Heroin – Use and Abuse

heroin is an illegal, highly addictive drug and acting more quickly than opiates. Heroin is processed from morphine, a naturally occurring substance extracted from the sheath of the seed of certain varieties of poppy plants.

the heroin is usually sold as a white or brown powder or as the sticky black substance known on the streets as ‘black tar heroin’. Street most of the heroin is cut with other drugs or substances such as sugar, starch, milk powder etc. In general, in the best of Malta or as is heroin know ‘smack’ is sold in packets made of paper, not more than one toe nail in size, Lm10 each. Heroin does not know the real strength of the drug and thus is always at risk of overdose or death. Other problems with heroin use is the transmission of HIV and other diseases that occur when sharing needles

how heroin is used?

the heroin usually injected, sniffed or smoked. Heroin addict can typically inject up to four times a day. Intravenous injections provide more intensity, more quick euphoric start, (7 to 8 seconds) while the intramuscular injection heroin that is sniffed provides a home relatively slow the euphoria (5 to 8 minutes) or smoked does not produce a fever and generally feel their effects peak within 10 to 15 minutes

(Adapted from the National Institute of Drug Abuse)

according to the NIDA researchers three forms of heroin administration are addictive. In the short term the immediate effects of heroin use are that the fever, depressed respiration, clouded mental functioning, nausea and vomiting and pain suppression. (Parker, 2002a:15) After the injection or inhalation, heroin crosses the barrier and is converted to morphine in the brain. It is when the abusers report quickly. “Having the best orgasm you’ve ever had. “Multiply by 1 thousand and you’re still far away”. This quote taken from the book and film ‘Trainspotting’ by Irvine Welsh better describes the ecstasy heroin addicts-induced feel. Heroin is particularly addictive as it enters the brain so quickly. ‘ The fever then is accompanied by a warm flushing of the skin, dry mouth and a heaviness in the limbs that can be accompanied by nausea, vomiting and severe itching. ‘ (Parker, 2002b:15) the long term effects are addiction, infectious diseases for example, HIV and hepatitis B and C, collapsed veins, bacterial infections, abscesses, infection of the lining of the heart and valves, arthritis and other rheumatologic problems. (Parker, 2002 c: 16)

addiction is more harmful effects long-term of heroin. Addiction is chronic, relapse of the disease, characterized by the pursuit of compulsive of drugs and the consumption and neuro chemical and molecular changes in the brain. As consumers of other drugs, heroin users gradually spend more time and energy obtaining and using the drug. Primary purpose of the abusers of heroin in life becomes search and use of the drug.

‘ garbage is not like alcohol or marijuana, a major means to enjoy the life. Trash is not a setback. It is a way of life.’ (Burroughs, 1953a)

physical dependence develops with doses higher drug. Withdrawal symptoms occur if use is reduced or stopped abruptly. Symptoms of withdrawal include restlessness, pain in muscles and bones, insomnia, diarrhea, vomiting, cold flashes (the term cold Turkey comes) and leg movements. Physical dependence and the appearance of withdrawal symptoms once thought that the key characteristics of heroin addiction. But cravings and relapse may occur weeks and months after that withdrawal symptoms are gone. This may be because the patient with pain looking for help and not the fever by the addict.

use Socio-psychological explanation.

there is a characteristic style of personality that can be called ‘addictive personality’. However, there are common traits of personality, symptoms and factors psychodynamic occurring in clusters of addicted persons. Many psychologists have devised theories to try to explain addiction.

function of Stanton et to the. results (1982) on the symptom in the families of addicts to drugs (heroin):

1. The euphoria of the regressive heroine, characterized by infantile fusion with the mother, allows the addict a symbolic reunification with the mother and the family of the children. Blunting of the drug effects allow the addict feel distant from overwhelming fears of incorporation while maintaining an illusory intimacy. This is true of other depressant drugs.

2. heroin causes a feeling of power and omnipotence that can unleash attacks to members of the family, especially parents. This ira allows the addict feel temporarily autonomous and free from family ties. Addicts elected life is also a challenging ‘quantum leap’ of the family.

3. regressive heroin, sexually equal high and the resulting “Rip and run” style of life, they prevent the man addicted to the development of intimate and lasting relationships particularly with women. In the latter stages of the addiction, drug use eliminated sex drive.

4. as result of the first three factors as underlying narcissistic personality, addicts are only pseudo family of procreation.” (Kaufman, 1994a:10)

dairy and Frosch (1973) found a difference between heroin and consumers of amphetamines which had abused both drugs and underwent a preference for one of the two. For those whose choice of drug was heroin, they suffer from depression and despair and relief from the anxiety by the withdrawal of others and repression of conflict through over and over again by the drug. In a later work, dairy and Frosch (1980) emphasized the need of the heroin to revive sporadic rabies opioid. Khantazian (1979) noted specific silencing and stabilize the effects of narcotics in rage and aggression. In a study of 200 heroin addicts, also found deficiencies in the development which led to outbursts of anger, poor impulse control, and dysphoria. Heroin then moderated the threat violent feelings that represent to themselves and others. In opiates, they experienced a sense of total physical relief, describing how soft and quiet. (Kaufman, 1994b:26)

heroin users usually belong to a subculture. Strong heroin users and controlled heroin users are bound together in small isolated groups who develop idiosyncratic rituals, rigid and social sanctions. These groups are always very fragile and focused on the drug. Ritual and compulsive users controlled users usually are the same. In both groups, people fight over who gets first, belts are used as links and so on. Ritual of the addict is an expression of the melancholy identification and bold outlaw stance is attractive for them.

the media, movies, music and stars has in recent decades put focus on heroin use and somehow added to his glamour. In the mid-90s a waif looking, emaciated, drug addicted look was popular in the fashion world. Pale skin, dark circles under the eyes and protruding bones were seen in models Runaways showing the appearance of ‘heroin chic’. Calvin Klein ads appears these looks in 1997. Fashion designers, model Kate Moss and movies like ‘Trainspotting’ and ‘Pulp Fiction’ were blamed by exalting the elegant appearance of heroin and lifestyle. Elegant fashion heroine always much controversy. In 1997 Bill Clinton felt he had to express its opinion on this. President Clinton lamented the fashion photography ‘heroin chic’, for sending a message using the drug once feared ‘glamorous’ or ‘sexy’. Clinton talking about policy drug United States took note of the recent admission by editors of journals that look ‘lost addict’ in some fashion designs had glorifies the use of heroin. He went on to say that the glorification of heroin was not creative and destructive. It was not art. Clinton went on to say that, although it has decreased the consumption of cocaine, heroin use had risen and said that you part of the reason the images that are finding their way to the young. David Sorrenti, a fashion photographer, who uses these images, died 20 years of a heroin overdose when Clinton made these statements to the press.

long before this incident of 1997, heroin has been the protagonist of letters, books, and deaths. The first book written in heroin was by Thomas De Quincy – confessions of a dining room of opium in the 18TH century. The Beat, mostly from William Burroughs generation, wrote important books on the subject. The most famous is ‘Junky’, which is autobiographical. Over the years, we have witnessed many fatal overdose in the entertainment industry, both in the world of cinema as River Phoenix, a young actor promising and numerous other deaths in music bands.

If you look at thes lyrics by Lou Reed and the Velvet Underground in the song with the self-explanatory title, “Heroin”, tells us that as many authors that write about the heroin, is the Center and the life of the addict.; ‘it is my wife and my life’, ‘because when the heroin flow, really I don’t already’ the soothing and relieving the pain produced by heroin users is clear in these letters, by the way affects the brain and the blood and the immense effect on thoughts of the person and the sense of being. Many later artists of Woodstock have written songs about heroin. Some songs about heroin: Neil Young: the needle and the damage done, the rolling stones: dead flowers, Red Hot Chilli Peppers: under the bridge, Velvet Underground: heroin, Guns N’ Roses: Mr Brownstone, of the: there goes, Dandy Warhols: not if you were the last junkie in the world, Wolfsheim: heroine, Velvet Underground: waiting for the man, the Ramones: Chinese Rock, Lou Reed : Perfect day, Pink Floyd: comfortably numb, U2: heroin and The Stranglers: golden brown:

“Brown texture Golden as the Sun
provides me WITH my mind works throughout the night

without having to fight
never a frown with golden”

the social correlates and consequences

in Malta not only traffic but also the possession of illicit drugs is a criminal offence. All users of drugs, because the possession at risk of criminal charges. In 2003, the drug squad made 597 arrests 528 people. 74% of these were only for possession while 22% where for possession and trafficking. It was mostly heroin and cannabis. (National Focal point on drugs and drug addiction)

30% of the population of Malta is accused or convicted of drug offences. All inmates tested are drugs at admission. 50% tested positive for drugs. The main drug of use was the heroine, with a staggering 81%. (National report 2004: situation of Malta drug)

many heroin users suffering from dual diagnosis, where a person has both a drug problem as a psychiatric, emotional problem. To recover fully, the person needs treatment for both problems. The most common problems are depressive disorders, disorders of anxiety and in some cases even the onset of disorders of personality and schizophrenia. What develops first? Most of the time the problem is mental that develops first of all other drugs in episodes dependence is the main condition and can then become a psychiatric illness.

in 2003, there were approximately 1,200 people with problems of heroin, in treatment-1,000 of these consumer hot spots are based on the criterion of daily use of heroin. Close to 700, this client population are in substitution treatment, taking methadone over a period of three months or more. (National report 2004: situation of Malta drug)

National Focal point on drugs and drug addiction believe that there are about 350 people who inject drugs unknown. Approximately 80% of heroin users inject. Syringe data indicate that approximately 220,000 syringes were distributed in 2003. The average age of clients in treatment with heroin or cocaine problems is usually about five years older than those with a problem of cannabis. Customer data heroin treated for the first time in 2003 demonstrated that started taking heroin at around 19. The mean age in the year 2003 was 28-year-old. 86% were male customers. (National report 2004: situation of Malta drug)

out of heroin are the most problematic. 71% are daily users, with 63% injection. The majority of clients using detoxification are heroin users, who make up 85%.

legal aspect and punishment

the Dangerous Drugs Ordinance controls possession and trading of narcotics, including equipment or materials used for the production of drugs. Part II of the Act prohibits the import and export of opium. Covers crimes of manufacturing, selling or trafficking in or use. The law specifies to also treat as a crop. Traffic penalties are severe, especially if it occurs 100 metres of a school, youth centre if supplied to a pregnant woman, minor of age or a person in rehabilitation. 101 dangerous drugs Ordinance (chapter)

punishment is established in said Ordinance. The Court of the judiciary is competent to try all offences against the Ordinance. The Attorney General has the right to appeal to the Court of Criminal Appeal from any decision handed down by the Court of magistrates in connection with criminal proceedings arising from the provisions of this Ordinance. The Criminal Court hands of twelve months to ten years Lm10000 fined for possession. For sale and treatment, the Criminal Court can be given a life sentence, the only exception is when the judgment is not unanimous and when the age of the offender, previous carried out, amount and nature of the drug or social circumstances ask for this measure. In this case the Court can give a penalty of four to thirty years more fine lm1000 lm50000. When the case is tried in the Court of magistrates, the punishment is less severe. For possession, one can receive imprisonment from three to twelve months or more/a fine of no more than Lm1000. For the sale and trafficking of one can be sentenced from six months to ten years more fine Lm200 Lm5000. For the crime of trafficking in persons, there is perpetual and confiscation of property. In the case of the cultivation of the Court may confiscate property used for farming.

the punishment increases if the traffic and sales occurred near a school or involving children of age or pregnant women. Parole and probation are rewarded only in the case of possession. In the case of possession of drugs by foreign, they are not pursued if medications delivery to customs officials and is obvious from the number that it was exclusively for their own use.

addicted to heroin are sentenced to Corradino Correctioal can benefit from the rehabilitation program offered by SATU (therapeutic substance abuse unit) which is located at Mtahleb or Caritas which also has an internal prison program based in Bahar ic – Caghaq. In both cases, inmates are eligible for these services in the last two years of his sentence

the treatment no specific treatment is valid for all drug addicts. It is important that the treatment is suitable for particular problems and State of mind of each individual. The treatment must meet the needs of the individual. To be effective you have to address consumption of the addict, which may be related to medical, social or professional problems.

(adapted from the NIDA on treatment for drug abuse entitled ‘ principles of drug addiction treatment: a research-based guide)

counselling (individual or group) and other behavioral therapies are critical components of effective treatment for addiction. In therapy, patients issues of motivation, build skills to resist drug use, drugs with drugs not constructive and rewarding activities activities to replace and improve the problem solving skills.

drugs are also an important part of treatment for many patients, especially when combined with counseling and other behavioral therapies. Methadone and levo-Alpha-acetylmethdaol (LAAM) are very effective in helping people addicted to heroin to stabilize their lives and reduce the consumption of illicit drugs. (Parker, 2002d:168) In Malta, the majority of customers abuse of heroin is seen in the detoxification Center, while 29% in community services and 20% in rehabilitation programs. (National-Malta report drug situation 2004)

medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. There are many types of treatments available. There are treatments free of drug patients, long-term residential treatment to medical detoxification and short-term residential treatment. There are two effective ways, prison-based treatment and treatment in the treatment of criminal drug abusers and addicts based on the community. Research shows that combines the sanctions of criminal justice, drug treatment may be effective to reduce the consumption of drugs and related offences.

in Caritas Malta and Sedqa are almost identical services to heroin addicts. There is also joy Oasi which offers residential rehabilitation services. Caritas and Sedqa both outreach and rehabilitation programs. They also offer information for parents and children and counseling for the whole family.


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