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Heroin is an opioid drug (derived from opium) made from morphine, a natural substance that is extracted from the seed pod of several poppy plants (opium poppy) that are grown in Southeast and Southwest Asia, in Mexico and in Colombia. Heroin can come in the form of white or brown powder, or as a black sticky substance that is known as “black tar.” Other common names of heroin are the ax, the devil, horse, queen, and black sugar; In English, it is called big H, horse, hell dust and smack.

 

How is heroin consumed?

Heroin can be injected, inhaled, aspirated or smoked. Some people mix heroin with crack cocaine, a practice known as “fastball” or speedballing.

 

What effects does heroin produce?

Heroin quickly enters the brain and adheres to opioid cell receptors located in different areas, especially those that are associated with pain and pleasure sensations and those that control heart rate, sleep, and breathing.

 

Prescription opioids and heroin

Prescription opioid analgesics, such as OxyContin® and Vicodin®, have heroin-like effects. Research suggests that inappropriate use of these medications may open the door to heroin use. Data from 2011 showed that approximately 4% to 6% of those who consumed unduly prescribed opioids went on to consume heroin, and about 80% of people who consumed heroin had previously consumed unduly prescribed opioids. More recent data suggest that heroin is often the first opioid people consume. In a study of people beginning treatment for opioid use disorder, about a third reported that heroin was the first opioid they used regularly to get high.

 

Short term effects

People who consume heroin report feeling euphoria or “rush”, a wave of pleasant sensations. However, the drug has other common effects, including:

  • Dry mouth
  • Redness and warmth of the skin
  • The feeling of heaviness in arms and legs
  • Nausea and vomiting
  • Intense itching
  • Clouding of the mental faculties
  • The repeated alternation between a waking state and numbness (conscious and semi-conscious state)

Long-term effects

People who consume heroin for a long time may experience:

  • Insomnia
  • Collapse of the veins in which the drug is injected
  • Damage to the tissues of the nose (in those who inhale or aspirate)
  • Infection of the pericardium (membrane lining the heart) or heart valves
  • Abscesses (inflamed and pus tissue)
  • Constipation and stomach aches
  • Liver and kidney diseases
  • Pulmonary complications, including pneumonia
  • Mental disorders such as depression and antisocial personality disorder
  • Sexual dysfunction in men
  • Irregular menstrual cycles in women

 

Injecting drug use, HIV and hepatitis

People who inject drugs such as heroin have an increased risk of contracting HIV and the hepatitis C virus. These diseases are transmitted by contact with blood and other body fluids, something that can happen when sharing needles or other items used to inject Hepatitis C is the most common blood-borne infection in the United States. You can also get HIV (and, less frequently, hepatitis C) during unprotected sexual activity, something that makes the drug more likely.

Learn more about the connection between heroin and these diseases in our report Heroin: Abuse and addiction.

 

Other potential effects

Heroin often contains additives such as sugar, starch or powdered milk that can clog the blood vessels that reach the lungs, liver, kidneys or brain, and cause permanent damage. In addition, sharing the elements used in the injection of the drug and not thinking clearly when the drug is used may increase the risk of contracting infectious diseases such as HIV or hepatitis (see “Injecting drug use, HIV and hepatitis “).

 

Is it possible to suffer a heroin overdose?

Yes, a person can suffer a heroin overdose. A heroin overdose occurs when the person consumes a sufficient amount of drugs to generate a reaction that endangers his life or causes death. In recent years there has been an increase in cases of a heroin overdose.

When a person suffers a heroin overdose, their breathing slows or stops completely. This can reduce the amount of oxygen that reaches the brain, which is known as hypoxia. Hypoxia can have short or long-lasting brain effects and effects on the nervous system, including coma and permanent brain damage.

 

How is a heroin overdose treated?

Naloxone is a medicine that can be used to counteract an opioid overdose if given immediately. Quickly adheres to opioid receptors and blocks the effects of heroin and other opioid drugs. Sometimes it is necessary to administer more than one dose to help the person begin to breathe again, so it is important to take the individual to the emergency room or to a doctor’s office to receive the additional help he or she needs. Learn more in the article Opioid Overdose Prevention – Instruction Manual of the Substance Abuse and Mental Health Services Administration.

Naloxone is available as an injectable solution (with a needle), as an auto-injector (EVZIO ® ) and as a nasal vaporizer (NARCAN ® Nasal Spray). Family members, friends or other community members can use the naloxone nasal spray or auto-injector to save someone who has suffered an overdose.

The increasing number of opioid overdose deaths has led to an increase in public health efforts to make naloxone available to people at risk and their families, as well as to initial relief staff and other community members. In some states, laws have been passed that allow pharmacists to sell naloxone without a prescription.

 

Is heroin addictive?

Heroin is extremely addictive. Frequently, people who consume heroin on a regular basis develop tolerance, which means they need larger or more frequent doses of the drug to get the effects they are looking for. When the continuous use of a drug generates health problems or problems in the performance of responsibilities in school, work or home, what is known as a drug use disorder occurs? These disorders can be mild or severe. Addiction is the most serious disorder.

Those who are addicted to heroin and stop using the drug abruptly may experience strong withdrawal symptoms. These symptoms, which may begin just a few hours after the last use of the drug, include:

  • Restlessness or restlessness
  • Strong pain in muscles and bones
  • Trouble sleeping
  • Diarrhea and vomiting
  • Waves of cold with “goosebumps”
  • Uncontrollable movements of the legs
  • Intense desire to consume heroin

Researchers are studying the long-term effects of opioid addiction on the brain. Studies have shown that there is some loss of white matter in the brain that is associated with heroin use, which can affect decision making, behavior control and responses to stressful situations.

 

How is heroin addiction treated?

There are several effective treatments to help a person stop using heroin. These treatments include medications and behavioral therapies, that is, therapies that modify behavior. It is important to identify the best treatment strategy for the particular needs of each patient.

Medications are currently being created to help with the withdrawal process. The FDA approved lofexidine, a non-opioid medication formulated to reduce opioid withdrawal symptoms.

Medications that help you stop using heroin include buprenorphine and methadone. These drugs adhere to the same opioid receptors to which heroin adheres to the brain but does so in a weaker way, thus reducing the intense desire for the drug and withdrawal symptoms. Another medication is naltrexone, which blocks opioid receptors and prevents opioid drugs from taking effect. A study by NIDA revealed that once treatment began, the combination of buprenorphine and naloxone is similar in efficacy to a prolonged-release naltrexone formulation to treat opioid addiction. Since it is necessary to complete the detoxification to perform the treatment with naloxone, it was difficult to begin treatment with active consumers,

Behavioral therapies for heroin addiction include methods such as cognitive behavioral therapy and contingency control. Cognitive-behavioral therapy helps to modify the expectations and behavior of the patient in relation to drug use and effectively manage the triggers and stress. Contingency control provides motivational incentives, such as coupons or small cash rewards, that reward positive behaviors, such as not using the drug. These behavioral therapy strategies are especially effective when combined with medications. Find out more about drug addiction treatments in our DrugFacts publication: Treatment approaches for drug addiction.DrugFacts: Treatment approaches for drug addiction.

 

Points to remember

  • Heroin is an opioid drug (derived from opium) made from morphine, which is a natural substance that is extracted from the seed pod of several poppy plants (opium poppy).
  • Heroin can come in the form of white or brown powder, or as a sticky black substance that is known as “black tar.”
  • Heroin is injected, inhaled, aspirated or smoked. Some people mix it with crack cocaine (this is known as “fastball” or speedballing ).
  • Heroin quickly enters the brain and adheres to opioid cell receptors located in many areas, especially those that are associated with pain and pleasure sensations and those that control heart rate, sleep, and breathing.
  • People who consume heroin report feeling euphoria or “rush.” Other common effects include dry mouth, heavy feeling in arms and legs, and clouding of mental faculties.
  • Long-term effects may include the collapse of the veins, infection of the pericardium (membrane lining the heart) or heart valves, abscesses and pulmonary complications.
  • Research suggests that inappropriate use of prescription opioid analgesics is a risk factor for starting heroin use.
  • It is possible to suffer a heroin overdose. Naloxone is a medication that, if administered immediately, can counteract a heroin overdose, although it may be necessary to administer more than one dose.
  • Heroin can lead to addiction, one of the drug use disorders. Withdrawal symptoms include severe muscle and bone pain, trouble sleeping, diarrhea, vomiting and an intense need for heroin.
  • There are several effective treatments to help a person stop using heroin; They include medications and behavioral therapies. However, treatment plans must be customized to suit the needs of the patient.
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