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Al-Fraywan 1 Noorah Al-Fraywan Ibarra HLTH 1050 Research Paper Heroin is processed from morphine, a naturally occurring opiate extracted from the seedpod of certain varieties of poppy plants (drugpolicy.org). Heroin was first synthesized from morphine in 1874. From 1898 through to 1910, Bayer, the German pharmaceutical company, marketed it under the trademark name Heroin as a cough suppressant and as a non-addictive morphine substitute (until it was discovered that it rapidly metabolizes into morphine). One year after beginning sales, Bayer exported heroin to 23 countries. Heroin-related overdose deaths are on the rise, but proven strategies are available to reduce the harms associated with heroin use, treat dependence and addiction, and prevent overdose fatalities. The chance of surviving an overdose, like that of surviving a heart attack, depends greatly on how fast one receives medical assistance. Heroin is manufactured from opium poppies cultivated in four primary source areas: South America, Southeast and Southwest Asia, and Mexico. Street heroin is rarely pure and may range from a white to dark brown powder of varying consistency. Heroin can be sniffed, smoked or injected. Heroin Tolerance, Addiction, and Withdrawal With regular heroin use, tolerance develops. This means the abuser must use more heroin to achieve the same intensity or effect. (narconon.org) As higher doses are used over time, physical dependence and addiction develop. With physical dependence, the body has adapted to the presence of the drug and withdrawal symptoms may occur if use is reduced or stopped. Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold sweats with goose bumps (“cold turkey”), kicking movements (“kicking the habit”), and other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week. Sudden withdrawal by heavily dependent users who are in poor health is occasionally fatal, although heroin withdrawal is considered much less dangerous than alcohol or barbiturate withdrawal. Regardless of dosage, these reactions may appear during heroin withdrawal: * Convulsions * Increased heart rate * Abnormal heartbeat * Heart attack * Sudden, sharp blood pressure increase * Stroke * Extreme depression * Suicidal behavior As withdrawal progresses, elevations in blood pressure, pulse, respiratory rate and temperature occur. Symptoms of heroin overdose – which may result in death – include shallow breathing, clammy skin, convulsions and coma. Al-Fraywan 2 Heroin can cause feelings of depression, which may last for weeks. Attempts to stop using heroin can fail simply because the withdrawal can be overwhelming, causing the addict to use more heroin in an attempt to overcome these symptoms. This overpowering addiction can cause the addict to do anything to get heroin. In 1972 brain researchers from Johns Hopkins University made a puzzling discovery that would illuminate scientists' understanding of drug addiction. (pbs.org) They found that the human brain's neurons had specific receptor sites for opiate drugs: opium, heroin, codeine and morphine. But then there was the obvious question. Why would nature put in our brains a receptor for a plant? After all, humans beings didn't evolve over millions of years eating opium or shooting heroin. The scientists reasoned there must be some other function for these receptors sites. They soon figured out that the active ingredient in all these opiates - morphine - had a chemical structure similar to endorphins, a class of chemicals present in the brain . Endorphins are feel-good chemicals naturally-manufactured in the brain when the body experiences pain or stress. They are called the natural opiates of the body. Endorphins flood the space between nerve cells and usually inhibit neurons from firing, thus creating an analgesic effect. On a lower level they can excite neurons as well. When endorphins do their work, the organism feels good, high, or euphoric, and feels relief from pain [analgesia]. Logically, endorphin levels go up when a person exercises, goes into labor, or is stressed out. Although they seem to be triggered by stress, endorphins can do more than relieve pain, they actually make us feel good. Like an evil twin, the morphine molecule locks onto the endorphin-receptor sites on nerve endings in the brain and begins the succession of events that leads to euphoria or analgesia. This imposter is more powerful than the body's own endorphins because the organism can actually control how much of the feel-good chemical hits the brain. Since we are all pleasure-seeking organisms, the motivation to self-administer such a drug is easy to understand. The drawback, of course, is addiction. Al-Fraywan 3 Heroin Detox The first step in the heroin addiction treatment process is a period of time spent going through heroin detox (projectknow.com). During detox, the drugs are removed from the patient's body using one of two processes. The first process is rapid detox, a quick flushing of the body while under anesthesia. The second process is a program of tapering off, where the patient is given an alternate opiate, which is less addictive and dangerous than the heroin and is then slowly tapered off its use. The choice of program is largely up to the patient, depending on the time available for treatment and the costs of the different programs. Rapid detox is always done under direct medical supervision. During the procedure, the patient is placed under light anesthesia for an hour or two while given medication that removes the heroin from the patient's system. After waking from heroin addiction treatment, the physical addiction to heroin is ended, though the psychological addiction remains. Any withdrawal symptoms are largely bypassed without the drug in the system, either not appearing at all or at a greatly reduced level. Tapering is a longer treatment process than rapid detox. During the tapering process, an alternative opiate is introduced into the patient's system. This alternative opiate binds to the opiate receptors in the brain in the place of the heroin, but fails to provide the same euphoric response. With the receptors occupied by the alternate opiate, the withdrawal symptoms fail to start. As the heroin addiction treatment tapering program proceeds, the dosage of the alternate opiate is lessened. The patient's body adjusts to this new lower level of opiate in the system, gradually becoming less physically dependent on the drug. Successful tapering relies on this adjustment occurring with each reduced dose, eventually reaching a dosage so low that the patient's body no longer needs the drug. When this point is reached, the drug is no longer given and the patient experiences only mild withdrawal symptoms or none at all. At some point during the tapering process the patient's body may fail to adjust to the lowered drug level and withdrawal symptoms may begin to occur. To combat this, the medical personnel monitoring the treatment will raise the dosage slightly, stopping the Al-Fraywan 4 withdrawal symptoms from continuing. Once the patient's body readjusts, the tapering off process continues. Tapering off as a form of heroin addiction treatment can take weeks to complete. The level of the initial dosage of the alternate drug is determined by the severity of the patient's dependency. For a light user, the process can be as short as 10 days to two weeks. For a long-term user that detox period can be as long as four to six weeks, with additional time sometimes necessary for the occasional readjustment due to the need for a higher dosage. After finishing the rapid detox or tapering off programs, the patient is kept under medical supervision for a period of 24 to 48 hours. This supervisory period is used to ensure that the patient does not suffer any undue side effects from the detox process. After the supervisory period, the patient often enters into a heroin rehab program. Heroin addiction is a chronic, relapsing disease that is characterized by changes in the brain and uncontrollable drug-seeking behaviors despite the negative consequences. Heroin is a synthesized opioid analgesic that comes from the Asian opium poppy plant. When used, heroin converts to morphine in the body. This substance is used on the streets as a recreational drug, also commonly called black tar, smack, brown, or tar. Upon initial use, people who use this drug feel a rush of pleasure, a sense of wellbeing, and joy. These strong feelings associated with the drug leave a user wanting more, which quickly leads to tolerance and addiction. Causes for Heroin Addiction While researchers have yet to pinpoint a single root cause for heroin addiction, it is thought to be the result of several factors working together that lead to the development of addiction. Some of the most common causes for heroin addiction may include: Genetic: While genetics will not cause you to start using heroin, once you have started using the drug, your genes may cause you to become addicted. Individuals who have a family member, especially a first-degree relative, with addiction disorders are more prone to develop an addiction themselves. Brain Chemistry: Repeated drug use changes the way in which your brain feels pleasure and may also cause physical changes to nerve cells in the brain. These nerve Al-Fraywan 5 cells use neurons to communicate, and when an individual is addicted to a substance such as heroin it disrupts communication in the brain. This causes an individual to use more of the drug to make up for the lack of neurotransmitters. Environmental: Environmental factors such as family beliefs, peer group attitudes, and friends that encourage drug use all play a role in an individual’s choice to begin using drugs. For example, individuals who grew up in home environments where drug abuse was accepted as a means to deal with negative emotions are more desensitized to the use of drugs. They may learn that drug abuse is a proper way of handling negative life events. Psychological: Individuals who are struggling with untreated or undiagnosed mental illnesses may attempt to self-medicate the symptoms of their illness with alcohol or recreational drugs. If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately. Symptoms of Heroin Addiction The signs and symptoms of heroin addiction will vary among users based upon genetic makeup, amount of drug used, frequency of use, and dependency on the drug. The most common symptoms of heroin addiction include the following: Depression Euphoria Mood swings Anxiety Hostility toward others Agitation and irritability Lying about drug use Avoiding loved ones Weight loss Scabs or bruises as the result of picking at the skin Delusions Disorientation Hallucinations Paranoia Decreased attention to personal hygiene Al-Fraywan 6 Possession of burned spoons, needles or syringes, missing shoelaces, glass pipes Stashing drug in various places around the home, car, and work Periods of hyperactivity followed by periods of exhaustion Inability to fulfill responsibilities at work or school Increased sleeping Apathy and lack of motivation Decline in occupational or academic performance Slurred speech Shortness of breath Frequent respiratory infections Dry mouth Wearing long pants and shirts, even in warm weather Going “on the nod” during conversations Forced, pressured speech Track marks on arms and legs Warm, flushed skin Constricted pupils Extreme itching Effects of Heroin Abuse The effects of heroin abuse will differ from person to person, depending upon the length of abuse, amount of heroin used, the presence of other substances, and individual makeup (optionsbehavioralhealthsystem.com). Severity of symptoms tend to get worse the longer the drug is abused. The most common effects of heroin addiction may include: Liver disease Skin disease and abscesses around injection sites Infections of the valves and lining of the heart HIV or Hepatitis B and C Chronic pneumonia Clouded mental functioning Collapsed, scarred veins Blood clots, leading to stroke, pulmonary embolism, and heart attack Kidney disease Risks of contracting chronic illnesses Risks for blood-borne pathogens Septicemia Al-Fraywan 7 Works Cited "Heroin Abuse & Addictions Side Effects, Symptoms, Signs & Causes." Options Behavioral Health Heroin Abuse Addictions Side Effects Symptoms Signs Causes Comments. N.p., n.d. Web. 09 Oct. 2015. <http://www.optionsbehavioralhealthsystem.com/addiction/heroin/effectssigns-symptoms#Effects-of-Heroin-Abuse>. "Heroin Addiction Information." Narconon International. N.p., n.d. Web. 09 Oct. 2015. <http://www.narconon.org/drug-information/heroin-addiction.html>. "Heroin Addiction Treatment." Project Know. N.p., n.d. Web. 9 Oct. 2015. <http://www.projectknow.com/research/heroin/>. "Heroin Facts and Effects." Drug Policy Alliance. N.p., n.d. Web. 9 Oct. 2015. <http://www.drugpolicy.org/drug-facts/heroin-facts>. "Heroin In The Brain." N.p., n.d. Web. 09 Oct. 2015. <http://www.pbs.org/wgbh/pages/frontline/shows/heroin/brain/>.