Heroin Addiction

Q) What is heroin?

A) Heroin is an illegal, highly addictive opiate drug. Its abuse is more widespread than any other opiate. Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy. It is typically sold as a white or brownish powder or as the black sticky substance known on the streets as "black tar heroin." Although purer heroin is becoming more common, most street heroin is "cut" (mixed) 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 always 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.

Q) What are the current trends for heroin abuse?

A) Data from the 1996 National Household Survey on Drug Abuse (NHSDA) conservatively estimated that approximately 2.4 million persons have used heroin at least once in their lifetime. In addition, nearly 455,000 people have used it at least once in the past year – but that number could actually be as large as 663,000. 

Q) What are some other names for heroin?

A) "smack", "junk", "horse", "skag", "H", "China white"

Q) In addition to heroin, what are some other examples of opiates?

A) There are many, both illegally obtainable and available by prescription:

Opium, Morphine, Codeine, Merperidine , Hydrocodone (Lortab, Vicodin), Oxycodone (Percodan, Roxicet, Roxiprin, Tylox, Percocet), Stadol, Talwin, Dilaudid, Fentanyl, Buprenorphine, Methadone, Propoxyphene (Wygesic, Darvocet)

Q) What are the statistics on heroin addiction in the United States?

A) New studies need to be conducted. However, there has been an increasing trend in new heroin use since 1992. A large number of recent new users were smoking, snorting, or sniffing heroin. Most were under age 26. Estimates of use for other age groups also increased, particularly among youths age 12 to 17. In fact, the incidence of first-time heroin use among this age group increased fourfold from the 1980s to 1995. The 1996 Drug Abuse Warning Network (DAWN), estimates that 14 percent of all drug-related emergency room (ER) episodes involved heroin. Even more alarming is the fact that between 1988 and 1994, heroin-related ER episodes increased by 64 percent (from 39,063 to 64,013).

In 1996, it was reported that heroin was the primary drug responsible for drug abuse treatment admissions in Newark, San Francisco, Los Angeles, and Boston. It ranked a close second to cocaine in New York and Seattle.

Q) How is heroin used?

A) Heroin is usually injected, sniffed/snorted, or smoked. A typical 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). Musculature injection produces a relatively slow onset of euphoria (5 to 8 minutes). When sniffed or smoked, peak effects of heroin are usually felt within 10 to 15 minutes. Although smoking and sniffing heroin do not produce a "rush" as quickly or as shooting it, researchers have confirmed that all three forms of heroin administration are addictive.

Injection continues to be the main method of use among heroin addicts.

Older users (over 30) continue to be one of the largest user groups in most national data. However, several sources indicate more young users across the country due to the lure of inexpensive, high-purity heroin.

Q) What are the immediate (short-term) effects of heroin use?

A) Heroin is particularly addictive because it enters the brain so rapidly. Abusers typically report feeling a surge of pleasurable sensation, or "rush" With heroin, the rush is usually accompanied by a warm flushing of the skin, dry mouth, and a heavy feeling in the extremities. There is a down side however, as a dose of heroin may also produce nausea, vomiting, and severe itching.

Drowsiness can occur for several hours after taking heroin. The drug clouds mental function by reacting to the central nervous system. Cardiac functions and breathing slow down, sometimes to the point of death.

Q) What are the long-term effects of heroin addiction and use?

A) Due to its intense addictive qualities, heroin is particularly dangerous. One’s degree of tolerance for the drug makes it particularly easy to get hooked.

Once addicted, the heroin abusers' primary purpose in life becomes getting more heroin. The drugs literally changes brain chemistry.

Physical dependence develops with higher doses of the drug. Withdrawal symptoms occur almost immediately if use is reduced abruptly. Withdrawal symptoms can occur just hours after the last time the drug is taken, and include:

• Restlessness
• Muscle and bone pain
• Insomnia
• Diarrhea
• Vomiting
• Cold flashes with goose bumps ("cold turkey")
• Leg movements.

Major withdrawal symptoms peak between 24 and 48 hours after the last dose. They 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.

Q) What are the medical complications of chronic heroin addiction and use?

• Scarred or collapsed veins
• Bacterial infections of the blood vessels and heart valves
• Abscesses (boils) and other soft-tissue infections,
• Liver or kidney disease
• Lung complications
• Arthritis
• Death from overdose

Q) Are heroin users at special risk for contracting HIV/AIDS and hepatitis B and C?

Yes! Heroin addicts often share needles and other injection equipment, so they are at special risk of contracting HIV and other infectious diseases. 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. Nearly one-third of Americans infected with HIV, are intravenous drug users. In fact, drug abuse is the fastest method of HIV infection in America.

Q) How does heroin abuse affect pregnant women?

A) 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.