Heroin
Heroin is an addictive drug, and its use is
a serious problem in America. Recent studies
suggest a shift from injecting heroin to snorting
or smoking because of increased purity and the
misconception that these forms are safer.
Heroin is processed from morphine, a naturally
occurring substance extracted from the seedpod
of the Asian poppy plant. Heroin usually appears
as a white or brown powder. Street names for
heroin include "smack," "H,"
"skag," and "junk." Other
names may refer to types of heroin produced
in a specific geographical area, such as "Mexican
black tar."
Health Hazards
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 and hepatitis.
The short-term effects of heroin abuse appear
soon after a single dose and disappear in a
few hours. 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
to the depression of the central nervous system.
Long-term effects of heroin appear after repeated
use for some period of time. Chronic users may
develop collapsed veins, infection of the heart
lining and valves, abscesses, cellulitis, and
liver disease. Pulmonary complications, including
various types of pneumonia, may result from
the poor health condition of the abuser, as
well as from heroin's depressing effects on
respiration.
Heroin abuse during pregnancy and its many
associated environmental factors (e.g., lack
of prenatal care) have been associated with
adverse consequences including low birth weight,
an important risk factor for later developmental
delay.
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, Addiction, and Withdrawal
With regular heroin use, tolerance develops.
This means the abuser must use more heroin to
achieve the same intensity of effect. As higher
doses are used over time, physical dependence
and addiction develop. With physical dependence,
the body has adapted to the presence of the
drug and withdrawal symptoms may occur if use
is reduced or stopped.
Withdrawal, which in regular abusers may occur
as early as a few hours after the last administration,
produces drug craving, restlessness, muscle
and bone pain, insomnia, diarrhea and vomiting,
cold flashes with goose bumps (“cold turkey”),
kicking movements (“kicking the habit”),
and other symptoms. Major withdrawal symptoms
peak between 48 and 72 hours after the last
dose and subside after about a week. 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.