opium smoking
Opiates have traditionally been used in medicine as painkillers and some are so strong they can even be used as anesthesia. Despite a great deal of time and research into the matter no other substances have been created that are as effective in treating severe pain.

In the United States today opium is sometimes prescribed as a treatment for diarrhea; morphine and some synthetic and opiates remains widely used as painkillers; codeine is used as a cough treatment; and synthetic opiates are sometimes used to treat anxiety associated with shortness of breath. Diarrhea drug like Lomotil use an opiate to temporally paralyze muscles in the intestines that help push digested food along. This stops the digestive process and stops diarrhea in its tracks. In the old days opiates were given as a treatment for severe depression and other psychiatric disorders but that is no longer the case..

Opiates used for recreation can be eaten, injected in a vein or under the skin, administered through the rectum or nasal membranes or smoked. Users sometimes experience an intense rush of pleasure when the use the drug---especially if it is injected---and then pass into pleasant drowsiness or dreamy state in which they have little sensitivity to pain. Heavy doses slow breathing, and cause the pupils to shrink to pinpoints and the skin becomes flush. Moderate doses make a user feel good but do not prevent him from functioning normally. First time user often feel nauseous.

Websites and Resources: U.S. Drug Enforcement Administration (DEA) justice.gov/dea/concern ; Vaults of Erowid erowid.org ; United Nations Office of Drugs and Crime (UNODC) unodc.org ; Wikipedia article on illegal drug trade Wikipedia ; Frank’s A-to-Z on Drugs talktofrank.com ; Streetdrugs.org streetdrugs.org ; Council of Foreign Relations Forgotten Drug War article cfr.org/drugs/forgotten-drug-war ; Illegal Drugs, country by country listing, CIA cia.gov/library/publications/the-world-factbook

Books: Buzzed by Cynthia Kuhn Ph.D. Scott Swartzwelder, Ph.D., Wilkie Wilson Ph.D. of the Duke University Medical Center (Norton, 2003); Consuming Habits: Drugs in Anthropology and History by Goodman, Sharratt and Lovejoy; Drug War Heresies: Learning from Other Vices, Times and Places by Robert MacCoun and Peter Reuter (Cambridge University Press).

Book: Opium, a History by Martin Booth (1998, St. Martin's Press); Opium: A Portrait of the Heavenly Demon by Barbara Hodgson (Chronicle)

How Opiates Work

In the early 1970s, scientists discovered natural receptor sites for morphine in the brain, spine and intestines. Later, researchers discovered that the human body produces its own morphine-like substances called endorphins that affect the receptor sites and play a part in regulating mood, controlling appetite and alleviated pain.

Opium, morphine, heroin and other opiates work by stimulating the endorphin-containing neurons in the body, causing them to release the endorphins into the nucleus acumbens, an area of the brain associated with pleasure. Opiates also stimulate receptors that slow the transmission of pain signals to the brain and excite the same neurons as brain's natural opioids only they do so more intensely. Opiates are so string because they stimulates so many endorphin transmitters. They also affect endorphin-like transmitters known as enkaphalins which affect breathing and digestion.

There are several different kinds of endorphins and at least three distinct types of opiate receptors. The mu-opioid receptor (MOR) seems to be responsible for the pain-relieving and pleasurable effects of opiates. Mice that have been genetically-engineered to not respond to MORs do not seek opiates or seem affected by them.

One of the main reason that opiates are so effective is that they dissolve in fatty substances that are easily transported through the bloodstream and can pass into cells. Long term use reduces the sensitivity of endorphin receptors. Users build up a tolerance and need more of the drug to stimulate the same number of endorphin receptors that were affected when the drug was first used.

Opiates and Health

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Morphine monojet
The long term effects of opiates other than addiction and withdrawal are relatively minor. The writer William Burroughs who was addicted to opiates much of life lived to be 83. Long-term users often look old before their time and are pale and skinny. But this has more to do with a lack of exercise and spending money on drugs over food than on the opiates themselves.

The worst side effect of heavy opiate use is constipation. Problems experienced by users while they are using opiates are nausea, vomiting, flushing of the skins and itching Sometimes people go into seizures. Many addicts have problems with a weakened immune system . Some male addicts become impotent and women stop menstruating.

The belief that opiate use causes apathy is a myth. Most users need opiates to function and when they have enough of the drug they are generally productive people. Many addicts have jobs and give off no indications that they are addicted.

Death and Opiates

The most serious side effect of opiate use is death from an overdose, often because breathing becomes so slow and relaxed it stops. Overdosing has nothing to do with long-term use. It can occur with a single dose. Often it happens when a user gets a stronger dose than he is used to. The overdosing process often unfolds over hours. First the user gets very sleepy and then slips into a coma and stops breathing. Death often occurs because no one is watching over the user.

Overdoses are most likely of the drug is injected but can occur if a enough of it is smoked, sniffed, swallowed or eaten. Opiate overdoses can be quickly reversed with an opiate antagonist such as naloxene or naltexone that have an affinity with receptors but don’t activate them. Hospital emergency rooms treat overdoses with nalozone, which suddenly makes the user up. The scene in the film Trainspotting in which Retton suddenly jumps up after being given nalazone is not far from the truth.

Every year a considerable number of people die from heroin overdoses. In the Netherlands there are about 100 deaths a year from heroin but only one or two from cocaine or ecstasy. Intravenous heroin users risk getting HIV/AIDS or hepatitis. Some users share needles and engage in risky, unprotected sex with people that might have HIV/AIDS or hepatitis.

An estimated 10,000 drug users die each year from overdoses involving heroin from Afghanistan.

Opium Use

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Akha man with opium pipe
Opium can be dried into a black, gooey, ball (gum opium) or pounded into a powder (opium powder). It can also be made into alcohol-water extract and called tincture of opium ( known as laudanum in the 19th century). The pods can be steeped in water to produce a bitter tea that has a mild, long-lasting high.

In some parts of the world, it is perfectly acceptable for old people to smoke opium. The drug is regarded as a kind of reward for a lifetime of hard work and a form of relief from the aches and pains of old age. What is frowned upon is young people who waste away their productive years smoking the drug and not working.

Particularly in the Golden Triangle of Southeast Asia, opium is consumed on casual, temporary basis by backpackers and other travelers. On drug traveler in Laos, who was still suffering after smoking opium the night before, told AP, "It wasn't what I expected. I thought it was going to be a much out-of-body sort of thing. I just felt like laying there and thinking. Any time I moved around, I thought I would get sick."

Opium Smoking

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Opium in India
The smoking of opium does not involve burning as is the case with cannabis or tobacco. Rather prepared opium is indirectly heated to temperatures that cause the active alkaloids, chiefly morphine, to vaporize. Opium users in much of the world have traditionally “smoked” the drug in a specially-designed pipe with a long bamboo stem and a glass, porcelain or metal bowl. They usually have taken the drug while laying on their side because the nature of the high discourages people from standing up or even sitting down. Those that try to sit up often just slump over.

To prepare the tar-like opium for consumption it is first heated and softened and rolled into a pea-size ball, enough for a single dose for one individual. Users seem take great pleasure going through the preparation process. The ball is then stuck on the bowl and heated indirectly by heating the bowl not than opium itself with a candle or lamp. Sometime users blows through the pipe to heat a piece of glowing charcoal to increases the heat. When the opium begins to vaporize the smoker inhales.

Often it takes two people to smoke opium: one person to smoke it and another person to heat the opium ball with a flame and make sure it releases the drug without being sucked into the pipe. Pipes were often designed with a rounded cross section that allowed the bowl to be rotated into the heat source and rotated back into an upright position. Chasing the dragon works with opium. In a conventional marijuana pipe opium often slides down the bowl before it fully vaporizes.

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19th century opium smoker
While it is being inhaled, opium gurgles, fizzes and hisses and slithers down the pipe like black mercury. Opium balls are smoked slowly and carefully lit and nurtured so they aren't sucked quickly into the pipe. The heated vapor is easily absorbed by the body. When the ball is finished, the smoker relaxes and spaces out. He usually doesn't have much to say, doesn't want to do much except lay there, and is quite happy being left alone with his happy thoughts.

I smoked opium once with the Lisu hill tribe in Thailand. We walked about a three hour walk from the main road to get to the village where we smoked it. The village and people were quite shabby. We paid about 50 cents for each hit, which was prepared and heated by a villager. I had six pipefuls, ignoring advise to limit myself to three, and felt good and relaxed while laying down and smoking it but nauseous and dizzy when I stood up. During the three hour hike back to my guest house I felt sick and disoriented. As walked I told my friends not to talk to me because I couldn’t concentration on too many things at once. Afterwards I had no real compulsion to try opium again anytime soon.

Heroin Use

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Chasing the dragon
Heroin can be injected, smoked, or snorted, with injecting it being the fastest and most efficient way to get it the brain and smoking being the second fastest. When it is eaten or taking in pill form much of the drug is absorbed in the intestines and liver which delays and draws out the passage to the brain, resulting in a milder high.

Heroin converts to morphine in the brain. It’s potency is tied to fat solubility, which allows it pass easily through cells and get to the brain faster. Snorted heroin passes easily through cells in the mucous membranes of the nose (something not true with other opiates) and takes effect after about 10 to 15 minutes . Smoked heroin is felt almost immediately but the effect is less than if the drug is injected because less of it reaches the brain.

In the 1960s and 70s many potential heroin users were put off by the drug’s association with needles and blood. The availability of higher purity of heroin at cheaper prices in the 1980s and 1990s meant that users could get a good buzz by snorting or smoking the drug and no longer needed to inject it to get a powerful kick. In the United States and Europe, the number of recreational users, including middle class university and high school students, and addicts soared. In opium-producing counties, which in the past had many opium smokers but very few heroin addicts, the numbers of users and addicts smoking and injecting cheap heroin also soared, and they too began to have serious drugs problems.

Chasing the dragon---inhaling the fumes of heroin burned on a piece of aluminum foil---is one of the most common ways of taking heroin. Heroin is also sometimes added to cigarettes or marijuana cigarettes. Some users have the mistaken belief that if they smoke or snort heroin they won’t get addicted. The number of heroin drug overdoes and people seeking help for heroin addiction in the United States has roughly doubled between 1990 and 1994 from around 8,000 to 16,000 people.

Injecting Heroin

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Heroin taken with a needle is mixed in a saline solution before it is injected. Heroin injected into the veins gives an intense high and rush within seven to eight seconds after it is injected. Heroin injected into the muscles take five to eight minutes to take effect.

Describing one addict Barry Bearak wrote in the New York Times, "Mr. Kahn" empties "a tiny bag of heroin into a plastic bottle cap, adding water and heating it on a small flame, drawing the hypnotic broth into a syringe...Mr Khan, 30, and a helpmate search his arms, hands, feet and groin before settling on faint line in his right biceps...The shot was transporting. His head lowered sideways as if he was laying it on a platter."

Users often begin by skin-popping. Injecting it just below the skin. Intravenous users often have tracks (needle marks) all over their arms. One of the biggest problems that addicts have is finding a vein. Some inject to remote places on the body.

Buzz from Morphine and Heroin

Allen Ginsberg and William S. Burroughs
Heroin users often use the word “rush” to describe the intense euphoria they feel after using the drug, something the late comedian Lenny Bruce said was "like kissing God." Afterwards the user fells pleasantly drowsy and often nods off (doze off). Users feels untroubled and have little desire for sex or anything else. They feel good until the effects wear off. Afer that long-time users and addicts get a craving for more and feel shitty until they get some.

In the novel Junkie , William Burroughs wrote that the heroin rush: “hits the backs of the legs first, then the back of the neck, a spreading wave of relaxation slackening the muscle away from the bones so that you seem to float without outlines, like lying in warm salt water. As this relaxing wave spreads through my tissues, I experienced a strong feeling of fear. I had the feeling that some horrible image was just beyond the field of vision, moving, as I turned my head so that I never quite saw it.”

“I felt nauseous. A series of pictures passed, like watching a movie: a huge neon-lighted cocktail bar that got larger and larger until streets, traffic and street repairs were included in it; a waitress carrying a skull on a tray; stars in the clear sky; the physical impact of the death; the shutting off of breath; the stopping of blood. I dozed off and woke up with a start of fear. The next morning I vomited and felt sick until noon.”

Image Sources: Wikimedia Commons; Normal Opium Museum

Text Sources: Buzzed, the Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy by Cynthia Kuhn, Ph.D., Scott Swartzwelder Ph.D., Wilkie Wilson Ph.D., Duke University Medical Center (W.W. Norton, New York, 2003); National Geographic, Time, Newsweek, New York Times, Washington Post, Los Angeles Times, Wikipedia, The Independent, Times of London, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

Last updated March 2011

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