- According to DAWNs Year End 1998 Emergency Department Data, 14 percent of all emergency department drug-related episodes had mentions of heroin/morphine in 1998.
- Typically, a heroin abuser may inject up to four times a day.
- Because heroin abusers do not know the actual strength of the drug or its true contents, they are at risk of overdose or death.
- Short-term effects of heroin include: warm flushing of the skin, dry mouth, slurred speech, constricted pupils and droopy eyelids, as well as itchy skin.
drug rehab and heroin addiction
All but one ethnographer (Los Angeles) reported that there are more heroin users in their teens and early twenties. Most of these younger users are inhaling or smoking their heroin, though injection among young users is reported in El Paso, Chicago, and Denver. In Denver, the ethnographer reported that all of the young users are injectors, and many use four or more days a week and as much as 1/4 gram each day. Most of the youths in this area who are using heroin are seasonal runaways or summer migrants to the Denver/Boulder area; heroin use among this group is reported as "doubled" since last summer.
In Chicago there is also increased heroin use by teens and young adults. Teens interviewed by the ethnographer say they prefer heroin over cocaine because they perceive it to be a drug which makes the user "calm, not crazy." These young users appear either to be misinformed about the ability of heroin to produce addiction, regardless of the method of ingestion; or they choose to deny that possibility. He reported that, while most of the young, new heroin users state emphatically that they would "never inject" (e.g, because it is dangerous, there is the risk of HIV, and they considered it to be "junkie" behavior), some confide privately that they indeed have begun to inject. He notes that many of these young, new heroin users have "no memory of the previous generation of addicts" and/or see their use, particularly because they are snorting the drug, as completely different.
The Miami ethnographer reported that there is an increased interest in heroin among the young Miami "club crowd" drug users, though drugs like MDMA and Rohypnol continue to be those used most often. He also reported that while heroin use is still relatively rare in that area, there is some increased use among older cocaine injectors.
Rising heroin use among middle income adults is reported in several areas. While the media account of the overdose death of an upper middle class young New York stockbroker who had been sniffing heroin with her husband stunned the nation in early August, several Pulse Check sources states that this was not surprising to them. Ethnographers in Chicago, New York, New Jersey, Denver and Connecticut stated that there is a significant increase in the number of white, suburban, upper income buyers of heroin in the dealing areas they observe. In urban neighborhoods like the area south of Columbia University; with its mix of collegiate, ethnic, and middle income populations, heroin is increasingly available from discrete street sellers. It was in this area that the young New York couple purchased the fatal supply.
A recent overdose death of a middle class high school student in the college town of Amherst, Massachusetts, also highlights the availability of the drug to new young users in some non-urban areas. The student had snorted heroin frequently and obtained his supply from a local college student (also a user) who also supplied a number of other young users in the area. Shortly after the Amherst student's death, the heroin overdose deaths of four middle class users in suburban Boston stunned the area, particularly since one of the victims was a popular local high school basketball coach.
One New York ethnographer reported that four of the heroin-related visits to New York City emergency rooms over the summer months are attributable to a single dealer who packages his product under the brand name "Black Magic." In each of these cases, the dealer had adulterated the heroin with scopolamine, a drug used for the treatment of motion sickness. These cases highlight a phenomenon mentioned in the last Pulse Check report. As heroin availability increases, the opportunities for new street level dealers expands, often attracting individuals who have not previously dealt heroin. These dealers (in some cases former crack dealers) may not be users of heroin themselves or know much about the drug, so may cut or adulterate the supplies with dilutants not typically used. The result may be increased numbers of heroin users appearing at emergency rooms for problems related to the substances with which heroin is mixed, rather than for problems related to the quantity or purity of the heroin ingested.
In Bridgeport, Connecticut, heroin is dealt primarily from two deteriorated housing projects, and suburban buyers in large numbers drive in and buy from curbside sellers without leaving their cars. The price is reported to be higher for suburban customers than for heroin users who may live locally. There are also proportionately fewer suburban buyers, but they constitute an active part of the market.
Most of the ethnographers report that the majority of both young, new users and middle income users inhale heroin rather than inject it. Reports from ethnographers in Denver and Texas are the exception. In these two areas, injection is still the most common form of ingestion among all users. However, the ethnographer at the Texas/Mexican border describes a technique used by young users in that area which they call "shabanging." This method involves dissolving heroin into liquid, drawing it up in a syringe and squirting it into the nasal passage; the membranes absorb the liquid in the same manner as administering nose drops. He notes that shabanging is seen among young users as a "partying" activity (which may also include injection) rather than as an alternative method of use among established users. This method is similar to one described a year ago in which young users dissolved black tar heroin in lemon juice and used the solution as nose drops. It should be noted that the predominate form of heroin in this area is the lower purity black tar, or Mexican, heroin. The lower purity requires injection or a similar "efficient" route of administration.
Both Texas reporters noted that there is an increase in the number of shooting galleries in Juarez, Mexico. This is seen as being in response to the effectiveness of a border crackdown on drug smuggling. With border patrol trucks stationed to block passage into El Paso, more heroin remains on the Mexico side. In response, prices in Juarez have dropped and shooting galleries have sprung up to allow "tecatos" from El Paso to cross the border, inject less expensive heroin there and then return home. Shooting galleries have also appeared in Denver. The Denver ethnographer noted that stricter law enforcement with Mexican nationals who are caught dealing (they are now jailed instead of deported) has encouraged more indoor dealing and perhaps explains the unusual number of shooting galleries. Similarly, the Miami ethnographer reported the appearance of "get-off" houses in the African American communities. "Get-off" houses are described as private places (homes, apartments) where heroin users can purchase and use heroin for a fee.
There was also an increase in the number of reports of heroin and cocaine or crack are being sold by the same dealers. This was reported in Atlanta, Chicago, and the Philadelphia area . Traditionally heroin and cocaine are dealt by separate distributors, even in different areas of a city or on different "corners." This is still the case in New Jersey and New York. However, increasingly, sources are reporting what the Chicago ethnographer reported is termed "double-breasted" dealing; that is, dealing both drugs together. This may occur because there is a combined market for these drugs as more cocaine users try heroin. Furthermore, there may be incentives to distribute both drugs and to increase the availability of both from a single supplier, as Colombian heroin increases its share of the market.
Prices for street level units of heroin remain the same. Most areas have "dime" or $10 and "twenties" or $20 glassine bags or balloons of heroin available. Larger quantities (1/8 ounces or more) show greater price variation, though the price per gram is approximately $80-$100. Purity is reported as high everywhere except Florida, though there is variation in quality reported in many places. Ethnographers in areas like New York or Chicago, where the purity has been consistently high, reported this quarter that there are noticeable differences in purity of street level units across their areas. Ethnographers in Texas, Colorado and Connecticut also noted that the unit sold to middle or upper income snorters is more expensive and of higher purity than that sold to established heroin injectors in inner city areas. This differential may help explain the appearance of more users at emergency rooms; they are both novices to heroin use and they are inhaling a higher purity product. If, for example, the model of inhaling cocaine is the users' point of reference --- repeatedly inhaling lines of cocaine over a short period of time --- they could quickly consume a lethal amount of high purity heroin.
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