Heroin

Heroin is an opiate made from morphine (opiates dull pain). Morphine is extracted from the opium poppy. Like many drugs made from opium, including synthetic opioids (e.g. methadone) heroin is a very strong painkiller. Ninety percent of Heroin found in the UK is supplied from Afghanistan.

Heroin Related Deaths

Seventy percent of Heroin related deaths are due to overdoses.

Figures from the Office for National Statistics show that deaths from heroin overdoses rose sharply in 2008-09. Figures from St George's hospital in London, a national centre for monitoring substance abuse, also showed a rise with the average age of victims now in the late 30s.

The ONS figures, drawn only from England and Wales, show an 11% overall increase in drug poisonings in 2008 - compared with the previous year – and a total of 2,928 fatalities. Of those, 897 involved heroin or morphine – up 8% on the previous year – and 235 deaths related to cocaine – up 20% on 2007. John Corkery, of St George's hospital, said the average age for drug victims had risen from 32 in 1998 to 37.8 in 2008.

Methodone Addiction Treatment

According to a 2006 study by the International Epidemiological Association:

• Age-standardized mortality rate for heroin/morphine increased from 5 to 30 per million between 1993 and 2000,subsequently declining to 24 deaths per million in 2004.
• Age-standardized mortality rates involving methadone were similar to heroin until 1997, after which they decreased to just over 1993 levels in 2004.
• During this period the number of methadone prescriptions more than doubled and the death rate per 1000 patient years fell by three quarters.
• The age-standardized rate for heroin/morphine deaths and methadone were strongly associated with law enforcement seizures of these drugs

Black Market Heroin

Nick Davies gives the following account of Black Market Heroin:

Heroin, so benign in the hands of doctors, becomes highly dangerous when it is cut by blackmarket dealers - with paracetomol, drain cleaner, sand, sugar, starch, powdered milk, talcum powder, coffee, brick dust, cement dust, gravy powder, face powder or curry powder. None of these adulterants was ever intended to be injected into human veins. Some of them, like drain cleaner, are simply toxic and poison their users. Others - like sand or brick dust - are carried into tiny capillaries and digital blood vessels where they form clots, cutting off the supply of blood to fingers or toes. Very rapidly, venous gangrene sets in, the tissue starts to die, the fingers or toes go black and then have only one destiny - amputation. Needless suffering - inflicted not by heroin, but by its blackmarket adulterants.

The Oxford Handbook of Clinical Medicine records that a large proportion of the illness experienced by blackmarket heroin addicts is caused by wound infection, septicaemia, and infective endocarditis, all due to unhygienic injection technique. Street users invariably suffer abscesses, some of them of quite terrifying size, from injecting with infected needles or drugs. Those who inject repeatedly into the same veins or arteries will suffer aneurysms - the walls of the artery will weaken and bulge; sometimes they will start to leak blood under the skin; sometimes, these weakened arteries will become infected by a dirty needle and rupture the skin, leaving the user to bleed to death.

Resources

• Nick Davies, What's wrong with the war on drugs , The Guardian, February 2001
• Nick Davies, The politics of the drug war , The Guardian, February 2001
• NHS National Statistics, Statistics on Drug Misuse, England 2009, NHS Website, Accessed 13-January-2009
• Oliver Morgan, Clare Griffiths and Matthew Hickman,Association between availabitlity of heroin and methadone and fatal poisoning in England and Wales_1994-2004, International Epidemiological Association, Journal of Epidemiology 2006;35:1579–1585 Oxford University Press:Oxford, 2006