Chelsea Doebereiner

English Writing Two

Final Paper
An ongoing epidemic
Dependence on painkillers became an epidemic across America nearly a decade ago.
Over the last few years the opiate known as heroin moved from lower class minority populations
to more suburban areas. The increase in heroin was seen across multiple populations forcing the
government to react and they controlled the drugs the best they could. In return, people began
looking for the next best thing, a cheaper alternative and something that was much easier to
obtain; heroin (Khazan, 1)
Heroin is a Narcotic. Narcotics can be divided into three categories, opium and its natural
components that can be taken from opium; morphine, codeine and thebaine. The second category
are derivatives from opium, these are created by making small changes in the chemical
composition of the drug morphine. The most popular type of example of this, is heroin. This
group is often called opiates in general. The third and last group are synthetic drugs that are in no
way chemically related to morphine, but produce effects much like those of opiates, these are
synthetic opiates.
Opium comes from the opium poppy, an annual plant that produces large flowers that are
white, pink, red or purple. This type of poppy is the only one of its kind that produces opium.
Once the petals of the plant have fallen off and the seeds are not completely ripe, harvesters
make small incisions into the seed capsules, allowing a milky white substance to come to the

surface. In the following hours, after having contact with the air, the milky white liquid will have
hardened into a reddish brown color and turned into the texture of something like honey.
Opium started being regarded to as a therapeutic drug, it gained its popularity in Western
Europe during the eleventh and twelfth century who learned of this magic liquid from the Arabs.
In 1520, Paracelsus, a physician, presented a medicinal drink that contained opium, wine, and
other spices. The mixture was called Laudanum and was recommended to fix just about every
know disease and ailment. Following in 1680, Thomas Sydenham produced a liquid concoction
much like that of Paracelsus. This presented an era of acceptable means of consuming opium in
the form of a drink throughout Europe and eventually the United States. The popularity of the
drinking of opium led to the recreational use of such a powerful drug.
The Opium Wars started in 1839 in attempt to force China to import opium in trade. The
wars were fought by the British and eventually the French and Americans. The success came
from winning against Chinese forces and China opening up the international trade. After this,
opium smoking and dependence became an overwhelming social problem. In 1860, a treaty was
signed that required China to legalize opium within its borders.
After the Opium wars, opium was everywhere. The biggest difference between the use in
China and the use in Britain was that of how it was consumed, not how much was consumed. In
Britain it was consumed through drinking such as the Laudanum potion, where as in China they
smoked opium, which was widely frowned upon in other areas of the world. As long as people
were not smoking opium, abusers and addicts were considered the same as drunks. Anyone could
use opium; this was often used on infants and young children to help with pain, colic or even just
to simply to keep a young child quiet.

Opium in the United States was extremely and highly widespread. Women outnumbered
men in the use of opium during the nineteenth century, the theory was that husbands drank at the
saloon while women took opium while at home. In the 1800'e opium, alcohol, nicotine and
cocaine were the most popular recreational drugs of the time. The popularity of opium came
from the readily availableness of it. All the way up to 1897, Sears mail-order catalog advertised
the Laudanum liquid opium drink for six cents an ounce. Also advertised in this catalog was a
quick fix to a man alcoholism, opium and for the abuser of opium the fix was, cocaine.
In 1803, Friedrich Wilhelm Adam Serturner isolated a yellowish white substance from
raw opium that happened to be its primary active ingredient, morphine. The invention of the
hypodermic syringe in 1856, would now allow morphine to be injected directly into the
bloodstream instead of taken orally which then speeds up that effects of the drug. A derivative
from morphine that is a painkiller was introduced to the scene in 1898 by the Bayer Company,
the same company that introduced aspirin. Heroin is three times stronger than morphine, it was
believed that it lacked the morphine dependence properties and was used as an entirely safe
cough suppressant to relieve the discomfort in the chest due to pneumonia and tuberculosis. The
actual potential for abuse of heroin was not understood or recognized until the last 1910's.
By the 1900's there were at least 250,000 opiate dependent people in the United States.
The Harrison Act of 1914 changed opiate use and abuse from there on out in the United States.
Although the Harrison Act did not actually ban opiate use, it required doctors to register with the
Internal Revenue Service what they were prescribing to patients and pay a fee for the right to
prescribe the drugs. Later in 1920 the courts decided that no physician was permitted to prescribe
an opiate based drug for nonmedical use. Without a legal source for their habit, addicts had to
abandon opiates and go to the black market. In 1925, there were an estimated 200,000 heroin

addicts in the United States. It was a market which is still highly popular and sought after to this
day. (Narconon, 1)
Heroin seemed to be the best fit for black market drugs. It was easy to obtain and it was
more profitable to refine from raw opium overseas and ship it to the country in small bags of
heroin powder rather than to transport raw opium with its known odor. In 1961, a crackdown on
smuggling of heroin resulted in a large shortage of street heroin, resulting in the price of heroin
skyrocketing; criminal behavior became associated with the increase in price which influenced
the African American and Latino population more than any other community. In the 1960's, the
caucasian population was affected more heavily by the addiction of heroin. This was the time of
the youthful counterculture of hippies, flower children, and sexually liberated youth that used
illegal drugs to get high. Increasing widespread recreational use of heroin was reported alongside
with alcohol and marijuana. One of the biggest groups that felt the impact of heroin was that of
the Vietnam veterans. At least one in ten veterans would return home dependant on heroin.
In 1980, the growth of crack cocaine abuse pushed the overwhelming issue of heroin
abuse out of everyone's view momentarily, heroin still continued to be cultivated in new and
inventive ways. One way of this is a almost completely pure, inexpensive form of heroin from
Mexico called black tar in 1985. Synthetic drugs also started appearing on the streets, created in
illegal underground drug laboratories in the United States. One drug was made from fentanyl,
which was a narcotic drug that was often prescribed, could be anywhere from ten to a thousand
times stronger than heroin, was referred to as China White. With the use of China White the risk
of overdosing and death increased drastically.

No laws actually applied to these designer drugs because they did not have the same
chemical composition as heroin. In 1986 any drug that shared chemical composition or
pharmacological effects like other controlled substances where illegal due to the Controlled
Substance Analogue Act.
The United States no longer got their heroin from Asia, instead it was smuggled in from
South America. The purity of the heroin from South America exceeded 60 percent, which was
ten times stronger than that of the heroin in the 1970s. In 1994, 90 percent purity heroin took
over the streets in New York City and resulted in several overdose deaths in a five day period.
The availability of highly pure heroine resulted in the need for the drug to no longer be injected.
Instead users, abusers and addicts could now snort or smoke the drug. Heroin abusers would then
frequently smoke mixtures of heroin and crack, called criss-crossing, or heating heroin and
inhaling it. The methods of smoking and snorting opened the door to other populations who
steered away from the drug due to the fear and dislike of hypodermic needles.
Heroin has many effects that are determined by the purity and amount of heroin
administered, how the drug is taken, snorted, smoked or injected, how long it has been since the
last dose of heroin taken and the level of tolerance the abuser has. If injected, the effects are
almost immediate including tingling sensations, warmth in the lower abdomen, intense euphoria,
drowsiness. These effects can last three to four hours, in this time the abusers interest in sex is
near nonexistent due the reduced levels of testosterone that opiates cause. Opiates also cause
nausea, vomiting, extreme itching over the entire body, reddening of the eyes and pupillary
constriction due the release of histamine into the blood stream. Heroin reduces the delicacy of
respiratory centers in the medulla to levels of carbon dioxide, which caused depression in

breathing. Blood pressure is also highly affected due to heroin intake. Due to the depression of
respiratory centers, in high doses heroin use can result in death.
The most popular way to administer heroin is through injections called mainlining or
shooting. Until recently, smoking heroin has not been a popular method to administer the drug.
People new to the drug may begin the dive into the addiction by snorting the drug or by injecting
it subcutaneously, called skin popping. Skin popping is the method in which drugs are injected
right under the skin instead of directly into the blood stream. After a long road of abuse some
users resort to smoking heroin and avoid using needles because they can no longer find veins that
are in good enough shape to inject the drug. On the other hand, taking heroin orally is close to
pointless because it have extremely poor absorption rates.
Chronic heroin abusers face tolerance and withdrawal symptoms. Greatest signs of
tolerance are determined by the degree of analgesia, euphoria, and respiratory depression. The
thrill of injection will also be lessened the longer someone is abusing the drug. Withdrawal is a
slippery slope with heroin. The first symptom is a deep craving for the next dose, the next fix,
which begins about four to six hours after the last dose was administered. This craving continues
for the next thirty two to seventy two hours. The withdrawal period is over is about seven to ten
days. When doses that have been administered have been less than ten percent the withdrawal
symptoms are those like having flu like symptoms. In worse cases withdrawal symptoms can
include severe weight loss and loss of body fluids.
The interest to continue taking heroin is partly to blame on the fear of encountering the
dreaded withdrawal symptoms and the craving for the drug itself and the physical and
psychological effects which ends up creating a dependence on the drug. Some heroin users, even

after they have recovered from their addiction continue to insert hypodermic needles into their
skin to experience the effects of heroin without actually taking the drug. This is an instance of
conditioning, their body learned to expect these symptoms and feelings when a needle is
inserted, therefore the body produces the same effects as being high on the drug.
Deaths due to heroin overdoes are often due to combinations of heroin with other highly
abused stimulant drugs like cocaine, depressants such as alcohol, valium or barbiturates. Other
instances include extremely fast and unexpected deaths due to heroin, some people have been
found with a needle still stuck in their veins. These deaths are usually due to an extremely high
release of histamine or due to an allergic reaction to some type of filler that is in their heroin that
the abuser has an extreme sensitivity to.
Treatment for heroin addicts begin at detoxification, the process in which a person goes
through withdrawal so the body is allowed to rid itself of the chemical effects that the drug has in
the bloodstream. Detoxification in done in a gradual fashion under supervision by a medical
specialist. The specialist will administer a synthetic opiate drug like propoxyphene or methadone
to substitute for heroin and then slowly decrease the doses of the synthetic drugs within two
weeks to decrease the effects of sudden withdrawal or quitting 'cold turkey.' Once detoxification
is completed, long term problems such as the issue of dependence still remains. The deep craving
for heroin still exists which raises the likelihood of relapse and going back to the drug. The
argument against methadone programs is that one drug is simply being replaced by another
instead of depleting the drug use entirely.
Other approaches in treating heroin addiction include Intreatment facilities. There are
facilities such as therapeutic communities that are living environments for people in treatment

for heroin and other abuse in which the individuals learn social and psychological skills to help
live in a life without drugs. Another way to help addicts are multimodality programs. These are
treatment programs where a combination of detoxification, psychotherapy and group support is
administered. 1
Heroin can affect any culture, race, age or gender. Heroin does not care how much money
you make or your profession. Young adults from the ages 18 25 are seeing the biggest increase,
with the usage more than doubling over the past decade. Many people who are using Heroin are
also using other substances, most commonly cocaine and prescription painkillers. Overdose
deaths between 2002 and 2013 have nearly quadrupled. Heroin addiction is serious and often
times the killer of the abuser. To help reduce the amount of Heroin addicts and prevent future
addicts, it takes the entire community, from the Federal government to the family to look for
signs that a loved one maybe using the drug.

Works Cited

Khazan, Olga. "The D.C. Heroin Epidemic: Progress Report." New England Journal of Medicine
N Engl J Med 287.22 (1972): 1154. Web. 4 May 2016.

"History of Heroin." RSS. N.p., n.d. Web. 03 May 2016.

Levinthal. "Narcotics: Opium, Heroin, and Synthetic Opiates." Drugs, Behavior and Modern
Society. 7th ed. Boston: Allyn & Bacon, n.d. 119-39. Print.

i Paragraphs two through nineteen are credited to Charles F. Levinthal, author of Drugs, Behavior, and Modern Society.
Seventh Edition. Chapter titled "Narcotics: Opium, Heroin, and Synthetic Opiates, pages 119-139.