In the past few years, Canada has begun using prescription heroin to treat opioid addiction. While this may seem like putting a fire out with gasoline to onlookers, prescribed heroin is significantly different from what you can get on the street. Users who receive heroin injections at Canadian clinics are getting real prescription heroin in a reliable dose.
The doses are controlled, and patients are given just enough to satisfy cravings. It’s a similar concept to the use of buprenorphine or methadone maintenance programs. Patients are given an opioid that helps to satisfy cravings in a safe environment. This allows them to stop a lifestyle of active addiction, where they are compelled to find heroin on the street by any means necessary.
This raises the question of responsible heroin use and if such a thing is even possible. Could you potentially take just enough heroin to achieve a high without risking dangerous symptoms like an overdose? Learn more about heroin, how it works in the body, and the viability of responsible use.
Heroin, also known as diamorphine, was once used as a medication in the U.S. to suppress coughs. In fact, the word heroin started out as a brand name that diamorphine was sold under. It was even thought to be less addictive than morphine. However, its addictive side effects caused the government to ban the drug in 1924.
Heroin is a partially synthetic opioid, which means it’s made by altering a naturally occurring opioid like morphine. Like other opioids, it mimics the body’s naturally occurring endorphins and binds to opioid receptors. When these receptors are activated, they block pain signals from reaching the brain, which makes heroin a fairly effective pain reliever. However, it also causes sedation, euphoria, and other nervous system depressant effects.
When heroin is injected, 100 percent of it makes its way into your bloodstream and toward your brain. It quickly passes the blood-brain barrier, which is a membrane the filters many chemicals in your blood from entering your brain. However, fat-soluble substances like heroin can pass through. Heroin is a prodrug, which means it breaks down into active substances when it’s metabolized. Once it reaches the brain, it breaks down into morphine and then binds to opioid receptors. Heroin is stronger than morphine partly because of its fat solubility. It can deliver opioids to the brain more efficiently than morphine on its own.
Once the opioid receptors are activated, they cause feelings of euphoria, analgesia, anti-anxiety, and sedation. Side effects include a loss of motor control, itching, drowsiness, sleepiness, diarrhea, nausea, and vomiting.
Heroin use is also associated with some long-term effects as well. However, there is a difference between the long-term consequences that are associated with the use of illicit heroin and the long-term effects of heroin itself. One of the clearest long-term effects of heroin use is physical dependence and addiction. The euphoric effects of heroin can cause changes in the reward center of the brain.
The reward center is designed to take notice of activities that cause the release of certain chemicals that are associated with positive activities like a warm hug or a good meal. Heroin causes an intense chemical response in the brain that your reward center can mistake for life-sustaining activities.
Addiction is a chronic disease that’s characterized by compulsive drug use, even despite the serious consequences. Though it’s a treatable disease, it’s difficult to get through on your own and typically requires professional treatment. Heroin use can also lead to uncomfortable bowel movements and diarrhea, which can cause problems if it’s not addressed.
Intravenous injection of illicit heroin can also lead to complications like the contraction of HIV and infectious diseases like hepatitis. You may also contract fungal endocarditis, a disease that affects the heart. Abscesses can also form when the heroin is injected in an environment that’s not sterile. Long-term heroin injection can lead to decreased kidney function, but it’s unclear as to whether this is caused by heroin or common additives in heroin.
Heroin is one of the most easily accessed illicit drugs in the United States, second only to marijuana. But the heroin you might be able to get from a local drug dealer is much different from the heroin you’d get in a Vancouver clinic. Street heroin is unpredictable in two ways: its overall strength and potentially dangerous additives. Drug dealers will often cut their heroin to stretch profits.
Typically they use inert substances like baking soda, cornstarch, sugar, talcum powder, or powdered milk. However, even some of these are dangerous because they can clump up and cause clotting when the substance is injected. Dealers may also include over-the-counter medicines, caffeine, and even rat poison in some cases. This weakens the effect of the heroin and users can get used the diluted drug. Then, when they get a new batch of purer heroin, they take a very high dose.
Heroin can become extremely dangerous when dealers add other powerful drugs into the mix. For instance, a potent opioid called fentanyl is often added to heroin to increase its potency and its perceived quality. Heroin that’s cut with inert substances is noticeably weaker, but even a small amount of fentanyl can mask the lack of heroin. Fentanyl is around 50 times more powerful than heroin and 100 times more powerful than morphine. A dose that’s lighter than a snowflake can be a fatal dose to the average person.
However, its potency makes it cheap and easy to transport. Fentanyl and other synthetic opioids in heroin have led to an increase in heroin overdose deaths in the U.S. In 2016, synthetic opioids were involved in 19,413 overdose deaths and the majority of those cases involved fentanyl.
Even in countries like Canada where you can get prescription heroin to treat addiction, you aren’t able to get the drug at a local shop like you can with alcohol and cigarettes. Heroin is extraordinarily addictive, and it can quickly lead to physical dependence and psychological use disorders, even with pure, controlled doses. In the United States, illicit street heroin is even more unpredictable, and it can cause addiction and a variety of other serious consequences. Addiction is a disease that affects the reward center of the brain.
If you or someone you know is struggling with addiction that’s related to an opioid like heroin, there is help available. To learn more about heroin addiction treatment, speak to an addiction treatment specialist at Serenity at Summit by calling 844-432-0416. Explore the addiction therapy options that might help you achieve lasting recovery and hear more about how treatment can help you escape a life of active addiction.
DEA. (n.d.). Fentanyl. Retrieved from https://www.dea.gov/factsheets/fentanyl
Gordon, E. (2018, September 27). In Canada, some doctors are prescribing heroin to treat heroin addiction. Retrieved from https://www.pri.org/stories/2018-09-27/canada-some-doctors-are-prescribing-heroin-treat-heroin-addiction
National Institute on Drug Abuse. (2018, June). Heroin. Retrieved from https://www.drugabuse.gov/publications/drugfacts/heroin