Heroin
Heroin is a highly addictive drug and is the most widely abused and most rapidly acting of the opiates. Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy plants.

Pure heroin, which is a white powder with a bitter taste, is rarely sold on the streets. Most illicit heroin is a powder varying in color from white to dark brown. The differences in color are due to impurities left from the manufacturing process or the presence of additives. Another form of heroin, "black tar" heroin, is primarily available in the western and southwestern U.S. This heroin, which is produced in Mexico, may be sticky like roofing tar or hard like coal, with its color varying from dark brown to black.

Heroin can be injected, smoked, or sniffed/snorted. Injection is the most efficient way to administer low-purity heroin. The availability of high-purity heroin, however, and the fear of infection by sharing needles has made snorting and smoking the drug more common. National Institute on Drug Abuse (NIDA) researchers have confirmed that all forms of heroin administration are addictive.

Extent of Use
According to the 2005 National Survey on Drug Use and Health (NSDUH), approximately 3.5 million Americans aged 12 or older reported trying heroin at least once during their lifetimes, representing 1.5% of the population aged 12 or older. Approximately 379,000 (0.2%) reported past year heroin use and 136,000 (0.1%) reported past month heroin use.

Health Effects
The short-term effects of heroin abuse appear soon after taking the drug. Intravenous injection provides the greatest intensity and most rapid onset of the initial rush that users experience. Intravenous users typically experience the rush within 7 to 8 seconds after injection, while intramuscular injection produces a slower onset of this euphoric feeling, taking 5 to 8 minutes. When heroin is sniffed or smoked, the peak effects of the drug are usually felt within 10 to 15 minutes.

In addition to the initial feeling of euphoria, the short-term effects of heroin include a warm flushing of the skin, dry mouth, and heavy extremities. After the initial euphoric feeling, the user experiences an alternately wakeful and drowsy state. Due to the depression of the central nervous system, mental functioning becomes clouded. Additionally, breathing may be slowed to the point of respiratory failure.

After repeatedly using heroin for a period of time, the long-term effects of the substance begin to appear in the user. Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses, and liver disease.
Additionally, pulmonary complications, including various types of pneumonia, may also result in the user.
One of the most significant effects of heroin use is addiction. With regular heroin use, tolerance to the drug develops. Once this happens, the abuser must use more heroin to achieve the same intensity or effect that they are seeking. As higher doses of the drug are used over time, physical dependence and addiction to the drug develop.

Within a few hours after the last administration of heroin, withdrawal may occur. This withdrawal can produce effects such as drug craving, restlessness, muscle and bone pain, and vomiting. Major withdrawal symptoms peak between 48 and 72 hours after the last dose and subside after about a week.

In addition to the effects of the drug itself, users who inject heroin also put themselves at risk for contracting HIV, hepatitis C (HCV), and other infectious diseases. Approximately 70–80% of the new HCV infections in the U.S. each year are among injection drug users.

Street heroin is often mixed with various substances, including sugar, starch, quinine, and sometimes, strychnine or other poisons, causing an added danger to using heroin. Because heroin abusers do not know the actual strength of the drug or its true contents, they are at a great risk of overdose or death.

Of an estimated 108 million emergency department (ED) visits in the U.S. during 2005, the Drug Abuse Warning Network (DAWN) estimates that 1,449,154 were drug-related. DAWN data indicate that heroin was involved in 164,572 ED visits.

Treatment
A variety of effective treatments are available for heroin addiction. For example, methadone, a synthetic opiate that blocks the effects of heroin and eliminates withdrawal symptoms, has proven successful for heroin addiction. Additionally, buprenorphine and many behavioral therapies are also used to treat heroin addiction.
From 1995 to 2005, the number of admissions to treatment in which heroin was the primary drug of abuse increased from 227,989 in 1995 to 254,345 in 2005. Heroin admissions represented 13.6% of the total drug/alcohol admissions to treatment during 1995 and 13.8% of the treatment admissions in 2005. The average age of those admitted to treatment for heroin during 2005 was 36 years. Those admitted to treatment for heroin during 2005 were primarily male (68.3%) and white (50.4%).

Arrests & Sentencing
During FY 2004, there were 32,980 Federal arrests for drug law violations, 1,881 of which were for heroin. Additionally, the Drug Enforcement Administration (DEA) reported 2,273 arrests for opiates in FY 2004.During FY 2006, there were 1,576 Federal offenders sentenced for heroin-related charges.


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