The use of heroin, especially through injection is one problem that significantly affects the general public health. This problem is especially significant due to the risks involved in its dependence. These risks are the consequences experienced by the user in the form of their health and social wellbeing, which in the case of heroin may include, HIV infections, hepatitis, fetal developmental issues in the case of maternal mothers; disruptions in the workplace, family and educational environments, violence, crime among others (National Institute on Drug Abuse, 2009). The risk of using and developing dependence on heroin is evidently real and exceeds those of other drugs. What aggravates this issue further is the fact that currently there is an increase in the potency and purity of this drug, consequently, leading to a decreased age for first time users and an increase in the rate of initiations that leads to dependency in the United States. Nonetheless, efficient treatment is accessible for people who depend on this drug. This research paper shows the history of this drug, its statistics the recurrent societal and health problems and the finally the programs meant for treatment including the ethical issues affecting it.
A brief look at the history of the drug indicates the long and treacherous path it has taken. Originally, development of this drug was from a very innocent perspective. In 1895, the pharmaceutical company called Bayer designed this drug as a suppressant to be used while experiencing cough fits. The drug came from a plant known as the Opium Poppy, comfortably placing it in a chemical class known as opiates (Brown, 2004). Interestingly for centuries, people have used the chemical substances in the opiates family for their pain suppressing and euphorigenic qualities including contemporary opioids such as morphine, codeine, methadone just to mention a few. Inasmuch as these drugs have immense beneficial qualities that include vasodilatory stimulation and analgesic efficiency and other positive properties such as reinforcement feelings, an opiate such as heroin has an innate ability to induce addiction when used or misappropriated as an alternative medication. Statistics clearly indicate that 53% of people who indulge in the use of heroin have become dependent on the drug as opposed to other drugs such as 11% in the case of alcohol use or 15% in the case of marijuana use (Brown, 2004).
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Heroin dependence is one chronic condition characterized by relapses and compulsive administration of the drug by the individual in spite of them knowing and experiencing the adverse consequences of the use of this drug. According to the World Health Organization, ICD-10 is the globally accepted criteria to use on diagnosis and classification of opioids use including heroin. Consistent with this definition, dependence is as a collection of behavioral, psychological, and cognition occurrences whereby the use of a class of particular substances is of a higher priority to the abuser than other behaviors of higher value that were once undertaken by the individual. In essence, the individual neglects his/her priorities for the use of substances classified as drugs (Brown, 2004). According to the documentation of this criterion in relation to the use of substances that are compulsive, the dependent individual manifests dependence in spite of the clear evidence that the drug is causing harm due to persistent use. In addition, the dependent user is more likely to display other phenomena such as the manifestation of withdrawal symptoms upon radical reduction or discontinued use, dysfunctional life and even tolerance development.
To understand the prevalence of heroin, one needs to know the problem of drugs and its effects on a global scale. Numerous governments the world over battle every single day with this kind of menace that is eating up the society at large and tearing up the fabric of families, the basic unit of a functional society. Moreover, drug abuse and dependence brings about a significant toll to the human life and is the sole reason for inducing a non-reproductive ability in most individuals worldwide. A look at the statistics indicates that there is an estimated 183,000 drug related deaths (United Nations Office on Drugs and Crime, 2014). This figure is commensurate to that of the mortality rate, which stands at 40% among the population aged 15-64. On a global scale and in estimates presented in the year 2012, 324 million people corresponding to a world population of 7% succumbed to their deaths due to the abuse of an illicit drug. This included the main substances commonly abused such as the opioids, cocaine, marijuana, amphetamines among other stimulants and suppressants. The extent of this problem remains at 16-29 million people.
Currently, the problem of heroin abuse and other opioids tops the list of all the drugs owing to their high effect of dependability and adverse withdrawal symptoms. In the world, this drug is at the top of the list in the category of drugs that bring about the most burden of disease transmission and deaths that are drug-related. Globally, for a third consecutive time, Afghanistan remains as the world’s largest cultivator of opium with an increase from 154,000 hectares of opium to 209,000. The Lao’s People Republic and Myanmar come in following Afghanistan according to statistics in 2013 (United Nations Office on Drugs and Crime, 2014).
In the United States, the drug’s commonness is increasingly evident. In a research by the National Survey on Drug Use and Health (NSDUH) in the past year, close to 669,000 Americans are said to have used heroin ("What is the scope of heroin use in the United States?", 2017). This number alone is shocking owing to the fact that the increase is close to 50%. Young adults at the age of 18-25 are the ones who have driven this trend leading to an unwanted number of heroin-dependent people. In addition, there has been an increase in the number of heroin users, and a look at the statistics carried out in 2012 depicts a clear indication of the rate of abuse which was 90,000 in 2006 and six years later it is 156,000 which is almost double. This predominance of heroin in the U.S. is not only limited to urban settings but also in the rural and suburban areas. Rural and suburban communities adjacent to Chicago experience the increase of seizure incidents as well as deaths due to an overdose of the drug. This goes largely in showing the huge menace that the drug is creating on the lives of many citizens due to the high number of users and those dependent on the drug alike. Impacts of heroin reverberate across the nation of America. This drug affects numerous local regions that stretch from one coast to the other.
The effects of heroin on every facet of life cannot be understated. Simply put, heroin devastates almost all aspects of life, as we know it. From the functional society structures and norms to the individual’s psychological well-being and health to the finances and economic development of a nation, heroin has captured the hearts and minds of almost all individuals in the world. Its use, characterized as a social abomination let alone the dependence on it befits its nature. Frankly speaking, heroin has no benefit whatsoever. The demerits of this class A narcotic far outweigh its perceived merits and infrequent myths of its advantage. Through many years of research, experimentation, proof of hypothesis and facts, heroin has emerged as a substance that affects the health of the individual using it, the society and psychological nature of the abuser.
The basic unit of the society is the family. While others may argue against this conjecture, it is a proven presumption by many psychologists the world over. Heroin use affects this primary societal structure in innumerable ways. Not only does the quick-paced changes in technology, the economy and the society affect and influence the stability of a family but also drug abuse on a larger scale. Many people regard the family unit as the primal source of strength that nurtures and supports its individual members and ensures the steadiness and continuity of more generations to come and in a true sense ensures the growth of a culture and the community at large. Therefore, the family is at the center stage of determining attitudes and potentially significant influences, behaviors and values of children. Consequently, heroin use by a family member results in the behavior being a source of tension, pathology and quite a number of problems in the family unit. Moreover, the view of the family is that of a medium for other broader social interactions with the community at large and other peer groups such as workers, classmates among others. In interfering with the family through heroin abuse, the results tend toward the inevitable disruption of this sensitive social fabric.
Throughout the 20th century, enactment of laws to control the use of heroin in legal medications took place. This made it harder to obtain or use the drug until eventually the prohibition of its sale on the legal market took place. Doing this created a new product in the black market, and since those early years, the selling of heroin happens illegally, and its market has grown a hundred fold leading to profuse and detrimental effects on the society. The illegality of the manufacture, use and eventual distribution of heroin has made it not only a hotbed for crime related activities but also the reason for a continually perverse society and innumerable vices that are evident today. This condition has permeated to the point that we currently see an exponential rise in the rate of crime. In the addict’s mind, he/she turns to crime to feed their addiction while in the supplier’s mind he/she is involved in criminal acts to compete in the market, for vengeance and other psychological issues affecting these two victims. Currently, a recent feature by the New York Times indicates that gangs associated with the cartels have spiked the homicide rate to a higher degree. Nowadays, turf wars are the order of the day in major U. S. cities with gangs stepping up their distribution game by any means possible. This, in turn, has resulted in a dysfunctional society that lives in fear and uncertainty.
Although education is the foremost means of preventing the use of drugs, one finds that among the youth and young adults’ first time users, most start abusing drugs while pursuing educational ventures. Adolescents undergo significant changes in their normal development. This is so since most of them are developing their self-identity. Subsequently, this leads them in creating social ties with peers who influence them to start abusing drugs. From here, their educational problems start. In a study conducted on heroin users, the conclusion reached was that they had difficulty in impulse control (Pau, Lee, & Chan, 2002). When this difficulty manifests in a young adult or an adolescent youth, they are more prone to suggestions of drug abuse as they have virtually no control over their impulses and urges, which in turn affects their overall educational performance. In addition, heroin affects the cognitive skills of a developing brain such as that of a teenage or young adult. Such effects as the diminished attention span, mental agility and abstract reasoning result in a reduction in the performance ability of the individual. Also in adults, heroin use causes reduced performance in mentally demanding work, and eventually the individual might also lose his/her job leading to other social issues.
In looking at the health effects of heroin, one is able to see clearly the detrimental disadvantages of the drug in broad daylight. On a medical standpoint, heroin has an adverse effect on the normal functioning of the body. Once heroin enters the brain, it binds to certain receptors called the mu-opioid (MORs) resulting in their activation. Activation of these reward centers of the brain results in the release of the chemical dopamine which is essentially a ‘good feeling’ chemical. Now, the downside of activating these opioid receptors is that depending on the level of activation, how long it binds and the method of administration, the drug user eventually becomes addicted. After administering heroin, the short-term effects of the drug kick in immediately. These short-term effects include a rash, rapidly accompanied by the flushing of the skin, the feeling of being heavy and a dry mouth. After this, the user experiences nausea, though not in all cases, severe itching and vomiting. These initial effects are soon followed by several hours of drowsiness, a cloudy mental faculty, and the heartbeat and breathing slow down to the point that it becomes severe (National Institute on Drug Abuse, 2009).
Eventually, constant heroin use takes an austere toll on the normal functioning of the body. Such kind of use causes changes in the physical structure and functioning of the brain creating imbalances in hormonal and neuronal systems that are long term and not easily reversible. In addition, through higher degrees of tolerance and dependence, heroin morphs into an addictive drug, that is not easy to overcome. Most medical journals describe tolerance as a condition in which there is the requirement of more and more drugs to fulfill the same desired effect. In dependence that is physical, the body gets used to the drug, and withdrawal symptoms occur if the drug is not present in the system. In heroin use, the withdrawal symptoms are quite diverse, since they occur within just a few hours of stopping its use. Such symptoms include insomnia, vomiting, diarrhea, flashes of cold and in some extreme cases vivid hallucinations. Eventually, the user becomes an addict. Addiction is a long-lasting relapse disease that places the user in a state whereby looking for the drug and using it becomes their primary purpose of life.
In utilization and administration of this drug, the users experience medical complications that are quite diverse. They experience lung complications such as pneumonia, tuberculosis and bronchitis because of poor health keeping and overall hygiene. Other disorders such as depression and antisocial personality disorder plague them. Men users go through varying degrees of sexual problems while women face an irregular menstrual cycle. Notably, the route of administering the drug greatly affects the medical consequences. A good example is the use of injection, whereby chronic use leads to scarring, the collapse of the vein, bacterial infections in the veins, boils and various soft tissue infections. All these bring about tissue death while a host of contaminants leads to arthritis and hematological complications. Furthermore, the use of injection significantly multiplies the risk of HIV exposure, viral hepatitis and other agents of infection. Through sharing of syringes and other paraphernalia, users develop many health complications.
In spite of the gloomy implications of heroin use, addiction to this drug is highly treatable. Varieties of efficient treatments are currently obtainable. Numerous programs have surfaced to show the need for solidarity for the treatment and recovery of heroin addicts. There are two approaches to this problem, one is through pharmacological treatment, which is the use of medications, and the other is behavioral therapies (National Institute on Drug Abuse, 2009). In addition, use of both approaches happens either concurrently or independently depending on the case. Use of pharmacological approach occurs during the initial stages of the heroin treatment when the user undergoes adverse withdrawal symptoms. The medication developed to treat these addiction cases usually works using similar opioid receptors. Nowadays, the most commonly used drug is methadone, which is an opiate, synthetic in nature that binds the receptors to prevent the occurrence of withdrawal symptoms. Another drug used is called Buprenorphine or Subutex, which medically is referred to an opioid agonist that is partial in its use. This drug relieves cravings while at the same time limiting the occurrence of dangerous side effects. In addition, the drug’s administration is through oral means thereby reducing the inclination to use injections and consequently relapse to hard-core drug use.
In behavioral therapies, many treatments are accessible for heroin addicts. Among the therapies that are most effective, include cognitive-behavioral therapy and contingency management. In this type of management, there is the employment of a voucher-based approach in which patients get points through drug tests that have a negative result. In cognitive-behavioral therapy, the design of the program works to change the expectation of the patient and their overall behaviors. Furthermore, this program helps to increase life coping skills and other life stressors. Ultimately, in heroin therapy programs, the most important duty remains to ensure the treatment approach matches patient needs.
Heroin is a hardcore narcotic that affects a large number of individuals in the world. In some parts of the world, the problem is dire and its effects are extremely profound. This problem is exceedingly increasing especially with the current trends in the world. The social implications of heroin cannot be understated and all must act upon this issue in order to create a better world. Although this is the case, the good news is the numerous programs that handle cases related to heroin addiction. Such programs offer hope in a world filled with sad realities. By giving a new profound sense of empowerment to patients who display stability, these programs act as beacons of change, transformation and a renewal.
Brown, R. (2004). Heroin Dependency. Wisconsin Medical Journal, 103(4), 20-26.
National Institute on Drug Abuse, (2009). Heroin (pp. 1-8).
Pau, C., Lee, T., & Chan, S. (2002). The impact of heroin on frontal executive functions. Archives of Clinical Neuropsychology, 17(7), 663–670.
United Nations Office on Drugs And Crime, (2014). World Drug Report 2014 (pp. 2-6). Vienna.
What is the scope of heroin use in the United States? (2017). Drugabuse.gov. Retrieved 11 April 2017, from https://www.drugabuse.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states