Heroin  is a highly addictive drug also  called smack, junk, skag, dope, and chaw.

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It is derived from morphine which is a natural opioid derived from the seed pods of poppy plants.

It is usually a pale brown powder, white powder or sticky tar like called tar heroin.

As per the Times of India, heroin manufacturing in the South east Asian countries is about 40 tonnes, 17 tonnes of which is consumed by India alone. This is stark evidence enough of the looming problem of heroin in the country.

Brown sugar which is the street form of heroin contains only 20 % heroin in it and is adulterated by talcum powder, milk powder, strychnine and other unknown substances. The adulterants makes it a very dangerous substance to consume.

Modes of intake

• Snorting
• Smoking
• Chasing (most common for brown sugar) wherein the substance is placed on a tin foil, which is heated from beneath it and the fumes thus created are inhaled.
• Fixed/injected – to inject brown or heroin it has to be mixed with an acid usually , ascorbic or citric acid. Even then many of the adulterants do not dissolve if it is brown sugar.
• Heroin is many times mixed with Crystal meth – this is called “Speedballing”

The Effects

The instant effect is a surge of euphoria created by the substance attaching itself to the opioid receptors in the brain  . It affects the areas controlling, pain, pleasure, heart rate, sleeping, and respiration.

Short term effects

Warmth of skin, dry mouth, heaviness of limbs, nausea, inability to function mentally.

Long term effects

Abscesses on body, ulcers, fired thickened walls of blood vessels, infection of the pericardium (lining of the heart) and the blood vessel linings Mental health issues like depression, anxiety, etc., sexual dysfunction in men and menstrual irregularities in women, liver and renal disease.

Diseases like Hepatitis C , HIV that are contracted due to sharing needles and risky sexual behavior of not using condoms during intercourse.

Overdose

Overdose commonly occurs with heroin and can happen with brown sugar too and is on the rise.

As a person is overdosing the person’s respiratory rate reduces resulting in hypoxia or lack of oxygen to the brain, this can result in seizures, coma and even death or permanent brain damage.

Withdrawals On Stopping Heroin/Brown Sugar

• Body ache- muscular and joint pains, at times bone pains- excruciating.
• Strong cravings which can be uncontrollable
• Stomach cramps
• Muscular cramps
• Restlessness
• Uncontrolled shaking of the legs
• Lachrymation, Coryza
• Lack of appetite
• Diarrhea and vomiting
• Sleep issues at times excessive sleep

Since a few years in India in  the withdrawals from Brown sugar –  seizures have also been observed caused primarily due to the unknown adulterants that go into its making.

Treatment

Harm reduction

Across the world harm reduction therapies have been tried for heroin and brown sugar which involves Buprenorphine and or Methadone being given at specified centres as per dose required to tide over the withdrawals.

However, Harm reduction has not been found to be too successful.

Long term successful treatment has been residential rehabilitation care after detox in a hospital. This in an environment that is voluntary, accepting, free, non- regimented,  non- judgmental, compassionate which involves  non -medical care with meditation, counseling and other alternate therapies as therapeutic techniques to go beyond finding the need to use.

The individual discovers self -love and dignity in life and learns to live a balanced fulfilling life.