops, use of the drug abruptly, he/she may experience severe symptoms of withdrawal. Such symptoms can begin within a few hours of the last use heroin, and may include restlessness, muscle and bone pain, insomnia, diarrhea, nausea, vomiting, cold flashes with goose bumps (“cold turkey”), kicking movements (“kicking the habit”), Sweating, Malaise, Anxiety, Clinical depression, Priapism, extra sensitivity of the genitals in females, a general feeling of heaviness, excessive Yawning or Sneezing, Tears, Rhinorrhea, chills, Cramps, or Fever. Many users also complain of a painful condition known as “itchy blood”, which often results in compulsive scratching, which will cause bruises and sometimes rupture the skin, leaving scabs, and other symptoms.
Major withdrawal symptoms peak between 48 and 72 hours after the last dose and typically subside after about a week; however, some individuals show persistent withdrawal symptoms for months. The intensity of the withdrawal syndrome depends upon the dosage of the drug used and the frequency of use.
How heroin addiction is treated
Appropriate treatment of heroin addiction must begin with a medically-supervised detox at a clinic or hospital of good standing. After completion of the detoxification process, the patient should go to a reputable inpatient heroin addiction recovery program that specializes in the treatment of addiction.
Some patients may be continued on methadone, buprenorphine, or other medications by a licensed addictionologist.
The treatment of heroin addiction at any substance abuse treatment centers can be difficult and lengthy because of the drug’s intensely addictive properties, which require daily use to prevent the effects of withdrawal. An important task is to match the best treatment approach to meet the particular needs of the patient. Moreover, several new behavioral therapies available at the drug addiction center, such as contingency management therapy and cognitive-behavioral interventions, show particular promise as treatments for heroin addiction.