a.k.a. Big H, Black Tar, Hell Dust, Chiva, Horse, Negra, Smack, Thunder
by Lindsay Cates
Addicts say that before trying heroin, they knew it was bad—they knew they were crossing an imaginary line into dangerous territory. Most never wanted to cross that line, but when addiction took hold they saw little way out.
“It’s mentally addicting, and it’s immediate relief,” said Katya Totty, 25, a current inmate at Rockbridge Regional Jail. “I don’t like getting high. It’s just something that my body and my brain tell me that I want to do.”
Public health officials all over the country are calling the spike in deaths from heroin and prescription opioid overdoses a national epidemic. Opioids are drugs that reduce the perception of pain in the brain, while creating a sense of well-being. Recent trends show that people addicted to prescription opioids are switching to heroin—a cheaper and more abundant option.
Opioid-related deaths now kill more people every year than car crashes, according to the Centers for Disease Control. Although Rockbridge County has yet to see a significant spike in deaths from heroin use, 11 people have died of a prescription opioid overdose since 2007, and one person died of a heroin-related overdose in 2015. Heroin is increasingly being cut with other harmful substances, such as fentanyl, a synthetic opiate more powerful than morphine. When heroin is sold to users, they often do not know the exact purity of what they are purchasing, let alone what else is mixed in.
Heroin, an illegal opioid painkiller, is typically sold as a white or brownish powder that often looks like brown sugar. It can also be a black, sticky substance known on the streets as black tar heroin.
Heroin can be injected, smoked, sniffed or snorted. High purity heroin is usually smoked or snorted. Snorting or injecting the drug allows it to spread faster, which increases the feeling of euphoria, but also the risk of an overdose. The drug brings a surge of euphoria or “rush,” followed by a twilight state of sleep and wakefulness.
Heroin is a Schedule I substance, meaning that it has a high potential for abuse and no currently accepted medical use in treatment in the United States.
EFFECTS ON THE BODY
The most dangerous effect of heroin use is addiction. With regular use, a tolerance to the drug develops and a user will have to use more of the drug to feel the same intensity. This leads to physical dependence and addiction. Because heroin abusers buy the drug from dealers, they usually do not know the actual strength of the drug or its true contents. This puts users at a high risk of overdose or death. There is no way of knowing the purity of the drug injected or its contamination with other dangerous drugs.
The signs of a heroin overdose are slow and shallow breathing, blue lips and fingernails, clammy skin, convulsions, coma and possible death.
WHERE IT COMES FROM
Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of certain varieties of poppy plants grown in Asia, Mexico and Colombia. It comes in several forms, the main one being “black tar” from Mexico (found primarily in the western United States) and white heroin from Colombia (primarily sold on the East Coast).
OPIOIDS: A CLOSE RELATIVE
Many turn to heroin after abusing prescription opioid painkillers because it is cheaper and easier to obtain. An opioid is a medication that relieves pain, and common prescription opioids include OxyContin and Vicodin.The number of prescriptions for opioids (like hydrocodone and oxycodone) has escalated from around 76 million in 1991 to nearly 207 million in 2013. The United States is the world’s biggest consumer, accounting for 100 percent of the world’s total consumption for hydrocodone and 81 percent for oxycodone.
Heroin has the same effect as prescription opioids—both reduce the intensity of pain signals to the brain, and affect the areas that control emotion. Heroin users describe being high as feeling euphoric and completely at ease.
Alexis, whose last name we are withholding because she is facing criminal charges, explains the sensation of “nodding out.” Alexis, 21, has been using heroin since she was 15 and describes the sensation of semi-wakefulness as “the best feeling.”
THE PRICE IS RIGHT
In 2015, The Washington Post reported that in most states you can buy a bag of heroin for less than a pack of cigarettes. Depending on the state, that’s anywhere from $4 to $10, with pricing depending on availability and how the drug is “cut.” Today heroin is much cheaper than it was when its usage last peaked in the 1970s and 1980s. Back then, a milligram of heroin cost $4 to $5; today the same amount is about 10 cents. A bag of heroin could contain anywhere from 30 to 100 milligrams (1 gram) of the drug, depending on purity. Someone with a serious addiction will use anywhere from 10 to 20 bags to get high, therefore spending $40 to $200 per day to fund his or her habit.
Based on street costs, heroin is less expensive than other addictive drugs like cocaine, a strong stimulant used as a recreational drug. One gram of cocaine can be anywhere from $20 to $60, while the same amount of heroin is about $10. Therefore, heroin also appeals to those who are struggling to finance a drug addiction.
Alexis grew up in the suburbs of Chicago, but now lives in Buena Vista and has frequently driven to Richmond to buy heroin. Each trip would require at least $250, she said, but her dealers would often throw in a few extra bags if she spent $300.
Heroin was invented in Germany in 1874 and was imported to the U.S. soon after. It was marketed to American doctors as a “safe, non-addictive” substitute for their morphine-addicted patients. Heroin, morphine and other opiates were sold legally in the U.S. until 1920 when Congress enacted the Dangerous Drug Act. The Narcotics Division of the U.S. Treasury Department banned heroin from use in 1923. Once heroin became illegal, those already addicted turned to the street to buy the drug.
The last time heroin spiked in popularity in the U.S. was in the 1970s and 1980s. But heroin use looks different now than it did 45 years ago. Then, more than 80 percent of people who began using opioids started with heroin; today nearly 80 percent of opioid users reported that their first regular opioid was a prescription painkiller, according to a report presented to the Senate Judiciary Committee in January. In the 1980s, heroin was mainly used as a recreational pastime in impoverished areas, but these days it is affecting all socio-economic groups.
“Drug patterns tend to be cyclical,” said Kirk Luder, a psychiatrist at University Counseling at Washington and Lee University. “The history of opioids goes up and down and it tends to track every other generation.”
A GROWING PROBLEM
As death rates rise, law enforcement agencies and community centers across the country are working to spread awareness about the dangers of prescription opioids and heroin. In Rockbridge County, Rockbridge Area Community Services (RACS) is working with the Rockbridge Regional Drug Task Force to promote prevention and treatment for addicts. Ann-Ashby McKissick, chair of the board at RACS, says the center has seen more heroin cases recently. She blames today’s “get rich quick” society for the trend. “We want things, and we don’t want to work hard for them…that encourages, in my opinion, drug use and misuse,” McKissick said.
Nationally, opioids were involved in more than 61 percent of deaths from drug overdoses in 2014. In Virginia, it’s 80 percent, according to Jodi Manz, policy adviser in Virginia’s Office of Health and Human Resources. In Virginia, deaths from heroin overdoses have more than doubled in the past three years from 135 deaths in 2012 to 344 in 2015.
Nationally, deaths from heroin overdoses have more than tripled since 2010 and are double the rate of deaths from cocaine, according to the Centers for Disease Control.