Heroin Addiction

Heroin – Description

Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of the Asian poppy plant. Heroin usually appears as a fine white or brown powder.  Can be sniffed, smoked (chasing the dragon), or taken orally, but is usually injected intravenously (mainlining).  Can also be injected under the skin (skin popping).  The dose varies according to availability, cost, purity, and person’s tolerance.

Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and, particularly in users who inject the drug, infectious diseases, including HIV/AIDS.

Short-Term Effects

The short-term effects of heroin abuse appear soon after a single dose and disappear in a few hours.  Effects include pain relief, euphoria, mental clouding, sense of well-being, relaxation, drowsiness, nausea, contraction of pupils, decreased urination, constipation, sweating, itchy skin, and slowed breathing.  With very large doses, the pupils contract to pinpoints, the skin is cold, and moist, blush, and breathing may slow to a complete stop, resulting in death.

After an injection of heroin, the user reports feeling a surge of euphoria (“rush”) accompanied by a warm flushing of the skin, a dry mouth, and heavy extremities.  Following this initial euphoria, the user goes “on the nod,” an alternately wakeful and drowsy state.  Mental functioning becomes clouded due the depression of the central nervous system.  Taken orally, the effects of heroin are felt more gradually.

Long-Term Effects

At high doses, severe constipation contracted pupils, moodiness and menstrual irregularities can occur. These effects disappear after a person stops taking the drug.  People who use chronic high doses may develop lung problems due to the effects of high-dose opioids on respiration.  Abscesses, cellulitis, liver damage, , and brain damage can also result.  Perhaps half of all opioid-dependent women have complications during pregnancy and birth.  Existing health problems such as anemia, cardiac disease, diabetes, pneumonia, and hepatitis may require special management during the pregnancy and may complicate the pregnancy.  Opioid dependence increases the risk of miscarriage, premature labour, breech delivery, caesarian section, and low birth weight.  Opioids cross the placenta and the infant may also be born dependent and may suffer withdrawal. However, the mother’s withdrawal from opioids prior to birth can cause stillbirth.

In addition to the effects of the drug itself, street heroin may have additives that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain.  This can cause infection or even death of small patches of cells in vital organs.

Tolerance and Dependence

Tolerance develops fairly rapidly, making higher doses necessary to maintain the intensity of effects.  Most opioids are highly addictive, and regular use may result in physical dependence.

Withdrawal Symptoms

Withdrawal symptoms include severe anxiety, insomnia, profuse sweating, and muscle spasms. Chills, shivering, and tremors, can occur four to five hours after the last dose.  The acute symptoms reach peak intensity after about 36 to 72 hours and are usually over within 7 to 10 days.  It may be 6 months or longer before total recovery from withdrawal occurs.  Sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal, although heroin withdrawal is considered less dangerous than alcohol or barbiturate withdrawal.

Opiates other than heroin: Dependence on opioids taken in tablet or capsule form (such as Percodan or codeine) can go undetected by a person for some time.  People may respond to the discomfort of withdrawal by taking another dose, without realizing they have become addicted