Semi-Synthetic Narcotics

One night a young father left his cheap apartment in New York City , where his seven-month-old baby would soon awaken and begin crying for food. With the money needed by the family, he purchased on the street a small cellophane bag of heroin. Alone again, he began to dissolve heroin in a hot spoon and then shakily injected it into his arm. Shortly afterward, he was found dead from an overdose.

Heroin is five times more potent than morphine and brings a life of living horror to those who are addicted to it.

Street names associated with heroin include "smack," "H," "skag," "Harry," "R," "boy," "white stuff," and "junk." Other names may refer to types of heroin produced in a specific geographical area, such as "Mexican black tar."

One reason for such a high mortality rate is the way in which heroin is bought and sold. Dealers cut the heroin down to weakened units with milk and sugar. But, in the process, some of it does not get "cut," and almost pure heroin is sold on the streets. Its use will prove fatal.

Another reason for heroin fatalities is the inability to properly judge how much heroin to inject. Too much of this powerful powder brings almost instant death. Then there are those who have been jailed for a while. Upon being released, they take a normal dose of heroin, but their bodies are not conditioned for it. Death results.

Authorities estimate that one heroin addict dies every day from an overdose.

It is reported that heroin addicts steal over $1 billion worth of goods each year in an attempt to support their extremely expensive habit. The stolen merchandise is sold to a "fence" who pays only about a fifth of its value. So it requires a lot of theft to finance a $50 a day habit.

Although heroin is generally "mainlined" (injected into a vein), it may also be taken orally or inhaled. It is of interest that some of the workers who mix and package heroin regularly become addicted to it-simply by inhaling small quantities of the dust for several days.

Young people who snort or smoke heroin face the same high risk of overdose and death that haunts intravenous users. Yet 40% of high-school

seniors polled do not believe there is great risk in trying heroin.

Recent studies suggest a shift from injecting to snorting or smoking heroin because of increased purity and the misconception that these forms of use will not lead to addiction.

The short-term effects of heroin abuse appear soon after a single dose and disappear in a few hours. After an injection of heroin, the user reports feeling a surge of euphoria ("rush") accompanied by a warm flushing of the skin, a dry mouth, and heavy extremities. Following this initial euphoria, the user goes "on the nod," an alternately wakeful and drowsy state. Mental functioning becomes clouded due to the depression of the central nervous system.

Reports from the Drug Abuse Warning Networks (DAWN) Annual Medical Examiner Data from 1997 show that heroin/morphine was the top-ranking drug among drug-related deaths in 14 U.S. major metro areas. It ranked second in another eight.

According to DAWN's Year End 1998 Emergency Department Data, 14 percent of all emergency department drug-related episodes had mentions of heroin/morphine in 1998. From 1991-1996, the number of heroin/morphine mentions more than doubled.

First synthesized from morphine in 1874, heroin was not extensively used in medicine until the beginning of this century. Pure heroin is a white powder with a bitter taste. Illegal heroin may very in color from white to dark brown because of various impurities. But, as mentioned above, white heroin may be far from pure, having been "cut" several times by mixing it with milk and sugar, white sugar, starch, powdered milk, or quinine, all of which are also white. The "cuts" range from 10 to 1 to 100 to 1.

The Asiatic poppy, from which heroin is extracted, is primarily grown at this time in Iran , Iraq , Turkey , Pakistan , and Afghanistan .

In an interview, a woman in her mid-forties, who had been dependent on heroin for over 20 years, told how the drug had ruined her life, destroyed all her family relationships and other friendships. Discussing how addicts must continually steal and shoplift in order to pay for the heroin, she told of the miserable experiences she had been forced to undergo as a prostitute for most of her life in order to keep obtaining heroin.

One newspaper article told of a Korean War veteran who accidentally got hooked on heroin and spent the following years in and out of jail, because of his habit of stealing up to $2,000 worth of merchandise a day to support his daily heroin needs.

The best-known heroin treatment center is a federally owned hospital at Lexington , Kentucky . But in the majority of cases, the end of a heroin addict's life will not be cure, but death by overdose.

Studies show that the life span of the average heroin addict is shortened 15 to 20 years, and he spends most of his time doing something illegal. As with all of the other illegal drugs, the sale of heroin can bring stiff fines and

mprisonment up to 20 years.

Summarizing some of the health hazards of heroin, first there are the irreversible effects: Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and infectious diseases, including HIV/AIDS and hepatitis.

Then there are the long-term effects. Long-term effects of heroin include collapsed veins, infection of the heart lining and valves, abscesses, cellulitis, and liver disease. Pulmonary complications, including various types of pneumonia, may result from the poor health condition of the abuser, as well as from heroin's depressing effects on respiration.

There is also infection. In addition to the effects of the drug itself, street heroin may have additives that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs.

2 - HYDROMORPHONE

The unripe seeds of the Asiatic poppy is the source of natural narcotics (opium, morphine, and codeine). But several semi-synthetic narcotic extracts are also derived from this poppy:

These semi-synthetic narcotics are heroin, hydromorphone (Dilaudid), oxycodone (Percodan), etorphine, and diprenorphine.

Hydromorphone is manufactured under the name Dilaudid; and, after heroin, it was the second semi-synthetic derivative of morphine to be extracted. It is two to eight times stronger in its pain-relieving effects than is morphine. It also acts more quickly and is more relaxing. Available only by a physician's prescription, it is still being misused.

Oxycodone, etorphine, and diprenorphine are synthesized thebaine, another constituent of the Asiatic poppy.

3 - OXYCODONE

-is similar to codeine in its effects, but more powerful, and with a higher addiction factor. Sold by prescription under the name Percodan, it is used for the relief of pain. But dope addicts take it also.

4 - ETORPHINE

-is more than a thousand times as powerful as morphine in all of its effects. It is so powerful that it is not given to humans; since, like heroin, it so quickly brings intense addiction. But it is sold to veterinarians under the name Etorphine Hydrochloride (M99) so they can quickly immobilize large wild animals.

5 - DIPRENORPHINE-

-is sold under the name Diprenorphine Hydrochloride, or M50-50. Also extracted from thebaine, it acts as a contrast agent, or antagonist, to the effects of etorphine. All of the semi-synthetic narcotics are strictly regulated by government; these are only available, legally, to physicians and hospitals.

6 - FENTANYL and MEPERIDINE-

These are two of the newer synthetic narcotics. They are often sold as heroin to unsuspecting users. Because they are stronger than heroin (fentanyl alone can be up to 1,000 times more potent!), they increase the risk of overdose, heart failure, and sudden death.

Meperidine is occasionally contaminated with a powerful neurotoxin that causes irreversible brain damage with symptoms similar to Parkinson's disease. Life is too wonderful to ruin it with substances like these.

7 - ROHYPNOL

Rohypnol has been a concern for the last few years because of its abuse as a "date rape" drug. People may unknowingly be given the drug which, when mixed with alcohol, can incapacitate and prevent a victim from resisting sexual assault. Also, rohypnol may be lethal when mixed with alcohol and/or other depressants.

Rohypnol produces sedative-hypnotic effects including muscle relaxation and amnesia. In Miami , one of the first sites of rohypnol abuse, poison control centers report an increase in withdrawal seizures among people addicted to rohypnol.

Rohypnol is not approved for use in the United States and its importation is banned. Illicit use of rohypnol began in Europe in the 1970s and started appearing in the United States in the early 1990s, where it became known as "rophies," "roofies," "roach," "rope," and the "date rape" drug.