Opiate Drugs, Narcotics, and other related Medications and Drugs
Heroin Heroin is an addictive drug, and its use is a serious problem in America. Recent
studies suggest a shift from injecting heroin to snorting or smoking because of increased purity and the
misconception that these forms are safer. Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of the Asian
poppy plant. Heroin usually appears as a white or brown powder. Street names for heroin include "smack," "H,"
"skag," and "junk." Other names may refer to types of heroin produced in a specific geographical area, such
as "Mexican black tar."
Health Hazards
Heroin abuse is associated with serious health conditions, including fatal overdose,
spontaneous abortion, collapsed veins, and, particularly in users who inject the drug, infectious diseases,
including HIV/AIDS and hepatitis.
In addition to the effects of the drug itself, street heroin may have additives that do not readily
dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can
cause infection or even death of small patches of cells in vital organs.
The Drug Abuse Warning Network* lists heroin/morphine among the three most frequently mentioned drugs
reported in drug-related death cases in 2001. Nationwide, heroin emergency department mentions were
statistically unchanged from 2001 to 2002, but have increased 35 percent since 1995.
Tolerance, Addiction, and Withdrawal
With regular heroin use, tolerance develops. This means the abuser must use more
heroin to achieve the same intensity of effect. As higher doses are used over time, physical dependence and
addiction develop. With physical dependence, the body has adapted to the presence of the drug and withdrawal
symptoms may occur if use is reduced or stopped.
Withdrawal, which in regular abusers 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 ("cold turkey"), kicking movements ("kicking the habit"), and other symptoms. Major
withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week.
Sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal, although heroin
withdrawal is considered less dangerous than alcohol or barbiturate withdrawal.
Treatment
There is a broad range of treatment options for heroin addiction, including
medications as well as behavioral therapies. Science has taught us that when medication treatment is
integrated with other supportive services, patients are often able to stop heroin (or other opiate) use
and return to more stable and productive lives.
In November 1997, the National Institutes of Health (NIH) convened a Consensus Panel on Effective Medical
Treatment of Heroin Addiction. The panel of national experts concluded that opiate drug addictions are
diseases of the brain and medical disorders that indeed can be treated effectively. The panel strongly
recommended (1) broader access to methadone maintenance treatment programs for people who are addicted to
heroin or other opiate drugs; and (2) the Federal and State regulations and other barriers impeding this
access be eliminated. This panel also stressed the importance of providing substance abuse counseling,
psychosocial therapies, and other supportive services to enhance retention and successful outcomes in
methadone maintenance treatment programs. The panel's full consensus statement is available by calling
1-888-NIH-CONSENSUS (1-888-644-2667) or by visiting the NIH Consensus Development Program Web site at
http://consensus.nih.gov.
Methadone, a synthetic opiate medication that blocks the effects of heroin for about 24 hours, has a
proven record of success when prescribed at a high enough dosage level for people addicted to heroin.
Other approved medications are naloxone, which is used to treat cases of overdose, and naltrexone, both
of which block the effects of morphine, heroin, and other opiates.
Buprenorphine is a recent addition to the array of medications now available for treating addiction to
heroin and other opiates. This medication is different from methadone in that it offers less risk of
addiction and can be dispensed in the privacy of a doctor's office. Several other medications for use
in heroin treatment programs are also under study.
There are many effective behavioral treatments available for heroin addiction. These can include
residential and outpatient approaches. Several new behavioral therapies are showing particular promise
for heroin addiction. Contingency management therapy uses a voucher-based system, where patients earn
"points" based on negative drug tests, which they can exchange for items that encourage healthful living.
Cognitive-behavioral interventions are designed to help modify the patient's thinking, expectancies, and
behaviors and to increase skills in coping with various life stressors.
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The short-term effects of heroin abuse appear soon after a single dose and disappear in a few hours. After
an injection of heroin, the user reports feeling a surge of euphoria ("rush") accompanied by a warm flushing
of the skin, a dry mouth, and heavy extremities. Following this initial euphoria, the user goes "on the nod,"
an alternately wakeful and drowsy state. Mental functioning becomes clouded due to the depression of the
central nervous system. Long-term effects of heroin appear after repeated use for some period of time. Chronic
users may develop collapsed veins, infection of the heart lining and valves, abscesses, cellulitis, and liver
disease. Pulmonary complications, including various types of pneumonia, may result from the poor health
condition of the abuser, as well as from heroin's depressing effects on respiration.
Terms of Use
