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The Department of Health and Human Services National Institutes of Health stated that an estimated 2.1 million people in the United States [were] suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin. (Volkow) Opioids are the most commonly prescribed drugs for managing moderate-to-severe chronic pain. This type of pain is defined as pain that endures for a longer period of time than what would be expected for the specific issue or pain that persists for longer than 6 to 12 weeks (Lipman). There are multiple types of opioids, that include heroin, morphine, and fentanyl, along with many others. Heroin addiction and abuse are currently on the rise, which is the purpose of this investigation. According to the National Institute on Drug Abuse, The number of people meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for dependence or heroin use disorder increased dramatically from 214,000 in 2002 to 626,000 in 2016. (NIDA, Heroin) Dependence and heroin use disorder are terms that suggest relatively the same concept, addiction. It can be implied, already, that heroin is strongly reshaping America and the question in research will be to what extent does heroin use and addiction affect Americans and their mood?, with research conducted through the cultural, social, and neuropsychology lens.

Heroin is typically used to obtain a temporary high or pleasure. As stated in The Book of Joy: Lasting Happiness in a Changing World, temporary enjoyment can come through our senses, it is inevitably fleeting and not the source of happiness. (Bstan-¼dzin-rgya-mtsho) That would justify why heroin addicts and abusers uniformly use heroin but do not seem to be happy. The authors also state that trying to seek happiness through sensory gratification is like trying to quench your thirst by drinking saltwater. (Bstan-¼dzin-rgya-mtsho) That would explain why when people are relieved from the euphoric rush, they are still not appreciating life. Michele Solis would concur with that statement because she states that without it, regular heroin users descend into the misery of withdrawal, with flu-like symptoms of shaking, sweating, … and vomiting. (Solis) Solis is a writer of science, particularly science about the brain and the biology of mental illness. Chris Elkins also states, When its abused, heroin makes people feel peaceful, relaxed and drowsy. It can also cause short-term relief from stress, anxiety, or depression. (Elkin, Heroin Addiction) That can be what makes people happy and John Stuart Mill, the author of Utilitarianism, says, happiness is the sole end of human action. (Mill) Based on the research executed, heroin negatively impacts American culture since it is highly addictive. Its negative results are because of what it does to the brain and given that it has extremely negative health and social effects on the person taking the medication and the people around them. Methadone can be a solution to this matter because it is one of the many substitutes for heroin addicts. Addicts insist that they lose the yearning for heroin after using this drug. There will be further data concerning this later in the essay.

To begin with, heroin is referred to as Big H, Horse, Smack, Cold Turkey, and so many other names. Heroin is a type of opioid and they are called opiates because they are obtained from the seed pod of opium poppy plants (Carson-DeWitt). Heroin, specifically, is made from morphine, which is also a natural substance that comes from poppy plants. Being addicted to or even using heroin can have negative health effects. The intensity of the impact of heroin on a persons health depends on many factors. For example, the more heroin a person uses the more severe the health problems can be. Other factors are current health status, height, weight, gender, the volume of the amount of heroin they take, method of drug intake and, length of abuse (Staff, Effects). Methods include smoking, injection, and sniffing or snorting (‘What Is Heroin And How Is It Used?’). Some short term health effects include a euphoric rush, a trance-like state, that usually lasts for about four to six hours, warm-flushed skin, limbs feeling heavy, severe itching, unnatural relaxing, muddled thinking, and depressed heart rate and breathing. The rush usually lasts for approximately three to five hours as it is the main reason people use the drug. The short burst of improved mood is usually followed by a rush of dysphoric feeling and can lead to the addiction of the drug (‘Prescription Pain Medicine & Heroin&). Opioid receptors are linked to breathing, which is why heroin abusers tend to have a depressed heart rate. This abnormal heart rate is when breathing becomes shallow and/ or irregular and the person receives less oxygen (Staff, What can be done). A large dose usually makes those symptoms so severe that they can not survive without medical assistance. The short term health effects are usually temporary and tend to dwindle, but lack of oxygen can become a long term issue because it leads to brain damage. All these negative health outcomes can impact how a person feels on a daily basis because they may cause a sense of pain. Pain directly influences a persons mood. To back that, the H-Wave website states that, living with pain can affect a persons mood by making someone more susceptible to emotional changes that can foster depression, anxiety, and fear (Chronic Pain On The Brain&).

All of those things occur to all people that use heroin, but there are additional risks that are specific to those that inject. They are at risk for human immunodeficiency virus (HIV) and hepatitis C (hep C) because they use needles. When taking heroin, likely, they do not care how they get the drug, they just know that they need it and will be willing to do anything to get it, including sharing unsterilized paraphernalia. HIV and hep C are both blood-borne diseases and can be transmitted through people by sharing needles and other paraphernalia (NIDA, Opioid Facts for Teens).

Although those results are indeed negative, withdrawal also has negative implications. Just as Michele Solis said, in the absence of heroin there are symptoms that are felt. There is a decrease in dopamine produced solely by the brain when there is heroin present, but when there is none, dopamine stops being made and that causes the withdrawal symptoms (Elkins, Heroin Effects On The Brain). Those symptoms can be anywhere from diarrhea and sweating to insomnia and anxiety (Juergens). At the same time, Josh C, a recovered addicted stated, But what’s even greater is that when I lay my head down at night, my conscience is clear (Foundation). That proves that being heroin free is better than the withdrawal symptoms that occur with being nondependent on the drug.

In addition to health responses, heroin can affect the brain in an absurd way. The brain naturally produces its own opioid chemicals to reduce pain. But the natural chemicals do not last long, nor are they sufficiently potent to help with chronic pain. As stated earlier, the opioid element of heroin binds to opioid receptors. Once the brain encounters these synthetic drugs it is likely that it will cease producing its opioids. In addition, the brain also decreases how much dopamine is produced when taking these drugs. When you decrease the amount of dopamine being created it is very hard for them to start producing again (Elkins, Heroin Effects On The Brain). That is the reason prescription opioids are prescribed for chronic pain. The brain also decreases the amount of dopamine made when there is the presence of a synthetic opioid. It causes brain confusion because they have adapted to not producing those transmitters. These are transmitters that lead to an increased mood and also addiction. That also makes it difficult for the user to function. The confusion can also cause brain damage since it is changing the structure of the reward system in the brain. Heroin can also lead to deterioration of the white matter in the brain which directly affects decision-making abilities (Elkins, Heroin Effects On The Brain).

In relation to addiction, it is a word that means enslaved by or bound to, in Latin and is known as a chronic disease that alters the structure and function of the brain (Publishing). In agreeance with that, Qingxiao Hong and his partners stated that addiction is a relapsing brain disorder characterized by continuous, compulsive drug-taking, uncontrollable drug-seeking behavior, and high reoccurrence rates. Hong is an affiliate of Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, and Ningbo University. He also has expertise in epigenetics and genetic analysis. Addiction triggers the brain reward center, too. The addiction does this by intervening with the central nervous system plasticity, and the system plasticity is used to start and support the drug-taking habit (Hong et al.). Specific to heroin, though, Once heroin use has impacted both the physiology and physical structure of the brain, there will be long-term disturbances to the brains hormonal and neuronal systems. (Staff, Effect)

Aside from having unfavorable results on the people taking heroin, there are repugnant repercussions for the people around and related to them. In pregnant women, there are adverse consequences for their babies. When females become pregnant they are introducing addiction to their babies (Hutchings 52). The baby will be just as addicted as the parent is. When they are abusing a drug they introduce problems in newborns. Problems include withdrawal symptoms when born, these symptoms are, but are not limited to, jerky movements, high-pitched crying, irritability, and disturbed eating and sleeping patterns (54). Some children have short attention spans. If these issues persist across several days or weeks the newborn will be required to be medicated with a tranquilizer or another drug (54). Furthermore, babies tend to be underdeveloped, due to the likeliness of premature labor, and they might be born so early that they need intense care. They could also experience breathing problems in the first few weeks of life (‘Heroin’). Likewise, all types of relations can fall apart due to heroin. Users could develop an addiction that can lead to them needing more which could take up a large sum of their time. Plus, friends may not be able to rely on the person as their moods can change depending whether they are using or not. Long-term use can lead to serious health and financial problems, which can also affect relationships (‘Heroin’). Concurrently, if the users loved ones do heroin, it might bring them closer together.

To treat heroin addicts, methadone maintenance is a great approach. It is a synthetic drug that is a cheap alternative to heroin. Heroin addicts would use methadone if heroin was unavailable, it was introduced as a maintenance treatment in 1945 and is currently a success for addicts (Hutchings 43). Doctors Vincent Dole and Marie Nyswander did a study at Rockefeller University in 1964, they studied heroin addicts at a New York City hospital (46). They found that if they gave their patients oral doses of methadone the patients would become almost normal (47). They seemed to lose their cravings for heroin and any narcotic drug hunger. Doctor Dole said that they were becoming normal presumably by maintaining a blockade of the sites of narcotic drug action. (48) He also stated that there should be no euphoria nor any other undesirable effects. After patients were released, they claimed they never craved opiates, they could be around addicts, and could tolerate difficult situations that would typically turn them back to drugs. The patients also felt no reactions when taking heroin after treatment (50). There are many positive aspects to this treatment, however, it leads to constipation (51), and just like heroin, if a female becomes pregnant while using the drug the child will be as physically dependent as their mother (52). Another treatment option could be a diamorphine treatment (Strang et al.). It would be similar to the methadone treatment, but instead of it being given orally it would be injected. This therapy would be for people who did not have any luck with the methadone. Its greatest limitation would be that it is illegal in the United States. Since it is illegal and because it would be a requirement to be open several sessions per day, every day, clinics would need to be open just about all day, every day. Clinics would also require a high level of support and interactions with staff (Strang et al.). Furthermore, naloxone (Narcan) would be used if the user took an extremely large dose of heroin. Naloxone is an opioid receptor antagonist so that it eliminates all signs of opioid interaction by rapidly binding to the opioid receptors before heroin can bind to it. One limitation is that it is only for overdoses, another is that it only buys enough time for medical assistance to arrive (NIDA, Heroin).

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