Heroin was released in 1898, the German manufacturer of “Bayer”, after the works of the chemist F. Hoffmann. The basis for a new drug diacetylmorphine was synthesized in 1874 in England by A. Wright.
The original manifestation and purpose of the medicinal action antitussive. The drug effect for a long time was not observed, and only in 1913 the manufacturer had to cease production of heroin, how strong psychoactive substances that causes severe forms of dependence in humans. The United States banned the use and production of the drug for any purpose.
To the 70-ies of XX century the drug was used in medicine of some countries as a substitution of medicines opium addiction. Then the production of heroin was stopped, and it was produced only in small batches for experimental purposes and as a palliative remedy for the treatment of dying patients in some countries.
The use of heroin gives a severe form of addiction with the rapidly emerging and severe forms of mental and physical dependence. This drug without exaggeration be called the most common among the opioid group. According to medical statistics, heroin users account for about 90% of all opiate addicts.
The mechanism of drug action
Heroin belongs to the opiate drug group. Pure product (white powder) is produced from morphine, artisanal options – from raw opium, poppy straw, etc. In this case, it looks dark resinous mass, often with toxic contaminants, providing additional poisoning.
Methods of use:
- inhalation through the nose (intranasal method);
- in the composition of mixes for Smoking;
- rectal suppositories and suppositories;
- solution for intravenous injection.
Please note: the last method is the most popular due to the maximum namefactory.
When the intake of injectable form of heroin hits the brain and is converted into morphine, by acting on all types of opioid receptors. These nerve structures are located in the intestine, spinal cord and brain.
The mechanism of drug actions is composed of several factors:
- release of histamine as a response to the introduction of heroin. This control effect causes the “rise” of state, accompanied by a sensation of pruritus;
- a pronounced analgesic effect due to the binding of metabolic products of heroin with opioid receptors, which normally excite internal endorphins;
- stimulation of gamma-aminobutyric acid (GABA) heroin metabolites, causing additional narcotic sensations.
Because of the similarity with endorphins, heroin opiates are able to act immediately on all types endorfinov (opiate) receptors. The whole complex of effects gives a strong analgesic effect, a feeling of complete calm, loosen up, relieve anxiety, fears, a pronounced euphoria.
Please note: heroin in potency is more powerful than morphine several times.
With prolonged use it markedly reduces the sensitivity of opioid receptors, and promotes increased release of glutamate – neurotransmitter that reduces the drug effect. This gives addictive (that is, reducing the narcotic effect of conventional doses). The addict begins to experience the need to increase the dose. “Breaking” at the termination of the use of Heroin is very strong.
The effect of the drug occurs within 2-3 minutes after dosing. Have took heroin person the feeling of heat spreading throughout the body, pronounced, pleasant relaxation, feeling of peace and joy. In some cases, the drug effects do not exist when the first cases of the reception. But after 2-3 iterations they appear in full force. Usually several episodes of heroin use is enough to make me hooked to it.
Time goes on, the dose required more and more, formed gerolomini. Attempt to dispense the drug causes severe withdrawal that occurs after 4-24 hours after the last anesthesia, it forces the addict to seek the next dose… the Disease progresses. Pleasure turns into the need of anesthesia.
In this position, the newly minted drug addict seriously frightened and tries to get rid of the problem themselves, resorting to alcohol, other psychoactive substances. But instead of healing often develop drug addiction.
To get away from the painful addiction becomes very difficult. Without the help of drug treatment almost all the heroin addicts not under the power of self-liberation from the troubles.
Doses used heroin addicts
The most common dose of heroin, which includes 5-10 mg diacetylmorphine (chemically pure version of heroin). Over time, the amount of the drug grows to 20-40 m, With the advanced form of the disease, the addict can take a very large quantity of the drug. Overdosing occurs at the individual level. The average lethal dose is 22 mg of heroin / 1 kg of body weight.
Please note: special danger polynarcomania mixture, in particular the “Speedball” combination of cocaine and heroin.
Signs of heroin use
After 1-2 minutes after injection, the addict begins to feel spreads throughout the body heat. These pleasant sensations that are associated in patients with fluctuating waves. Against this background, developing causeless joy, a feeling of indescribable pleasure, inner peace. This is the phase of “coming”. It lasts a half hour max. Replaced by “hovering” – a state of pronounced relaxation that is gradually gaining strength. This stay may experience delusions, hallucinations. This relaxation phase is gradually disappearing for 3-5 hours.
Heroin intoxication is accompanied by:
- severe pain relief;
- inhibition of the vomiting, respiratory and cough centres (with a large dose, and small – can cause the opposite effect);
- the contraction of the pupils and dryness of mucous membranes, various eye disorders;
- the noise in the ears;
- inhibition of bowel function, reduction of process of urine secretion, while the tone of the anal and urinary sphincters increases;
- voltage increase of bronchial muscles, which may cause bronchospasm, especially in asthma;
- slowing of metabolic processes and lowering overall body temperature, due to the severe heat.
Complications, which gives long-term use of heroin
The main active substance constituting the heroin – diacetylmorphine. Of the complications it can give only an overdose.
“Ballast” that is part of the artisanal variants of the drug, often causes liver damage, heart disorders of microcirculation, the death of brain cells, allergic reactions (anaphylactic shock), thrombotic and inflammatory complications of blood vessels, etc.
Drug users can infect each other with HIV, hepatitis, other infections (through the reuse of non-sterile syringes).
Prolonged anesthesia causes in men, problems of potency. In women, menstrual function is disturbed. All patients develop constipation.
More than half of heroin addicts will sooner or later pass this is a dangerous complication.
It is characterized by:
- development of lethargy and sleepiness;
- various forms of impairment of consciousness (SOPOR, stupor, coma);
- sharply constricted pupils, which as they progress status expanded, a drop in blood pressure, slowing breathing and heartbeat. Sometimes there are pathological types of breath;
- the failure of the heart and blood vessels;
- pulmonary edema;
- psychosis (hallucinations, delusions, affective flashes, discoordination).
Withdrawal syndrome in gerolomini
Abstinence when the drug is formed very quickly. The addict deprived of a dose of heroin, at the end of action of the drug begins to experience severe withdrawal. Pain is based on blocking its own analgesic system.
Please note: the duration of the withdrawal symptoms in heroin addiction depends on the length of anesthesia, age, physical condition of the patient. Upon receipt of adequate therapy the term withdrawal syndrome is reduced to 3-14 days.
Abstinence takes place in 4 stages:
- Symptoms start 8-12 hours after last dose of heroin. The patient’s pupil dilate, there is frequent yawning, watery eyes, nasal mucosa is irritated and swollen. Develops a runny nose with sneezing. Patient is chilly (goose pimples). Growing internal tensions.
- After 30-36 hours the patient starts to annoy alternation of increasing chills with goose bumps, and the heat, the body is covered with drops of sweat. The addict feels a strong weakness, bouts of yawning and sneezing (1-2 times per minute), in muscles feeling strong, convulsive tension. In the facial and masticatory muscles – paroxysmal sharp pain.
- After 40-48 hours of pain in the body worse. The patient begins to “rotate”, “pinch and squeeze”. In the extremities convulsions. Growing an irresistible desire to facilitate the state to take the necessary dose of heroin. Patient “rushes”, depression, feeling of despair and hopelessness, aggressiveness and tearfulness.
- After 72 hours of abstinence from heroin to the listed manifestations joined by sharp abdominal pain, severe and frequent diarrhea with cutting pain (up to 15 a day). This stage lasts 5-10 days.
Gradually, symptoms of withdrawal from heroin begins to decrease. When you experience more than a year, addicts are not able to undergo withdrawal without medical intervention. It should be noted that, despite the hard feelings, they do not pose a threat to the life of the patient. Although the patient’s behavior during withdrawal may mislead the ignorant person who is unfamiliar with the manifestations of heroin addiction.
Please note: the hysteria and “dying” behavior of patients with heroin addiction do not match the intensity of their feelings. All of this is nothing more than an attempt to elicit the drug.
In favor of this observation says the behavior of the addict in breaking, when he is alone and behaves quite adequately, although, of course, suffers.
Methods of treatment of gerolomini
The clinical manifestations of a heroin overdose patients immediately hospitalityat in toxicology, intensive care or specialized substance abuse Department.
Therapy of overdose:
- gastric lavage when taking the drug inside with the use of adsorbents;
- the excretion of heroin and its products of catabolism with detoxification of a solution administered into a vein (for internal and intravenous use of narcotic substances);
- the introduction of blockers of opioid receptors as antidote (Naloxone) that neutralizes the heroin.
Getting rid of gerolomini is done in a network of narcological clinics. Treatment for this type of addiction requires long time participation of experienced experts, relatives and friends of the patient, and most importantly – the desire of the patient.
Treatment of heroin addiction – step, it includes a sequential therapeutic interventions:
- A detoxifying therapywhere the body displays all the narcotic substances and compounds that are catabolic by-products of the drug. The duration of this stage – from several hours (in the case of AMLO – ultrafast opioid detoxification), to several days, sometimes 1-2 weeks. Apply pharmacological and non-pharmacological methods (vlok, plasmapheresis, etc.)
- Pathogenetic treatment. The patient is assigned a drug complex, restoring the normal exchange of neurotransmitters, enzymes and hormones, which was violated by the admission of the drug. Simultaneously used drugs that restore the function of the brain and peripheral nervous system, heart muscle, liver cells, and other diseased organs.
- If gerolomini in some countries, the use of substitution therapies – methadone, buprenorphine. In Russia these methods are not used.
- Psychotherapy. The objective of this exposure – removing the psychological dependence from heroin, elimination of severe mental disorders.
For after the hospital recovery, the most suitable rehabilitation centers where patients resocializarea and adapt to a healthy life. Only the whole complex of measures can lead to a good remission and positive Outlook.