The heroin epidemic in the Pacific Northwest is reaching a breaking point. Increases in prescription painkiller use has led to record amounts of heroin users.
The issues in Washington and the Northwest are seen throughout the United States. As more people seek rehabilitation for heroin addiction, it’s important to ask how this all came to be. Here are some interesting facts about heroin, and how it has become one of America’s riskiest illicit drugs.
- Heroin is an opioid drug derived from morphine. Morphine is a natural substance found in the seed pod of the Asian opium poppy plant.
- Heroin comes in many forms. It can be a white or brown powder, or it may appear as a sticky black substance (AKA black tar heroin).
- In 1895, the drug company Bayer marketed diacetylmorphine as Heroin, and sold it as over-the-counter cough suppressant.
- In the US and Pacific Northwest, it’s known as dope, junk, smack, boy, brown sugar, dragon, China white, H, mud, skunk, thunder and horse. Its chemical name is diacetylmorphine.
- Heroin users often pair heroin with crack cocaine. This is called a speedball, and combines both the depressive and stimulant effects of each drug respectively.
- Heroin is the fastest acting opioid.
- Semi-synthetic opioids are made from natural opiates or morphine esters. Semi-synthetics include hydrocodone, oxycodone, heroin, etc.
- Common short-term side effects include euphoria, loss of consciousness, clouded thoughts, dry mouth, flushing skin and heaviness in both hands and feet.
- Adverse effects include collapsed veins, infection in the heart, constipation, liver disease, kidney disease, lung complications, and abscesses in the veins.
- The sharing of needles increases the risk of HIV, hepatitis, and other infections.
For many heroin users in the Pacific Northwest, their heroin addictions began with use of prescription painkillers. These narcotics were prescribed for chronic pain or surgery. This led to increased tolerance and misuse. This is how the heroin epidemic in the US is said to have begun. Those abusing prescription pain medications found heroin to be much less costly and easier to obtain. According to the National Institute on Drug Abuse, “The emergence of chemical tolerance toward prescribed opioids, perhaps combined in a smaller number of cases with an increasing difficulty in obtaining these medications illegally, may in some instances explain the transition to abuse of heroin, which is cheaper and in some communities easier to obtain than prescription opioids.”
- Heroin and opioid use are at crisis levels in King County. In 2015, 229 individuals died from heroin and prescription opioid overdose in King County alone.
- According to the Centers for Disease Control and Prevention, more people die in the United States of drug-related overdose than from automotive accidents, a difference that has been growing since 2008. In 2000, there were more than 40,000 traffic-related deaths and fewer than 20,000 from drug overdose; in 2013, there were 43,982 overdose-related deaths and 32,719 traffic fatalities.
- In March 2016, King County Executive Dow Constantine, Seattle Mayor Ed Murray, Renton Mayor Denis Law and Auburn Mayor Nancy Backus convened the Heroin and Prescription Opiate Addiction Task Force.
- According to the task force report, “From 2010 to 2014 the number of people who entered the publicly funded treatment system for heroin use disorders annually in King County grew from 1,439 to 2,886.”
- When high, heroin users experience a state that alternates between wakefulness and drowsiness. Users call this “the nod.” Heroin is a depressant and can make someone feel very sleepy, so much so that they cannot be roused. While in this comatose state, breathing become dangerously slow and may lead to death.
According to the Seattle Times, “In King County, Washington’s largest population center, data shows there were 49 heroin-involved deaths in 2009. In 2012, there were 84 such deaths, according to UW researchers. As for the average annual number of deaths in Washington state involving heroin and prescription-type opiates, UW researchers reported that from 2000-2002 the number was 310. From 2009-2011, that statewide figure was 607. Researchers say most of those deaths involved prescription-type opiates.”
- Heroin can be injected, snorted and smoked.
- Heroin is rarely sold pure. It is cut with other drugs like sugar, sugar substitutes, quinine, fentanyl, phenobarbital, cocaine, morphine, caffeine, procaine, acetaminophen, methaqualone and strychnine.
- Naloxone is a drug often administered by emergency healthcare technicians to reverse the effects of overdose due to heroin or other opioid use. This rescue drug saves many lives.
- Naloxone works specifically to reverse the activation of the brain’s opioid receptors. The higher the dosage of the opioid, the more Naloxone needed to counter the drug’s effects, especially for drugs like fentanyl and carfentanil.
- “For many years, Naloxone was available only in an injectable formulation and was generally only carried by medical emergency personnel. However, FDA has recently approved a new hand-held auto-injector of naloxone to reverse opioid overdose that is specifically designed to be given by family members or caregivers.” (NIDA)
According to NIDA, “The liquid for injection is commonly used by paramedics, emergency room doctors, and other specially trained first responders. To facilitate ease of use, NARCAN® Nasal Spray is now available, which allows for naloxone to be sprayed into the nose. While improvised atomizers have been used in the past to convert syringes for use as nasal spray, these may not deliver the appropriate dose. Depending on the state you live in, friends, family members, and others in the community may give the auto-injector and nasal spray formulation of naloxone to someone who has overdosed.”
According to NIDA, “Withdrawal describes the various symptoms that occur after long-term use of a drug is reduced or stopped abruptly. Length of withdrawal and symptoms vary with the type of drug. For example, physical symptoms of heroin withdrawal may include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes. These physical symptoms may last for several days, but the general depression, or dysphoria (opposite of euphoria), that often accompanies heroin withdrawal may last for weeks. In many cases, withdrawal can be easily treated with medications to ease the symptoms, but treating withdrawal is not the same as treating addiction.”
- Heroin use can make you itchy. Opioids cause histamine release. Histamines are formed in the body during allergic reactions and irritate the skin. Heroin users report feeling itchy or like their skin is crawling.
- During heroin withdrawals, users experience cold flashes that create goosebumps on the skin. This is where the term “going cold turkey” comes from.
- Many children are born addicted to opioids. If they were exposed to the drug in utero, they may experience dangerous withdrawals when born. It is called neonatal abstinence syndrome (NAS).
- In its purest form, heroin is a fine white powder, but often, it can be rose gray, black or brown. These are often mixed or “cut” with another drug.
- In 1924, US Congress outlawed the importation of opium for the manufacture of heroin. Over time, heroin use for medication or recreational use was prohibited and enforced.
- Heroin is a Schedule I drug in the Unites States. Being caught with simple possession can lead to a year in prison. Trafficking charges (100g or more) can lead to a five-year minimum sentence with up to five million dollars in fines.
If someone is using heroin, they may be exhibiting these symptoms: shortness of breath, dry mouth, small pupils, and cycles of hyperactivity followed by drowsiness. Their actions or behavior may be bizarre – ranging from nice and happy to agitated and violent. As they experience withdrawal from the drug, they may begin sweating and their heart rate will spike.
- According to NIDA, “People who regularly use heroin often develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects. A substance use disorder (SUD) develops when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. An SUD can range from mild to severe, the most severe form being addiction.”
- Drug abuse costs the government a lot of money. According to the National Drug Intelligence Center, “The estimated economic cost of illicit drug use to society for 2007 was more than $193 billion. This estimate reflects direct and indirect public costs related to crime ($61.4 billion), health ($11.4 billion), and lost productivity ($120.3 billion). The abuse of several major illicit drugs, including heroin, marijuana, and methamphetamine, appears to be increasing, especially among the young.”
- Criminal gangs (street, prison, and outlaw motorcycle gangs) remain in control of most of the retail distribution of drugs throughout most of the United States – especially in major and midsize cities.
- The primary gateway for illicit drug smuggling to the United States is the Southwest Border. Smugglers under the direction of Mexican traffickers move most of the cocaine, heroin, foreign-produced marijuana, and foreign-produced methamphetamine available in this country through, between, and around land border crossings in Arizona, California, New Mexico, and Texas.
- According to the National Drug Intelligence Center, “Heroin is smuggled across the border primarily in southern California. However, increased heroin seizures in Arizona during 2008 and in South Texas during 2010 indicate a potential increase in heroin smuggling through those areas.”
- The primary threat of drug smuggling to the U.S. via aircraft will are from South American and Caribbean criminal organizations smuggling cocaine and South American heroin on commercial flights.
- The availability of heroin in the U.S.—and the number of markets in which it is available—is increasing because of higher production in Mexico (even as Colombian production declines).
- Mexican black tar and brown powder heroin are becoming more widely available, especially in East Coast markets that were historically dominated by typical white powder heroin.
- Some cocaine dealers and distributors are switching to heroin sales because of a cocaine shortage and the higher availability of heroin.
- The increase in heroin availability has resulted in an increase in heroin-related overdoses in several locations throughout the United States including cities in the Pacific Northwest.
- Although Afghanistan produced an estimated potential 630 pure metric tons of heroin in 2009, most Southwest Asian heroin is destined for Europe, Russia, Canada, Iran, and China. For now, Southwest Asian heroin has limited availability in the U.S.
- To reduce the number of opioids prescribed by doctors, more healthcare organizations are investing in physician education. This education is meant to teach physicians the signs and symptoms of opioid and heroin abuse as well as focus on alternative pain relief for patients.
- Although educating children and teens on the dangers of drugs is important, it’s difficult to see how effective these attempts are. Parents also need to be educated on the dangers of opioids and the common use of heroin in many communities.
- It is also important to teach everyone the proper way to dispose of pain medications. Adolescents tend to get their hands-on opioids for the first time through family members and friends. These medications are often found in the home in medicine cabinets, bathrooms, etc.
- Pharmacies are another place where authorities can reach consumers of all ages to educate them on the perils of opioid misuse.
- Treatment for heroin addiction in the Pacific Northwest varies. They may include medication and behavioral therapies. One thing is certain, detoxification from the drug should be monitored by a healthcare professional.
- Medications that are used to treat heroin addiction include buprenorphine and methadone. They bind to the same opioid receptors that heroin does. They reduce cravings and diminish withdrawal symptoms.
- Behavioral therapies for opioid use often include contingency management (incentives to keep the patient motivated) and cognitive-behavioral therapy.
- Heroin habits are expensive. They cost between $150 to $250 per day.
- Rehab centers exist to help those ready to stop using heroin and other opioids. Detoxification coupled with rehabilitation and good diet are the first steps in becoming sober.
According to the King County Substance Abuse Prevention and Treatment Annual Report, “From the first half of 2008 through the second half of 2011, there was a steady increase in the number and percentage of young adults under 30 years old entering detoxification services. The numbers and percentages of young adults leveled off during 2012, and have remained at higher levels. Among all individuals admitted in 2014, 85% of those younger than 30 years old indicated opioids are their primary drug used compared to 41% of those 30 years or older.”
These staggering numbers emphasize the importance of having quality rehabilitation and drug detoxification centers throughout the Pacific Northwest. They provide heroin addicts opportunities to safely and with the help of a compassionate team, learn to live a drug-free lifestyle. With a high likelihood of heroin relapse, it’s so important to have a comprehensive rehabilitation and therapy plan in place.