Heroin

Published on March 6th, 2014

Heroin is an opioid drug that has been synthesized from morphine. This is a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Typically heroin will appear as a white or brown powder or as a black sticky substance, known as “black tar heroin.” Reach shows that in 2011, there was an estimate of 4.2 million Americans aged 12 or older that had used heroin at least once in their lives.

How Is Heroin Used?

Heroin can be used through injection, inhaled by snorting or sniffing, or smoked. Each of these routes of administration delivers the drug to the brain very rapidly, all of which contribute to the health risks associated with heroin use, as well as to its high risk for addiction,  which causes changes in the brain creates uncontrollable drug-seeking no matter the consequences this is known as a chronic relapsing disease.

How Does Heroin Affect the Brain?

When heroin enters the brain, it is converted back into morphine, which then binds to molecules on cells known as opioid receptors. The opioid receptors are located in various areas of the brain and in the body, targeting those involved in the perception of pain and in reward. Opioid receptors are also located in the brain stem, this is what controls automatic processes critical for life, such as blood pressure, arousal, and respiration. When an individual overdoses on heroin they usually experience suppression of breathing, this can be fatal.

When heroin is intravenously injected the user will feel a surge of euphoria known as the “rush”, this is often accompanied by dry mouth, a warm flushing of the skin, heaviness of the extremities, as well as clouded mental functioning.The user will then go “on the nod” where they are in an alternately wakeful and drowsy state. Those who do not inject the drug may not experience the initial rush, however the other effects are the same.

Regular heroin use changes the way the brain functions. Some individuals will develop a tolerance as result, this is when increased doses of the drug are needed to achieve the desired effects. This could also lead to a dependency as result, which is characterized by the need to continue use of the drug to avoid withdrawal symptoms.

Injection Drug Use and HIV and HCV Infection

There is a high risk with those who inject drugs of contracting HIV and hepatitis C (HCV). These diseases are transmitted through contact with blood or other bodily fluids, which may occur when the individual is sharing needles or other injection drug use equipment. Heroin also impairs the individuals judgement, even if they do not share needles the individual is at great risk of contracting these blood born diseases due to risky sexual behaviors.

What Are the Other Health Effects of Heroin?

Heroin is connected to a large number of other serious health conditions, this includes fatal overdose spontaneous abortion, and infectious diseases like hepatitis and HIV. Chronic heroin users may develop collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, as well as liver or kidney disease. Heroin also has serious effects on the individual breathing, resulting in serious pulmonary complications, such as various types of pneumonia.

Heroin itself may contain toxic chemicals or additives that may clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs.

Regular use of heroin often leads to the individual developing a physical dependency, where the body has adapted to the presence of the drug and requires it to prevent any unpleasant symptoms of withdrawal when abruptly stopping the use of the drug. These symptoms of withdrawal can begin as soon as a few hours after the last drug administration and may include restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps (known as “cold turkey”), and kicking movements (known as “kicking the habit”). Many individuals will experience severe cravings for the heroin during withdrawal, which leads to relapse and prolonged drug abuse.

Heroin use during pregnancy does not only pose a risk of spontaneous abortion, along with poor nutrition and inadequate prenatal care the fetus is at risk of a low birth weight, as well as later delays in development. The infant of a mother who uses heroin regularly throughout her pregnancy may be born physically dependent on heroin and could suffer from neonatal abstinence syndrome (NAS), which is a drug withdrawal syndrome in infants that requires hospitalization.

Treating Heroin Addiction

Treating a heroin addiction requires life long support and maintenance by the individual. There is a wide array of treatment available to heroin addicts that include behavioral therapies and medications. This could help the individual to return to living a stable and more productive lifestyle.

Common medications used in the treatment of heroin addiction include buprenorphine and methadone. Both of these medications work by binding to the same cell receptors as heroin but more weakly, this helps the individual to wean off the drug and reduce craving. Another medication used is naltrexone, which blocks opioid receptors and prevents the drug from having an effect. Naloxone is an medication that is typically used in the emergency treatment of an individual experiencing the effects of heroin overdose.

Statistics and Trends

Monitoring the Future Study: Trends in Prevalence of Heroin for 8th-Graders, 10th-Graders, and 12th-Graders; 2013 (in percent)*
Drug Time Period 8th-Graders 10th-Graders 12th-Graders
Heroin Lifetime 1.00 1.00 1.00
Past Year 0.50 0.60 0.60
Past Month 0.30 0.30 0.30
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