Southeast Missouri State University student publication

Illicit Opioids

Thursday, May 3, 2018

Heroin, a highly concentrated derivative of morphine, produces effects in the body similar to prescription opioids. The DEA classifies heroin as a Schedule I drug. It takes the form of brown or white powder or black tar, and is most often injected, snorted or smoked.

On the street or black market, heroin is often “cut” or mixed with additional substances — most notably, the synthetic fentanyl — greatly increasing risk of overdose and death. Color is generally associated with purity, but increasingly and inconspicuously, drugs are combined by sources to increase profit. Besides fentanyl, common cutting agents include various household powder products such as baking soda, sugar and rat poison.

Heroin represents a more potent, affordable and available opioid high and is often precursed by prescription drugs, although only a small percentage of prescription user switch to heroin, according to National Institute on Drug Abuse.

The euphoria associated with heroin is often described as an immediate rush, a feeling of weightlessness and elation, by way of a massive dump of dopamine. The initial high, which is relatively short-lived, is followed by hours of extreme drowsiness and confusion, sometimes classified as “the nod.”

Pleasure and euphoria diminish as tolerance builds, which can lead to increased dosages, and greatly increased risk of overdose.

Withdrawal — extreme physical sickness and mental disorientation — prompts recurring use.

When diverted for misuse and abuse, prescription opioids are also considered illicit. Modes of rapid entry in relation to misuse include nasal ingestion and injection of crushed pills.

Clandestine synthetics

Fentanyl, created clandestinely, began appearing in heroin in the late 1980s and early 1990s according to a DEA Briefing for First Responders.

Fentanyl is 50 to 100 times more powerful than morphine and presents massive risk of death, especially when used intravenously. Cheap and simple to produce, the drug is considered discreet and can be impossible to identify without laboratory-testing.

It is regularly combined with heroin in infamous brands such as “white china,” and “alligator” but users may not be aware of its presence. The Dark Web allows fentanyl to be moved, nearly untraceably, between source and dealer, and is often imported from another country. Counterfeit tablets, composed in whole or part of fentanyl, are passed off as pharmaceutical brand names and even as “cocktail” mystery pills.

DEA Assistant Special Agent Larry J Reavis Jr., at an opioid summit held in September, said that fentanyl presence has increased 300 percent in recent years.

According to the DEA’s First Responder’s Guide Carfentanil, which is similar to fentanyl, is up to 10,000 stronger than morphine.

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