From Medical News Today By Kathleen Davis FNP: Heroin is an illegal, highly addictive opiate drug derived from morphine, a naturally occurring substance extracted from the opium poppy plant.
Discovered by the Sumerians in 3400 BC, opium's strong pain relieving and sedative properties caused the drug to gain popularity worldwide.
The pharmaceutical company Bayer first synthesized heroin from morphine in 1874, marketing it in 1898 as a non-addictive cough suppressant, as well as a treatment for morphine addiction.
Heroin was later discovered to metabolize into morphine, and all opium derivatives (except in prescription medications) including heroin were eventually prohibited.
The drug has been illegal in the US since 1924 and is classified a Schedule I controlled substance, meaning it has a high potential for abuse with no currently accepted medical use. Currently, heroin abuse in the US is at epidemic proportions.
Contents of this article:
What is heroin?
Extent of heroin use
Health risks of heroin
Treatments for heroin
You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.
Fast facts on heroin
Here are some key points about heroin. More detail and supporting information is in the main article.
The number of heroin users in the United States has increased from 90,000 in 2006 to 669,000 in 2012.
Globally, there are around 16 million illicit opioid users.
Heroin's chemical name is diacetylmorphine.
Pure heroin is an extremely potent white powder with a bitter taste.
Today, the US supply of illicit heroin comes primarily from South America and Mexico.
The brain becomes conditioned by the repeated dopamine rush caused by heroin.
According to the Centers for Disease Control and Prevention (CDC), the heroin death toll quadrupled in the decade that ended in 2013.
More than 75% of high school heroin users turned to heroin after first being introduced to prescription painkillers.
Heroin addiction accounts for 18% of admissions for drug and alcohol treatment in the US.
The toxic effects of heroin can be reversed with a short-acting opioid receptor antagonist known as naloxone.
What is heroin?
Heroin is an opioid drug that relieves pain and slows body functioning. It is a partial synthetic that combines morphine and diacetyl acid. It can look like a white or brown powder, or black tar. Users snort, smoke, or inject the drug just under the skin (popping or chipping), or into a muscle.
Heroin with a spoon and a syringe.
Heroin can take the form of a white powder and can be injected using a syringe.
Its effects can be felt almost immediately, and the duration of action is 4-5 hours. No matter how it is delivered into the body, heroin is highly addictive.
Heroin binds to and activates specific receptors in the brain called mu-opioid receptors (MORs). When MORs are activated in the reward center of the brain, they stimulate the release of the neurotransmitter dopamine, causing a sensation of pleasure. Individuals intoxicated with heroin appear sedated or nod off, have slurred speech and pinpoint pupils.
Once it reaches the US, local distributors and dealers each "cut" the heroin with additional substances, varying the purity of a batch anywhere from 20-70% heroin. Additives used include a variety of water-soluble and sometimes lethal chemicals such as powdered milk, sugar, baking soda, laundry starch, brick dust, floor cleaner and even rat poison.
Every batch of heroin is unique and potentially far more dangerous than one expects. Recently, heroin has been found to be laced with fentanyl, an opiate that is nearly 100 times more potent than morphine and 50 times more powerful than heroin.
Because of the impurities and unpredictable purity, both the experienced and novice user can easily use more than intended, leading to complications or death from overdose.
Heroin street names
Extent of heroin use
Despite its sale and use being illegal in most parts of the world, heroin use is growing as a problem in many cities. Higher quality and lower priced heroin is available throughout the nation, affecting both suburban and rural communities.
Heroin use is on the rise among young adults aged 18-25. Individuals in this age group seeking treatment for heroin abuse increased from 11% of total admissions in 2008 to 26% in the first half of 2012. According to the 2013 National Survey on Drug Use and Health, an estimated 24.6 million (8%) Americans aged 12 or older were current (past month) illicit drug users.
After ingesting heroin, the user's pleasure center fires all at once, producing a pain-free, anxiety-free surge of euphoria (a rush) accompanied by a warm, comfortable feeling. The rush is then followed by drowsiness or nodding.
Other side effects of use may be nausea, vomiting, severe itching, heavy limbs, constipation, clouded mental function and slowed vital signs.
On the next page, we look at the health risks of heroin and available treatment options for heroin misuse.
Read more: Heroin Facts Effects and Health Risks