Heroin is the one of the most powerful known (semi or non-synthetic) painkillers. It is one of the opiates that come from the dried milk of the opium poppy, which include morphine and codeine. Heroin isn't a naturally occurring drug – it is refined from morphine. It is therefore more powerful, although its effects are very similar. Heroin's medical name is diamorphine.
Heroin comes from many places: China, Mexico, the mountains around the borders of Iran, Pakistan and Afghanistan and such areas are poppy rich. Opium poppies (a flower, as above) grow best in dry, warm climates. They are often grown in these areas by farmers with small plots of land. The sap is collected by the farmer, then it's bought by a merchant or broker who takes the opium to a morphine refinery.
The opium is refined into morphine base and then reacted with acetic anhydride, a chemical also used in the production of aspirin. Most black market heroin is highly impure due to contaminants left after refinement of opium into morphine, which then remain in the final product.
Heroin is often found as a powder. In its purest form (diamorphine), this powder is white.
However, the heroin most commonly used is brown (below). Colors can vary from white, yellow, brown and even grey.
Below - A "fold" (folded piece of paper) which contains some brown powder heroin.
More and more often, "Mexican Mud" or Black Tar (below) heroin is finding popularity in the US. With recent terrorism and security measures, smuggling heroin across the US and Mexico border is becoming profitable and logical.
Above - Black Tar heroin before it is crushed and packaged in balloons for distribution.
Above - Mexican Mud black tar heroin as packaged and sold in the street. Each balloon is about $20-30 and weighs .10 gram. Larger balloons are sometimes available.
Heroin doesn't dissolve easily, so users have to dissolve it in a spoon with water before they can inject it. Heat is often used to help it dissolve and many users suffer from "cotton fever" as they do not realize that the cotton ball filter itself can cause extreme sickness and fever. Cigarette filters are also the cause of fiber build up in the users lungs. Still though, the benefits of filtering outweigh the risks of not.
Heroin can be injected intravenously (into a vein) or intra-muscularly (into a muscle). Some users inject into the tissue just under the skin: this is called 'skin popping'.
Above - Infections, scars and abscesses from skin popping.
Injecting heroin into a vein results in an almost immediate effect, as the drug enters the bloodstream and arrives at the brain very rapidly. Injecting into muscle produces a slower reaction. To see more of the effects that heroin has on the body, click here.
Heroin is smoked using a method called 'chasing the dragon'. This involves heating up the powder on some foil, and then inhaling the fumes through a small tube. The effect from this is felt very quickly – between two and five minutes after smoking.
Snorters can sniff the powder up their nose, like cocaine users do or:
Tar users also dump out Visine, add water and drop a $20 hit or two in. They shake it until it dissolves then squirt the liquid up their nose. It burns and they walk around with a brown nose dirt or ring patch, but it still gives them their desired effect.
Because the drug enters the bloodstream so fast, there's a much greater chance of overdose. There is also a high risk of infection with HIV and hepatitis, if more than one person shares a needle or even works. Abscesses, gangrene and collapsed veins can also result. Long-term injectors sometimes experience heart disease and lung disorders.
Heroin is a µ-opioid agonist, which is a substance that binds to a receptor, triggering a reaction in the cell. In this case, it acts on endogenous (ie - produced inside the cell) µ-opioid receptors that are spread throughout the brain, spinal cord and gut in almost all mammals.
The body responds to heroin in the brain by reducing (and sometimes stopping) production of the endogenous opioids when heroin is present. Endorphins are regularly released in the brain and nerves and weaken pain. The reduced endorphin production in heroin users creates a dependence on the heroin. This is why, when users stop taking the drug, they experience pain even when there's no physical trauma.
Heroin makes pain more tolerable by reducing your emotional reactions to it. It cushions you from the psychological impact of hunger, discomfort, fear and anxiety too. This relief from suffering is experienced as a positive feeling of well-being, contentment and happiness. It's been described by some users as a 'blissful apathy', so it's easy to see why those undergoing emotional troubles are attracted to it. Users talk of feeling 'wrapped up in cotton wool' and having all their troubles fade away.
People who feel bad about themselves and feel they have little to live for can find heroin attractive. Heroin can produce a euphoric feeling – a rush – especially when injected intravenously.
Heroin is highly addictive, physically and psychologically. Not only that, repeated use very soon results in tolerance. How does this work? Just as your brain adapts to the presence of something new, there is neuroadaptation when it leaves the brain. Through neuroadaptation the brain changes its function to compensate for the presence or absence of the drug. But if you increase your intake of heroin, the brain attempts to adapt to that too. After constant consumption and ongoing adaptation, it will now take more heroin to produce the same effect as the first hit. Tolerance has developed and substantial adaptation has taken place.
This is why you have to take more and more heroin to produce the effect you want. Many users respond to this by changing their method of taking the drug from smoking to injecting, which carries many more health risks.
You want to die. Imagine the time you had the worst flu and multiply it by three. On top of that, add the knowledge that you have the ability to make it simply "go away" and you can feel better with just one more hit/shot. Is it any wonder that one would be unwilling to walk away from heroin once addicted?
If a heroin user decides to quit, their body tries to return to its original state. But because of the neuroadaptation that's taken place, they experience very unpleasant symptoms of withdrawal. These begin 8 to 12 hours after their last fix. They include sweating, anxiety, depression, cold sweats, chills, severe muscle and bone aches not caused by any physical trauma, nausea and vomiting, diarrhea, gooseflesh and fever. Many addicts also complain of compulsive scratching that causes bruises and sometimes ruptures the skin. Withdrawal is very hard, and users often go back on heroin as a result.
Heroin users can be secretive, even with their friends. These might be tell-tale signs:
However, remember that some of these 'signs' may be related to other problems – or to no problem at all. It's important not to jump to conclusions.
If you're sure someone you're close to is taking drugs, it's important to talk calmly and discuss all the facts. You'll need to let the person know it's OK to talk to you openly.
At this point, you'll want to find the answer to the ultimate question: