Heroin

Heroin is a semi-synthetic opioid and is derived from the substance morphine. The natural source of morphine is the poppy plant (Papaver somniferum). The official name of heroin is diacetylmorphine. 

The drug is notorious for its highly addictive effects and high risk of abuse.  The drug evokes images of emaciated junkies, needles, illegal drug traffic and overdoses. 

In 1874, the drug was first synthesized from morphine by a chemist from England. Twenty-four years later the drug came on the market as a commercial product, brought out by the German company Bayer. They gave the drug the name "Heroin”. This product name has been used freely ever since for a variety of reasons, for example to designate certain recreational opioids that may or may not contain diacetylmorphine. 

What is labeled "heroin" today is often a mix with other adulterants such as the highly potent and dangerous fentanyl. Cheap substances are also added including milk sugar, paracetamol, caffeine and chemicals. 

Bayer marketed the product as a non-addictive alternative to morphine in cough drops. At the time, morphine was a popular drug and the potential for addiction was high. The company was looking for a drug that could replace morphine without these effects. In the end, heroin proved to be even more addictive. 

Soon the popularity of the drug took off, causing a growing addiction problem and a thriving drug trade worldwide. 

In terms of chemical structure, it is closely related to morphine. Furthermore, it is analogous to other morphine-like substances, including codeine, ethylmorphine, hydrocodone, and oxycodone. 

Other names for the drug include H, dope, smack, hero and brown. 

Street slang

• Pieces of heroin: chinese rocks
• Chinese: heating heroin on a piece of aluminum foil. The released vapor is inhaled through a straw and absorbed directly through the lungs
• Shot: a shot is the injection of the stuff
• Speedball: a combination of heroin and coke that is injected
• Cold turkey: withdrawal symptoms of heroin users who are addicted

Originally derived from the poppy plant

Heroin is semi-synthetic. It is derived from morphine, which in turn is derived from opium. This is extracted from the poppy plant. The production of opium takes place mainly in countries including Turkey, Iran, Iraq, Afghanistan, India, Nepal, Bangladesh, Mexico, Colombia and parts of South America. 

The effects

The drug is an odorless, bitter-tasting substance, usually in the form of white powder or brown crystals. Heroin converts to morphine in the body. It is a highly addictive drug, even stronger than morphine, because it is absorbed faster by the body. It passes the blood-brain barrier very quickly. 

A typical feature of heroin is the "flash effect”. A very intense feeling that lasts for several seconds after a user has injected or inhaled. 

Then, for about four to five hours, a user is in a blissful, secure state. In this, all pain and suffering falls away. A user no longer feels sadness, anger or physical symptoms. Basic things like "hunger" also fall away. At the same time, other aspects also fall away, such as infatuation, motivation and rejoicing. A heroin user is in a state of intoxication and indifference. 

In the brain it is converted into morphine and produces, among other things, a strong analgesic effect. In the United Kingdom, heroin is used as a medicine for severe pain. 

Morphine binds to endorphin receptors in the brain. Endorphins are neurotransmitters and play a role in experiencing pleasure. Furthermore, it creates an intoxication to dopamine, another important substance in our brain. It is also described as a substance that plays an important role in the reward system. This makes addiction especially likely, because the body is programmed to want something that feels like a "reward" and therefore feels good again. Dependence can occur after only a short time, causing a user to become addicted. Heroin is therefore considered one of the most addictive drugs available. 

Different forms

Heroin comes in a variety of forms. Most often this is either a white powder form, or brown crystals. Another variety is black substance also called black tar, or 'black tar'.

Often heroin is used by means of 'chinese'. In this process, the vapor is inhaled. A user heats the drug on a piece of aluminum foil. The vapors released are then inhaled using a straw. 

Another method that is widely used is to inject the drug. There are many risks associated with this. This form of use is less popular with newer generations, but is still widely used in countries where it is still common. 

Effects of heroin

• Analgesic: as a powerful painkiller it has a strong sedative effect. A user with back pain, for example, will no longer notice this. A characteristic of heroin is the 'sinking', in which a user lets his head hang down and can lose consciousness. It is also possible to 'sleep' for short periods while sitting or standing. 
• Physical euphoria: The euphoric feelings that occur when using the drug are very intense, especially when compared to certain other opioids such as codeine or tramadol. The feeling can be described as pure bliss, warmth and physical comfort. On a mental level, a user also feels like they are on a high of happiness. 

Heroin compared to other drugs

Drugs were ranked according to their harmfulness, in the short and long term, risk of addiction and social harm suffered by the user. In this list, heroin scores the highest, when it comes to acute harmfulness and high risk of overdose. Following this are crack, methamphetamine and alcohol. Heroin also scores the highest in terms of addictiveness. In comparison, XTC, magic mushrooms and LSD score the lowest in terms of risk of dependence. Furthermore, when it comes to problems on a social level, the drug is second only to crack. In third place is alcohol. 

Looking at this comparative overview, it is striking how safe magic mushrooms, khat and XTC are. And how harmful legal drugs like alcohol and tobacco are. 

Heavy prescription painkillers vs. heroin

Today, much of the world is struggling with what is known as an opioid epidemic. Pain relief, a major reason for use, is needed for certain serious conditions, illnesses and injuries. Hence, these heavy painkillers are prescribed by the medical profession. 

For example, a user with severe back pain is prescribed the heavy painkiller oxycodone. This is a very powerful drug and is increasingly being made available by prescription for people with certain (chronic) pain conditions. These painkillers are as addictive as heroin and often much more potent. Meanwhile, tens of thousands of people die each year from overdoses in the United States. 

As a result, it has been referred to as an epidemic since 2015. 80% of the world's opioid production is consumed in America, which is 5% of the total world population.

Patients who become addicted to expensive heavy prescription painkillers can no longer afford them over time. For this reason, they turn to other available illegal substances including heroin. In the U.S., about half of young heroin users start with abusing prescription medications such as Oxycontin and Oxycodone. A recent analysis shows as much as 80%. 

Heroin is in many cases one tenth the price of a heavy prescription painkiller. 

An upward trend in the number of opioid addicts is also observed in the Netherlands. Heroin is only one of the participants. 

Fentanyl and other heavy painkillers

The so-called heroin sold on the street is often mixed with other substances. 

In the last few years, there has been a lot of fuss about fentanyl, a drug that belongs to the synthetic opioids. Where heroin still has a natural source, namely the poppy plant, fentanyl is obtained entirely synthetically. The drug is 50 to 100 times stronger than morphine and a single dose can be fatal. 0.25 mg of fentanyl can already be an overdose. Fentanyl is absorbed through the skin, which is why it is often available in the form of strips, which one sticks on the skin. 

Despite the high risk of abuse, fentanyl is counted among substances of medical value. Therefore, it is available by medical prescription. Fentanyl is manufactured today in many illegal drug labs, often from China.

The drug is cheaper than heroin and is often used as an adulterant. As a result, a customer sometimes buys "heroin," which is actually made up of a portion of fentanyl, making the stuff even more potent. Many overdoses are the result of ignorance and misjudgment.

The number of opioid overdoses has been growing significantly in recent years.

Addiction and Recovery

Being dependent on heroin has drastic consequences on your life. First, the drug is illegal; in the Netherlands it is on the first list of the Opium Act. Being in possession of the drug has legal consequences. 

Furthermore, it affects your mood, financial situation and social life.

Some short-term consequences may include:

• Overdose
• Vomiting
• Cardiac arrest
• Pneumonia
• Infections (from contaminated needles)
• Rehab symptoms
• Constipation

Long-term:

• Isolation from society
• Loneliness
• Paranoid
• Financial problems
• Mental health problems
• Serious physical health problems

When a person stops using heroin, there are several serious withdrawal symptoms. This is a big reason why it is so difficult to quit. 

Rehab symptoms can include:

• Insomnia
• Depression
• Anxiety attacks
• Chills
• Nausea
• Vomiting
• Spasms
• Sweating

In the Netherlands, an experiment in treating people with heroin addiction produced interesting results. Users who participated in a program to get clean were given heroin on medical prescription. This measure proved more effective, according to the study, with a larger proportion of users having fewer social problems, improving physically and causing less nuisance, related to illegal practices. 

This is in contrast to regular treatment, in which users are not given heroin, but high doses of methadone. Methadone is a heavy painkiller, like heroin derived from morphine, and is used as a drug in treatment for people with opioid addiction. It has the same risks and addiction potential as heroin. 

One difference between heroin and methadone is the so-called "flash”. This is what many heroin users are looking for, as it is an effect they usually prefer. Methadone does not provide this.