After a brief hiatus during which it was replaced in the spotlight by prescription painkillers, heroin use is once more on the rise, ironically, as a more readily available and less expensive substitute for those prescription painkillers. It’s all in the family: the opioid family, that is.
Heroin is one of the most addictive drugs available, up there with cocaine and nicotine, followed by barbiturates and alcohol. It came to America from Germany, touted as a safe substitute for the Trojan horse that was morphine – a supposed wonder drug that proved deadly addictive and destroyed the lives of thousands of America’s sons during the Civil War. It was widely distributed by doctors and snake oil salesmen alike for decades, until the Harrison Act required a license to sell it. Whereupon it went promptly underground, where it has flourished to various degrees ever since.
The User Experience
Heroin presents in several forms. Highly pure heroin can be snorted or smoked and may be more appealing to new users because it eliminates the stigma associated with injection drug use. “Black tar” heroin is sticky like roofing tar or hard like coal and is predominantly produced in Mexico and sold in U.S. areas west of the Mississippi River. The dark color associated with black tar heroin results from crude processing methods that leave behind impurities. Impure heroin is usually dissolved, diluted, and injected into veins, muscles, or under the skin.
Once heroin enters the brain, it is converted to morphine and binds rapidly with molecules in the central nervous system called opioid receptors. These receptors are located throughout the brain and body in areas which manage the perceptions of pain and pleasure, blood pressure, sexual arousal, and breathing. Heroin and morphine are chemically similar to neurotransmitters (brain chemicals) called endorphins, which give the sensation of pleasure and deaden feelings of pain. They are sometimes called the body’s “natural opiates.” Opiate drugs act like extremely powerful endorphins. They are more intense and powerful than the body’s naturally produced endorphins. Another neurotransmitter affected by drug use is dopamine – the “reward” chemical.
The “high” one experiences depends on how the heroin was administered. Users shooting up often feel a surge of pleasurable sensation or euphoria – called a “rush.” This is usually accompanied by dry mouth, flushed skin, arms and legs feeling “heavy,” and poor mental functioning. This rush usually lasts one or two minutes. In some cases the rush may be accompanied by nausea, vomiting, and severe itching.
After this initial rush, the experience differs depending on how the heroin was taken. Intravenous users go “on the nod” by feeling alternatively wakeful and drowsy. Another reaction heroin abusers have had during this time period is a sleepy, satisfied state, and a sense of distance from the world around them. This high can last about four or five hours, during which time mental function is clouded; heart function slows; and breathing is also severely slowed, sometimes enough to be life-threatening. Slowed breathing can also lead to coma and permanent brain damage.
The insidiousness of heroin lies in the fact that not only does it create an intense rush that the user longs for ever thereafter, but it alters the brain’s chemistry, training the body to crave it. Heroin withdrawal symptoms are intense and can include: cold sweats, depression and anxiety, loss of appetite, unstable moods, muscle cramping, nausea and vomiting, diarrhea, and seizures.
The various sensations of withdrawing from heroin can be likened to being in the grips of a particularly bad case of the flu, which has led to the slang term “super flu” being used to describe the withdrawal stage.