Heroin Addiction
Heroin is an illegal, highly
addictive drug. It is both the most abused and the most rapidly
acting of the opiates. Heroin is processed from morphine, a naturally
occurring substance extracted from the seed pod of certain varieties
of poppy plants. It is typically sold as a white or brownish powder
or as the black sticky substance known on the streets as "black
tar heroin." Although purer heroin is becoming more common,
most street heroin is "cut" with other drugs or with
substances such as sugar, starch, powdered milk, or quinine. Street
heroin can also be cut with strychnine or other poisons. Because
heroin abusers do not know the actual strength of the drug or
its true contents, they are at risk of overdose or death. Heroin
also poses special problems because of the transmission of HIV
and other diseases that can occur from sharing needles or other
injection equipment.
What is the scope of heroin
use in the United States?
According to the 1998 National
Household Survey on Drug Abuse, which may actually underestimate
illicit opiate (heroin) use, an estimated 2.4 million people had
used heroin at some time in their lives, and nearly 130,000 of
them reported using it within the month preceding the survey.
The survey report estimates that there were 81,000 new heroin
users in 1997. A large proportion of these recent new users were
smoking, snorting, or sniffing heroin, and most (87 percent) were
under age 26. In 1992, only 61 percent were younger than 26.
The 1998 Drug Abuse Warning Network (DAWN), which collects
data on drug-related hospital emergency department (ED) episodes
from 21 metropolitan areas, estimates that 14 percent of all
drug-related ED episodes involved heroin. Even more alarming
is the fact that between 1991 and 1996, heroin-related ED episodes
more than doubled (from 35,898 to 73,846). Among youths aged
12 to 17, heroin-related episodes nearly quadrupled.
NIDAwhich provides information about the nature and patterns of drug
use in 21 cities, reported in its December 1999 publication that heroin
was mentioned most often as the primary drug of abuse in drug abuse
treatment admissions in Baltimore, Boston, Los Angeles, Newark, New
York, and San Francisco.
How is heroin used?
Heroin is usually injected,
sniffed/snorted, or smoked. Typically, a heroin abuser may inject up to
four times a day. Intravenous injection provides the greatest intensity
and most rapid onset of euphoria (7 to 8 seconds), while intramuscular
injection produces a relatively slow onset of euphoria (5 to 8 minutes).
When heroin is sniffed or smoked, peak effects are usually felt within
10 to 15 minutes. Although smoking and sniffing heroin do not produce
a "rush" as quickly or as intensely as intravenous injection,
NIDA researchers have confirmed that all three forms of heroin administration
are addictive.
Injection continues to be the predominant method of heroin
use among addicted users seeking treatment; however, researchers
have observed a shift in heroin use patterns, from injection
to sniffing and smoking. In fact, sniffing/snorting heroin is
now the most widely reported means of taking heroin among users
admitted for drug treatment in Newark, Chicago, and New York.
With the shift in heroin abuse patterns comes an even more
diverse group of users. Older users (over 30) continue to be
one of the largest user groups in most national data. However,
the increase continues in new, young users across the country
who are being lured by inexpensive, high-purity heroin that
can be sniffed or smoked instead of injected. Heroin has also
been appearing in more affluent communities.
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