About 810,000 Americans are addicted to heroin. Heroin is a highly addictive drug that has a devastating impact on society and cost billions of dollars each year. Major health problems caused by heroin abuse include miscarriages, heart infections and death from overdose. People who use heroin intravenously are also at risk for infectious diseases, including HIV/AIDS and hepatitis. Although heroin addiction has decreased during the past several years, its pervasiveness is still higher than in the early 1990s. Heroin also is increasing in purity and decreasing in price, which makes it a more attractive drug.
Heroin (chemical name diacetylmorphine) is an opiate that belongs to the morphine-codeine family and is derived from the opium poppy. Heroin is consumed intravenously, or through smoking or snorting through the nostrils. However, most abusers prefer injection. Heroin primarily acts on the central nervous system and in the few seconds of its being absorbed into the system causes euphoria. Immediately after being consumed, heroin enters the area that is the barrier between the brain and blood causing it to be converted into morphine. After the euphoria wears off the user will immediately experience withdrawal symptoms such as dry mouth, skin flushing, and a feeling of heaviness. This in turn can lead to vomiting, nausea and itching. The user then normally becomes sedate and sleepy for many hours. Many of the vital cognitive functions slow down and get impaired including the ability to reason. Heartbeat and breathing slow down considerably.
Long-term heroin drug addiction leads to damage to the arteries, lungs, liver, kidneys and veins, and several infections, abscesses and bone diseases such as arthritis. Heroin withdrawal symptoms, which begin within hours of the last use, include muscle and bone pain, restlessness, diarrhea, insomnia, cold flashes with goose bumps, strong body movements, convulsions and vomiting. These symptoms can last for months. A client will need to detox before entering a drug rehab. Behavior therapies are also helpful, these may include cognitive behavioral interventional therapies that strive to restructure the addict’s outlook on life and help him deal with stressful situations without recourse to the drug.
Heroin use in many parts of America is changing. Sugar cane farmers in Mexico use aggressive sales tactics and low prices to increase black-tar heroin sales in the United States. Black-tar is a semi-processed form of heroin that now has a demand in cities and small towns that previously had little to no demand for heroin. In many of these places with low demand for heroin, those who suffer from addiction more commonly used prescription pain pills. However, black-tar heroin is less expensive than pain medications. Aggressive tactics helps the sales, users can phone in their orders and drivers will bring the drug to them, and sometimes they are even called to check on the quality of customer service they received. Over the last decade, production of Mexican heroin has climbed rapidly while Columbian output has dropped due to U.S. funded efforts to eradicate Columbian poppy fields according to the U.S. Justice Department 2009 National Threat Assessment. The report estimates that black tar now accounts for two-thirds or more of the U.S. heroin market.
After a 2009 study where a vaccine reduced cocaine use in 38% of addicted individuals, it is now believed that vaccines are scientifically achievable to provide addiction treatment for nicotine, heroin, and methamphetamines. Vaccines against nicotine and cocaine are the most progressive, but versions to block the effects of methamphetamine, heroin and phencyclidine, or PCP, are also in development. In 2010, the FDA approved a new treatment for addiction to heroin or prescription narcotic painkillers. Vivitrol is different from traditional heroin treatments such as methadone and buprenorphine. Vivitrol is injected monthly, instead of orally daily, so it’s easier to stick to. Although patients can obtain buprenorphine at a drug store, they must go to clinics daily to get methadone. And, unlike methadone and buprenorphine, Vivitrol isn’t an opioid but a long-acting form of naltrexone, which blocks opioids. There are drug and alcohol rehab programs that oppose the use of methadone or buprenorphine; and Vivitrol may be more acceptable.
Methadone, like heroin, directly stimulates opioid receptors in the central nervous system, and therefore has many of the same risks and liabilities as heroin. However, whereas heroin rushes into the brain when used, leading to an intense and very psychologically addictive “high,” methadone comes into the brain slowly and stays there for quite a while at stable concentrations. This allows methadone to protect someone with a heroin addiction from opioid withdrawal and to do so in a legal and medically controlled manner. Suboxone is a combination of buprenorphine and naloxone. Unlike methadone, buprenorphine acts like an opioid at lower doses and like an “anti-opioid” at higher doses. As a result protects against heroin withdrawal, but is not as likely to lead to abuse as is methadone. Naloxone further reduces the danger of abuse, because if the medication is abused it will immediately set off severe withdrawal symptoms. Whatever the treatment strategy is for someone addicted to heroin, they will need inpatient detox and then intensive treatment at a drug rehab center.
