What Is Heroin?
Heroin is a powder derived from opium poppies. It may come from South America, Mexico, or Southeast and Southwest Asia. Most heroin in the United States comes from South America, but “black tar” varieties from Mexico are more common in the western US. It has the appearance of coal or roofing tar, with a dark brown to black color.
The drug is extremely addictive. It works by binding to mu-opioid receptors in the brain. According to the National Institute on Drug Abuse (NIDA), these receptors are turned on as a result, stimulating the release of dopamine and inducing a feeling of pleasure. Normally, the body’s natural neurotransmitters bind to these same receptors to release dopamine. The process regulates pain and hormone release. It also helps a person naturally feel a sense of wellbeing.
By activating opioid receptors artificially, one can essentially rewire the reward system. A repeated cycle of craving and euphoria leads people down the path to addiction. Soon, they become chemically dependent on the drug and, without it, experience the severe symptoms of withdrawal. The body also develops a natural resistance to the substance, so people require higher doses over time to compensate for the lack of pleasure and/or increased withdrawal symptoms.
Street heroin is almost never pure. It may be a white powder or dark brown. The consistency can vary widely as there may be many impurities depending on the manufacturing process. Sugars, starches, powdered milk, and even other types of drugs may be added as filler. The unpredictable strength of the drug further complicates matters on top of the person’s addiction to it.
Many heroin overdoses are accidental. Some people switch from a prescription opioid-based medication to the drug, for various reasons. The problem is these medications are supplied in known dosages and compositions, and heroin isn’t. Even if heroin may be easier to obtain, the purity can vary regardless of the source. There’s little or no regulation of dosage, so people often don’t know how much drug they are taking.
Impurities may be introduced to increase potency or cut production costs. In 2009, the United Nations Office on Drugs and Crime reported Afghanistan had identified several chemicals used for cutting heroin. Substances included caffeine and other compounds, such as phenolphthalein, chloroquine, and paracetamol. Caffeine makes heroin vaporize when exposed to lower temperatures, while chloroquine, a drug used to fight malaria, is widely available and low in price, but does not change the properties or use of the drug. Some believe the additive may be sold as fake heroin in Southwest Asia.
Cutting agents used include:
- Phenolphthalein: This substance has been used as a laxative, acid, or base indicator, and is a known carcinogenic, but its reasons for cutting heroin are not fully known.
- Paracetamol: An over-the-counter painkiller, it has a bitter taste and a mild analgesic effect. It might be used to disguise poor-quality heroin and is commonly used in many countries.
- Fentanyl: This narcotic pain medication is used as a cutting agent or sold as heroin. It is as much as 100 times more potent than morphine, which is why the House of Representatives Judiciary Committee approved bill H.R. 3713 in 2016 to increase the penalty of trafficking heroin cut with this drug by up to five years. This drug has been the reason for many drug-related deaths in the US.
- Tylenol PM: Cutting black tar heroin with these tablets is more practical because of the cooking process used for creating what’s known as cheese heroin. Other medications with diphenhydramine and acetaminophen may be used as well.
Flour, chalk, talcum powder, starch, and more dangerous agents, such as cocaine, methamphetamine, alprazolam, ecstasy, and crack cocaine, may also be used. The purity of street heroin, therefore, can vary greatly, anywhere from 3-99 percent, based on statistics from Johns Hopkins University. One can easily see why the risk of overdose is so high.