Heroin addiction

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What is heroin addiction?
- Heroin is an illegal substance in the opioid class, (other opioids include morphine, codeine, pethidine, buprenorphine and methadone). According to a report published in April 2019 by ENACT, a European-Union funded project that tracks organized crime in Africa, South Africa is in the grip of a heroin crisis. Up until the 1990’s, heroin was generally only available in the metropoles and purchased by white males. This demographic has changed, with heroin addiction now prevalent in towns and rural areas.
  
  Heroin primarily comes from Afghanistan, the world’s largest grower of poppy plants. According to the United Nations, despite international efforts to curb the production of opium- it reached record levels in 2017. As law enforcement has tightened in other countries such as the Balkans, so drug traffickers have begun to make use of the east coast of Africa. Ten years ago, between 80 and 90% of the heroin that arrived in South Africa, via this route, was then shipped directly to more lucrative markets in Europe and North America. Now, a significant amount of the drug remains in the country as South Africa makes the transition from “being a heroin transit hub to a retail destination”.
- Heroin is a central nervous system depressant. It is a highly addictive and dependency on the substance is created rapidly. Repeated use changes the physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. The brain’s white matter starts to decrease over time, which may severely affect behaviour, emotions and cognitive ability.
Methods of use
- Heroin is mainly injected, smoked or snorted. The drug is frequently cut with other substances. The full effects of one dose of heroin lasts for a few hours, but the immediate euphoria and rush only last a few minutes. Once the high wears off, the person may begin “nodding,” or falling in and out of unconsciousness.
Effects on the user
- Which may include
  - Euphoria
  - Relief from pain
  - Vomiting
  - Nausea
  - Shallow breathing
  - Drowsiness
  - Decrease in body temperature
  - Constriction of the pupils
  - Loss of sex drive.
Harmful side-effects and health risks
- Long-term use of heroin may lead to severe damage to the heart, brain, kidney, liver and lungs.
- Prolonged intravenous use may cause the veins to collapse, when this happens, users may start injecting themselves in other places, such as:
  - The feet (between the toes)
  - Behind the knees
  - In the groin area
  - The neck
- Infections or abscesses may occur in the above areas.
- Intravenous use raises the risk of HIV infection and the transmission of Hepatitis C.
Withdrawal symptoms
- Withdrawal may occur within 6-12 hours after the last usage. Major withdrawal symptoms peak between 24–48 hours after the last dose of heroin and subside after approximately 5 days. However, some people have shown persistent withdrawal signs for many months.
- Symptoms of withdrawal may include:
  - Restlessness
  - Muscle and bone pain
  - Insomnia
  - Diarrhoea
  - Vomiting
  - Hot and cold flushes, sweating
  - Sporadic leg movements
  - Sneezing
  - Yawning
  - Craving
  - Dry mouth
- It is recommended that withdrawal from the drug be conducted under the care of trained medical professionals together with experienced, trained, addiction counsellors.
Overdose potential
- Overdoses from heroin have been on the rise. There is the potential for a person to overdose the first time they use the substance.
- An overdose may cause low blood pressure, weak pulse, respiratory failure, cardiac arrest, coma and/or death.

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