Heroin, also known as diacetylmorphine, is one of a group of drugs known as opioids. Other opioids include opium, morphine, pethidine, codeine, oxycodone and methadone. The basic natural opioid is opium, which is extracted from the opium poppy grown in many parts of the world.
The common medical painkillers, morphine and codeine, are processed from opium and the strongest of all opioids, heroin, is manufactured from these drugs by a special chemical process. It is used in medicine as a very effective potent painkiller but its use is now restricted. Like all opioids, it is a depressant drug that slows down the activity of the central nervous system, including breathing, which is a very serious adverse side effect. The illicit use can be by injection of dissolved powder and inhalation of powder.
What are the immediate effects of heroin?
The effects vary from person to person and depend on the size and health of the person and whether other drugs such as alcohol are being taken. Heroin produces a rush of pleasure within minutes of taking it, leading to a feeling of warmth and serenity. Any feelings of pain are relieved.
Other symptoms and signs include:
What are typical street (slang) names of heroin?
H, Big H, Big Harry, GOM (God’s own medicine), crap, hammer, junk, horse dynamite (high-grade heroin), lemonade (low-grade heroin). Its form varies from granules to powder.
Injection of powder is called mainlining, blast or smack.
What are the effects of an overdose of heroin?
The effects of a heroin overdose are depression of the brain, which leads to drowsiness, snoring sounds, confusion, convulsions and eventually coma, cravings, slowing of the heart, low blood pressure and possible heart failure, slow and shallow breathing, and cyanosed lips, with the main danger being respiratory arrest. ‘Pinpoint’ pupils are another feature. It can be treated with the antidote drug naloxone. Call an ambulance (000) immediately.
What are the long-term effects of heroin dependence?
The effects that make life uncomfortable for the dependent person include memory impairment, mood swings, depression, mental deterioration, constipation, irregular periods and infertility in women, and a loss of sex drive in men.
There are also the very serious effects of intravenous use, especially the risk of blood-borne diseases such as hepatitis B, hepatitis C, septicaemia and HIV (AIDS virus), particularly when sharing needles.
People who are physically dependent on heroin usually develop a tolerance to the drug, making it necessary for them to take more to get the desired effects, especially the ‘rush’. Eventually a ‘dose plateau’ is reached in which no amount of drug is enough. At this stage, the drug tends to be used to avoid the withdrawal effects. Those who are psychologically dependent find that using it becomes more important than other activities in their lives. This leads to bad habits and even crime to get money to pay for the drug.
What are the withdrawal effects?
These develop within 12 hours of ceasing regular usage. The peak withdrawal symptoms usually occur between 36 and 72 hours later and tend to subside after 7 to 10 days. The symptoms include restlessness, irritability, anxiety and panic, craving, twitching, chills and shivering, loss of appetite, nausea and possibly vomiting, excessive sweating, runny nose and watery eyes, insomnia, crying, depression, low blood pressure, muscle aches and cramps, abdominal colic and diarrhoea.
Treatment involves a combination of methods and has to include the medical management of physical dependence and withdrawal in addition to the complex social and emotional factors. Patients should be referred to a treatment clinic, so that a shared-care approach can be used. Counselling, group therapy and social support are important strategies. If necessary, a patient can go ‘cold turkey’ (abrupt cessation) with the support of various drugs or undertake an ultra-rapid opiate detox (UROD) using drugs such as naltrexone.
Medication detoxification programs used to treat withdrawal and ongoing maintenance are naltrexone, buprenorphine and methadone, which are all taken orally.
Methadone, an opioid drug, acts as a substitute for heroin and saves the heroin-dependent person money and the need to inject drugs that may be ‘dirty’ and of unknown strength.
Many people successfully grow through their period of dependence, especially with medical help, and a high percentage become rehabilitated by their mid-30s.
‘Dirty’ street heroin, which is a mixture of heroin of different strengths with substances such as caffeine and sugar, can be very toxic and dangerous.
Sharing needles creates a risk of transmission of the AIDS and hepatitis viruses.
Using heroin while pregnant can harm the unborn child, who usually needs special resuscitation after birth.
It is unsafe and illegal to drive while taking heroin.
For help, ask your doctor or approach the Australian Drug Foundation, www.adf.org.au. Information hotline, ph: 1300 85 85 84.