Heroin abuse

Galassi G, Gentilini M et al (1998) Motor neuron disease and HIV-1 infection in a 30-year-old HIV-positive heroin abuser a causal relationship Clin Neuropathol 17(3) 131-135 Gherardi R, Lebargy F et al (1989) Necrotizing vasculitis and HIV replication in peripheral nerves. N Engl J Med 321(10) 685-686... 

Weber RJ, Gomez-Flores R, Smith JE, Martin TJ (2004) Immune, neuroendocrine, and somatic alterations in animal models of human heroin abuse. J Neuroimmunol 147(1-2) 134-137... 

Omstein TJ, Iddon JL, Baldacchino AM, Sahakian BJ, London M, Everitt BJ and Robbins TW (2000). Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers. Neuropsychopharmacology, 23, 113-126. 

Novick, D.M. et al., Natural killer cell activity and lymphocyte subsets in parenteral heroin abusers and long-term methadone maintenance patients, J. Pharmacol. Exp. Ther., 250, 606, 1989. 

Sexual problems related to heroin abuse and how much these bother the drug user. 

Heroin abuse in West and Central Europe has stablized at 1.4 million. In East Europe levels are higher than in West and Central Europe. Estimates of the number of heroin abusers in Europe as a whole (3.3 million people) are higher than the corresponding estimates for the Americas (1.5 million). The largest numbers of heroin abusers are found in Asia, which accounts for almost half of all heroin use worldwide (5.4 million). Asia and Europe together account for more than three quarters of the world s heroin abuse. 

Countries in East Africa, particularly Kenya, Mozambique and United Republic of Tanzania, have reported large increases in heroin abuse in recent years. An increase in opiate abuse has also been reported by South Africa and a number of countries in West Africa. In general, these increases are linked to greater amounts of heroin transiting these regions. 

However, when it comes to heroin abuse (or drug injecting), there seems to be a general agreement that annual prevalence data derived from national household sur-... 

Capture-recapture models are another method based on probability considerations, which can be undertaken without additional field research.11 If in one register (e.g. arrest register) 5000 persons are found (for possession of heroin) and in a second register (e.g. treatment register) 2000 persons are found (for treatment of heroin abuse), and there are 400 persons who appear in both registries, it can be assumed that 20% (400/2000) of the drug addicts have been arrested, so that the total heroin addict population could be around 25,000 (5000/20%), five times larger than the total number of arrested heroin users. Results can usually be improved... 

Health consequences of chronic heroin abuse include scarred and collapsed veins, bacterial infections of the blood vessels and heart valves, boils, a variety of soft-tissue infections, kidney problems, and liver disease. Pneumonia, tuberculosis, and other lung diseases are also common among long-term users, which can be attributed to either poor nutrition and depressed respiratory function or both. Many of the additives heroin is cut with do not dissolve in the body and can block blood vessels, translating into higher risk of sudden death from stroke or heart attack. 

Heroin abuse has repercussions that extend far beyond the individual user and his or her family. The consequences of drug abuse and addiction carry a social price in festering criminality, violence, and disruptions to the workplace and educational environments that cost billions of dollars each year. 

For short-term detoxification, a person would decrease and stop methadone in less then a month. It should be noted that people in short-term detoxification programs have a higher likelihood of returning to heroin abuse than do people in a long-term methadone detoxification program. 

Heroin abusers comprise the vast majority of those in treatment for opiate abuse. According to the SAMH-SA s Treatment Episode Data Set (TEDS), only 1% of admissions for addiction treatment recorded in 1999 were related to opiates other than heroin. However, the number of these admissions that was for opium itself cannot be determined from the available data because opium is categorized with all other drugs with morphinelike effects. Methadone was part of the treatment plan for 22% of those admitted. 

Buprenorphine is a potent and long-acting phenanthrene derivative that is a partial receptor agonist. Its long duration of action is due to its slow dissociation from receptors. This property renders its effects resistant to naloxone reversal. Its clinical applications are much like those of nalbuphine. In addition, studies continue to suggest that buprenorphine is as effective as methadone in the detoxification and maintenance of heroin abusers. 

H-Y. Lim and S-T. Chow, Heroin abuse and a gas chromatographic method for determining illicit heroin samples in Singapore, J. Forens. Sci., 23 319 (1978). 

Enkephalins could be implicated in dopamine mesoaccumbens-depen-dent appetitive motivation and behavioral positive reinforcement by separated mechanisms involving both mu and delta receptors. Activation of the former in heroin abusers produces sedation and overstimulation, lack of vigilance, and possibly fear. These effects cannot be reached with dual inhibitors, and one can speculate that this is related to an increased level of endogenous enkephalins leading to a preferential interaction with delta receptors for both binding and anatomical reasons. 

One final set of data has addressed the possible connection between delta receptors and opioid abuse in humans. In a population of 103 German heroin abusers, a correlation was identified between a polymorphism in the delta receptor gene and the likelihood of heroin abuse [111]. However, two subsequent studies in larger populations failed to replicate this finding [112,113],... 

Bilateral pulmonary edema associated with heroin abuse has been reported several times (12). Bronchospasm has been noted following the use of street heroin, perhaps due to contaminants (13). 

Reflex sympathetic dystrophy, in which there is an excessive or abnormal sympathetic nervous system response in a limb, has been associated with rhabdomyo-lysis secondary to heroin abuse (18). 

Profound reversible deafness with vestibular dysfunction has been attributed to heroin abuse (34). 

Coprolalia is a typical symptom of Tourette s syndrome that can take on a malignant quality in response to pharmacological agents. Malignant coprolalia in association with heroin abuse has been reported (27). 

Since the mechanisms that underlie heroin abuse and Tourette s syndrome overlap, specifically involving dopaminergic innervation, it is likely that this condition was caused by the effects of heroin in the ventral tegmental area and its projections. 

The papers dealing with the GC/MS detection of 10 different opiates in hair are listed in Table 7. The first report was published in 1984 about codeine detection in animal hair after administration of the drug. One paper is included with direct insertion of the probe and Cl. As heroin samples always contain codeine as an impurity, this substance also can be detected in cases of heroin abuse. Morphine is a metabolite of codeine and can be detected when codeine is abused. The quantitation of both drugs allows differentiation between codeine and heroin abuse. The detection of heroin or 6-acetylmorphine opens the possibility to prove directly the abuse of heroin.2 2" Here also, the more lipophilic 6-acetylmorphine exceeds the morphine in most samples. 

Sectional analysis of a hair sample from a heroin dealer who confessed to personal heroin abuse before she was imprisoned. The hair was taken about 10 months after she was imprisoned. 

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