Who uses heroin?

Experts from the Upstate New York Poison Center say that some users turn to heroin because it is cheaper than prescription pain medicine. They may inject it, inhale it by snorting or sniffing, or smoke it. About half of the young adults who inject heroin report abusing prescription opioids first, according to the National Institute on Drug Abuse.

How does it affect the brain?

Opioids relieve pain by altering a person‘s perception of pain signals from their body. With prolonged use, the sites where the opioid works become adapted, and then it requires more of the drug to get the desired effects.

What does it feel like?

Heroin users describe treatment of their pain, relaxation and a sensation of being high. People with chronic pain who use heroin may experience hyperalgesia, where they feel as though they are in greater pain.

Why is this a crisis?

The death rate from drug overdoses is climbing at a much faster pace than other causes of death, according to The New York Times, a trend similar to that of the human immunodeficiency virus in the late 1980s and early 1990s.

In Onondaga County, deaths from heroin overdoses climbed nearly 31 percent in 2015. Most deaths were of white men in their 20s.

How does heroin kill?

Heroin and all opioids decrease central nervous system activity, resulting in a decreased level of consciousness and, eventually, a decrease in the activity of the breathing center. Patients usually die because they stop breathing or breath too little to allow for enough oxygen to reach the brain, and death typically happens one to three hours after injection.

What are some signs of heroin use?

Someone who has started abusing heroin may exhibit a change in behavior or mannerisms or have a new circle of friends. He or she may withdraw from family activities and may react with anger or excuses when questioned why. School grades may deteriorate.

A heroin user may display a lack of motivation, a lack of self-control and/or irrational behavior. His or her temperament may become difficult, or aggressive, and he or she may have constant fatigue.

People using heroin may neglect personal hygiene and appearance and develop an impaired sense of judgment. Their speech may slur, or they may have trouble expressing themselves verbally. The pupils in their eyes may become pinpoints, their lids may be heavy, and needle tracks may be visible on their arms. They may say they feel insects crawling all over their body.

Heroin users could have in their possession “drug paraphernalia,” including tinfoil, weight scales, zip-lock bags, square folded paper envelopes, butane torches or cigarette lighters, small porcelain bowls, hypodermic needles, balloons, mirrors or short straws.

This article appears in the fall 2016 issue of Upstate Health magazine.