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The aims and objective of the project are to research the history of heroin. The report will give an insight into medical uses and the effects it has on humans both physically and mentally during short and long term use. It will also go on to detail its effects on society.
The aim is to use various sources to research heroin. The first source of information will come from internet websites detailing the history of heroin from its origin.
The internet will also be used to find out its chemical structure and its medical uses past and present. Additionally, information will be gathered from this source on the short and long term effects on the human body.
There will be extra research in the form of police consultations and statistics relating to criminal heroin misuse and interviews with known users within the town of Ayr and the effect it has had on their lives.
Another source of information will come from statistics from the NHS showing the rise of heroin misuse within today's society.
My final research source will be articles from my local newspaper The Ayrshire Post on drug related crime within the West of Scotland.
HISTORY OF THE DRUG HEROIN
The therapeutic use of opium poppy cultivation for pain relief dates back as far as 3400BC in lower Mesopotamia ( the area corresponding to modern Iraq, as well as some parts of northeastern Syria, parts of southeastern Turkey and some parts of the Khuzestan Province of southwestern Iran which ran along the Tigris and Euphrates rivers during the Bronze Age.) Although more recently the chemical analysis of opium became prominent in the 19th century. The discovery of heroin occurred as chemists synthesized the ascribed alkaloids of opium namely codeine and morphine.
In 1847 an English chemist C.R Alder Wright combined morphine with various acids during experimental methods and conditions resulting in the chemical compound diacetylmorphine. No further developments in the medical use of diacetylmorphine were undertaken until twenty three years later by the German chemist Felix Hoffman who was employed by the pharmaceutical company Aktiengesllschaft Farbenfabriken (today known as Bayer AG, the 3rd largest pharmaceutical company in the world.)
During testing and experimentation to produce codeine from morphine, Hoffman discovered by default that if a specific acid (citric acid) was added to morphine then the formation of acetylated morphine occurred. This resulted in a stronger pain relief drug which was one to two times more potent than morphine itself.
From 1898 Bayer marketed the compound diacetylmorphine as a cough suppressant and a non-addictive morphine substitute to consumers under the trademark name "Heroin".
Throughout the civilized world the drug was widely available to purchase over the counter until 1910 as a cure for morphine addiction. This however was to change when after further testing it was discovered that heroin rapidly metabolized into morphine but was quicker acting than morphine itself and more addictive.
In1914 the Harrison Narcotics Tax Act was passed in the United States of America to control the sale of all opioids including heroin. This act meant that the drug could only be prescribed or sold for medical use. Heroin manufacture, sale and importation were banned by the United States Congress in 1924 as a result of the rise in drug addiction throughout the U.S.
Today it is illegal for non medical use as stated within the Single Convention on Narcotic Drug Treaty set by signatory nations including the United Kingdom. It is the highest schedule 1 substance along with "Cocaine". Possession of schedule 1 such as cocaine and heroin could result in imprisonment or even the death sentence in certain parts of the world.
CHEMICAL STRUCTURE OF HEROIN
The chemical structure of opium, morphine and heroin are very similar. They all display cyclic carbon structures and have functional groups that can undergo substitution reactions when synthesized. This type of chemistry was the main reason for the production of the drug heroin.
Colour Image of a Heroin Molecule Black Rock Heroin
PHARMACOLOGY OF HEROIN
The organs and the systems of the human body are made up of collections of single cells that work in unison to maintain homeostasis. The cells of the body must be able to control the entry and exit of all materials from the cell. Therefore all cells and their organelles are surrounded by a plasma membrane .The membrane is made up of many different molecules. When studied under an electron microscope the membrane contains carbohydrates, proteins phosphates, lipids and cholesterol. These molecules make up a model that scientists call the fluid mosaic plasma membrane. (See Diagram 1 and 2)
Diacetyl morphine undergoes extensive first-pass metabolism when administered orally. Therefore it is a pro-drug for the systematic delivery of morphine. However, if heroin is injected into the blood stream the drug avoids the first- pass metabolism and rapidly crosses the blood-brain barrier. This is due to the acetyl groups present thus rendering it more lipid soluble than morphine allowing it to enter the cells of the brain, gut and spinal cord via the phospholipid bylayer membrane. (See diagram 1 and 2)
Diagram 1 Diagram 2
When heroin enters the cells of the brain it is quickly deactylated resulting in the chemical 6-MAM (6- monoacetylmorphine) and morphine. These chemicals bind to receptors in the brain known as µ-opoid receptors. This binding is the reason for the feelings of analgesic (pain relief), anxiolytic (ant-anxiety) and euphoria .The µ-opoid receptors also bind to endogenous opoid peptides Î²-endorphin, Leu-enkephalin and Met-enkephalin which are naturally occuring neurotransmitters.
On its own diacetylmorphine has very low affinity for the µ-opoid receptor but when administered intravenously, diacetylmorphine creates a greater histamine release with similar effects as morphine itself and also the greater feeling of a body high. In most first time users feelings of pruritus (itching) may occur.
Unfortunatley prolonged use of µ-opoid agonists like diacetylmorphine, hydromorphone, oxymorphone, 6-MAM and morphine result in physiological changes including a decrease in the number of µ-opoid receptors. Physiological alterations such as these are the main reason for tolerance and dependence of frequent users.
When users try to quit such drugs, uncomfortable feelings such as pain and muscular spasms occur as well as the psychological symptoms of anxiety and insomnia. The medical term is opoid withdrawal syndrome, and it is also known as going through "cold turkey".
MEDICAL USE OF HEROIN AND RECREATIONAL MISUSE
Heroin is prescribed as a strong analgesic in the United Kingdom. Under the name diamorphine it is used to treat different types of pain such as acute pain during severe physical trauma. The drug is normally administered intravenously by a medical professional or physician.
Diamorphine is widely used in the U.K in palliative care to ease the suffering of patients. It has also been prescribed to reduce the suffering of patients with end stage cancer and terminal illnesses.
A more radical approach has been taken in some countries to eradicate drug addiction and drug related crime whereby heroin is prescribed to addicts instead of the heroin substitute methadone.
The use of diacetylmorphine as a recreational drug has been known throughout the United Kingdom for more than a century. Due to developments in science and drug manufacture worldwide there has been an increase in heroin use in the U.K over the last two decades.
There are many theories as to why this has happened. A major factor is the amount of money that is involved in the illicit drug trafficking by organized crime syndicates around the globe. Another factor is that heroin is highly addictive. It was once described as "the perfect whatever drug" by the Anthropologist Michael Agar.
Heroin use has been known to have major physical and psychological effects on humans. When the drug is taken feelings of intense euphoria and transcendent relaxation occurs within the body of users. The use of heroin on a regular basis normally results in a rapid tolerance being built up by the cells of the body therefore larger doses are taken for the user to enjoy the same effects.
Diacetyl morphine is known to produce stronger euphoric feelings than other opoids when injected. Whilst opoids such as codeine produce only morphine, heroin produces the psycho-active metabolite 6-MAM as well. Users report an intense rush which occurs during the metabolism of diacetylmorphine into 6-MAM and morphine in the brain.
The most common method of illicit heroin use is via intravenous injection ( known on the street as "shooting up" or "slamming" ). Other methods like smoking or snorting are commonly known as "chasing the dragon" and oral administration is called "balling" or "gubbing".
Diacetylmorphine sold on the streets in the United States is mainly found in the form of a hydrochloric salt and therefore only requires mixing with water and heating to prepare it for injecting. Heroin found or used within Europe and the U.K is called "Heroin base". This particular type will only dissolve in water with the citric acid found in lemon juice after which it is heated.
A first time user starts with approximately five to twenty milligrams of diacetylmorphine per day until a tolerance builds up. An addict may use in the region of several hundred milligrams per day. Users initially inject heroin into the easily accessible veins in the limbs. Unfortunatley prolonged injections into these veins result in them collpsing due to the acid. Addicts will revert to injecting in other areas of the body such as the hands, feet, neck and even the genitals. (See Image 1)
Studies have shown that the effects of diacetylmorphine depend upon the route administration and that the subjective pleasure of drug use is proportional to the rate at which the level of the drug increases.
In comparison to all methods of administering heroin intravenous injection provides the most intense and fastest rush within seven to eight seconds. Injections direct into the muscle produces a relatively slow onset of the drug's effects of five to eight minutes. Smoking or snorting heroin reaches its highest effects within a ten to fifteen minute timescale. If orally ingested the diacetylmorphine causes no euphoric rush and its effects take approximately thirty minutes to reach their peak.
Is there a link between drug misuse and crime in Ayrshire?
Yes definetly the link is there as many known users in Ayr resort to shoplifting, armed raids and house breaking to feed their habits.
Has there been an increase in heroin misuse in Ayrshire?
There has only been a small increase in heroin misuse in Ayrshire in comparison to the cities of Edinburgh and Glasgow.
In your opinion does the methadone prescription program work to reduce crime?
Definitely not heroin uses at its related crimes are still prevalent in Ayrshire even though most users are being prescribed Methadone on a daily basis.
Has there been an increase of crime relating to methadone users?
There has been an influx of criminal activity in the area lately as there seems to be illegally manufactured valium being sold by dealers
Has there been an increase in other drug use and crime in Ayrshire?
Cocaine seizures have also increased in the area and of course valium within the heroin and methadone communities.
Which drug has been seen to cause the biggest increase in crime in Ayrshire?
Within the general public cocaine possesion and use has increased. This is mainly due to the glorification and hype of the use of the drug by the rich and famous to whom many young people see as role models.
What are the police doing to fight in the war against drugs?
The powers of the Police have increased due to new laws. These laws allow us to stop and search any civilian suspected of criminal activity on the streets and in their motor vehicles. Unfortunately warrants must be issued to search the premises of suspected drug users and dealers which sometimes take longer than we would like.
What advice do you give to schools on drug use?
Throughout Strathclyde Police force there are community police teams that visit Primary and secondary schools which take part in seminars and question and answer sessions on a regular basis. During these meetings they hand out packages with information on how to spot the warning signs of drug abuse Information is also given to the students and staff about what to do if they see dealers on their premises.
What advice do you give to local communities on drug use?
The community police teams and the policemen and women on patrol give out information on a daily basis to the general public on how to spot drug users and abuse within the community they live in. There is also the crime stoppers free telephone number where any criminal activities witnessed by a member of the public can be reported anonymously and in confidence in order to help us fight crime.
DRUG USER INTERVEIEW
What drug did you try first?
I smoked hash (cannabis) when I was ten years old with older boys in the area.
When did you start taking heroin?
I took valium and ecstasy which got me into downers at the age of twelve and continued until I was fifteen when I took heroin.
Why did you start taking heroin?
I was drunk when I took it at first and was offered it by a friend.
How did it make you feel?
I was going through problems at home and the drug was a release from reality. It made me feel relaxed and without a care in the world.
Is that the reason you took it again?
Yes but also it gave me a tremendous feeling of euphoria. I only really took it at the weekends to begin with but it eventually became required everyday for me to function.
Have you ever tried to stop?
I tried on various occasions but only managed to give it up for a week tops.
How do you feel during "cold turkey"?
You suffer severe muscle cramps all over your body especially the stomach area which are shortly followed by short sleeps and insomnia. These symptoms resulted in me becoming anxious and angry with everyone and everything.
Did you seek any advice or help whist trying to quit?
I went to Bridge Project in Ayr, where I was prescribed methadone.
Is the methadone prescription program for heroin users good at helping you quit?
Yes it does although many users still use both drugs at the same time. Methadone is actually harder kick than heroin. Heroin lasts in your body for about two weeks whereas methadone and its effects last longer when you are trying to quit. I have been clean from using heroin for three years but I still take methadone and valium.
How much did you spend a day on heroin and how did you afford it?
My habit would range from twenty pounds to a hundred pounds depending on how strong the gear was therefore I began shoplifting and housebreaking to feed my habit.
Have you ever been charged, convicted or imprisoned because of your drug use?
I was imprisoned in HM Prison Bowhouse Kilmarnock on three separate occasions. Whilst in prison the last time I managed to give up heroin completely and cut down on my methadone intake. I have not returned to prison since and I am in a long term relationship.
POLICE AND NHS STATISTICS
This table was constructed from statistics produced by the Drug Misuse Information Scotland organisation for the year 2005. The statistics are made up from the offences recorded by Scottish police forces and based on offences relating to the Misuse of Drugs Act 1971.
AREA IN THE UNITED KINGDOM
RATE PER 100,000 POPULATION2
INTENT TO SUPPLY
INTENT TO SUPPLY
In 2008/09, 11,955 'new' individuals were reported to the Scottish Drugs Misuse database (SDMD). This corresponds to a rate of 245 per 100,000 of the Scottish population. The breakdown of all the cases reported for illicit drug use to the Scottish Drug Misuse Database were as follows. (See text below and Graph 1)
64% reported using heroin (5,955 individuals).
During 2008/09 there were 5,867 general acute hospital discharges with a diagnosis of drug misuse, a rate of 118 discharges per 100,000 population.
In Scotland in 2008/09 there were 493,770 prescriptions for methadone mixture, around 96 prescriptions per 1,000 population.
MISUSE AND ITS EFFECTS ON TODAY'S SOCIETY
Our national and local papers regularly report and print articles on drug misuse. Below is a summary of the articles of drug abuse or crimes within the Ayrshire area over the past five years.
April 13th 2006 Irvine Herald
A drug dealer John Gorman (aka Piddy) and his gang flooded Ayrshire with heroin, cocaine and cannabis for years. Gorman was also involved in money laundering through various businesses throughout Scotland and England.
The Scottish Drug Enforcement Agency along with other organisations including the Spanish customs prevented Gorman from importing £24 million of cannabis into the country after a two year surveillance operation. This resulted in Gorman being taken to court where he was found guilty of laundering money gained through his criminal activities.
January15th 2010 Ayrshire Post
The article written reported that a drug dealer had been dramatically evicted from his council house after complaints were made to the police and South Ayrshire council by concerned neighbours.
January22nd 2010 Ayrshire Post
A drug user tested positive for anthrax poisoning after being admitted to a hospital in Ayrshire and Arran. It is thought the addict had injected heroin from a contaminated batch imported into the country.
January 29th 2010 Irvine Herald
The police in Irvine are using ultra violet torches to detect cocaine use within public bars and nightclub toilets in a bid to reduce drug crime.
February 5th 2010 Ayrshire Post
An Ayrshire man was locked up in France after he tried to smuggle 206 kilos of cocaine and 43 kilos of amphetamine in his haulage truck.
February 5th 2010 Ayrshire Post
Kilmarnock drugs haul worth an estimated street value of £115,000 was uncovered in woodland in the Ayrshire village of Drongan.
Effect of drugs on the streets in Ayrshire
Within Ayrshire the effects of drug abuse can be seen on a day to day basis. Examples are easy to spot such as long queues of people hanging around and inside chemists for private consultations or to be prescribed methadone.
On many streets and town centres throughout the country congregations of users begging or collecting together is obvious to the trained eye as most heroin and methadone users have appearance similar to jaundice, have bad teeth and are gaunt.
What is apparent is that society on a whole is ignorant of the sheer volume of drug users within local communities throughout the United Kingdom. Therefore it is sometimes hard to visualise the effects or damage that drug misuse has on society.
In the first instance there is the drug addiction itself and its effects on the user. Such drug addiction creates severe financial infringements on the addict, his family and on the general public. A vast amount of the taxpayer's money is used to help fund the NHS. Drug use on any scale has financial implications and reduces the amount available for treatment of disease and research.
The cost to the taxpayer of policing the streets to reduce drug related crime increases every year as well as the finances of the justice system and the cost of imprisonment of users and dealers. The crimes committed by many users to feed their habit also have financial implications on the purchases we make in shops without us knowing or thinking about it.
The important question is "Why are the goods we buy today more expensive the next day?" The answer is simple "the criminal activities of our society". Losses made by multinational companies due to criminal proceedings are recouped by price increases therefore it can be argued that drug use has a hand in this.
One issue that arises from drug addiction which has severe financial implications for the general public is that most users cannot gain or hold on to employment. This has a domino effect on the users' lives as they are reduced to surviving on state benefits (including housing benefit and council tax benefit) for the rest of their lives.
Drug use and addiction also affects society in other ways that society as a whole does not take in to consideration. There are the families that are broken up daily due to the use of drugs.
These include the families not just of the users but also of those killed in car crashes by drug drivers or even the soldiers killed in Afghanistan fighting terrorists who are funded by the production of heroin from the poppy fields.
The effects of drug use on the immediate family are also paramount. The pain and anguish parents must feel when they see their own flesh and blood change from happy smiling toddlers into sick teenagers or adults who lie and steal from them in order to feed their habits must be unbearable.
Actions such as these often result in the break up of families. Parents may often feel that they are to blame for the misdeeds of their children. The disowning of the user by family members often happens because of ignorance of the physical effects that hard drug use has on the addict and also because of the perceived public humiliation.
Victims of circumstance such as children born into the family of a user may be are put at risk during police raids and also must be monitored closely by the social services to prevent them coming into contact with chemicals and drug paraphernalia. Encouragement by the general public to promote the wellbeing of children born into these family circles are essential as this could be the difference between a child becoming or not becoming a drug addict in the future.
Therefore the perceptions held by society on drug use or addiction is far from reality. There have been many arguments as to why people take drugs in the first place including bad parenting, social groups, where a person lives (postal code) and even the genetics of the user.
A survey carried out by BBC named "Factors Identified as Being Associated with Class A Drug Use" produced alarming results. These are listed below:
Earning less than five thousand and earning more than thirty thousand per annum.
People who were educated to A-level (not degree) reported the highest levels of general dug use.
Single young males who frequent public houses three times a week.( Top factor)
Analysis of all these elements would therefore help to create a mosaic on drug use and addiction but never the true story. Drug use is purely down to the individual and whether they are strong enough to reject the temptation of trying something different.
There are many interesting facts regarding the history of heroin. I was not aware of its chemical structure, pharmacology, medical use, misuse and its effects on today's society when I first decided to produce this report. Below is a brief summary of my findings:
Cultivation of poppies for the opium it produces dates back to 3400 B.C.
In 1847 an English chemist C.R Alder Wright combined morphine with various acids during experiments resulting in the chemical compound diacetylmorphine.
In 1898 Bayer marketed the compound diacetylmorphine as a cough suppressant and a non-addictive morphine substitute to consumers under the trademark name "Heroin".
Bayer A.G discovered and are the largest producer of the prescribed heroin substitute "Methadone"
The chemical structure of opium, morphine and heroin all display cyclic carbon structures and have functional groups that can undergo substitution reactions when synthesized.
Diacetylmorphine is used to treat different conditions such as acute pain during severe physical trauma
Diacetylmorphine metabolises within the blood stream more rapidly when intravenously injected.
All opiates target receptors in the brain, spinal cord and the digestive organs.
There were 5,955 new heroin users registered in Scotland in2008/2009.
There were 886 drug offences committed in South Ayrshire in 2008/2009.
Drug addicts are entitled to an extra £25 on their benefit if they own a dog.
People who earn less than five thousand or more than thirty thousand per annum, and who are educated to A-level, but do not have a degree, are more susceptible to drug use if they frequent public houses at least three times a week, and are single young males.