From morphine to epidemic: the history of heroin

Heroin

History of Heroin

Heroin is an opiate derived from the morphine within the opium poppy seed. The drug is a singular chemical that has a history associated mainly with the use of opium as a cure for diarrhea as well as to reduce pain and create euphoria in the user. Opium, which is a compound again derived from the opium or oriental poppy (papaver somiferum) that has been used for thousands of years but refining the various compounds with their differing effects or uses began in the 19th century. The three compounds that are most important as individual compounds which are derived from the poppy are, morphine, codeine and thebaine. Codeine is widely used as an analgesic and has less euphoric properties than morphine, which is used as a more heavy duty painkiller and from which heroin is derived. While thebaine has no narcotic properties and is most likely to cause nausea in individuals it is frequently used for the manufacture of synthetic or semi-synthetic opiate drugs. Heroin, the "brand name" for diacetylmorphine HCl in short is the substance believed to be the most euphoric inducing as it act as a direct carrier for the morphine within the compound to the brain and is derived from morphine, usually in its natural state. (Moraes, 2000, pp. 1, 8-9, 10) Initially the compound was isolated from morphine by a chemist in 1874 who boiled morphine in a week acid solution and created diacetylmorphine HCl (heroin). The chemical was later then picked up by the medical scientific community (namely the Bayer company) as an effective cough suppressant. The way in which heroin suppressed cough was by slowing breathing, but given that tuberculosis was a number one killer in the day and this new compound became widely used to treat cough associated with tuberculosis. (Moraes, 2000, pp. 11-12) the long-range potential for dependency was not considered as it had not really been tested and the medical community was in dire need of anything that would treat or suppress the symptoms of tuberculosis which was commonly fatal at that time due to the fact that there were no antibiotics to kill the tuberculin bacteria. Heroin and aspirin became the main money making chemicals of the Bayer company. (Moraes, 2000, p. 12) in the 19th century there was little concern for the effects of opium as alcohol was the main vilified drug of the day, due to the temperance movement which later then expanded to attack legitimate and illegitimate uses of opium and its derived compounds as it was also widely used as a euphoric, especially by new Chinese labor immigrants, who mostly drank or smoked the substance and in turn those who labored around them. Moraes claims that the use of the drug was considered a minor vice similar to the use of coffee and/or cigarettes are today. In the modern day most heroin users either smoke the substance or inject it. (2000, pp. 12-14)

Heroin Abuse Statistics

According to the National Institute on Drug Abuse (NIDA) the use of heroin has declined over the last few years and it is believed that about 338,000 people were heroin users in 2006 as compared to about 153,000 in 2007. The average age of first use is 21.8 years and the number of first time users over the age of 12 was 106,000 in 2007. (NIDA, August 2009, p. 5) the cost of heroin treatment as well as lost productivity is estimated to be in the billions by some sources. (Moraes, 2000, p. 12)

Heroin's Affect on the Brain

Heroin is more effective as a chemical than morphine for passing the blood brain barrier and therefore allows the morphine remaining in the drug to more rapidly reach the brain, especially via the injection route, as most injections are intravenous. Heroin has a much less effective action through the eaten or even smoked routs of delivery, which is why most users currently inject the drug either into the muscle, IM or the subcutaneous level SQ or for a faster physical reaction intravenously IV. (Fernandez, 1998, pp. 55-56) When it is known that purer forms of the drug are on the streets some users will revert to a slower method of delivery, such as snorting (inhaling through the nose) to try to avoid overdose. One of the most serious concerns of heroin is that in its illicit street form it can be ameliorated with nearly any white powdery substance, some of which can do serious harm to the user. (Fernandez, 1998, pp. 40-41)

Depending on the route of delivery heroin can have different effects on the body, but as was detailed earlier the heroin itself is not the drug that has the effect it is the carrier across the blood brain barrier as well as the chemical that delivers the morphine within the drug and any other companion drug to the cells in the brain. Therefore it is important to understand that the effects on the brain discussed are those of morphine. (Moraes, 2000, pp. 3-4) Ultimately the drug is effects the central nervous, the cardiovascular, respiratory, gastrointestinal, genitourinary and endocrine systems. The CNS is affected most rapidly and most strongly producing a "rush" of warmth, euphoria and reduction in any pain sensations the body may have been having before as the synapses are opened and the active ingredient in the drug are absorbed, heroin users are experience rapid sleepiness. The pupils rapidly constrict and the circulatory system is affected by a rapid decrease or suppression of breathing. The cardiovascular and other effects are results of the brain affects but are lesser than the CNS affect and include a reduction in heart rate and blood pressure which can cause problems when the individual attempts to rise from a laying down or sitting position, orthostatic hypotension is a common event. This event occurs when the extremities do not return blood to the circulatory system fast enough to support sitting up or standing and individuals may actually lose consciousness as they attempt these movements. The cells in the brain that control the autonomic systems of the body such as heart and respiration rate as well as gastrointestinal motility are reduced in effectiveness as the drug's active component replaces the chemicals that are intended to propel these cell function these cells in some of the receptors. (Fernandez, 1998, pp. 54-57)

Treatment

Treatment for heroin addiction is considered one of the most difficult of all social issues, as challenges to daily life are many and relapse is relatively frequent. According to NIDA: A range of treatments exist for heroin addiction, including medications and behavioral therapies. Science has taught us that when medication treatment is combined with other supportive services, patients are often able to stop using heroin (or other opiates) and return to stable and productive lives. (NIDA, August 2009, p. 2) Drug treatment options are used often in combination with traditional cognitive behavioral and social behavioral therapies to reduce the craving for the drug and include: Methadone Buprenorphine, Naltrexone. (NIDA August 2009, pp. 2-4)

Heroin's Appearance

The drug can appear as a white or brown powder or in the form of a brown sticky substance known on the street as "black tar heroin." (NIDA August 2009, p. 1)

Long-Term Effects,

There are many long-term effects of heroin, not including the life interruption process of treatment and recovery that include; cognitive impairment (Ornstein et al. 2000, p. 113) life altering patterns of living and of course the serious social stigma of having been a user and recovering from the addiction. (Fernandez, 1998) (Brezina, 2009) (Moraes, 2000)

Street Terms

Heroin, Dope, White, Brown, Black, Black Tar, Smack, Junk as well as a few other terms are used to describe heroin on the street and often vary by region appearance and suspected region of source.

Laws About Heroin.

Heroin users are all considered abusers, even if they are productive in the rest of their lives because heroin is considered an illicit drug. Heroin is illegal in the U.S. universally across states and has varied criminal offences for sale, distribution, possession and use like all illicit or illegal substances. The medicinal forms of opium, i.e. morphine and codeine are widely used in the medical field, for pain and cough suppression (as well as in synthetic forms) but are also showing a strong trend toward dependence and illegal use and if used without a prescription or distributed illegally also carry serious legal consequences. Heroin itself has been illegal since 1954 with the passage of the Illegal Drug Act. (Brezina, 2009, p. 48)

Average Street Price of Heroin

Current estimated street price of heroin is between 70 and 100 dollars a gram, depending on the quality and region, according to an anonymous source.

Resources