Many people are shocked by the resurgence of heroin as such a prominent player in drug overdose deaths and addictions. This drug is made from the opium poppy plant that is typically raised in Asia. The morphine substance from the poppy plant is naturally occurring and can be white, brown, or black (black tar heroin).
This drug is much more prominent due to the tight regulation of prescription painkillers. Those that have become addicted to these painkillers when they were freely dispensed all of a sudden, once tightly regulated by the DEA, have been unable to get physicians to write these prescriptions for their documented pain. Now many folks have sought relief from these street drugs.
According to national statistics, well over 4 million Americans over the age of 12 years old have used heroin at least one time and about a quarter of these individuals are now dependent on it. I personally think that these statistics may be a little low.
Many folks not familiar with street drugs have asked me questions about how it is used. The problem with heroin is that it is open to all types of creativity – it can be injected, inhaled, or smoked. It can be mixed with other drugs such as Fentanyl to increase the high or potentiate the effect.
All three of the above routes will get the narcotic rapidly to the brain and it is thought that this might be one of the ways that people get hooked so quickly. It is also thought that this leads to a chronic relapsing process that yields drug-seeking behavior despite the consequences. In many ways the behavior for that individual is uncontrollable.
Once heroin is in the brain, it will bind rapidly to receptors that are responsible for pleasure, reward, and pain. These receptors are called the opioid receptors and they will also control breathing and some of the automatic processes that we need to be stable in order to live – blood pressure, breathing, pulse, and the ability to awake.
It is this mechanism that leads to many of the deaths. When a person is so deep in drugs, their breathing will slow or stop. The result is hypoxia that leads to death. You have read about the drug Narcan. It is this drug that immediately blocks the heroin effects on the receptors and there is an acute withdrawal of heroin. The person will “wake up” rapidly and sometimes violently.
The long-term effects of this addiction can lead to tolerance. This means that the person needs more and more of the drug to get the same effect. When this occurs, they skirt even closer to the suppression of vital body functions. Many heroin addicts will also tell you that they keep using because they just can’t bear the thoughts of withdrawal, which can be incredibly painful and miserable.
I think the biggest push that we can do to prevent more drug overdose deaths is to get to kids before the problem starts – cut off the pipeline. Another unforeseen problem of the overutilization of narcotics and the abrupt withdrawal due to legislation is the unforeseen consequence of those who have true pain not being able to get a physician to take care of them nor the prescriptions that they need. I think this is going to take a community wide discussion to solve this problem.