Drug Abuse: Opium and Heroin

The idea of all pain going away sounds amazing, but what if it came with a huge sacrifice? What if you lost your mind, becoming enslaved to the painless existence? That’s what opium and opiates do, and even though the pain might be gone, your life went with it.

Narcotics, or opiate-derived and opiate-related drugs, produce a dreamlike effect on the user and might even induce sleep at higher doses. The most important trait of this type of drugs is that they have powerful analgesic properties, greatly reducing the feelings of pain. So it’s not a surprise that they became so widely abused over the years. It’s important to note that the term narcotics has been misused as a synonym for any illicit psychoactive drug, while it only stands for opiate-related drugs.

Narcotic drugs are divided into three main categories. The first one includes opium, an analgesic and euphoriant drug produced from the dried juice of the opium poppy, and three natural components can be acquired from it: morphine, codeine, and thebaine. The second category involved opium-derived drugs which a slightly changed chemical composition, such as heroin. These four drugs are often referred to as opiates. The last category of narcotics is the synthetic opiates. These opiates are chemically in no way similar to morphine or any of its derivatives, but still produce the same opiate-like effects. They were created to try and achieve the same type of analgesic results without any potential for abuse.

The history of opium and heroin go back thousands of years. The source is the opium poppy (botanical name Papaver somniferum, “the poppy that brings sleep”), an annual plant growing up to four feet high. Its flowers vary in colors and size, but this variety is the only one that produces opium. Garden poppies such as red Oriental poppy or yellow California poppy might look similar, but don’t produce the same results. The way opium is harvested hasn’t really changed for more than three thousand years. “When the petals of the opium poppy have fallen but the seed capsule is not yet completely ripe, laborers make small, shallow incisions in the capsules, allowing a milky white juice to ooze out. The next day, this substance will have oxidized and hardened by contact with the air. At this point, now reddish brown and having a consistency of heavy syrup, it is collected, plant by plant, onto large poppy leaves.”

Descriptions of Opium can be dated back to 1200 BC Cyprus, where A ceramic opium pipe was excavated. In 1520, laudanum, a mixture of opium, wine, and an assortment of spices created by Paracelsus, was referred to as the stone of immortality. In 1680’s, Thomas Sydenham, an English physician, created a similar drink to laudanum, and it became a widely accepted phenomenon to drink it for the next two hundred years.

In 1803, Fredrich Wilhelm Adam Serturner, a German drug clerk, isolated a yellowish-white substance in raw opium which turned out to be its primary active ingredient. He named it morphine, which representing roughly 10% of the total weight of opium, but was found as 10 times stronger than raw opium. Soon all twenty-five opiate products were separated, but found much weaker than morphine. Besides morphine, codeine (0.5% of raw opium) and thebaine (0.2% of raw opium) were isolated, though they have a much weaker effect.

In around 1898 a new painkilling morphine derivative, heroin, was introduced. Heroin was not perceived as a dependence producing drug at first, due to which its abuse became very common until 1905. In reality, heroin is stronger than morphine due to its chemical composition. “Heroin consists of two acetyl groups joined to a basic morphine molecule. These attachments make heroin more fat-soluble and hence more rapidly absorbed into the brain. Once inside the brain, the two acetyl groups break off, making the effects of heroin chemically identically to that of morphine.”

The effects of heroin depend on five factors:

1. The quantity and purity of the heroin taken,

2. The route through which heroin is administered,

3. The interval since previous dose of heroin,

4. The degree of tolerance of the user to heroin itself.

5. The setting, circumstances, and expectations of the user.

Nonetheless, there’s several effects that occur as a typical experience. “If heroin is injected intravenously, there is an almost immediate tingling sensation and sudden feeling of warmth in the lower abdomen, resembling sexual orgasm, for the first minute or two. There is a feeling of intense euphoria, variously described as ‘rush’ or a ‘flash,’ followed later by a state of tranquil drowsiness that heroin abusers often call being ‘on the nod,’ as described by Kurt Cobain in his Journals. During this period, lasting from three to four hours, any interest in sex is greatly diminished. In the case of male heroin abusers, the decline in sexual desire is due, at least at part, to the fact that narcotics reduce the levels of testosterone, the major sex hormone.”

A sudden release of histamine in the bloodstream produces an intense itching over the whole body and a reddening of the eyes with constricted pupils, called “pinpoint pupils.” Heroin also reduces the sensitivity of respiratory centers resulting in a depression in breathing. Blood pressure is also depressed from heroin.

In 1973 morphine-receptive receptors were discovered in the human brain, meaning that our brains actually produce morphine-like molecules which activate these receptors. These morphine-like molecules are enkephalins, beta-endorphin, and dynorphins, and are collectively referred to as endogenous opioid peptides. They are all peptide molecules, have opiate-like functions, and are produced within the central nervous system. These discoveries were made due to small chemical alterations made in the morphine molecules, resulting in a new group of drugs with acted as an antagonist on opiates, meaning they would reverse of block the effects of morphine. These types of drugs (naloxone, nalteroxone) are used by heroin abusers to stop their habits, and even though it’s painful at first due to the withdrawal symptoms, it works wonders. It’s also used during overdoses, waking up the respiratory centers and helping the abuser breathe. See an example of a heroin abuser “shooting up.” falling into a trance, and being woken up by a nurse with naloxone in an excerpt from the movie Trainspotting below.

The withdrawal symptoms are exactly opposite of the heroin induced symptoms. It makes sense, since the endorphin-sensitive receptors of a heroin abuser are being stimulated by the opiates coming from the outside then the production of endorphins declines in the body. When the outside endorphin stimulant is cut off, the opposite reaction occurs. The first sign of heroin withdrawal, about four to six hours after the last dose, is a craving for another fix. This usually lasts up to seventy-two hours, and the withdrawal period ends in about five to ten days.

Smoking heroin has been linked to leukoencephalopathy, an incurable neurological disease in which a progressive loss of muscle coordination can lead to paralysis and death. Injecting heroin is not a better option, since death by over-dose is an ever-present risk. It is unknown how much heroin actually is in a bought bag, since often it is mixed with other substances for volume. So the content in a bag could be 10-90% heroin, and the chances of doing a ten times higher dose than usual are very high due to increased content of heroin in a bag. Also mixing heroin with other drugs has high potentials of death, especially if it’s cocaine or alcohol. The abuser can’t know how pure the heroin is, and might ingest synthetic drugs and acquire Parkinson’s disease due to a loss of dopamine-sensitive neurons in their brains. The psychological addiction to heroin can be so severe that the abuser might simply feel high just from injecting an empty needle into their skin.

Treating heroin abuse is not easy since the risk of long-term relapse always stays. There’s several ways to treating heroin abuse, and in the end it depends on the abuser not to go back to the habit five years later. The first form of treatment is detoxification, where the user is given synthetic opiate-like drugs such as propoxyphene or methadone, and under professional supervision the dosage is reduces over a two week period. Often a long term oral administrations of synthetic opiates are substituted for the injected heroin, called methadone maintenance. Often heroin abusers need to move from their homes due to a change of scenery during the treatment, so there are no triggers around them. A literal new and fresh start is required to support the withdrawal, and in many cases it works wonders.

There are still medical uses of all opiates, except for heroin. The main use is for the treatment of pain, pre or post surgery, dealing with severe burns, and more. Also dealing with dysentery, and the suppression of coughing. Though side effects of narcotic medications often include respiratory depression, intestinal spasms, and sedation. Often medical analgesic medications are abused outside of the medical world, the most abused medicine of this kind is oxycodone, or OxyContin, or hydrocodone, brand name Vicodin.

Life without pain sounds like a dream, though is it really life if you are enslaved by a substance which slowly kills you? It is heavily encouraged never to try these types of drugs unless medically prescribed, and it is forbidden by law in most of the countries for a reason. If you, or your loved one, have an opiate abuse problem, please get in touch with professionals and get help. It’s not worth it to waste your life away on something so unreal. It’s okay to have a problem as long as you admit it, and try to turn your life around. We are all here for you.

****

Graphs and Citations:

Levinthal, Charles F (1988) Messengers of Paradise: Opiates and the brain. New York: Anchor Press/ Doublepay.

Hodge, John, Danny Boyle, and Irvine Welsh. Trainspotting. Great Britain: Miramax Films, 1997.

Levinthal, Charles F. Drugs, Society, and Criminal Justice. Pearson, 2016.

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