Heroin
Heroin is processed from morphine, a naturally occurring substance extracted from the Asian poppy plant the seed pod. Heroin is usually a white or brown powder.
Routes of Administration
Heroin is usually injected, sniffed/snorted, or smoked. A heroin abuser may inject up to four times a day. Intravenous injection provides the greatest intensity and euphoria in about 7 to 8 seconds, while intramuscular injection produces euphoria in about 5 to 8 minutes. When heroin is sniffed or smoked, peak effects usually occur in about 10 to 15 minutes. All forms of heroin are addictive.
Effects
Soon after injection or inhalation, heroin crosses the blood-brain barrier in the brain. Heroin is then converted to morphine and binds rapidly to opioid receptors. Uers typically report a surge of pleasure or "rush." The intensity of the rush is a function of the amount of heroin that is ingested and how rapidly the drug enters the brain to bind to natural opioid receptors. With heroin, the rush is usually accompanied by flushing of the skin, dry mouth, and a heavy feeling in extremities. Nausea, vomiting, or severe itching may also accompany the rush. After the initial effects, users are usually drowsy for several hours, mental function is clouded, and cardiac functions slow down. Respiration also decreases, sometimes to the point of death. Heroin overdose is a particular risk on the street, where amount and purity of heroin is unknown.Health Hazards
Heroin is highly addictive and its use constitutes a serious problem in America. An estimated 600,000 people need treatment for heroin addiction. Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and infectious disease, including HIV/AIDS and hepatitis.Chronic heroin users may develop infection of the heart lining and valves, abscesses, cellulitis, and liver disease. Pulmonary complications, including pneumonia, may result from the poor health of the abuser, as well as from heroin's depressing effects on respiration. In addition to the effects of the drug itself, street heroin may have additives that do not readily dissolve and result in clogging blood vessels that lead to the lungs, liver, kidneys, or brain, which can cause infection or cell death in vital organs.
Tolerance, Addiction, and Withdrawal
With regular heroin use, tolerance develops. As higher doses are used over time, physical dependence and addiction develop. Withdrawal, which in regular users 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, kicking movements, and other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week. Sudden withdrawal in heavily dependent users, especially those in poor health, may be fatal.
Information adapted from the University of Notre Dame Office of Alcohol and Drug Education (2006)