The use of heroin continues to climb in most areas. The number of varieties and sources of heroin available, combined with an increased domestic demand make the heroin market the fastest growing drug market reported. While there are indications of increased use of heroin among younger, suburban users, it is the cadre of older, inner-city heroin users that drive the heroin market (DEA 1996). Almost all areas report that the majority of heroin users are older drug users (over 30) who have been using for many years. However, many areas are reporting an increase in the number of new or younger users.
Heroin (AKA: smack, horse, mud, brown sugar) has been a part of the drug culture for many years. It is primarily used through injection causing wide spread concerns for everyone. Syringes lost or left behind by users carry disease and narcotics which can effect anyone who comes in contact with them. Syringes from heroin addicts have been found at bus benches, vacant lots by schools, alleyways and public bathrooms. Diseases such as HIV, hepatitis, and tetanus are common amongst heroin addicts (Strategy 1996). Heroin is an opiate or a downer and is made from the resin taken from the seedpod of the poppy plant. The resin is processed in a variety of ways resulting in the final product known as heroin. The processing method determines the appearance of heroin as it is seen on the street. Black tar heroin looks like tootsie roll candy and/or dark caramel and has a strong vinegar odor to it. Black Tar heroin is packaged in small pieces of aluminum foil, tightly wrapped plastic and/or cellophane from cigarette packages.
The heroin affects the brain’s pleasure and pain system. It interferes with the brain’s ability to perceive pain and activates the brain’s pleasure system. The drug is fast acting, especially when injected or smoked. Injected heroin reaches the brain in 15-30 seconds, smoked heroin reaches the brain in 7 seconds” (Mckim, 1996). Non-intravenous heroin doesn’t give nearly as intense a rush and so is thought to be less addicting. People who snort heroin can often do so on and off for long periods of time without becoming strongly addicted. This occasional use of heroin is called “chipping” and it seems that some lucky people can remain successful chippers over months or even years. Unfortunately, a high percentage of chippers become addicts. Most junkies begin as chippers with no thought that they would ever become addicts (Drug Free, 1996). With the preferred method of heroin use being injection, you will generally see certain types of paraphernalia.
This paraphernalia will include, but is not limited to, spoons with residue in the spoon along with a piece of cotton, the bottom side of the spoon having burn marks and the handle being bent downward somewhat. Syringes are also included in this paraphernalia along with soda bottle caps, which have the same use as the spoons. The spoons or caps are used to dilute and liquefy the heroin. The cotton in the spoon is for filtering the heroin as it is drawn into the syringe.
To put a perspective on heroin, morphine is one of the strongest legal painkillers known and heroin is five times stronger. Heroin tends to relax the user. An immediate rush usually will occur and sometimes be accompanied by side effects such as restlessness, nausea and vomiting. A user of heroin may go on the “nod”. This is best described as going back and forth from feeling alert to drowsy. Due to the use of needles with this drug, infections and abscesses on the body are common. Heroin users will normally have injuries that have been left unattended due to the drug’s pain killing abilities. Addiction usually leads to malnutrition and weight loss. A person addicted to heroin may look like they are in a daze, almost to the point of sleep, have a dry mouth, low raspy voice, droopy eyelids, profuse itching, and fresh puncture marks or sores covering their body (Mckim, 1996). Morphine, which is used as painkiller in most hospitals and terminally ill patients, can have a down side to it as well. Morphine may be said to cultivate crime instinct; at all events, it prepares the way to certain criminal acts, which often have some previous predisposition. The perversion and damage to the higher centers, which govern the ethical relations of life, are always associated with morphinists (JAMA, 10-11-99)
The greatest risk of being a heroin addict is death from heroin overdose. Each year about one percent of all heroin addicts in the United States die from an overdose of heroin despite having developed a fantastic tolerance to the effects of the drug. In a non-tolerant person the estimated lethal dose of heroin may range from 200 to 500 mg, but addicts have tolerated doses as high as 1800 mg without even being sick. No doubt, some overdoses are a result of mixing heroin with other drugs, but appear to result from a sudden loss of tolerance. “Addicts have been killed one day by a dose that was readily tolerated the day before” (Nadelmann, 1996). The physical dangers of using heroin, are but not limited to, contaminated needles, contamination of the drug, using too much of the drug to the point of overdose, or combining it with other drugs such as cocaine (speedballing).
As with any drug, when addiction occurs the addict will go to extreme means to obtain the drug. This translates to increased crime in our community. The illicit drugs being used in our community directly affect the crime rate. Burglary, shoplifting, and robbery are a few that are most often connected to a heroin addict (DEA, 1996). Prostitutes are common users of heroin and can spread disease with the syringes they use and the service they provide. “Prostitution and heroin go hand in hand” (DEA, 1996). Prostitution is first used as a means to afford heroin and soon becomes a way of life as the addict’s body and mind deteriorate. Prostitution has been labeled by some as a victimless crime but in affect it has several victims. One victim being the addicted prostitute, another victim is the family of a customer who contracts HIV. The number of new and younger users is rising. Some of these are described as fairly affluent, non-urban dwellers who come into the city to buy heroin. In most cases, these new users are snorting the drug rather than injecting it.
The availability is attractive to the younger users. “The heroin can be found not only on the street, but in most clubs, and even in some quick-stop type gas stations” (Newsweek, 1996). Many rock stars have died from heroin overdose in the past and the numbers are still growing today. This issue should be alerting the younger generation of the problems with this drug. However, it is making heroin a “cool drug”. The youths look at the effects of the drug on the music artists and can only focus on the tremendous high that they themselves can obtain from the drug. They do not believe the side effects or even death could occur to them. The price is also appealing for youths. In general, heroin prices are low, but there is considerable variation. Some areas report bags of heroin starting as low as $5.00. Others report somewhat higher prices. In general, purity is also high, though there is considerable variation even within the same geographic area. Heroin prices reported by police vary by area: $250-300 per gram in the Northwest to $150 per gram in Colorado, to $60-70 per gram in the East. This is due, in part, to the type of heroin available (Mexican, Southeast Asian, Colombian). Purity is also variable from lows of less than 10 percent in the Northwest to highs of more than 60 percent in the East (DEA, 1996).
Heroin is such an addictive drug that it needs substantial detoxification treatment. Methadone maintenance is the most effective known treatment for heroin addiction. “Used properly, methadone reduces drug use, related crime, death, and disease among
heroin users. Methadone has been handicapped by restrictive government regulations, due to misinformation among treatment providers and drug users alike. Methadone treatment is not widely used” (Nadelmann, 1996). Methadone is the most tightly restricted drug in America. It is confined to specialized treatment programs, which tend to be under-funded, punitive, and in short supply. Doctors in general medical practice can’t prescribe methadone, and regular pharmacies don’t distribute it. Given the upswing in heroin use in many U.S. cities, coupled with a raging HIV/AIDS epidemic among drug injectors, it is now essential to reinvent methadone as a harm reduction intervention. Moreover, methadone treatment has been shown to dramatically reduce death rates and HIV-risk behavior (JAMA, 10-13-99). This means delivering methadone treatment in such a way that it is available and acceptable to a far greater range of heroin users. It is time to give serious consideration to foreign methods of providing methadone, which utilize not only standard methadone clinics but family medical doctors, pharmacies, methadone buses (mobile clinics), and reduced-service clinics. Both moderate and high-dose methadone treatment resulted in decreased illicit opiod use during methadone maintenance and detoxification (JAMA, 3-17-99). “There is no sound economic, medical, or practical argument against at least trying these innovations, which are already commonplace in many other western nations with great success” (Nadelmann 1996). The majority of people in treatment for heroin addiction are older, experienced drug users. In all regions, 65 percent or over are in their thirties, and over 70 percent of them have been in drug treatment before (NADELMANN, 1996). The best programs provide a combination of therapies and other services, such as referral to other medical, psychological, and social services to meet the needs of the individual patient. Participation in self-help support programs during and following treatment often can be helpful in maintaining abstinence (JAMA, 10-13-99). Education is critical in combating the use of Heroin. Without education the motivation to get treatment will not be present until it is too late.
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