Origin, Effect and Treatment of Heroin known as diamorphine

Heroin, also known as diamorphine is an illegal substance which can be white or brown powder or a black, sticky goo. It's an opioid drug made from morphine, a natural substance in the seedpod of the Asian poppy plant. It can be mixed with water and injected with a needle. Heroin can also be smoked or snorted up the nose. All of these ways of taking heroin send it to the brain very quickly. This makes it very addictive.

Heroin (like opium and morphine) is made from the resin of poppy plants. Milky, sap-like opium is first removed from the pod of the poppy flower. This opium is refined to make morphine, then further refined into different forms of heroin.

THE ORIGINS OF HEROIN

Heroin was first manufactured in 1898 by the Bayer pharmaceutical company of Germany and marketed as a treatment for tuberculosis as well as a remedy for morphine addiction.

A vicious circle

During the 1850s, opium addiction was a major problem in the United States. The “solution” was to provide opium addicts with a less potent and supposedly “non-addictive” substitute—morphine. Morphine addiction soon became a bigger problem than opium addiction.

As with opium, the morphine problem was solved by another “non-addictive” substitute—heroin, which proved to be even more addictive than morphine. With the heroin problem came yet another “non-addictive” substitute—the drug now known as methadone. First developed in 1937 by German scientists searching for a surgical painkiller, it was exported to the US and given the trade name “Dolophine” in 1947. Renamed methadone, the drug was soon being widely used as a treatment for heroin addiction. Unfortunately, it proved to be even more addictive than heroin.

By the late 1990s, the mortality rate of heroin addicts was estimated to be as high as twenty times greater than the rest of the population.

How heroin works in the body

Heroin is a central nervous system depressant. This means it slows down a person’s brain function and affects their breathing (which can slow down or even stop). The person’s body temperature and blood pressure drop, and their heartbeat can become irregular. The person may lose consciousness or lapse into a coma. Ambulance officers, family and friends can give the medication naloxone to reverse the effects of heroin.In February 2016, naloxone was rescheduled to be made available for purchase over the counter. Talk with your pharmacist for more information.

Effects of heroin

The effects of any drug (including heroin) vary from person to person. How heroin affects a person depends on many things including their size, weight and health, also whether the person is used to taking it and whether other drugs are taken around the same time.

The effects of any drug also depend on the amount taken. This can be very hard to judge as the quality and strength of illicit drugs can vary greatly from one batch to another.

There is no safe level of drug use. Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.

Immediate effects

Depending on how heroin is taken, the effects may be felt within 7-8 seconds (injecting) or within 10–15 minutes (snorting or smoking). The effects of heroin can last for approximately 3–5 hours.

Low to moderate doses

Some of the effects that may be experienced after taking heroin include:

feelings of intense pleasure
strong feelings of wellbeing
confusion
lowered cough reflex
pain relief
reduced sexual urges
drowsiness
slurred and slow speech
reduced coordination
constricted pupils
dry mouth
slow breathing rate
decreased heart rate and blood pressure
nausea and vomiting
reduced appetite.

Higher doses of heroin

A high dose of heroin can cause a person to overdose. This means that a person has taken more heroin than their body can cope with.

The risk of overdose increases if the strength or purity of the heroin is not known. Injecting heroin increases the risk of overdose due to large amounts of the drug entering the blood stream and quickly travelling to the brain.

High doses of heroin can intensify some of the effects. People may also experience:

impaired concentration
going "on the nod" (falling asleep)
shallow and slow breathing
nausea and vomiting
increased sweating and itching
urge to pass urine but difficulty doing so
drop in body temperature
irregular heartbeat
unconsciousness
death.
Naloxone (also known as Narcan®) reverses the effects of heroin, particularly in the case of an overdose. Naloxone can be administered by authorised medical personnel such as ambulance officers.

After an overdose, it is strongly advisable to seek assessment at a hospital or by a medical practitioner.

Coming down

A person who is coming down from using heroin may feel irritable as the drug leaves their body. They may also feel depressed when coming down.

Long-term effects

The long-term effects of heroin use on health can include:

dependence
constipation
menstrual irregularity and infertility in women
loss of sex drive in men
intense sadness
cognitive impairment
tetanus
damage to heart, lungs, liver and brain.
Some other long-term effects of heroin are related to the method of use:
Repeated snorting damages the nasal lining.
Frequent injecting in the same place can cause inflammation, abscesses, vein damage and scarring.
Injecting can also result in skin, heart and lung infections.
The impurities and additives in heroin, if injected can also damage veins. This can also cause thrombosis.
Other effects of heroin use
Taking heroin with other drugs
The effects of mixing heroin with other drugs, including alcohol, prescription medications and over-the-counter medicines, are often unpredictable.

Mixing heroin with other depressant drugs (such as alcohol or benzodiazepines) increases the depressive effects and can result in an increased risk of respiratory depression, coma and death.

Combining heroin with stimulant drugs such as amphetamine also places the body under great stress.

Pregnancy and breastfeeding

Most drugs that a mother takes will cross the placenta and affect her foetus, or will be present in her breast milk.

Using heroin while pregnant can increase the chances of problems in pregnancy such as miscarriage, or going into labour early, which can mean that babies are born below birth weight.

Heroin is often "cut" with other substances that can also cause problems during pregnancy and affect the developing foetus.

Check with your doctor or other health professional if you are using or planning to use heroin or any other drugs during pregnancy or while breastfeeding.

Driving

It is dangerous to drive after using heroin. The effects of heroin, such as drowsiness and reduced coordination, can affect driving ability. The symptoms of coming down and withdrawal can also affect a person's ability to drive safely.

Heroin and the workplace

Under occupational health and safety legislation, all employees have a responsibility to make sure they look after their own and their co-workers' safety. The effects of heroin such as drowsiness and confusion can affect a person's ability to work safely and effectively.

Symptoms of heroin overdose

One of the most dangerous adverse effects of heroin use is the risk of overdose. The symptoms of overdose include:

dangerously low body temperature
slowed breathing
blue lips and fingernails
cold, clammy skin
convulsions and coma.

Symptoms of heroin withdrawal

Withdrawal symptoms can start after a matter of hours without a dose of heroin. They may include:

cravings
diarrhoea and vomiting
stomach cramps
sweating
bone, joint and muscle pain and twitching
mood swings and crying.

What are treatments for drug addiction?

There are many options that have been successful in treating drug addiction, including:

behavioral counseling
medication
medical devices and applications used to treat withdrawal symptoms or deliver skills training
evaluation and treatment for co-occurring mental health issues such as depression and anxiety
long-term follow-up to prevent relapse

A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.