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Street Names: Horse,
Smack, H, Mexican Mud, Tar, China White.
Other Forms: Opium, Pharmaceuticals-codeine, Morphine, Vicodin, Loratab, Diludid, Percodan, methadone,
Darvon, Demerol, Talwin, Laam and others.
The opiate group of drugs are naturally occurring (opium
poppy extracts) and synthetic drugs that are commonly used
for their analgesic (pain relief) and cough-suppressing
properties. Morphine was isolated from opium in the early
1800's and was widely available without prescription until
the early 1900's when the non-medical use of opiates was
banned. However, as stated by Julien (1998) in his book,
A Primer of Drug Addiction:
"The use of opioids is deeply entrenched in society;
it is widespread and impossible to stop. Opioids exert pleasurable
effects, produce tolerance and physiological dependence,
and have a potential for compulsive misuse, all liabilities
that are likely to resist any efforts at legal control.
Also, the opioids will continue to be used in medicine because
they are irreplaceable as pain-relieving agents." (8)
Heroin, which gained increasing popularity in the 1990's,
and is continuing to gain popularity, is a main component
in the opiate family and accounted for 39% of drug induced
deaths from overdose and 11% of drug abuse-related emergency
room episodes in 1992 (10). 
Heroin is a white to brown powder or gummy substance derived
from the opium poppy, is injected directly into a vein,
sniffed, or smoked. Typically, heroin is used every four
to six hours in doses of 4 to 8 milligrams each. The intense
euphoria of heroin lasts only a few hours.
Signs of heroin abuse include a constricted, non-reactive
pupil; muscle relaxation (e.g., droopy eyelids, slurred
speech, a slow gait); a decrease in pulse, reflexes, blood
pressure, and respiration rate; and fresh needle marks.
Heroin use drives out the neurotransmitter endorphin; when
this happens and heroin isn't used, withdrawal symptoms
set in, those include insomnia, muscle ache, nausea, chills,
sweating, gooseflesh, vomiting and diarrhea. Addiction periods
("runs") usually last four to six months, often
ceasing because the addict is arrested or enters a drug
treatment program. Periods of abstinence usually last no
longer than a few weeks or months, and relapse is usually
precipitated by physical or mental stress. Once addicted
to intravenous use of heroin, a staggering 70 to 80 percent
of users continue intermittent use for many years or a lifetime.
Below is the description used in classification of Opioid
Addiction used in the DSM-IV (3)
304.00 Heroin Dependence
Most individuals with Opioid Dependence have significant
levels of tolerance and will  experience
withdrawal on abrupt discontinuation of opioid substances.
Opioid Dependence includes signs and symptoms that reflect
compulsive, prolonged self-administration of opioid substances
that are used for no legitimate medical purpose or, if a
general medical condition is present that requires opioid
treatment, that are used in doses that are greatly in excess
of the amount needed for pain relief. Persons with Opioid
Dependence tend to develop such regular patterns of compulsive
drug use that daily activities are typically planned around
obtaining and administering opioids. Opioids are usually
purchased on the illegal market, but may also he obtained
from physicians by faking or exaggerating general medical
problems or by receiving simultaneous prescriptions from
several physicians. Health care professionals with Opioid
Dependence will often obtain opioids by writing prescriptions
for themselves or by diverting opioids that have been prescribed
for patients or from pharmacy supplies.
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