A study conducted on young, urban injection drug users found that 86 percent of them had used opioid pain relievers nonmedically before using heroin, and their initiation into nonmedical use was characterized by three primary sources of opioids: family, friends, or personal prescriptions.
The rate of these studies represents a significant shift of people entering treatment for heroin addiction, who began using opiates in the 1960s. During this time, more than 80 percent started using heroin, and those who began to abuse opioids in the 2000s reported 75 percent of the time they started with a prescription drug. Nearly 80 percent of heroin users reported using prescription opioids before heroin.
The crisis has grown to such levels that there are serious considerations of medically prescribing heroin to help manage the overdose deaths attributed to heroin. With the emergence of drugs like fentanyl, there have been many situations where mass overdoses are taking place.
Heroin is not the same drug it once was. Not only will the purity vary from one dealer to another, but you can never be sure what the drug is cut with. In 2017 alone, 47,000 people lost their lives from opioid-related overdoses, a figure that rivals the number of deaths from the peak of the AIDS crisis in 1995. Even worse, a recently published study concludes that Americans are more likely to die from an opioid overdose than a car accident.
Life expectancy has continued to decrease in the United States while it grows in other developed countries. This marks the first time since the influenza pandemic of 1918 that the United States has reported such a trend in loss of life. The mortality trend is heavily influenced by the opioid epidemic and rising rates of suicide. The highest rates of death from drug overdose occurs in adults between ages 25 and 54. When it is broken down further, 28,500 of the 47,000 total deaths are directly related to synthetic opioids.
The U.S. government has done its fair share to address the opioid crisis. In 2017, President Donald Trump vowed to curve opioid deaths. In October 2017, the president and his commission released 56 recommendations to curb the crisis. These efforts have shown some promise for 2018 overdose statistics, but the scale of the scope of people struggling with substance abuse demands comprehensive action from the government and health care sectors. At any time, someone can purchase a tainted bag of heroin and become a victim of the statistics.
What Is Heroin?
Heroin is classified as a Schedule I substance, meaning it has no accepted medical value and is only available through illicit black markets. It is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast Asia, Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a sticky black substance that is known as black tar heroin.
Heroin can be ingested in many ways such as smoking, snorting, or injecting. Administering the drug intravenously is one of the most common means of getting high on it, but it is also one of the most deadly.
Common short-term side effects of heroin include:
- Warm flushing of the skin
- Dry mouth
- Heavy feeling in the arms and legs
- Severe itching
- Clouded mental functions
Long-term side effects of heroin include:
- Collapsed veins (in intravenous users)
- Damaged tissue inside the nose (for those who snort the drug)
- Infection of the heart lining and valves
- Abscesses (swollen tissue filled with pus)
- Constipation and stomach cramping
- Liver and kidney disease
While heroin is a dangerous drug on its own, the increased drug cutting to increase profits has made it even more deadly. Because the U.S. Food and Drug Administration (FDA) does not regulate the substance, dealers can cut their heroin with virtually anything if it nets them an extra few dollars. The user’s life is not taken into consideration by these people who push poison. Below, we examine what heroin is commonly cut with
What is Heroin Cut With?
Heroin can be cut with many different items, and without proper screening of the drug, you may never know until it’s too late. Some of the most common substances cut with heroin include:
- Baking soda
- Talcum powder
- Over-the-counter painkillers
- Powdered milk
- Laundry detergent
- Rat poison
None of these listed above are safe to snort or inject directly into your bloodstream. Heroin that is cut with stimulants can be dangerous because it will mask signs of an overdose which can lead to a much higher risk of brain damage or death.
Other substances will not completely dissolve into the injection solution, which can lead to serious health problems such as particles building up or blocking arteries. This can lead to heart attacks or other heart conditions including infection of the heart tissues, blockages in the brain, and liver damage.
There also has been increasing concern about heroin users cutting the drug with other intoxicants to enhance the effects. In the past couple of years, the rise of fentanyl-laced heroin has swept the nation and contributed significantly to the epidemic.
Fentanyl is a synthetic opioid that is between 30 to 50 times more potent than heroin. In its purest form, it can be deadly to the touch. There have been situations where first responders have entered into rooms without protection and exposed themselves to the drug. Unfortunately, in a case in Toronto, it turned deadly.
When these two drugs are used in conjunction with one another, it significantly increases the odds of overdosing and dying. Opioid overdoses involve severe respiratory system and other essential bodily functions as this class of drug depresses the central nervous system (CNS). It will cause a user to breathe very slowly or take shallow breaths to the point of suffocation. It can result in rapid cell death, coma, and brain death.
Opioid Overdose Symptoms
Opioid overdose symptoms can include:
- Slow or shallow breathing
- No breathing
- Gurgling sounds
- Lack of response to stimuli
- Floppy arms
- Floppy legs
- Blue lips
As we’ve discussed, an opioid overdose can be fatal. It is imperative to call 911 if you suspect someone has overdosed. There is no other option but medical intervention, and many people can be saved with naloxone (Narcan).
What to Expect in Opioid Detox
If you are using heroin, you can never know what to expect when you purchase that next bag. Even if you are using prescription drugs such as OxyContin or Norco that were bought on the street, they have been notorious for being laced with fentanyl. The best way to avoid this ever happening is to seek treatment.
The first stage in the continuum of care will be medical detoxification. During your time in detox, you will spend three to seven days while the drugs are removed from your system. In the event of bad withdrawals, medication will be administered by the staff to alleviate the symptoms. Upon completion, the clinicians will determine the next level of care that best suits your needs.