Heroin Facts, History, and Statistics
History of Heroin
Heroin is a powerful opiate narcotic that has no legal medical use in the U.S. Outside of the U.S., pharmaceutical grade heroin is still produced for limited therapeutic use. It is occasionally prescribed for severe pain in countries such as the United Kingdom. Other names include:
- Morphine diacetate.
Origins of Heroin
Humans have cultivated the opium poppy and used the resin from its flowers as a medicinal and recreational drug since at least the time of the ancient Sumerians 5500 years ago—in what is today known as Iraq. The ancient Greeks and Romans were familiar with opium as a pain reliever, and it was a common product transported along the Silk Road from Asia to markets in medieval Europe.
When purified morphine was first extracted from opium in the early 1800s, it was one of the most powerful painkilling drugs known to man.
Morphine is 10 times more powerful than opium. Not long after its purification was heralded publicly, Western physicians turned their full attention to morphine and related drugs—collectively known as narcotics, opiates, or opioids.
The British chemist Charles Romley Alder Wright was the first to synthesize heroin in 1874 when he added 2 acetyl groups to the chemical structure of morphine. Although he and his colleagues experimented with the new substance by injecting it into dogs and rabbits, no practical use resulted from this discovery, and it was largely ignored by the scientific community.
Heroin as a Medicine
In August 1897, Felix Hoffmann, the German chemist who first created aspirin for the Bayer pharmaceutical company, synthesized heroin in an attempt to convert morphine into another narcotic analgesic—codeine. This new drug was found to be up to twice as potent as morphine, and Bayer gave the powerful new substance the trade name “Heroin” after “heroisch,” a German word meaning heroic.
Heroin was presented to doctors as a cough suppressant and analgesic for agonizingly painful respiratory illnesses such as pneumonia and tuberculosis, which were commonly treated at that time with other narcotics like codeine.
Though Bayer could not patent heroin due to Wright’s earlier discovery, it was widely marketed by the company as a non-addictive alternative to morphine and codeine. It soon became used for a variety of medical applications, including:
- Respiratory infections.
- Serious injuries.
- Control of certain mental disorders.
Although physicians around the world seized on heroin as a safe, non-addictive substitute for morphine, evidence quickly mounted that it was, in fact, quite dangerous in its own right.
Reports soon appeared in medical literature indicating that tolerance rapidly developed in patients treated with heroin, requiring doses to be increased over time, and that patients would often continue taking it even after their condition improved and their doctor had stopped prescribing it. Even more alarming, many patients who stopped taking heroin experienced withdrawal symptoms more severe than those caused by morphine dependence.
Regulation and Prohibition
Heroin addiction became a serious problem in the U.S. in the beginning of the 20th century, in part because there were no nationwide regulations restricting its availability. It’s interesting to note that:
- The Bellevue Hospital in New York City admitted its first case of heroin dependence in 1910.
- Only 5 years later, it admitted 425 patients for heroin addiction.
Part of the heroin problem in the U.S. stemmed from the innumerable “patent” remedies that were available in local pharmacies without prescriptions. Many of these medicines contained heroin and other powerful drugs, but they rarely revealed their ingredients.
The Pure Food and Drug Act of 1906 required accurate product labels, and many consumers began avoiding products containing potentially addictive ingredients such as heroin.
Governmental control of heroin was extended by the Harrison Narcotic Tax Act of 1914, which:
- Limited the permissible medical uses of heroin and other drugs.
- Required sellers of narcotics to get a license
- Outlawed the prescribing of narcotics to addicts.
Though it may have encouraged some addicts to search for a way out of their drug dependence, the Harrison Act also marked the beginning of the practice of criminalizing drug addiction instead of treating it as a health issue.
Finally, Congress outlawed the importation of opium for the purpose of manufacturing heroin in 1924, essentially ending legal production of the drug in the U.S. Subsequent laws further restricted legal use of heroin, and today it is broadly prohibited for all medical and recreational purposes.
Heroin is converted to morphine in the brain. The morphine molecules then produce pain-relieving and euphoric effects in users by binding to opioid receptors in the brain and spinal cord.
The chemical structure of heroin allows it enter the brain more quickly than morphine, so the effects of heroin are felt more quickly and more strongly than those of an equivalent amount of morphine.
The powerful, euphoric high abusers feel when snorting, smoking, or injecting heroin often leads to repeated and habitual use of the drug. However, the body rapidly adapts to the overstimulation of opioid receptors and, over time, abusers must take greater doses of heroin to achieve the same “high.”
Finally, after a period of chronic heroin use, most users will enter a state of physical dependence, in which the body has become so accustomed to the drug that the addict will become physically ill if he or she stops taking the drug suddenly.
Who’s Abusing Heroin?
Currently available statistics on heroin abuse show a steady increase since the early 2000s in:
- The number of people using it.
- The amount of money being spent on it.
- The number of deaths associated with it.
Though the number of past-year and past-month heroin users has stabilized in the last 2 years and addiction treatment facility admissions have declined, it is difficult to tell if this is the beginning of a decline in heroin abuse in this country or only a pause in the growth of its popularity.
The National Institute on Drug Abuse (NIDA) and the Drug Enforcement Agency (DEA) have linked this upswing in abuse to the dramatic rise in prescriptions for opiate painkillers written by doctors since the 1990s. Individuals who become addicted to prescription opiates often switch to heroin because it is less expensive than many illicit pharmaceutical narcotics. This switch is especially prevalent in oxycodone users.
Some important statistics on heroin use in the U.S. from the 2013 National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future National Survey include the following:
- Nearly 170,000 people over the age of 12 tried heroin for the first time in 2013—this number has not changed much over the last decade.
- More than 680,000 people used heroin at some point in 2013—a number that rose steadily from over 370,000 in 2007.
A 2015 study published in the Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report examined data from the NSDUH and the National Vital Statistics System and reported the following trends in heroin use from 2002 to 2013:
- Between 2002 and 2013, heroin use increased by 63% overall, and increases were observed across all genders, most age groups, and all income levels.
- The rate of heroin use among women doubled from 0.8% to 1.6% in a decade.
- Data from 2011 to 2013 indicated that the greatest demographic risk factors for using heroin were: male gender, 18-25 years old, non-Hispanic white race, urban residence, <$20,000 household income, Medicaid insurance coverage, and past-year abuse of or dependence on opioid pain relievers.
Online Interest in Heroin
Internet searches including the term “heroin” show similar patterns to known statistics of heroin abuse. Notable parallels include an increase in the number of searches since 2004 and a higher number of searches from Northeastern states, which has been the region most affected by the resurgence in heroin addiction.
The Heroin Market
The demand for heroin is global, with an estimated 16.4 million opiate users and 560 tons of the drug produced worldwide in 2013. Figures for heroin use and law-enforcement seizures of the drug show that central Asia and the Russian Federation are squarely at the center of the world’s heroin market.
One reason for the severe heroin problem in Russia, Iran, and nearby countries is their proximity to Afghanistan, the world’s preeminent producer of this drug. Opium cultivation and production have long been an important source of income for Afghans, and the industry survived both the harsh rule of the Taliban and the American invasion in 2001 virtually unscathed. Afghanistan has greater than 4 times as much land dedicated to poppy cultivation as the next largest source, Myanmar. In addition, the amount of opium produced per hectare in Afghanistan is far higher than that of other producing countries. The result of these factors is that Afghanistan now produces about 80% of the world’s supply of heroin.
The primary source of most of the heroin in the U.S. is not Afghanistan, but Colombia, and the market forces in this country differ from those of Europe and Asia. Effective cooperation between U.S. and Colombian anti-narcotics efforts has begun to decrease the supply of heroin and cocaine available, resulting in increased prices for both drugs.
Though the increase in U.S. heroin use over the past 15 years is due in large part to the low price of this drug compared to the price of pharmaceutical painkillers on the black market, street prices have increased sharply in recent years, from a low of $779 per 1/10th of a gram of pure heroin to $995 in 2010. It remains to be seen if this cost increase is one of the reasons why growth in heroin use has slowed over the past several years.
Is Heroin Illegal?
Heroin is classified as a Schedule I controlled substance by the DEA. Drugs listed in this Schedule are considered to have:
- Strong potential for abuse and dependence.
- No recognized medical use.
All possession of heroin without a license is strictly prohibited. Other Schedule I drugs include cannabis, ecstasy, and peyote.
Seizures of heroin by the DEA have closely correllated with overall use in the U.S., reaching a low of around 400 kg in 1999 before steadily increasing over the next decade to over 1000 kg in 2011.
Legal Penalties for Using Heroin
As a dangerous Schedule I drug, legal penalties for those found to be in possession of heroin are severe.
- First-time federal charges for simple possession can lead to up to a year in prison.
- Trafficking charges, which are usually brought in cases involving large amounts of heroin (100 grams or more), can lead to a 5-year minimum sentence for a first offense and up to $5 million in fines.
How Dangerous Is Heroin?
Like most opioid drugs, pure heroin’s main danger is tolerance and dependence, which can precipitate life-threatening overdose. Adding to its danger is the fact that it is manufactured in an unregulated environment and abused under many risky conditions—making obtaining and using it in the real world a highly dangerous activity.
Another primary danger users face is the fact that batches of street heroin vary enormously in strength and levels of impurities. A huge variety of adulterant substances—some quite potent, such as the pharmaceutical fentanyl—is used to dilute heroin and places users at risk of overdose, poisoning, cardiovascular issues, and/or allergic reactions.
Injecting heroin can easily lead to a potentially fatal overdose if it is more pure than expected. Overdose victims usually die when their breathing stops, and so mixing heroin with other depressants such as alcohol or tranquilizers also greatly increases the dangers of a fatality. If reached in time, medical professionals can treat cases of overdose using opioid antagonists—like naloxone (Narcan)—that reverse the effects of heroin.
- There were 188 opioid overdose prevention programs using naloxone in 2010.
- 10,171 opioid overdoses were reversed using naloxone between 1996 and 2010.
Intervenous use of heroin has many other inherent dangers separate from those posed by the drug itself. The sharing of non-sterile needles and other injecting paraphernalia increases a person’s risk of:
- Contracting diseases such as HIV or hepatitis.
A great danger of heroin is its incredible potential to cause dependence and addiction in users. Heroin addiction is a powerful force that causes individuals to continue using despite negative consequences for their personal lives and finances. Many people have lost their families, friends, and wealth while pursuing the next fix.
Heroin Addiction Treatment Programs
If you or a loved one is struggling with heroin addiction, help is available and recovery is possible. Treatment can start anyone battling problematic substance use on the path to a healthier and happier life. Rehab programs are located throughout the U.S., and a variety of treatment types is available. You can use SAMHSA’s Find Treatment tool to search for facilities. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’
American Addiction Centers (AAC) is a leading treatment provider and has trusted rehab programs across the country. For helpful advice, information, or admissions, please contact a caring AAC representative free at .