On the street it’s known as smack, H, boy, junk, tar or dope. In Latin it’s papaver somniferum. But whatever the name, it’s heroin. And it’s not only one of the most highly addictive drugs on the planet, but it can also be lethal. Heroin is either injected, snorted or smoked. Injected heroin causes a rush of powerful euphoria lasting a few minutes, followed by a sedation that can last a few hours. When snorted there’s a slower onset and a less intense peak of effects. When smoked there’s immediate euphoria, but less extensive duration. Heroin users sometimes mix the drug with powder or crack cocaine. That’s called speedballing.

Short Term Effects of Heroin

Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain's white matter due to heroin use. That may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.  
Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence (that is, addiction), the body adapts to the presence of the drug, causing withdrawal symptoms if use is reduced abruptly.

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LONG TERM EFFECTS OF HEROIN

Irreversible Effects:

Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed.

BEHAVIORAL ALTERATION:

Studies have shown some deterioration of the brain’s white matter due to heroin use. That may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

PHYSICAL DEPENDENCE:

Heroin also produces profound degrees of tolerance and physical dependence. Tolerance occurs when more and more of the drug is required to achieve the same effects. With physical dependence (that is, addiction), the body adapts to the presence of the drug, causing withdrawal symptoms if use is reduced abruptly.

Heroin Withdrawal

Heroin withdrawal may begin within 6–24 hours of stopping. This time frame though can fluctuate with the degree of tolerance, as well as the amount of the last consumed dose. Withdrawal symptoms may include: sweating, malaise, anxiety, depression, akathisia (restlessness), priapism, a general feeling of heaviness, excessive
yawning or sneezing, tears, rhinorrhea(runny nose), insomnia, cold sweats, chills, severe muscle and bone aches, nausea, vomiting, diarrhea, cramps, watery eyes,fever and cramp-like pains. Withdrawal may also cause involuntary spasms in the limbs (that’s thought to be the origin of the term "kicking the habit”).
A range of treatments including medicines and behavioral therapies are effective in treating heroin addiction. It’s important to match the best treatment approach to meet the particular needs of each individual patient. Behavioral therapies for heroin addiction include cognitive-behavioral therapy and contingency management. Cognitive-behavioral therapy helps modify the patient’s drug-use expectations and behaviors, and also helps effectively manage triggers and stress. Contingency management provides motivational incentives for staying drug-free. These behavioral treatment approaches are especially effective when used along with medicines.
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HISTORY OF HEROIN

  • 1874: Heroin is first synthesized from morphine by chemist C.R. Alder Wright at St. Mary’s Hospital in London. The new compound, a more potent, acetylated form of morphine called diacetylmorphine (or morphine diacetate), is sent to F. M. Pierce of Owens College in Manchester. Pierce subcutaneously injects the drug into young dogs and rabbits. But beyond rudimentary analysis, the potential of Wright’s invention is not recognized.
  • 1897: Heroin is re-synthesized by Felix Hoffman at Bayer Pharmaceutical in Elberfeld, Germany. Bayer immediately recognized the drug’s potential and began heavily marketing it for the treatment of a variety of respiratory ailments, as well as a “non-addictive morphine substitute.” Bayer names their product “Heroin,” from the German heroisch (heroic), because early users claimed that was how it made them feel. Within a year the Heroin brand will be available in 23 countries.
  • 1901:The philanthropic Saint James Society in the U.S. mounts a campaign to supply free samples of heroin through the mail to morphine addicts who are trying give up their habits. By 1903, heroin addiction rates will have surpassed those of morphine.
  • 1906: Several physicians experiment with treatments for heroin addiction, including Drs. Alexander Lambert and Charles B. Towns (early founder of Alcoholics Anonymous). The two claim to have come up with the most “advanced, effective and compassionate cure” for heroin addiction. And its 7-day regimen included a five-day purge of the addict’s system with doses of belladonna delirium.
  • 1906: U.S. Congress passes the Pure Food and Drug Act requiring contents labeling on patent medicines by pharmaceutical companies. As a result, the availability of opiates and opiate consumers significantly declines.
  • 1914: U.S. Congress passes the Harrison Narcotics Tax Act to control the sale and distribution of cocaine, heroin and other opioids for medical purposes. This required doctors, pharmacists and others who prescribed narcotics to register and pay a special tax.
  • 1924: U.S. Congress passes the Anti-Heroin Act of 1924 banning the sale, importation, manufacture and possession of heroin.
  • 1925: A thriving opium black market opens in Chinatowns of New York, Los Angeles and San Francisco.
  • 1930s: China White starts infiltrating American markets.
  • 1940s: The French encourage Hmong farmers in Laos, Thailand and Vietnam to increase opium production.
  • 1948: Burma achieves independence from Britain; heavily expands its own opium production.
  • 1950s: French and U.S. efforts to contain the spread of Communism in Asia involves forging alliances with tribes and warlords inhabiting the areas of the Golden Triangle (an expanse covering Laos, Thailand and Burma). This results in an explosion of heroin into the United States.
  • 1960s: U.S. involvement in Vietnam is responsible for a further surge of illegal heroin being smuggled into the States. The CIA’s own Air America charter airline helps Corsican gangsters transport raw opium from Burma and Laos to Marseille, where it is refined into heroin and shipped to the U.S via the French connection.
  • 1970s: Saigon falls. The heroin epidemic subsides. The search for a new source of raw opium yields Mexico’s Sierra Madre. “Mexican Mud” would temporarily replace “China White” heroin until 1978.
  • 1978: The U.S. and Mexican governments begin spraying poppy fields with Agent Orange, reducing the amount of “Mexican Mud” available in the U.S. drug market. The Golden Crescent area (Iran, Afghanistan and Pakistan) consequently takes Mexico’s place as the leading source of illegal heroin in the U.S.
  • 1992: Colombia’s drug lords begin using their well-established cocaine smuggling routes to introduce a high-grade form of heroin into the United States.

HEROIN IN CULTURE

Heroin has been making its mark in the arts since about the time the drug started being outlawed. While visual artists generally tend toward the purer opium, there were exceptions. Most notably was the painter Jean-Michel Basquiat, who died from an heroin overdose 1988, and whose paintings now fetch upwards of $100 million. Dash Snow, another New York artist with a penchant for notoriety met the same fate in 2006. Fortunately, Boston-based sculptor Domenic Esposito’s dropping his 800-pound hand-forged steel burnt spoon in front of opioid kingpin Purdue Pharma’s Stamford, Connecticut headquarters seems to suggest that visual artists are now more intent on using heroin as a symbol, rather than actually using heroin itself. Jazz’s heroin past is much more extensive -- and lethal.
Many cite musicians’ desire to emulate genius saxophonist/composer Charlie “Bird” Parker. Others blame the prevalence of heroin in Harlem (since the Renaissance) and Paris (where many jazz masters exiled). Whatever the reason, Miles Davis, Dexter Gordon, Art Blakey, Sonny Rollins, Chet Baker, Bud Powell, Stan Getz, John Coltrane, Fats Navarro and scores of other players were all on smack. Some (Davis, Rollins, et al) managed to kick the habit. Far too many others however did not, including Bird himself, who died at 34. Legendary jazz singer Billie Holiday also succumbed to the effects of heroin. She died handcuffed to a New York hospital bed at 44. Clint Eastwood’s poignant Bird and the 1972 Diana Ross vehicle Lady Sings the Blues are, respectively, well worthy tributes to each.

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