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Different Drugs

VIEWS: 123 PAGES: 12

									                                    Different Drugs
1. Opium
Opium is a narcotic formed from the latex (i.e. sap) released by lacerating (or "scoring") the immature
seed pods of opium poppies (Papaver somniferum). It contains up to 16% morphine, an opiate alkaloid,
which is most frequently processed chemically to produce heroin for the illegal drug trade. The resin
also includes codeine and non-narcotic alkaloids, such as papaverine and noscapine. Meconium
historically referred to related, weaker preparations made from other parts of the poppy or different
species of poppies. Modern opium production is the culmination of millennia of production, in which the
source poppy, methods of extraction and processing, and methods of consumption have become
increasingly potent.
Cultivation of opium poppies for food, anesthesia, and ritual purposes dates back to at least the
Neolithic Age. The Sumerian, Assyrian, Egyptian, Minoan, Greek, Roman, Persian and Arab
Empires each made widespread use of opium, which was the most potent form of pain relief then
available, allowing ancient surgeons to perform prolonged surgical procedures. Opium is
mentioned in the most important medical texts of the ancient world, including the Ebers Papyrus
and the writings of Dioscorides, Galen, and Avicenna. Widespread medical use of unprocessed
opium continued through the American Civil War before giving way to morphine and its
successors, which could be injected at a precisely controlled dosage. American morphine is still
produced primarily from poppies grown and processed in India in the traditional manner, and
remains the standard of pain relief for casualties of war.
Recreational use of the drug began in China in the fifteenth century, but was limited by its rarity
and expense. Opium trade became more regular by the seventeenth century, when it was mixed
with tobacco for smoking, and addiction was first recognized. Opium prohibition in China began
in 1729, and was followed by nearly two centuries of exponentially increasing opium use. China
had a positive balance sheet in trading with the British, which led to a decrease of the British
silver stocks. Therefore, the British tried to encourage Chinese opium use to enhance their
balance, and they delivered it from Indian provinces under British control. A massive
confiscation of opium by the Chinese emperor, who tried to stop the opium deliveries, led to two
Opium Wars in 1840 and 1858, in which consequence Britain suppressed China and traded
opium all over the country. After 1860 opium use continued to increase with widespread
domestic production in China, until more than a quarter of the male population was addicted by
1905. Recreational or addictive opium use in other nations remained rare into the late nineteenth
century, recorded by an ambivalent literature that sometimes praised the drug.
Global regulation of opium began with the
stigmatization of Chinese immigrants and                                            opium dens,
leading rapidly from town ordinances in the                                         1870s to the
formation of the International Opium                                                 Commission
in 1909. During this period the portrayal of                                        opium       in
literature became squalid and violent, British                                      opium trade
was largely supplanted by domestic Chinese                                            production,
purified morphine and heroin became widely                                          available for
injection, and patent medicines containing                                                 opiates
reached a peak of popularity. Opium was prohibited in many countries during the early twentieth
century, leading to the modern pattern of opium production as a precursor for illegal recreational
drugs or tightly regulated legal prescription drugs. Illicit opium production, now dominated by
Afghanistan, has increased steadily in recent years to over 6600 tons yearly, nearly one-fifth the
level of production in 1906. Opium for illegal use is often converted into heroin, which
multiplies its potency to approximately twice that of morphine, and can be taken by intravenous
injection, and is easier to smuggle.
A field of opium poppies in Burma
Ancient use (4200 BC - 800 BC)
The use of the opium poppy dates from time immemorial. At least seventeen finds of Papaver
somniferum from Neolithic settlements have been reported throughout Switzerland, Germany, and
Spain, including the placement of large numbers of poppy seed capsules at a burial site (the Cueva de los
Murciélagos, or "Bat cave", in Spain), which have been carbon dated to 4200 B.C. Numerous finds of
Papaver somniferum or Papaver setigerum from Bronze Age and Iron Age settlements have also been
reported.[2] The first known cultivation of opium poppies was in Mesopotamia, approximately 3400
B.C., by Sumerians who called the plant Hul Gil, the "joy plant".[3][4] Tablets found at Nippur, a
Sumerian spiritual center south of Baghdad, described the collection of poppy juice in the morning and
its use in production of opium.[1] Cultivation continued in the Middle East by the Assyrians, who also
collected poppy juice in the morning after scoring the pods with an iron scoop; they called the juice
aratpa-pal, possibly the root of Papaver. Opium production continued under the Babylonians and
Opium was used with poison hemlock to put people quickly and painlessly to death, but it was also used
in medicine. The Ebers Papyrus, ca. 1500 B.C., describes a way to "prevent the excessive crying of
children" using grains of the poppy-plant strained to a pulp. Spongia somnifera, sponges soaked in
opium, were used during surgery. The Egyptians cultivated opium thebaicum in famous poppy fields
around 1300 B.C. Opium was traded from Egypt by the Phoenicians and Minoans to destinations around
the Mediterranean Sea, including Greece, Carthage, and Europe. By 1100 B.C. opium was cultivated on
the Mediterranean island of Cyprus, where surgical quality knives were used to score the poppy pods,
and opium was cultivated, traded, and smoked. Opium was also mentioned after the Persian conquest of
Assyria and Babylonia in the sixth century B.C.
From the earliest finds opium has appeared to have ritual significance, and anthropologists have
speculated that ancient priests may have used the drug as a proof of healing power. In Egypt, the use of
opium was generally restricted to priests, magicians, and warriors, its invention credited to Thoth, and it
was said to have been given by Isis to Ra as treatment for a headache. A figure of the Minoan "goddess
of the narcotics", wearing a crown of three opium poppies, ca. 1300 B.C., was recovered from the
Sanctuary of Gazi, Crete, together with a simple smoking apparatus. The Greek gods Hypnos (Sleep),
Nyx (Night), and Thanatos (Death) were depicted wreathed in poppies or holding poppies. Poppies also
frequently adorned statues of Apollo, Asklepios, Pluto, Demeter, Aphrodite, Kybele and Isis,
symbolizing nocturnal oblivion.
Raw opium
In South American countries, opium poppies (Papaver somniferum) are technically illegal, but
nonetheless appear in some nurseries as ornamentals. They are popular and attractive garden plants,
whose flowers vary greatly in color, size and form. A modest amount of domestic cultivation in private
gardens is not usually subject to legal controls. In part this tolerance reflects variation in addictive
potency: a cultivar for opium production, Papaver somniferum L. elite, contains 92% morphine, codeine,
and thebaine in its latex alkaloids, whereas the condiment cultivar "Marianne" has only one-fifth this
total, with the remaining alkaloids made up mostly of narcotoline and noscapine.
Seed capsules can be dried and used for decorations, but they also contain morphine, codeine, and other
alkaloids. These pods can be boiled in water to produce a bitter tea that induces a long-lasting
intoxication (See Poppy tea). If allowed to mature, poppy pods can be crushed into "poppy straw" and
used to produce lower quantities of morphinans. In poppies subjected to mutagenesis and selection on a
mass scale, researchers have been able to use poppy straw to obtain large quantities of oripavine, a
precursor to opioids and antagonists such as naltrexone. Poppyseeds are a common and flavorsome
topping for breads and cakes. One gram of poppy seeds contains up to 33 micrograms of morphine and
14 micrograms of codeine, and the Substance Abuse and Mental Health Services Administration
formerly mandated that all drug screening laboratories use a standard cutoff of 300 nanograms per
milliliter in urine samples. A single poppy seed roll (0.76 grams of seeds) usually did not produce a
positive drug test, but a positive result was observed from eating two rolls. A slice of poppy seed cake
containing nearly five grams of seeds per slice produced positive results for 24 hours. Such results are
viewed as false positive indications of drug abuse, and were the basis of a legal defense. On November
30, 1998, the standard cutoff was increased to 2000 nanograms (two micrograms) per milliliter. During
the Communist era in Eastern Europe, poppy stalks sold in bundles by farmers were processed by users
with household chemicals to make kompot ("Polish heroin"), and poppy seeds were used to produce
koknar, an opiate.

Harvesting and processing
When grown for opium production, the skin of the ripening pods of these poppies is scored by a sharp
blade at a time carefully chosen so that neither rain, wind, nor dew can spoil the exudation of white,
milky latex, usually in the afternoon. Incisions are made while the pods are still raw, with no more than a
slight yellow tint, and must be shallow to avoid penetrating hollow inner chambers or loculi while
cutting into the lactiferous vessels. In India, the special tool used to make the incisions is called a
nushtar, and carries three or four blades three millimeters apart, which are scored upward along the pod.
Incisions are made three or four times at intervals of two to three days, and each time the "poppy tears",
which dry to a sticky brown resin, are collected the following morning. One acre harvested in this way
can produce three to five kilograms of raw opium.[60] In the Soviet Union pods were typically scored
horizontally, and opium was collected three times, or else one or two collections were followed by
isolation of opiates from the ripe capsules. Oil poppies, an alternative strain of P. somniferum, were also
used for production of opiates from their capsules and stems.
Effect of opium
In an election about positive and negative effect of opium, the result was-

                                   Is Opium...

                                   Bad?                 80% [ 12 ]

                                   Good?                20% [ 3 ]

                                  Total Votes : 15
Chantald says, about 100 years ago, Opium was normally available in drugstores and pharmacies. It
helped many people who had a lot of pain. Now these days because of people, who use it just for the fun
and not against the pain, this medicine is classified as a hard drug. In some medicines its still (morphine)
used and makes the patient more relaxed in the right use, if wrong used it's deadly, used also by
2. Morphine
Morphine (INN) (pronounced /ˈ            n/)
                                 mɔrfiː is a highly-potent opiate analgesic drug and is the principal
active agent in opium and the prototypical opioid. It is also a natural endocrine product in humans and
other animals. Like other opiates, e.g., diacetylmorphine (heroin), morphine acts directly on the central
nervous system (CNS) to relieve pain, and at synapses of the nucleus accumbens in particular. Studies
done on the efficacy of various opioids have indicated that, in the management of severe pain, no other
narcotic analgesic is more effective or superior to morphine. Morphine is highly addictive when
compared to other substances; tolerance, physical and psychological dependences develop very rapidly.
The word "morphine" is derived from Morpheus, one of the Greek gods of dreams.

A Hungarian chemist, Janos Kabay found and internationally patented a method to extract morphine
from 'poppy-straw': dried poppy pods and stem, and other parts of the dry plant, except for seeds and
root. In natural form, in poppy plant, the alkaloids are bound to meconic acid. The method is to extract
from the crushed plant with diluted sulfuric-acid, which is a stronger acid than meconic acid, but not so
strong to react with alkaloid molecules. The extraction is performed in many steps (one amount of
crushed plant is at least six to ten times extracted, so practically every alkaloid goes into the solution).
From the solution obtained at the last extraction step, the alkaloids precipitated by either ammonium-
hydroxide or sodium-carbonate. The last step is purifying and separating morphine from other opium
alkaloids (Opium poppy contains at least 15-20 different alkaloids, but most of them are of very low
concentration). In the 1950s and 1960s, Hungary supplied nearly 60% of Europe's total legal,
medication-purpose morphine production. To this day, poppy farming is legal in Hungary, but poppy
farms are limited by law to 2 acres. It is also legal to sell dried poppy in flower shops for use in floral

         Morphine was first isolated in 1804 in Paderborn, Germany by the German pharmacist Friedrich
Wilhelm Adam Sertürner, who named it "morphium" after Morpheus, the Greek god of dreams. But it
was not until the development of the hypodermic needle in 1853 that its use spread. It was used for pain
relief, and as a "cure" for opium and alcohol addiction. Later it was found out that morphine was even
more addictive than either alcohol or opium, and its extensive use during the American Civil War
allegedly resulted in over 400,000 sufferers from the "soldier's disease" of morphine addiction. This idea
has been a subject of controversy, as there have been suggestions that such a disease was in fact a hoax
and soldier's disease did not occur after the Civil War.
Diacetylmorphine (better known as heroin) was derived from morphine in 1874 and brought to market
by Bayer in 1898. Heroin is approximately 1.5-2 times more potent than morphine on a milligram-for-
milligram basis. Using a variety of subjective and objective measures, the relative potency of heroin to
morphine administered intravenously to post-addicts found 1.80 mg of morphine sulfate equals to 1 mg
of diamorphine hydrochloride (heroin). The pharmacology of heroin and morphine is identical except the
two acetyl groups increase the lipid solubility of the heroin molecule, and thus the molecule enters the
brain a bit more rapidly. The additional groups are then detached, yielding morphine, which is what,
causes the subjective effects of heroin. Therefore, the effects of morphine and heroin are identical except
that heroin is slightly more potent and acts slightly faster. Morphine, heroin and cocaine became
controlled substances in the U.S. under the Harrison Narcotics Tax Act of 1914, and possession without
a prescription in the US is a criminal offense.
In 1952, Dr. Marshall D. Gates, Jr. was the first person to chemically synthesize morphine at the
University of Rochester. This breakthrough is well renowned in the field of organic chemistry.
Morphine is routinely carried by soldiers on operations in an auto injector.
Morphine was the most commonly abused narcotic analgesic in the world up until heroin was
synthesized and came into use. Even today, morphine is the most sought after prescription narcotic by
heroin addicts when heroin is scarce.
Slang terms for morphine include M, Big M, Miss Emma, morph, morpho, Murphy, cube, cube juice,
White Nurse, Red Cross, mojo, hocus, 13, Number 13, mofo, unkie, happy powder, joy powder, first
line, Aunt Emma, coby, em, emsel, morf, dope, glad stuff, goody, God's Medicine, God's Own
Medicine, hard stuff, morfa, morphia, morphy, mud, sister, Sister Morphine, stuff, white stuff, white
merchandise and others.

Side effects:
               Coma                                            Respiratory arrest
               Hypoventilation                                 Cardiac arrest
               Spontaneous abortion                            Death
               Bradycardia                                     Faintness
               Palpitation                                     Flushing of the face
           Ear, nose, and throat:                               Visual distortions
               Dry mouth
           Endocrinal:                                       Gastrointestinal:
               Eugonadism                                      Nausea
           Eye:                                                 Constipation
               Pupil constriction
               Intermittent blurring                        Hepatological:
      Renal failure                                       Euphoria
   Hematological:                                          Sedation

   Musculoskeletal:                                     Respiratory:
      Muscle twitch                                       Slow and shallow respiration
      Analgesia                                        Skin:
   Psychological:                                          Itchiness
      Anxiolysis                                          Flushing
      Confusion

Morphine Side Effects
Morphine has many side effects including the most dangerous which is respiratory
depression. Common Morphine side effects are nausea and vomiting due to the action of
morphine stimulating centers in the brain concerned with vomiting called the chemotactic
trigger zone. Other central nervous system side effects of morphine are cough
suppression, sedation, and dependence leading to addiction. Morphine can also cause
histamine release, which causes itching of the skin and nose as well as a mild flushing of
the skin.
Morphine side effects include but are not limited to:
      anxiety                                             exaggerated sense of well-being
      involuntary movement of the                         seizure
       eyeball                                             dreams
      blurred vision / double vision                      light - headedness
      constipation                                        swelling due to fluid retention
      "pinpoint" pupils                                   dry mouth
      chills                                              nausea
      depressed or irritable mood                         tingling or pins and needles
      itching                                             facial flushing
      cramps                                              sedation
      dizziness                                           tremor
      rash                                                fainting / faintness
      diarrhea                                            sweating
      drowsiness                                          uncoordinated muscle
      rigid muscles                                        movements
      inability to urinate                                floating feeling
      vomiting                                         high/low blood pressure
      weakness                                         appetite loss
      hallucinations                                   accidental injury
      agitation                                        hives
      abdominal pain                                   apprehension
      headache                                         memory loss
      allergic reaction                                insomnia
      abnormal thinking

3. Heroin
Heroin is a drug made from morphine, a natural substance in the seedpod of the Asian
poppy plant. Heroin usually appears as a white or brown powder. Heroin can be injected,
smoked or snorted. Heroin abuse is a serious problem in the United States. Major health
problems from heroin include miscarriages, heart infections and death from overdose.
People who inject the drug also risk infectious diseases, including HIV/AIDS and
Regular use of heroin can lead to tolerance. This means users need more and more drug to
have the same effect. At higher doses over time, the body becomes dependent on heroin.
If dependent users stop heroin, they have withdrawal symptoms. These symptoms include
restlessness, muscle and bone pain, diarrhea, vomiting and cold flashes.

Heroin (INN: diacetylmorphine, BAN: diamorphine) is a semi-synthetic opioid
synthesized from morphine, a derivative of the opium poppy. It is the 3, 6-diacetyl ester
of morphine (hence diacetylmorphine). The white crystalline form is commonly the
hydrochloride salt diacetylmorphine hydrochloride. One of the most common methods of
heroin use is via intravenous injection. When taken orally, heroin undergoes extensive
first-pass metabolism via deacetylation, making it a prodrug for the systemic delivery of
morphine. When the drug is injected, however, it avoids this first-pass effect, very rapidly
crossing the blood-brain barrier due to the presence of the acetyl groups, which render it
much more lipid-soluble than morphine itself. Once in the brain, it is deacetylated into 3-
and 6-monoacetylmorphine and morphine, which bind to μ-opioid receptors resulting in a
sense of extreme well-being with the feeling centered in the gut.
As with other opiates, heroin is used both as a pain-killer and a recreational drug.
Frequent administration has a high potential for causing addiction and may quickly lead
to tolerance. If a continual, sustained use of heroin for as little as three days is stopped
abruptly, withdrawal symptoms can appear. This is much shorter than the withdrawal
effects experienced from other common painkillers such as oxycodone and hydrocodone.
 Internationally, heroin is controlled under Schedules I and IV of the Single Convention
on Narcotic Drugs.[5] It is illegal to manufacture, possess, or sell heroin in the United
States and the UK. However, under the name diamorphine, heroin is a legal prescription
drug in the United Kingdom. Popular street names for heroin include black tar, smack,
junk, skag, horse, brain, and others. These are specific references to heroin and not used
to describe any other drug. Dope could be used to refer to heroin, but may also indicate
other drugs, from laudanum a century ago to nearly any contemporary recreational drug.
The opium poppy was cultivated in lower Mesopotamia as long ago as 3400 BC. The
chemical analysis of opium in the 19th century revealed that most of its activity could be
ascribed to two ingredients, codeine and morphine.
Heroin was first processed in 1874 by C.R. Alder Wright, an English chemist working at
St. Mary's Hospital Medical School in London, England. He had been experimenting with
combining morphine with various acids. He boiled anhydrous morphine alkaloid with
acetic anhydride over a stove for several hours and produced a more potent, acetylated
form of morphine, now called diacetylmorphine.
In the United States the Harrison Narcotics Tax Act was passed in 1914 to control the sale
and distribution of heroin. The law did allow heroin to be prescribed and sold for medical
purposes. In particular, recreational users could often still be legally supplied with heroin
and use it. In 1924, the United States Congress passed additional legislation banning the
sale, importation or manufacture of heroin in the United States. It is now a Schedule I
substance, and is thus illegal in the United States.
Production and trafficking: The Golden Triangle
Manufacturing: Primary worldwide producers of heroin.
Heroin is produced for the black market
through opium refinement process - first,
morphine is isolated from opium. This crude
morphine is then acetylated by heating with
acetic anhydride. Purification of the obtained
crude heroin as a hydrochloride salt provides
a water-soluble salt form of white or
yellowish powder.
Crude opium is carefully dissolved in hot water but the resulting hot soup is not boiled.
Mechanical impurities - twigs - are scooped together with the foam. The mixture is then
made alkaline by gradual addition of lime. Lime causes a number of unwelcome
components present in opium to precipitate out of the solution. (The impurities include
the useless alkaloids, resins, proteins). The precipitate is removed by filtration through a
cloth, washed with additional water and discarded. The filtrates containing water-soluble
calcium salt of morphine are then acidified by careful addition of ammonium chloride.
This causes the morphine to precipitate. The morphine precipitate is collected by filtration
and dried before the next step. The crude morphine (which makes only about 10% of the
weight of the used opium) is then heated together with acetic anhydride at 85 °C (185 °F)
for six hours. The reaction mixture is then cooled, diluted with water, alkalized with
sodium carbonate and the precipitated crude heroin is filtered and washed with water.
This crude water-insoluble free-base product (which by itself is usable, for smoking) is
further purified and decolorized by dissolution in hot alcohol, filtration with activated
charcoal and concentration of the filtrates. The concentrated solution is then acidified
with hydrochloric acid, diluted with ether and the precipitated white hydrochloride salt of
heroin is collected by filtration. This precipitate is the so-called "no. 4 heroins", the
standard product exported to the Western markets. (Side-product residues from
purification or the crude free base product are also available on the markets, as the "tar
heroin" - a cheap substitute of inferior quality.)
The initial stage of opium refining - the isolation of morphine - is very easy to perform in
rudimentary setting - even with substituting suitable fertilizers for pure chemical reagents.
However, the later steps (acetylating, purification, and precipitation as hydrochloride) are
more involved - they use large quantities of dangerous chemicals and solvents and they
require both skill and patience. The final step is particularly tricky as the highly
flammable ether can easily ignite during the positive-pressure filtration (the explosion of
vapor-air mixture can obliterate the refinery). If the Heroin does ignite, the result is a
catastrophic explosion.
History of heroin trafficking
The origins of the present international illegal heroin trade can be traced back to laws
passed in many countries in the early 1900s that closely regulated the production and sale
of opium and its derivatives including heroin. At first, heroin flowed from countries
where it was still legal into countries where it was no longer legal. By the mid-1920s,
heroin production had been made illegal in many parts of the world. An illegal trade
developed at that time between heroin labs in China (mostly in Shanghai and Tianjin) and
other nations. The weakness of government in China and conditions of civil war enabled
heroin production to take root there. Chinese triad gangs eventually came to play a major
role in the heroin trade.
Heroin trafficking was virtually eliminated in the U.S. during World War II due to
temporary trade disruptions caused by the war. Japan's war with China had cut the normal
distribution routes for heroin and the war had generally disrupted the movement of
opium. After the Second World War, the Mafia took advantage of the weakness of the
postwar Italian government and set up heroin labs in Sicily. The Mafia took advantage of
Sicily's location along the historic route opium took from Iran westward into Europe and
the United States. Large scale international heroin production effectively ended in China
with the victory of the communists in the civil war in the late 1940s. The elimination of
Chinese production happened at the same time that Sicily's role in the trade developed.
Although it remained legal in some countries until after World War II, health risks,
addiction, and widespread abuse led most western countries to declare heroin a controlled
substance by the latter half of the 20th century.
Between the end of World War II and the 1970s, much of the opium consumed in the
west was grown in Iran but in the late 1960s, under pressure from the U.S. and the United
Nations, Iran engaged in anti-opium policies. While opium production never ended in
Iran, the decline in production in those countries led to the development of a major new
cultivation base in the so-called "Golden Triangle" region in South East Asia. In 1970-71,
high-grade heroin laboratories opened in the Golden Triangle. This changed the dynamics
of the heroin trade by expanding and decentralizing the trade. Opium production also
increased in Afghanistan due to the efforts of Turkey and Iran to reduce production in
their respective countries. Lebanon, a traditional opium supplier, also increased its role in
the trade during years of civil war.
Soviet-Afghan war led to increased production in the Pakistani-Afghani border regions. It
increased international production of heroin at lower prices in the 1980s. The trade shifted
away from Sicily in the late 1970s as various criminal organizations violently fought with
each other over the trade. The fighting also led to a stepped up government law
enforcement presence in Sicily. All of this combined to greatly diminish the role of the
country in the international heroin trade.
Sandra Gregory has written an autobiography covering her experience of getting caught
with Heroin at a Thai airport.
Effect of heroin
Long-term effects of heroin use
One of the most detrimental long-term effects of heroin use is addiction itself. Addiction
is a chronic, relapsing disease, characterized by compulsive drug seeking and use, and by
neuro-chemical and molecular changes in the brain. Heroin also produces profound
degrees of tolerance and physical dependence, which are also powerful motivating factors
for compulsive use and abuse. As with abusers of any addictive drug, heroin abusers
gradually spend more and more time and energy obtaining and using the drug. Once they
are addicted, the heroin abusers’ primary purpose in life becomes seeking and using
drugs. The drugs literally change their brains and their behavior. Physical dependence
develops with higher doses of the drug. With physical dependence, the body adapts to the
presence of the drug and withdrawal symptoms occur if use is reduced abruptly.
Withdrawal may occur within a few hours after the last time the drug is taken. Symptoms
of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting,
cold flashes with goose bumps (“cold turkey”), and leg movements. Major withdrawal
symptoms peak between 24 and 48 hours after the last dose of heroin and subside after
about a week. However, some people have shown persistent withdrawal signs for many
months. Heroin withdrawal is never fatal to otherwise healthy adults, but it can cause
death to the fetus of a pregnant addict. At some point during continuous heroin use, a
person can become addicted to the drug. Sometimes addicted individuals will endure
many of the withdrawal symptoms to reduce their tolerance for the drug so that they can
again experience the rush. Physical dependence and the emergence of withdrawal
symptoms were once believed to be the key features of heroin addiction. We now know
this may not be the case entirely, since craving and relapse can occur weeks and months
after withdrawal symptoms are long gone. We also know that patients with chronic pain
who need opiates to function (sometimes over extended periods) have few if any
problems leaving opiates after their pain is resolved by other means. This may be because
the patient in pain is simply seeking relief of pain and not the rush sought by the addict.

Short- and Long-Term Effects of Heroin Abuse

Short-Term Effects:                              Long-Term Effects:
■ “Rush”                                         ■ Addiction
■ Depressed respiration                          ■ Infectious diseases, for example,
                                                 HIV/AIDS and hepatitis B and C
■ Clouded mental functioning
                                                 ■ Collapsed veins
■ Nausea and vomiting
                                                 ■ Bacterial infections
■ Suppression of pain                            ■ Abscesses
■ Spontaneous abortion                           ■ Infection of heart lining and valves
                                                 ■ Arthritis and other rheumatologic

                                                 Heroin is used as a recreational drug for
                                                 the intense euphoria it induces, which
                                                 diminishes with increased tolerance. Its
                                                 popularity with recreational drug users,
                                                 compared to morphine and other opiates,
                                                 stems from its perceived different
                                                 effects; this is unsupported by clinical

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