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									                                    Temecula Valley Young Marines
                                                31337 Huron St
                                              Temecula, Ca 92592

                                                                                   26 Mar 06

                                               Class Outline

Terminal Learning Objective: In a classroom setting provided a test or written assignment complete all
questions in a timely manner.

Enabling Learning Objectives:

   (1) Without the use of your guide book, Describe in writing “What are some of the Signs and Symptoms
   of Heroin use?”
   (2)Without the use of your guide book, Describe in writing “What are the complications of Heroin use?”
   (3) Without the use of your guidebook, Describe in writing, “What is Methadone?”
   (4) Without the use of your guidebook, Describe in writing, “What are the effects of Heroin to unborn
   (5) Without the use of your guidebook, Describe in writing, “What is withdrawal sickness”?
   (6) Without the use of your guidebook, Describe in writing, “How many people are affected in the United

Class Outline

               Heroin is highly physically addictive, more so than morphine, and on a par with nicotine.
Regularity of use is as important as the amount in the development of addiction. To compound things, the body
quickly builds a tolerance to the drug. Long term, larger and larger doses are needed to achieve the same effect.
                                        THE HEROIN STORY
                                                                    QUICK FACTS:
    Heroin, an (opiate) narcotic is an illegal and highly addictive drug. Opiate dependence producing (addictive) properties are displayed by: 1.
    abusive regular use of the drug; 2. sudden attempts to stop using the drug will cause significant and painful withdrawal symptoms; 3.
    reuse of the drug will cause the withdrawal signs to disappear; 4. abuse may lead to compulsive drug seeking behavior (craving); and 5.
    abuse leads to increased frequency or dosage of the drug (tolerance).

    Heroin and other opioids primary addictive qualities are exerted on those regions of the brain and central nervous system that are
    responsible for the pleasure sensation of “reward” and the “physical / psychological dependence syndrome.” The brain’s neurochemicals
    associated with the opiates control pain and physical endurance. The additions of these drugs into the system account for the abuser’s loss
    of control. Heroin itself, as well as the “drug abusing” lifestyle, may suppress the body’s immune system. This suppression makes users
    “high risk” for infections, some life threatening. Intravenous drug abusers account for the highest percentage of HIV (AIDS) and hepatitis
    virus infected population.

HISTORY OF DRUG                                             UNDER THE INFLUENCE                       History - (continued from column 1 - this page)
                                                            SIGNS AND SYMPTOMS
The term opiate refers to certain alka-                    With moderate use, the user                In 1898 heroin was marketed as a safe
loids or chemical compounds found in                                  will                            product; free from the addictive proper-
the milky fluid of the unripe seed pod of              be subject to:                                 ties then known to result from morphine.
the poppy plant Papaver somniferum,                                                                   Being considered a depressant, it was
the only one of 28 main types of poppies                Nausea and occasional vomit-                 used in sleeping aids; also for coughs,
from which opium is obtained. There                       ing because the drug acts on the            asthma, and was proposed as a treatment
are over 25 known alkaloids in the                        nausea center in the brain.                 for “morphinism.” However, heroin was
poppy, but the most important are mor-                  Pinpoint pupils because opiates              soon to reveal a high potential for addic-
phine and codeine.                                        affect the muscles which control            tive abuse, causing a dependency quicker
                                                          muscle size.
                                                                                                      than morphine. It was then outlawed in
                                                        Slowed respiration and pulse
Heroin is the name, copyrighted in Ger-                                                               the United States and is listed as a
                                                          because the drug affects the part
many at the end of the 19th century, for                                                              scheduled non-prescribed drug. Heroin
                                                          of the nervous system that
the     synthesized      drug     “diacetyl-                                                          has become the opiate of choice by its
                                                          controls those functions.
morphine.” This drug is derived from                                                                  users because of the potency, which is 4
                                                        Dry skin and itching (histamine
acetylating the natural opium compound                                                                to 5 times greater than morphine. Heroin
morphine (C17H19N03) into a semi-
                                                        Slowed speech and movement.                  has a “built in trap” for the beginning
synthetic drug by the name of diacetyl-                                                               user. Heroin, when used, creates a eu-
morhpine (C21H23N05), also known as                    With larger quantities to get a de-            phoric feeling of relaxation. Along with
Heroin. Like morphine, pure heroin is a                sired euphoric effect the user will be         that euphoric feeling is a more intense
white, bitter, powdered substance.                     subject to:                                    experience which occurs when the user
                                                                                                      injects the drug into the vein. This expe-
Traffickers dilute it with substances that              Suppresses breathing to dan-                 rience is referred to as a “Rush” or
color it from off-white to brown. In re-                   gerous levels.                             “Needle Rush.” Although the novice
cent years, illicit manufacturers have                  Slows the heart rate, lowers the             user may also feel sick and even vomit
now taken a shortcut by acetylating the                    blood pressure and become un-              after an injection, this “satisfaction”
tar opium and converting the available                     conscious.                                 quickly captivates the thinking of many;
morphine in the tar opium into heroin.                                  ——-                           thus establishing a desire that just about
This type of end product takes on a “tar               If the user wants emotional effects            assures continued use - and eventually
like” appearance. Usually a dark brown to              for longer period of time, they could:         addiction.
black in color, and soft to hard chunk
consistency in appearance. This product                 Become severely constipated.                 If drugs did only what people wanted
is sold as” tar heroin.”                                Become drug dependent.                       them to, then drugs wouldn’t be much of a
                                                        Lose sexual desire.                          problem. But drugs not only generate
                                                                                                      desired emotional and physical effects,
                                                                                                                                              (continued on page 2)
                    (continued column 3 - this page)
History - (continued from page 1)      UNBORN INFANTS SUFFER ADDICTION                       IMPLICATIONS OF
they also trigger unwanted dan-      Heroin can penetrate the placenta, harming            NARCOTIC ADDICTION
gerous side effects. This compe-     the developing fetus.
tition between                                                                            Most heroin addicts are socially
the emotional effects that users      Heroin use impedes needed oxygen deliv-            non-functional. Their daily activi-
                                       ery to the fetus.                                  ties are centered around commit-
  METHODS OF USE                                                                          ting crimes to obtain money for
Heroin has been ingested, in-         Heroin use contributes to the danger of mis-       heroin, making a “connection”
jected, smoked, and sniffed            carriage, stillbirth, and infant mortality.        with a dealer, and trying to avoid
(insuffilation)    into the nose.                                                         withdrawal pains. The activities
In the United States, the major-      Heroin exposed infants suffer 10 times             that an addict will resort to in
                                       more chance of having birth defects than do        order to obtain money to purchase
ity of those using heroin do so by
                                       unexposed fetuses.
taking a “fix” (an injection of                                                           heroin are usually harmful and
enough heroin to bring on the                                                             destructive to the person and those
                                      Heroin use regularly during pregnancy in-          around them. A career of heroin
desired effects). This consists of     creases the assurance the child will be born
dissolving the drug in a little                                                           addiction may lead to destructive
                                       addicted and suffer withdrawal symptoms
water, filtering it through cotton                                                        changes in personality or impaired
                                       after birth that may be more severe than
into a needle, and injecting it,                                                          emotional maturation.
                                       those experienced by adults.
usually into a vein. Continued
injections develop scar tissue or     Heroin injections often result in infection that
“track marks” on the vein.             is transmitted to the infant; leading to mental
                                       retardation, impaired coordination, lack of                METHADONE
Due to the public awareness of         full muscle control, and even death.
the infectious diseases that are                                                                 MAINTENANCE
associated with intravenous use      Medical treatment can help control some of           A synthetic opioid developed to
and shared needles, the users are    the immediate symptoms and suffering. Some
                                                                                          help control pain and heroin ad-
now more aware of rinsing their      may persist for months, and some may be
                                                                                          diction was developed by the name
needles out with bleach between      irreversible. The child may continue to be
                                                                                          of Methadone or “Dolophine.” It is
injection sharing.                   hyperactive, have limited attention span, poor
                                     coordination, and have speech problems.              the only legally authorized opioid
                                                                                          (that is not an opiate blocker) to
                                                                                          treat heroin addiction through a
                                                                                          program           known          as
                                           NEWBORNS HAVE SUFFERED:                        “maintenance.” Methadone is
                                                                                          usually taken orally causing pain
                                       Below normal weight       Food rejection           killing and depressant effects that
                                       Watery eyes               Breathing difficulty     last for 4 to 6 hours. It also
                                       Runny nose                Muscle spasms            reduces the drug craving and
                                       I rritability             Dehydration              blocks withdrawal symptoms for
                                       Sleeplessness             Severe vomiting          24 hours. Thus, only one dose is
 HEROIN AND OPIOID                     Fever                     Diarrhea                 needed every day instead of 4 to 6
    ANTAGONISTS                        Pain                      Convulsions              doses of heroin. There is great
                                       Excessive crying          Death                    controversy         about       the
Opiate or opioid antagonists do                                                           “maintenance” programs because
not have much effect on the                                                               there are those who do not believe
body except for their ability to                                                          you should treat drug abuse with
block the effects of the drug.
Naloxone is effective in treating
heroin or opiate overdose. Nal-
trexone is used to prevent the
addict from using. It is usually a           KIT FOR
requirement that the user be
free of heroin for a few days               INJECTING
before starting this program.
Taking Naltrexone daily will                HEROIN
block the effects of heroin or any
other opiate or opioid.
KICKING “COLD TURKEY”                                                          PARAPHERNALIA                                                             HEROIN SYRINGE
                                         The most common method of using
                                         heroin is injecting it into the veins. Para-
            FIRST PERIOD                 phernalia for injecting heroin is called
                                         an “outfit”, “rig”, “kit”’ or the “works”.
The first symptoms to appear are watery It usually consists of a spoon or bottle
eyes, mucous is discharged from the cap, syringe, needle, needle sheath, cot-
nose, perspiration becomes noticeable, ton, match or lighter, and tourniquet.
and the addict begins to yawn. Restless-
ness develops, accompanied by increas- Once the addict is in possession of the
ing nervousness; both becoming worse as injection paraphernalia and heroin, they
the addict progresses toward maximum are ready to “fix” (inject the heroin into                                                                      HEROIN ABUSE
discomfort.                              the vein.)
     WITHDRAWAL SICKNESS                                           The heroin will be taken out of the
Regardless of the severity of the first                            packaging and placed in the empty                                             Respiratory depression
period symptoms, the worst is still to be                          spoon or cap. Water will be put into the                                      Infection of inner heart lining
endured. Piercing abdominal cramps,                                syringe and then into the spoon or cap                                        Swelling lung tissue
nausea, vomiting, retching, gagging,
                                                                   containing the heroin. The mixture is                                         Blood clots lodged in the lungs
choking, plus mental despair reaching
                                                                   then heated with a heat source until the                                      High blood pressure
                                                                   first bubble rises to the surface of the                                      Liver disease
the level of hopelessness, hardly de-
                                                                   solution and the heroin dissolves. A                                          Tetanus
scribes the “kicking” experience addicts                           small amount of cotton is placed in the                                       Abscesses
suffer. Huddled under what covers they                             bowl of the spoon or cap to prevent                                           Clots and inflammation of
have, resorting to a fetal position, shiver-                       clogging of the needle. The solution is                                        blood vessels
ing even in hot weather, they become                               then drawn into the syringe through the
pictures of a tragic scene of a human                              cotton. The cotton is saved for a “rainy
                                                                                                                                                   DESIGNER HEROIN
being who has hit bottom.                                          day” and can be squeezed to help the
                                                                   addict maintain until they can score                                       Street versions of fentanyls (alpha,
                     CRAVING                                                                                                                  3 methyl) and Demerol (MPPP,
                                                                                                                                              MPTP), manufactured in illegal lab-
After the several days during which a                                              INJECTION SITES                                            oratories, are extremely potent and
user “kicks it out”, the worst symptoms of                                                                                                    can cause drug overdoses and even
abstinence decline until most signs of drug                                                                                                   nervous system damage. Sold as
deprivation disappear. The memory of                                                                                                          “China White,” these drugs bear
euphoria, the drug crutch to “lean” on, and                                                                                                   witness to a growing sophistication
other     recollections    often     become                                                                                                   of street chemists who now can by-
overwhelming.       Addicts, ignoring the                                                                                                     pass the traditional smuggling and
dangers involved, experiencing the “old”                                                                                                      trafficking routes of heroin. Street
mental craving, yield to the temptation of                                                                                                    fentanyls can be up to 3,000 to
“just one heroin fix”, thus the whole                                                                                                         20,000 times stronger than regular
cycle begins over again- and again - and                                                                                                      heroin. Street Demerol containing a
again. Thus the adage “a hype -is a hype                                                                                                      chemi- cal MPTP, can destroy
-is a hype.”                                                                                                                                  brain cells and neurochemicals and
                                                                                                                                              induce the degerative           nerve
                                                                                                                                              condition known

                                                                  “HEROIN: THE DRUG OF DEATH”

       There are an estimated 800,000 to 1.5 million heroin abusers in the United States. Over half of all drug deaths
       in the United States are the result of heroin use. The ever presence of higher grade and synthetic heroin is
       expected to cause drug related deaths to increase. Overdose is a constant danger as street heroin is never cut
       (diluted) in an exact scientific proportion. It is whatever each peddler decides the traffic will bear. The heroin
       overdose death is usually very quick. Addicts who have overdosed have been found with the needle still sticking in
       the vein. The speed of this killer drug leaves little anyone can do to save the persons life.

        This information is provided free of charge. Please feel free to duplicate it for distribution. For other publications, contact us at (661) 775-6960, or visit our web site at: www.cnoa.org
Lesson Summary:

              During this period of instruction you have learned

                     a. What are some of the Signs and Symptoms of Heroin use?

                     b. What are the complications of Heroin use?

                     c.   What is Methadone?

                     d. What are the effects of Heroin to unborn Babies?

                     e. What is withdrawal sickness?

                     f. How many people are affected in the United States?

              Narcotic Educational Foundation of America
                      Drug Abuse Education Provider of the:
                       California Narcotic Officers’ Association


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