Heroin is an opioid or narcotic drug. All opiates are derivatives of the poppy plant and share similar properties. Thus, all opioid drugs are derivatives of opium, and every drug in this class has a high potential for the development of physical dependence and abuse/addiction. Heroin is considered to be one of the most addictive drugs of abuse available.
History of Heroin
Heroin is associated with an interesting history that may be surprising to some readers. According to the book Heroin: Its History, Pharmacology, and Treatment:
- Heroin was initially believed to be nonaddictive. Heroin was developed in 1874 by Chemist C. R. Adler Wright who was attempting to find an effective yet nonaddictive painkiller to replace morphine because of serious global issues with morphine addiction. Morphine was regularly used medicinally as a method of pain control for surgery and chronic pain.
- Heroin was used to treat morphine addiction. Because it was initially believed that heroin use did not result in addiction, heroin was routinely used as a treatment for morphine addiction. Heinrich Dreser, the chemist largely responsible for the Bayer Company’s development of heroin as a medicinal drug, became addicted to heroin.
- Heroin was marketed by the Bayer Company. In the United States, the Bayer Company began marketing heroin as a type of miracle drug during the late 1890s. From most accounts, it appears that the company gave the drug its popular name (heroin) under its marketing campaign. The Bayer Company also marketed heroin as a cure for tuberculosis, and its distribution was targeted at children. Bayer stopped manufacturing heroin in 1913, the year before it was regulated by the government.
- Heroin is named after the German term for “heroic.” The name heroin comes from the German word heroisch meaning “heroic.” Heinrich Dresser used the term to describe the drug because he believed that it made individuals feel heroic.
- Heroin addiction was rampant at one point. Heroin, like many opioids, is an effective cough suppressant. Thus, much of its distribution before it was made illegal was in cough syrups. This resulted in a large number of middleclass females developing serious heroin addictions. The number of heroin addicts during the late 1800s was triple what it was in the 1990s, a period often referred to as having an “epidemic of heroin addiction.”
- Eventually, the government caught on. Due to massive issues with addiction, the Harrison Narcotics Act of 1914 made the use of opiate drugs and drugs that were derivatives of the coca leaf (cocaine) illegal. However, the act did not apply to prescriptions of these drugs, and users could still get the drugs with prescriptions from a physician. It was the Heroin Act of 1924 that made the drug completely illegal in the United States. Heroin is still considered to be a drug without medicinal purposes, according to the United States Drug Enforcement Administration. Heroin is classified as a Schedule I controlled substance.
- In most countries, heroin is now illegal. Heroin is generally considered to be illegal in most countries in the world; however, some countries, such as the Czech Republic, allow individuals to possess very small amounts of the drug for personal use. The Netherlands has government-sponsored needle sharing programs even though the drug is illegal, and other countries, such as the United Kingdom, still list heroin as a drug that has potential medicinal purposes. Nonetheless, distribution of heroin is considered to be a serious criminal offense in most countries.
Medicinal Uses of Heroin
Even though the United States Drug Enforcement Administration classifies heroin as a drug without medicinal uses, the drug does have several potential medicinal uses.
- Pain control: Heroin, like most narcotic drugs, is a highly effective pain suppressant. It is still used in the United Kingdom medicinally for this purpose, although it is strictly regulated. It can be used for the control of chronic pain or for acute pain due to surgery.
- Cough suppressant: Most opioid drugs effectively suppress coughing but also carry the risks of the development of physical dependence, abuse, sedation, drowsiness, etc.
- Control of diarrhea: A side effect of narcotic drugs is constipation. This means that they can be used effectively to control diarrhea.
- Opioid replacement therapy: Heroin was once commonly used as a replacement drug for individuals addicted to morphine. It still has the potential for use in withdrawal management from other narcotic medications, although this is very rare.
Color of Heroin
Heroin on the street may have different colors. According to Heroin: Its History, Pharmacology, and Treatment, it appears that the color of heroin is associated with its origins.
- Brown: Heroin produced in South American countries like Colombia tends to be chalky and brown. The heroin that comes from Afghanistan also tends to be brown.
- Black: “Black tar heroin” comes from Mexico. When the drug is cooled, it is hard, but when it’s warmed, it becomes soft and sticky and appears similar to the tar used on the roofs of homes. This form of heroin is similar to opium, and it is not as pure as some other forms.
- White: White powder heroin is typically associated with an origin from Southeast Asia. This form of heroin is considered to be more refined and purer than most other street forms. However, some of the heroin sold in the United States may have fillers added, such as starch, powdered milk, or even sugar, and may appear white as a result.
A Bevy of Names
There are too many different street names used for heroin to be able to mention them all here. However, some of the common street names for heroin include:
- Hell dust
- Brown sugar (obviously, brown-colored heroin)
- Black tar (obviously, the heroin from Mexico)
- DOA (for heroin that is allegedly extremely potent)
- Comatose (again for supposedly extremely potent heroin)
There are also regional names that come from inner-city suppliers, such as “Gucci.”
A number of other popular slang phrases are associated with heroin use or withdrawal from heroin:
- Junkie: This comes from the slang term for heroin (junk) in the 1920s in the United States.
- Kicking the habit: This term may have originated from the leg spasms and kicking movements that occur in heroin addicts who undergo severe withdrawal symptoms.
- Cold turkey: A withdrawing heroin addict may experience a number of symptoms, such as goose bumps and cold flashes, and these experiences are associated with the common phrase going cold turkey.
- That’s some heavy stuff: The term heavy stuff was originally a street term to describe potent drugs like heroin and even cocaine.
- What a rush: The use of the term a rush comes from the experience individuals initially get when injecting heroin.
Heroin’s Effects on the Brain, Body, and Behavior
Individuals who use heroin typically inject, snort, or smoke it. Heroin use has a number of specific effects on the brain and body of individuals who take the drug. According to the National Institute of Health and a number of other academic sources, when heroin is taken, it crosses the blood-brain barrier (a safeguard in the body to keep foreign substances from entering the brain) and is converted back into morphine. Heroin then binds with neurons known as endogenous opioid receptors, which are neurons in the brain that are specialized to control the perception of pain, exertion, and behavior reinforcement.
The endogenous opioid receptors are also located heavily in the area of the brain known as the brainstem, which controls basic automatic functions that maintain life support, such as breathing rate, blood pressure, level of arousal, etc. Heroin use is associated with a suppression of basic bodily functions controlled by the brainstem. One of the most important of these is in individual’s respiration rate.
Heroin overdose often results in a comatose state where these processes are suppressed to the point of the individual losing consciousness. The resulting lack of oxygen due to decreased respiration can lead to significant damage in the brain and other organs. In extreme cases, oxygen can totally be shut off due to extremely suppressed or halted respiration (a condition known as anoxia), and the individual can develop severe brain damage or even die. Even chronic hypoxia, which is decreased oxygen supply to the brain as opposed to a total lack of oxygen (anoxia), can occur from heroin use and result in a number of consequences as a result of brain damage, including issues with thinking and judgment.
The immediate effects associated with heroin use typically include:
- Extreme euphoria commonly referred to as a “rush”
- The suppression of any physical pain
- A warm feeling
- Flushed skin
- Sedation that includes a feeling of heaviness
- Slowed breathing rate
- Slowed heart rate
- Dilated pupils
- Dry mouth
It is also not uncommon for individuals to experience an itching sensation and/or become nauseous. Individuals using heroin may become lethargic, be very pleasant, become anxious, and demonstrate significantly slowed thinking processes and often slurred speech.
Complications of Heroin Use
Side effects of heroin use affect many different bodily functions and systems. Side effects of chronic heroin use include:
- Lung complications: These can include a higher probability of developing diseases like tuberculosis or pneumonia. In individuals who snort heroin, scarred lung tissue may be present.
- Cardiovascular complications: These include an increased risk to develop infections of the cardiovascular system, abscesses, blockages, and scarred or collapsed veins.
- Issues with the central nervous system: These include issues with the brain and spinal cord, including changes in the structure of the brain and increased risk to develop infections. Cognitive issues, such as memory loss, confusion, issues with attention, loss of motivation, and issues with decision-making, may also occur.
- Psychiatric problems: These may include issues with anxiety, depression, and even psychotic behavior, such as hallucinations.
- Neonatal abstinence syndrome: In pregnant women, there is a severe risk of the development of a neonatal abstinence syndrome. The drug crosses the placenta into the fetus, and the fetus develops a physical dependence on the drug.
Other general issues that can occur in chronic users include prolonged issues with constipation, disruption of one’s sleep cycle, sexual dysfunctions, menstrual issues in females, physical damage as a result of use (e.g., nasal damage if snorted, issues with the skin, etc.), and a high probability that the individual will engage in risky behaviors, such as needle sharing (which can lead to the person acquiring certain blood-borne diseases), illegal activities (such as theft or other crimes to obtain more heroin), financial issues, and troubles with one’s personal and professional relationships.
Of course, chronic users of the drug will inevitably develop physical dependence on the drug (the acquisition of both tolerance and withdrawal syndromes) and are highly likely to develop a formal addiction to the drug.
Heroin is a drug that was initially developed to be a nonaddictive alternative to morphine use in the control of chronic pain, and it was originally marketed for a number of medicinal purposes. The drug was initially embraced in the United States; however, once its highly addictive potential was recognized, the government made the drug illegal in all forms. It is considered to be a drug that has no legitimate medicinal purposes in this country.
Nonetheless, the drug is still used in other countries for the control of pain and for other medicinal uses. In a very few countries, individuals are allowed to possess small amounts of the drug for personal use (e.g., the Czech Republic). However, the manufacture and marketing of heroin are deemed illegal in the majority of countries around the world. The drug is highly addictive and associated with a number of detrimental physical, mental, and emotional effects when chronically abused.