sheet - heroin use
in South Africa
Alcohol & Drug Abuse Research Group
Medical Research Council
(diacetylmorphine) is a semi-synthetic opiate which acts as
a central nervous system (CNS) depressant and an analgesic.
- It is
produced from morphine, which is extracted from the Asian
poppy (Papaver somniferum)
has the appearance of a white or brownish powder.
the main mode of heroin use has been through injection.
in the purity of heroin and the fear of HIV have resulted
in more new users snorting or smoking heroin.
is little culture of injection use in SA, with heroin users
preferring to smoke heroin with dagga or inhale the vapours
("chasing the dragon").
acts on the opioid receptor sites in the brain, resulting
in feelings of intense pleasure and a dulling of pain. This
rush includes a flushing of the skin, a dry mouth, heaviness
in the limbs, and may involve nausea, vomiting, and severe
initial effects are accompanied by feelings of relaxation
and drowsiness, dulling of mental functions, and slowed breathing
and cardiac functions.
- The rush
occurs within 7 to 8 seconds of intravenous heroin use and
within a couple of minutes of snorting or smoking heroin.
chronic use, psychological and physical addiction occurs and
tolerance and craving for the effects of heroin develop. If
heroin is not used regularly, the addicted user will experience
withdrawal symptoms, for example hypothermia, stomach cramps,
insomnia, diarrhoea, and vomiting.
- In large
doses, heroin toxicity (overdose) may occur due to the depressant
action of heroin on the CNS, which may lead to coma and potentially,
death. The risk of overdosing increases with the concurrent
use of other CNS depressants (such as alcohol), greater heroin
dependence, and a longer history of heroin consumption.
drug users risk developing bacterial infections of the blood
vessels, heart valves, and heart lining; collapsed veins;
skin abscesses, wound botulism, and tetanus, from the use
of unsterile or blunt needles.
used intravenously, contaminants in heroin may clog the blood
vessels of vital organs, resulting in infection, loss of cell
patches, or immune reactions (eg arthritis).
problems (eg pneumonia and tuberculosis).
of body's ability to resist and fight infection.
- Use during
pregnancy may place a child at risk for developmental difficulties.
There is an increased risk of miscarriage, low birth weight,
and foetal abnormalities.
and direct sharing of injection equipment places the user
at high risk for contracting HIV and other blood-borne viruses
such as Hepatitis B, C, and G.
is a link between heroin use and trauma unit visits in the
USA, with heroin being the primary drug involved in drug-related
emergency room visits and mortality.
a link exists between heroin use and criminal activity in
the USA and Europe, with heroin use being linked to property
crime and crimes of violence. These crimes are often committed
to support the heroin addiction.
psychological consequences: impaired concentration, attention,
and memory; impaired psychological development (especially
for adolescents); together with impaired social and occupational
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