Facts About Heroin

How Did Heroin Use Get Started?

First sold on a commercial scale in 1898 by the Bayer Company, heroin was largely hailed as a “wonder drug” initially. It is a more potent painkiller than morphine or codeine, two of the main drugs used to combat pain during that period. 

It showed promising clinical results in a variety of areas, including helping with pain that resulted from respiratory diseases. It would only be later when experts began to fully understand the addictive nature of heroin.

The Progression to Addiction

People have always struggled with pain, and doctors have always used the latest technologies to treat them. Often, people in pain are treated with very powerful drugs that come with unintended consequences.

In the late 1800s and early 1900s, doctors often treated their patients with morphine and opium powders. Morphine and opium were also widely available in opium dens and private homes. By the end of the 19^th century, opium addiction was widespread. It wasn’t until the early 20^th century that states started to pass legislation banning morphine abuse.

Even with bans, heroin use persisted. However, the drug shifted from pharmacies to the streets, where dealers started selling the drug to desperate people who couldn’t get by without it.

In the late 1990s, history repeated itself. Purdue Pharma produced the brand-name drug OxyContin, which contained a derivative of opium. Doctors were told the drug was both effective and not addictive. Patients started taking this drug, and when they developed a tolerance to it, they increased their doses. In time, some transitioned to heroin as a stronger and cheaper alternative.

Researchers said dependence on opioid painkillers was the strongest risk factor for heroin use in the mid-2010s. This transition opened up the market to more illicit drugs, including doses tainted with highly potent fentanyl.

Medical Necessity

It’s important to note that opioids have a legitimate place in medicine for controlling moderate to severe pain. It’s just important that the risks of these drugs are understood and that doctors use the least risky pain relief option available to them that can provide their patients needed relief. 

While heroin had a legitimate place in medicine in the past, the real issue was its overprescription and a widespread misunderstanding of its risks. 

Crime & Increasing Use

By the 1930s, there was a shortage of access to legitimate heroin prescriptions, with experts beginning to more fully understand its risks and the public largely viewing it as a drug of addiction and abuse. Unfortunately, this signaled an opportunity for the criminal underworld to take advantage and begin selling black market heroin. 

The amount of confiscated heroin would spike, seeing a massive increase over the coming decades and indicating the beginning of an issue that would snowball. Heroin, combined with prescription painkiller overprescription, had become a major component of the modern opioid epidemic at this point, discussed more later. It is a major reason opioid abuse shifted from a problem associated mostly with wealthier women (many whose lives were still ruined by opioid use and are worth discussing and remembering) to an issue more associated with the wider public. 

Quick Timeline of the History of Heroin

The following is a timeline of the above:

• 1895: About 1 in 200 Americans is addicted to some form of opioid.
• 1898: There is widespread commercial availability of heroin through the Bayer Company.
• 1900: Partially due to the widespread availability of heroin and soldiers regularly developing an addiction to opioids due to their overuse in war, the people most commonly affected by addiction began to shift from wealthier women to something more similar to what is seen today.
• 1930s: A more widespread understanding of the risks associated with opioids, combined with various political factions using opioid fears as a political tool, leads to tighter regulations and harsher penalties associated with opioid use and sales.
• 1930s to present: Heroin begins to take its modern place in history, with criminal organizations capitalizing on the dwindling availability of legally available heroin. It is a core component of the second wave of the modern opioid epidemic. Heroin use eventually levels off, but fentanyl use rises, making any positive change in heroin use debatable in a fuller context.

Basic Facts About Heroin

Heroin is a short-acting opioid, associated with a particularly short half-life and an intense euphoric high. It is considered to have significant addiction and abuse potential, with no accepted use in modern medicine in the U.S. 

Most heroin in the United States originates from Mexico. In other parts of the world, their primary source of heroin is often Afghanistan. It largely depends on which area is geographically closer, as that significantly impacts how difficult it is to smuggle large amounts of drugs from one area to another.

Despite common statements made by political figures to the contrary, most opioids (including heroin) are smuggled through official ports of entry, with people hiding drugs on their persons or in areas like secret compartments in their vehicles and driving the drugs right through checkpoints without attracting suspicion. While drugs are sometimes passed through the border in other ways, such as sneaking them over the border by finding areas of the border that aren’t guarded and hopping or tunneling under any barriers, this isn’t very common. 

Heroin & the Law

When legislators became aware of heroin’s dangers, they took action and passed laws to control its sale and manufacture. Those laws have changed with time.

The first law addressing heroin was the Harrison Narcotic Act of 1914, which was considered a complex compromise. Per this law, anyone who distributed or sold narcotics like heroin had to make a record of the sale and pay a small tax. People with heroin without a prescription could be fined and imprisoned for up to five years.

The Hague Opium Convention of 1912 took a similar stance on an international scale. Officials placed heroin in the same category as morphine and cocaine, asking parties to do their best to limit the manufacture and sale of the drug. While these rules were designed to reduce the exportation and trafficking of heroin, they had little impact.

In the 1930s, states regained control of drug policies. The shift was attributed to prohibition, as some states wanted to allow people to drink and reduce the widespread crime associated with illicit alcohol. However, stronger drugs like heroin were swept up in the legislation, allowing for a patchwork of rules and regulations that persists today.

In the 1970s, American officials recognized that addiction persisted and that legislation wasn’t enough to block the manufacture and sale of heroin. Legislators crafted policies allowing for methadone clinics and other forms of treatment. Rather than punishing people for addiction with jail sentences, they would try to treat them through therapy and medicine.

In 2014, more than 65% of Americans surveyed said they’d like the government to shift the focus from prosecuting drug crimes to treating addiction. At this point, some states were easing penalties for drug offenses, and the community seemed to support that shift.

Destigmatizing Addiction

While a person should avoid heroin use and seek help to stop using the drug if they can’t stop on their own, it’s also important not to stigmatize any type of opioid addiction, including heroin addiction.

Opioids like heroin fundamentally change the brain’s reward systems, slowly making it much more difficult to stop taking opioids once one begins. Addiction is a disease, a fact backed by medical evidence. It is not some moral failing. 

Very few people intend to get addicted to a drug. Instead, they are driven to drug abuse by other issues in their life and then struggle to stop their drug use as they grow physically and psychologically addicted to drugs. 

Statistics on the Opioid Epidemic

The number of people dying from drug overdoses in 2021 is six times higher than the rate seen in 1999. While many people die every year from heroin overdoses, experts say that opioid use changes over time. The current death rate is largely attributed to substances other than heroin.

Three waves of opioid overdose deaths have been identified by experts as follows:

• Wave 1: This phase started in the 1990s and was driven by prescription opioids like Vicodin and OxyContin.
• Wave 2: This phase started in 2010 and was driven by heroin.
• Wave 3: This phase started in 2013 and is caused by illicitly manufactured fentanyl. Dealers add this very powerful substance to drugs like heroin, cocaine, and counterfeit pills. People overdose, as they have no idea they’re taking very strong, tainted drugs.

Getting Help for Heroin Addiction & Abuse

Fortunately, opioid addiction, including heroin addiction, is well researched, with a number of evidence-based treatments available. While there is no cure for addiction, it can be effectively managed for life. 

The primary treatment for addiction is cognitive behavioral therapy, where you work with mental health experts to better understand what drives you to use drugs. You’ll learn to identify unhealthy thought patterns around drugs and drug use, avoiding those thoughts and feelings when possible and channeling them in healthier ways when they do occur so you can avoid drug use even if you feel a craving to use drugs. 

Medication-assisted treatment (MAT) can help make quitting drugs like heroin easier, and it is often considered the gold standard in treatment for opioid use disorder. Drugs like methadone and Suboxone, which combines buprenorphine and naloxone, can be taken on a schedule to suppress drug cravings and withdrawal symptoms. Combined with therapy and counseling, these MATs have been shown to often make it much easier for a person to avoid opioid abuse long term and see better results from their addiction recovery treatment.

Aftercare and ongoing support are critical to sustained recovery, and most addiction treatment programs will prioritize these as part of the overall treatment plan. While heroin is an incredibly potent drug, people recover from heroin addiction every day, going on to live full lives in recovery.

Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More