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Heroin
Street terms for heroin: smack, thunder, hell dust, big H, nose
drops1
What does heroin look like?
"Black tar" heroin is sticky like roofing tar or hard like coal,
and its color may vary from dark brown to black.
How is heroin used?
-
Injecting
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Smoking
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Snorting
Who uses heroin?
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In the United States in 1999 there were 104,000 new heroin
users.
-
In 2000, approximately 1.2% of the population reported heroin
use at least once in their lifetime.2
How does heroin get to the United States?
-
The U.S. heroin market is supplied entirely from foreign sources
of opium.
-
Production occurs in South America, Mexico, Southeast Asia, and
Southwest Asia.3
How much does heroin cost?
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Nationwide, in 2000, South American heroin ranged from $50,000
to $200,000 per kilogram. Southeast and Southwest Asian heroin
ranged in price from $40,000 to $190,000 per kilogram.
Wholesale-level prices for Mexican heroin were the lowest of any
type, ranging from $13,200 to $175,000 per kilogram. The wide
range in kilogram prices reflects variables such as buyer/seller
relationships, quantities purchased, purchase frequencies,
purity, and transportation costs.4
What are some consequences of heroin use?
-
One of the most significant effects of heroin use is addiction.
Once tolerance happens, higher does become necessary to achieve
the desired effect, and physical dependence develops.5
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Chronic use may cause collapsed veins, infection of heart lining
and valves, abscesses, liver disease, pulmonary complications,
and various types of pneumonia.6
-
May cause depression of central nervous system, cloudy mental
functioning, and slowed breathing to the point of respiratory
failure.7
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Heroin overdose may cause slow and shallow breathing,
convulsions, coma, and possibly death.8
-
Users put themselves at risk for contracting HIV, hepatitis B
and C, and other viruses.9
1Office of National Drug Control Policy, Street Terms:
Drugs and the Drug Trade.
2Substance Abuse and Mental Health Services
Administration, Summary of Findings from the 2000 National
Household Survey on Drug Abuse, September 2001.
3Drug Enforcement Administration,
Drug Trafficking in the United States, September 2001.
4Ibid.
5U.S. Department of Health and Human Services, National
Institute on Drug Abuse, Infofax: Heroin, 2000.
6Ibid.
7U.S. Department of Health and Human Services, National
Institute on Drug Abuse, Research Report: Heroin Abuse and
Addiction, 1999.
8Drug Enforcement Administration, Drug Descriptions:
Heroin.
9Office of National Drug Control Policy, Drug Facts:
Heroin.
Heroin, as with other
opiates, causes rapid tolerance when used frequently, so doses
increase dramatically from first dose in a month to 20th dose in
a month. There has been some debate about how much heroin doses
actually increase with tolerance.
Howard Lotsof, a reknowned
researcher into ibogaine treatment of heroin addiction, has
estimated that a "low end analgesic dose of heroin would be
about 1mg." Most users start with doses much higher than this.
Insufflated doses of heroin probably start at between 5 and 20mg
of pure heroin and intravenous doses probably start between 5
and 10 mg.
As usage increases, however,
the doses get much higher. Dr Lotsof wrote "In close to twenty
years of research and involvement with the treatment of opioid
dependence with ibogaine the highest dose I personally saw used
of heroin in Europe was 2 grams [per day], that is 2,000 mgs." 2
grams per day, however, is extremely high, much higher than most
heroin addicts achieve. Heroin is very expensive and this dosage
level would be fatal in most people who had not worked up their
dosages slowly.
In the book "The science and
love of Alcohol and Caffeine" by Stephen Braun (1996), he
writes:
"Longtime heroin users,
for instance, have been observed to require ten thousand times
the dose they injected when they began their habit. Their brains
adapt to heroin to such an extent that they inject themselves
with quantities of this narcotic that could kill a person not
tolerant to heroin." (Page 168)
Braun gives "Goldstein, A.
'Addiction, from Biology to Drug Policy.' New York: Freeman." as
his source for this information, but this "10,000 times"
increase in dose appears to be exaggerated.
When the Swiss government
began allowing maintanence of heroin users, they were able to
collect reliable data about exactly how much heroin was being
used. The Swiss found that users offered unlimited quantities
would, on average, max out at between 300 and 500 mg. of
diacetylmorphine per day. One author writes "I've known people
prescribed a full gram per day, but they were quite unusual, and
such habits on the street are impossible except for relatively
high level dealers. Remember, I'm talking about pure
pharmaceutical or number 4 if on the street. There are certainly
cases of pain patients receiving larger equivalent dosages of
opioids, but I've never heard of one of these beating a 1000/1
ratio."
The Swiss data was published
in 1999:
Prescription of
Narcotics for Heroin Addicts: Main Results of the Swiss National
Cohort Study
Volume One. Uchtenhagen,
A;Dobler-Mikola, A.; Steffen, T; Gutzwiller, F.; Blattler, R;
Pfeifer, S. Karger; Basel; 1999
Page 20 states that the mean
daily dose of heroin IV ( when used alone, without methadone on
the side) was 491.7mg.
Page 22 states "A stable
dose was achieved after 6 months at most; beyond this point,
almost no further increases in dose were required."
Later in the volume, the
authors state that most users tend to gradually reduce their
dosages after achieving a peak.
This Swiss data is the best currently available
about maximum daily heroin dosages when humans are given nearly
unlimited access to the chemical. Using their data, it appears
the actual ratio between initial doses of heroin, a low of 5mg
per dose, and highly-tolerant maximum daily doses of heroin of
about 500mg, this is a 1 to 100 ratio. But it also ignores the
difference between single-dose use and repeated dose use. In the
same way that its easy to finish off several bottles of wine
over the course of several hours, while few ever drink several
bottles of wine in just a few minutes, heroin users who are
using throughout the day will go through a lot more heroin. So
its inappropriate to compare single-dose initial values to
daily-ingestion amounts. The increase between no-tolerance
dosages and high-tolerance dosages is thus much less than 1 to
100.
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