What is heroin?
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.
NIDA's Community Epidemiology
Work Group (CEWG), which 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.
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Source:
Community Epidemiology Work Group, NIDA, December 1999
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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.
