Opium poppies and their derivatives — including the painkillers codeine and laudanum, the cough-suppressant noscapine, as well as morphine — have been renowned throughout human history.
Neolithic burial sites in Spain show evidence of poppy use. The first recorded reference to opium comes from 3400 B.C., when the opium poppy was grown in Mesopotamia, according to the Drug Enforcement Agency (DEA). The ancient Sumerians referred to the poppy as Hul Gil (the “joy plant”), and ancient Egyptian, Greek, Minoan, and Sanskrit texts document the use of poppy-derived medicines.
In the early 1800s, the Opium Wars resulted when British merchants attempted to correct a trade imbalance with China by flooding the Asian nation with cheap opium, which resulted in widespread addiction. Chinese officials attempted to halt the trade in opium, but invading British troops forced China to accept open trading policies — including opium imports — with European powers. According to Humberto Fernandez and Therissa A. Libby, authors of “Heroin: Its History, Pharmacology, and Treatment” (Hazelden, 2011), by 1900, China had 13.5 million addicts consuming 39,000 metric tons of opium per year.
Medical useIt is a narcotic pain relief that is used in the treatment of severe pain.
How can we use Heroin?It is most often injected intravenously (IV), however, it may also be:
- vaporized (“smoked”)
- sniffed (“snorted”)
- used as a suppository
- orally ingested.
Heroin from southwest Asia may be ‘smoked’ by heating the solid on a metal foil above a small flame and inhaling the vapor. Those intending to inject this form must first solubilize it with, for example, citric acid or ascorbic acid. The southeast Asia type is suitable for the direct injection of a solution. A typical dose is 100 mg at street level purity. Except when used therapeutically as a pain relief drug, ingestion of diamorphine/heroin is a much less effective route of administration.
What are the treatments for heroin addiction?A variety of effective treatments are available for its addiction, including both behavioral and pharmacological (medications). Furthermore, both approaches help to restore a degree of normalcy to brain function and behavior, resulting in increased employment rates and lower risk of HIV and other diseases and criminal behavior.
Control statusIt is listed in Schedule I of the United Nations 1961 Single Convention on Narcotic Drugs. Diamorphine is also included in a generic sense in the 1972 Protocol, which revised the 1961 Convention, extended control to esters, and ethers of scheduled substances. For that, diamorphine is the diacetyl ester of morphine (Schedule 1).
An accidental discoveryMorphine was first extracted from opium resin in 1803; it quickly gained popularity among doctors as a painkiller and was used widely in the U.S. Civil War and other conflicts.
In 1898, while using morphine to synthesize codeine — an opiate less potent and less addictive than morphine — chemist Felix Hoffman combined morphine with acetic anhydride and accidentally created heroin (diacetylmorphine), which is several times more potent than morphine.
Hoffman’s company, which eventually grew to become the pharmaceutical giant Bayer, marketed diacetylmorphine as “Heroin” based on its supposed heroic qualities. The company promoted its new product as a safer painkiller than morphine until it was discovered that heroin rapidly metabolizes into morphine in the body.
The United States and most other countries eventually banned heroin; it’s now listed under the U.S. Controlled Substances Act as a Schedule I narcotic, which means it’s considered to have no medical benefit and a high potential for abuse, according to the DEA.
The addictive narcotic can be a white or brown powder, or black sticky substance known as “black tar heroin,” said Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Long Island, New York.
Taking the drug can lead to euphoria, and is often accompanied by a dry mouth, flushed skin, a feeling of heaviness in the extremities, and clouded thinking, according to the U.S. National Institute on Drug Abuse(NIDA). Because heroin stimulates the reward pathway of the brain, people often return to the drug to get a pleasurable feeling, NIDA reported.
“It gives people an immediate rush or a high, and ultimately can be deadly,” Krakower told Live Science.
How heroin worksHeroin is known by street names including “horse” and “smack.” It is often cut with substances such as powdered milk, sugar, starch, quinine, or other impurities, according to the DEA. (A drug may be mixed with other compounds so the dealer can make more money on a small amount of heroin, or give the user a better high, Krakower said.)
In powder form, heroin can be inhaled, “snorted” into the nostrils, or smoked, Krakower said. Many, however, prefer to inject a liquid form of the drug, as this method can result in a faster, more intense high, he said.
Like other opioid-based painkillers, heroin binds to opioid receptors in the brain and spinal cord, especially to receptors that are located along the reward pathway, such as the nucleus accumbens, according to NIDA.
The binding results in an intense “rush” of euphoria and freedom from pain, followed by a warming sensation and the drowsy sense of well-being typical of opioid painkillers, Krakower said. This high can last for several hours, depending on the strength of the dose.
Other namesA large number of street terms are in use, including horse, Smack, Dope, Mud, Skag, Junk, H, Black tar, Black pearl, Brown sugar, Witch hazel, Birdie powder, Dragon, Hero, White stuff, China white, Boy, Chiva, Mexican horse, Pluto, Skunk, Number 2
