Heroin is the street name for a powerful and highly addictive narcotic drug called diacetylmorphine, derived from the opium poppy. In the United Kingdom, diacetylmorphine, also known as diamorphine, is frequently prescribed in medical settings, usually to treat severe pain, and is preferred to morphine for its less severe side effects. Used as a recreational drug, it is called heroin and is estimated to be used by 15 to 21 million people worldwide. Heroin can be injected, snorted, smoked, taken orally or in suppositories.
It is used primarily for the euphoric and relaxing sensations it produces, which are more intense than those of many other drugs. However, it is also associated with many negative effects and its addiction is known to be difficult to treat.
Heroin, which was actually originally a trademark, was developed by Bayer, a German pharmaceutical company, as an over-the-counter cough suppressant. It was initially marketed as a replacement for morphine, a popular recreational drug at the time. It was promoted as a non-addictive product – a claim that proved to be largely inaccurate.
Heroin is derived from the opium poppy, grown primarily in Asia, but also in parts of Mexico and Colombia. In 2004, Afghanistan was estimated to account for 87% of the world’s supply of diacetylmorphine, the heroin derived from Afghan poppies killing about 100,000 people per year. These poppies are usually exported and synthesized into heroin elsewhere, mainly by organized crime gangs in the case of illicit trafficking. Heroin is then trafficked around the world to meet the demand.
The drug is deeply embedded in popular culture and many celebrities are known to have used or succumbed to it. Heroin addiction is among the most debilitating of all drugs and has negative effects on many organs. Governments around the world are working hard to prevent the trafficking of heroin, destroy the supply and help addicts kick their addiction.
The term “heroin” is actually a street name, as it is called diacetylmorphine in medical terms. Being a widely used drug in the world, it also has several other street names. These include “dope”, “junk”, “smack” and “skag” among others and these names often vary from country to country or region to region.
There is also a large lexicon of slang terms associated with heroin-related activities and associations of heroin with other drugs. “Chasing the dragon,” for example, refers to smoking heroin, while “cooking” refers to mixing it with water to prepare it for injection. As with the names of the drug itself, there are many other street names related to heroin and heroin use.
People use heroin mainly to feel euphoria and relaxation. Users experience flushing, heavy limbs and alternate between feeling awake and drowsy. However, street heroin is associated with a variety of negative side effects, both short and long term. This is reinforced by the fact that street heroin is often cut with other harmful chemicals, which further increases the risks.
In addition to addiction problems, repeated use of heroin can lead to infection of the heart walls and valves, chronic constipation and impaired kidney and liver function. Injecting the drug into the veins allows it to pass through the system immediately, but over time, the same vein used each time will eventually collapse and new veins will have to be found. Using needles to inject heroin puts people at risk for diseases such as hepatitis and HIV, as well as other infections.
One of the most important risks of heroin use is addiction. The body quickly develops a tolerance to the drug, leading to the use of larger and larger doses, to the point where no sense of euphoria is felt and addicts use heroin just to avoid withdrawal symptoms.
This is why the risk of overdose is particularly high with heroin. Users have no way of knowing what the heroin is cut with, often with harmful chemicals of unknown proportions. It is often these chemicals, rather than the heroin itself, that are fatal in an overdose.
Heroin is one of the most strictly regulated drugs, classified as Schedule I in the United States, Class A in the United Kingdom, and subject to similar regulation throughout the world. This does not, however, completely prevent its trafficking.
Heroin is derived from the opium poppy, which is grown in parts of Asia, primarily Afghanistan. Much of the world’s poppy cultivation also takes place in an area called the “Golden Triangle,” which spans parts of Myanmar, Laos, Vietnam, Thailand and China. Mexico and Colombia have also begun growing poppies in increasing quantities in recent years, and Mexico is now the world’s second largest exporter, supplying much of the U.S. heroin market.
With the exception of Mexico, opium poppies are rarely synthesized into heroin in the same country in which they are grown. The process used to turn poppies into morphine, and then into diacetylmorphine, is a tedious process that consumes resources that food crops often cannot afford. Instead, the poppy is exported to other countries, where it is processed in heroin labs to obtain the final product, before being shipped to the country in which it will be sold and consumed.
Trafficking in heroin carries heavy prison sentences and in many Southeast Asian countries, the death penalty. Heroin trafficking has been largely controlled for many decades by organized crime networks. During the first half of the 20th century, the illicit heroin trade was mainly controlled by the Chinese triads. However, after the end of World War II, the Italian mafia began to manufacture the drug in heroin laboratories located in Sicily. Sicily was ideally situated along the main trafficking route from Asia to Europe. The war in Afghanistan later helped to increase poppy production in that country, as money from this lucrative crop was used to buy weapons. Mexican and Colombian drug cartels control a huge portion of the heroin trade in Central and South America.
Heroin use is relatively evenly distributed around the world, with markets in almost every region. There are particularly large numbers of users in Russia and China and, in proportion to their respective populations, also large numbers in Pakistan and Iran. There are well-established heroin markets in Europe, Africa and the Americas, with millions of users in each region. In terms of the amount of heroin actually consumed, in 2008 Europe (including Russia) was responsible for nearly half of global heroin use. North America accounted for about 6%.
Asian and Middle Eastern countries also have extraordinary levels of opium use, which many prefer to heroin, particularly in Iran. Almost all of the heroin circulating in Europe, Asia and Africa comes from Asia, while almost all of the heroin in North and South America comes from Mexico and Colombia.
Governments vary in their approach to treating heroin addiction. Although the drug is illegal in almost all countries, there are programs to help addicts kick the habit, including providing controlled doses to addicts on the premise that the symptoms of addiction and withdrawal can be treated more effectively, while reducing the risk of using impure batches. This arrangement is considered far preferable to having drug users perpetuate the illicit drug market. Initiated in Switzerland, this approach is now being used in parts of Denmark, Canada, Holland, Germany and the UK, apparently with relative success.
FACTS AND STATISTICS
- The term heroin is actually the street name given to diacetylmorphine, a drug used in medicine as a painkiller.
- It was first synthesized by Bayer, a German pharmaceutical company, in 1895 as an over-the-counter cough remedy. It was unintentionally marketed as a non-addictive product and the company was severely embarrassed when it became clear that this was not the case.
- It is deeply rooted in popular culture, serving as the inspiration for many books, movies and songs. Many famous people have suffered from heroin addiction and some have died from it.
- Heroin is one of the most addictive drugs, which can take a huge toll on the body.
- The opium poppy, from which heroin is derived, is grown in only a few countries, mainly in Asia. However, it is now increasingly being sourced from Mexico and Colombia. In 2008, Mexico was the world’s second largest supplier of opium, although it is still far behind Afghanistan, where most of the world’s heroin comes from.
- In the past, the heroin trade was largely controlled by criminal networks, including the Chinese triads, the Italian mafia and the Mexican and Colombian drug cartels. This is still the case today.
- In addition to its use in hospitals for pain control, diacetylmorphine is also prescribed in some countries to heroin addicts to help them wean themselves off the drug. By controlling the supply, it is possible to prevent the harmful effects of chemicals and compounds added to street heroin. It also helps to treat the physiological and psychological symptoms of addiction and withdrawal.
- The manufacture of heroin is a complex process, with each ton of heroin produced requiring several tons of opium.
- In 2009, the global heroin market was estimated at approximately $55 billion.
- Afghanistan accounts for nearly 90% of all heroin production. Heroin production peaked in the country in 2007, with over 8,000 tons of opium produced, before declining slightly in subsequent years.
- In 2008, it was estimated that there were almost 12 million heroin users worldwide. In
- Russia, the rest of Europe, the Americas, Africa and China, heroin users number in the millions.
- Of the 343 tons of heroin consumed worldwide in 2008, almost half was consumed in Europe, with 70 tons consumed in Russia alone.
- In 2007, opium production reached nearly 9,000 tons, its highest level ever recorded.
- More than 3.5 million Americans have reportedly tried heroin.
- The average American heroin addict spends more than $150 to satisfy their addiction.
- In 2009, 642 kilograms of heroin were seized by the DEA.
- Each kilogram of Afghan heroin requires approximately 7 kilograms of Afghan opium for production.
- Afghan poppies generally produce more opium than Myanmar poppies, which require 10 kg.
- About 14% of all drug-related hospitalizations involve heroin.
- In England and Wales in 2006, heroin and morphine contributed to 713 deaths, far exceeding any other illicit drug.
SIGNS OF ADDICTION
Heroin addiction is one of the most serious drug addictions and can manifest itself through a number of signs. The physiological effects of a dose of heroin include slowed breathing, dry mouth, red skin and alternating between drowsiness and alertness. Once the effects wear off, users experience withdrawal symptoms that include craving, depression, sweating, insomnia, nausea, fever, cold sweats, anxiety and excessive yawning or sneezing. These effects vary depending on the individual, the amount and duration of use, and the individual’s tolerance, and usually occur within 6 to 24 hours of the last use.
Heavy use of heroin can cause a person to become disconnected from reality and preoccupied with how and where to get their next fix. Abandoning usual routines, limiting interaction with others and losing interest in previously enjoyed activities can be signs of drug use. Heroin is known to be highly addictive, and heroin addicts will do anything to obtain it, sometimes even engaging in illegal activities. Persistent financial problems, lying to family and friends, and stealing money and items can be signs of heroin addiction.
Marks where the heroin addict has injected the drug, usually on the arms, but also on any part of the body where he or she can find a vein, can be a sign of heroin use. As drug dependence and tolerance worsens, the above symptoms can become more pronounced over time as dosages increase.
Since heroin is a highly addictive drug and the effects of withdrawal are very pronounced, withdrawal on its own, although possible, will most certainly be a traumatic period for a heroin addict and will have little chance of success. This is why it is always best to consult your doctor before trying to quit. Even with the help of health professionals, heroin is one of those drugs that is very difficult to get off.
In some countries, diacetylmorphine may be prescribed to facilitate withdrawal. Pure doses of the drug will be administered under supervision, to reduce the risk of adverse health effects caused by the harmful chemicals commonly used to cut street heroin. At the same time, the dosage can be gradually reduced and some of the withdrawal symptoms can be treated medically. However, this treatment is not offered in all countries. Methadone, an opiate substitute, can have similar results. Regular use of an appropriate dosage of methadone can help avoid withdrawal symptoms and allow a user to participate in regular activities and return to a normal life. The downside of methadone treatment is that at some point the user will have to stop the methadone itself, although there are other medications available to help with this transition.
Withdrawal symptoms begin about 12 hours after the last dose of heroin, peak after 2-3 days and last for more than a week. Although not life-threatening if there are no other complications, the effects of withdrawal can be very distressing and disabling for heroin users.
Trained health care professionals can ease the transition and treat some of the symptoms such as insomnia and nausea. This allows the heroin addict to be cared for in a safe environment, where they are not at risk of harming themselves or others.
The most important thing in helping a heroin addict wean himself off is to make sure that he can’t get another dose. This is why it is recommended that they be hospitalized or enter a detoxification center. In these centers, medical treatment of symptoms can be accompanied by behavioral and cognitive therapies, which can help address the often complex underlying causes of heroin addiction. There are many, many issues that can lead to drug addiction and relapse can occur if left untreated. Occupational status, social relationships and general well-being, combined with a predisposition to addiction, can be contributing factors to heroin use. Many heroin users will need support for several months or even years after stopping the drug.
Regardless of the treatment chosen, getting rid of a heroin addiction is never easy. However, the fact that so many people manage to do so shows that it is perfectly within the reach of anyone who is sufficiently motivated. To give yourself the best chance of success, it is recommended that you first consult your doctor to discuss the best approach to take. This will usually be a multi-faceted treatment that takes into account the physical symptoms of withdrawal and the underlying factors that contributed to the addiction.
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