I’m having trouble peeing

Urine retention is an inability to pee, and we get it, this is not an exciting topic to read about. However, it’s one of the most common complaints from heroin users. That begs the question. Why do heroin addicts have a trouble peeing? That’s what this page will answer.
 

Normal urination

It would be difficult to fix a broken television unless you understand what an unbroken television was supposed to do. Following that logic, it’s important to understand normal urination, so that you can fully understand abnormal urination.

Normal urination requires two separate events to occur simultaneously.

1.  The nervous system must excite the muscle surrounding the bladder in order to contract the bladder.
2.  The nervous system must relax the sphincter muscles within the outflow tract of the bladder so that urine can escape.

When the bladder contracts and the urethral muscles relax we urinate.
 

Bladder and Kidneys

The primary reasons why heroin makes it difficult to urinate is linked to functional changes within two organs in the body. These two organs are the bladder and the kidneys.

Bladder

Heroin use relaxes the detrusor muscle that surrounds the bladder, which increases bladder capacity by 20 – 65 percent. At the same time heroin use inhibits the parasympathetic nervous system, which decreases the sensation of bladder fullness. Lastly, it tightens both internal and external urethral sphincters, which increases resistance through the outflow tract of the bladder.
 

Kidneys

Everyday, our kidneys filter about 135 quarts of blood to produce about 1 1/2 quarts of urine. But when a person uses heroin, the brain tells the pituitary gland to release ADH (antidiuretic hormone). ADH tells the kidneys to reabsorb water from urine and move it back into the bloodstream. This tends to make urine much darker, because it’s more concentrated, i.e. there are more solutes and less water.
 

Can’t pee after using heroin

The combination of decreased water in urine, increased bladder capacity, decreased sensation of bladder fullness and increased outlet resistance results in an uncomfortable problem whereby people who use heroin cannot pee.
 
We know now that intravenous heroin users are more likely to experience higher rates of urine retention as compared with heroin sniffers and smokers. In addition, short half-life opioids such as heroin generally have less urine retention as compared to longer half-life opioids, such as Methadone. In other words, heroin wears off quickly while Methadone does not.
 
 
 

Glossary – Terms

1. The urethral sphincters: These two muscles control the release of urine. The external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.

2. The detrusor muscle: is a smooth muscle found in the wall of the bladder that remains relaxed to allow the bladder to store urine but contracts during urination to help release urine.

3. The guardian reflex: Is a neurophysiological reflex that inhibits a person from urinating without consent. In other words the guardian reflex’s purpose is to allow the bladder to fill without having an accident. It inhibits contraction of the detrusor muscle, while simultaneously contracting the external sphincter.

Among heroin addicts there is an unofficial term used to describe heroin-related memory loss. That term is “CRS” which is an acronym for “Can’t Remember S__t.” Not surprising, the scientific evidence backs up the term.

For instance, we know two things for sure; that heroin use clouds mentation and impairs brain function. Since memory is a function of the brain, it is reasonable to assume that heroin use might cause memory loss. Yet the question remains. How does heroin affect your memory? That is what this page will answer.
 
 

What is Memory?

Memory is a cognitive function that perceives, stores and retrieves information. Your brain stores information either as short-term or long-term memory. What’s so fascinating is that memory always begins as short-term memory. Yet if short-term memory is deemed important, for whatever reason, your brain refiles it as long-term memory.

Short-term Memory

Hold on to your socks because the following information might surprise you. Short-term memory can only store about 7 letters and 9 numbers (plus or minus 2) for about 15-30 seconds. Then it either discards the information or refiles it as long-term memory. This is why you can remember 7-digit phone numbers with relative ease, but find it almost impossible to remember 10-digit phone numbers.

Long-term Memory

Long-term memory is divided into two types: declarative (knowing what) and procedural (knowing how).

Declarative memory has to do with retrieving facts, i.e. knowledge of the universe, like the earth revolves around sun; and events, like Donald Trump beat Hillary Clinton during the November 2016 U.S. Presidential election.

Procedural memory has to do with retrieving the skills necessary to perform a task, such as driving a car or using a telephone. Procedural memories are acquired through repetition, and are composed of automatic behaviors so deeply embedded in our mind that we carry them out without thinking.

Heroin and Memory Loss

Emotions

There is strong evidence that emotionally-charged events lead to the creation of vivid long-lasting memories. Think about that for a minute. Let’s say you were swimming in the ocean and a shark bit your leg. That would be an emotional event. Would you agree? You might never forget that event either. In fact, it’s likely, from that day forward, anytime you visited a beach you would develop a funny feeling and recall vivid memories about a shark biting your leg.

Memory Circuits

There are specific mechanisms in your brain that help you learn, such that perception, retention and recall are not random, but rather precise circuits, that predetermine where and how information is stored.

If a shark bites your leg, a storm of data will run through one or more of your memory circuits. In this way, the information teaches you to avoid sharks. We now know that the hippocampus→ hypothalamus→ anterior thalamic nucleus→ cingulate gyrus→ neocortex is one of the brain’s primary memory circuits (Papez circuit).

Norepinephrine and Adreno-Receptors

Emotional arousal leads to activation of the Locus Coeruleus (LC), which is the brain’s primary producer of norepinephrine (NE). Whenever we have emotions, various amounts of NE are released into the brain. The more emotional an event becomes the more NE that gets released. NE has been shown to activate adreno-receptors atop neurons within memory circuits. The hypothesis being that neurons with activated adreno-receptors function better. In other words, better functioning neurons within a memory circuit enhance your memory.

Memory Loss

Your brain typically uses norepinephrine (NE) to help you breathe, pump blood, stay awake and remember. Yet staying awake and memory seem to be its secondary function. We know now that heroin directly suppresses NE, which is why you’ll likely breathe less, have fewer heart beats, fall asleep and forget a lot if you use heroin. In other words, if you consume heroin, you have less NE available for the adreno-receptors within your memory circuits, and consequently, your brain becomes less capable of perceiving, retaining and recalling information, ergo poor memory.

Will My Memory Improve After I Quit?

Fortunately, heroin related memory loss may only be temporary. Much of the evidence indicates that if you achieve a year of abstinence, your ability to perceive, store and retrieve information shows little to no-noticeable impairment. This is good news, but it’s only good news if you stop. Otherwise you’ll keep on forgetting.
 
 
 

Natural Treatment to Improve Your Memory

If you want to improve your memory, you are going to have to improve your brain. The best way to improve your brain is to give it what it needs and avoid the things that may harm it.

What Your Brain Needs

1. Oxygen:  The brain needs oxygen rich blood. One of the best ways to increase oxygen to the brain is through aerobic exercise. That also means you should not smoke cigarettes or anything else for that matter.
2. Mental Exercise:  The brain needs mental exercises to stay sharp. One of the best ways to increase your brain’s sharpness is to exercise it by reading and writing. You might like to read a book or write a letter or do crossword puzzles.
3. Nutrients:  The brain needs nutrients. Some of the best brain nutrients are blueberries, seeds (pumpkin, sunflower and flax), nuts “(walnuts, almonds and hazelnuts) and salmon.
4. Sleep:  The brain needs adequate rest and the best way to give the brain adequate rest is through proper sleep hygiene. Go to sleep at the same time every night. Take a short 30-60 minute nap around 1pm everyday.

Why was heroin invented?

At the time heroin was invented, the only effective medication for pain, diarrhea and coughing was morphine. Unfortunately, many people became addicted to morphine. In response, many chemists tried to create something safer. In the quest to find morphine’s replacement, heroin was invented.

Famous quotes about heroin

Who invented heroin?

The person who invented heroin a.k.a. diacetylmorphine, which was originally made by mixing anhydrous morphine with acetic anhydride and boiling it for several hours, was C.R. Alder Wright way back in 1874.

How Strong Is Heroin?

It turned out that heroin was 2-3 times stronger than morphine. When Wright realized that heroin was that much stronger, he knew it was unsafe, and so he decided to tuck his notes away forever. Unfortunately, he decided to publish it first. His notes were published in a local trade journal – The Chemical and Pharmaceutical Journal. That article turned out to be Wright’s second misstep. Decades later, another person would read Wright’s article and subsequently change the world forever.

Big pharma

Almost twenty-five years after C.R. Alder Wright tucked away his notes, and just a few years after his death, another man named Heinrich Dreser came across Wright’s formula in an old copy of the Chemical and Pharmaceutical Journal. Dreser knew that he might have stumbled upon something that could make the company and himself rich. He asked his colleague Felix Hoffman if he would take time out of his busy schedule to verify that the formula worked. Unfortunately for Dreser, Hoffman was busy working on his own new drug, which he had recently named “Aspirin.” Dreser pleaded with Hoffman to temporarily halt his work on Aspirin, and Hoffman begrudgingly agreed. In short order, both Hoffman and Dreser knew they found a brand new drug that would make them and the company a lot of money. This moment in history is considered the infancy of Big Pharma. Some even say that Big Pharma began in the year 1898, the same year that Bayer began worldwide distribution of HEROIN.

Dreser and Hoffman worked for Bayer pharmaceuticals, a company headed by Carl Duisberg. In June, 1898, Carl Duisberg renamed diacetylmorphine under Bayer’s trademark name “Heroin,” and began marketing it as a safe and non-habit-forming cough remedy for children. Within a year, Bayer was exporting it across the globe to about 23 nations. Soon after, physicians and scientist began reporting of its habit-forming effects. When Carl Duisberg heard of those reports he quipped, “that one had to silence the opponents.”

The first nation where heroin addiction seems to have become a major problem was the United States. The main site of that addiction problem was New York City where 98 per cent of all drug addicts were reported to be heroin addicts. We now know, that heroin is a prodrug of morphine, which means it’s 2-3 times stronger than morphine, and equally more addictive.

Bayer and Heroin

Mr. Dreser is often credited with inventing heroin, but what he really did was steal the work of C.R. Alder Wright, call it “HEROIN”, and sell it to the public as a safe non-habit-forming cough remedy. Ironically, the person most responsible for bringing HEROIN to the world, Mr. Heinrich Dreser, died of a stroke at age 64, a lonely heroin addict.

The first heroin addict

Dreser could be the world’s first heroin addict. We know he died a heroin addict. We also know that he tested it on himself prior to shipping it around the world. It is plausible that he inadvertently became the world’s first heroin addict.

Heinrich Dreser, Felix Hoffman and Carl Duisberg of Bayer Pharma AG all conspired to sell heroin to the public as a safe medication. That decision has since led to the deaths of millions upon millions of people across the globe.

How You Can Die From Heroin Withdrawal

There are not many rules about what “not” to do when you’re withdrawing from heroin, except not to use heroin. Yet because your health and safety are critically important, you should never use stimulants while you’re detoxifying.

Stimulants

Stimulants are chemical substances that affect the nervous system by stimulating it. They include substances, such as cocaine, methamphetamine, Adderal, Ritalin and more. Stimulant use during heroin detoxification may complicate the clinical picture because they exacerbate withdrawal.

The primary aftereffects of acute heroin withdrawal include increased heart rate and higher blood pressure. The potential hazard of stimulant use during heroin detoxification are seizures, which may be fatal.

Dehydration

Vomiting and diarrhea are common symptoms of heroin withdrawal and both dehydrate and weaken the body. These symptoms may complicate the clinical picture for illnesses, such as the flu, asthma or pneumonia. In addition, vomitus may enter the lungs, which may cause a lung infection, which can kill you.

Is Heroin Withdrawal Life-Threatening?

As withdrawal symptoms disappear, tolerance drops. Consequently, those who have just gone through a detoxification program can overdose on a much smaller dose than they’re used to. They no longer know, with any certainty, what dose is safe, and experience tells us that even a tiny overdose can be fatal.

Naloxone

In rare cases, serious complications and fatality have been reported following treatment for opioid overdose. Particularly in persons who are undernourished or have underlying electrolyte abnormalities. In these rare cases, naloxone was administered as emergency treatment for opioid overdose. The primary aftereffect was acute opioid withdrawal, including increased heart rate and respiration, which put the patient into cardiac arrest.

Conclusion

Heroin withdrawal has the “potential” to kill, but it’s extremely unlikely. To be clear, heroin withdrawal is difficult, but typically not life threatening, especially if the individual in question is in good health. If heroin detoxification protocols are done correctly, heroin detoxification is actually very safe.

What Is The Most Difficult Detox?

Available resources for additional information on the causes and consequences of drug and alcohol use and addiction and the prevention of Substance Use Disorders (SUD’s).

National Institutes of Health (NIH)

9000 Rockville Pike
Bethesda, MD 20892
Phone: 301-496-4000

Substance Abuse and Mental Health Services Administration (SAMHSA)

1 Choke Cherry Road
Rockville, Maryland 20857
Phone: 877-SAMHSA-7 (877-726-4727)
Center for Substance Abuse Prevention (CSAP)

National Institute on Drug Abuse

Advancing science on the causes and consequences of drug use and addiction and to apply that knowledge to improve individual and public health.

6001 Executive Blvd
Rockville, Maryland 20852
Phone: 1-301-443-1124

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

5635 Fishers Lane, MSC 9304
Bethesda, MD 20892-9304
Phone: 1-301-443-3860

National Institute of Environmental Health Sciences (NIEHS)

111 T.W. Alexander Drive
Research Triangle Park, NC 27709
Phone: 1-919-541-3345
Children’s Health
Environmental Health Topics

National Institute of Mental Health (NIMH)

6001 Executive Boulevard, Room 6200, MSC 9663
Bethesda, MD 20892-9663
Phone: 1-866-615-6464

National Library of Medicine (NLM)

8600 Rockville Pike
Bethesda, MD 20894
Phone: 1-888-346-3656
Office of the Assistant Secretary for Planning and Evaluation (ASPE)
200 Independence Avenue, SW
Washington, DC 20201
Phone: 1-877-696-6775

The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Bldg 31, Room 2A32, MSC 2425
31 Center Drive
Bethesda, MD 20892-2425
Phone: 800-370-2943

Other Resources

National Prevention Network (NPN)

National Association of State Alcohol/Drug Abuse Directors (NASADAD)
1025 Connecticut Avenue, NW, Suite 605
Washington, DC 20036
Phone: 202-293-0090

United Nations Office on Drugs and Crime (UNODC)

Vienna International Centre
Wagramer Strasse 5
A 1400 Vienna
Austria
Phone: +(43) (1) 26060

Centers for Disease Control and Prevention (CDC)

1600 Clifton Road
Atlanta, GA 30329
Phone: 800-CDC-INFO (800-232-4636)

Indian Health Service (IHS)

The Reyes Building
801 Thompson Avenue
Rockville, MD 20852
Phone: 301-443-3593

National Prevention Network (NPN)

National Association of State Alcohol/Drug Abuse Directors (NASADAD)
1025 Connecticut Avenue, NW, Suite 605
Washington, DC 20036
Phone: 202-293-0090

United Nations Office on Drugs and Crime (UNODC)

Vienna International Centre
Wagramer Strasse 5
A 1400 Vienna
Austria
Phone: +(43) (1) 26060

Non-Governmental Resources

Annie E. Casey Foundation

701 St. Paul Street
Baltimore, MD 21202
Phone: 410-547-6600

CASA The National Center on Addiction and Substance Abuse

633 Third Avenue, 19th Floor
New York, NY 10017
Phone: 212-841-5200

Casey Family Programs

2001 Eighth Avenue, Suite 2700
Seattle, WA 98121
Phone: 206-282-7300

Community Anti-Drug Coalitions of America (CADCA)

625 Slaters Lane, Suite 300
Alexandria, VA 22314
Phone: 800-54-CADCA (800-542-2322)

Drug Strategies, Inc.

1150 Connecticut Avenue, NW, Suite 800
Washington, DC 20036
Phone: 202-289-9070

National Asian Pacific American Families Against Substance Abuse (NAPAFASA)

340 East 2nd Street, Suite 409
Los Angeles, CA 90012
Phone: 213-625-5795

National Black Child Development Institute (NBCDI)

1313 L Street, NW, Suite 110
Washington, DC 20005
Phone: 800-556-2234, 202-833-2220

Partnership for Drug-Free Kids

352 Park Avenue South, 9th Floor
New York, NY 10010
Phone: 212-922-1560

Robert Wood Johnson Foundation

Route 1 and College Road East
P.O. Box 2316
Princeton, NJ 08543
Phone: 877-843-7953

William T. Grant Foundation

570 Lexington Avenue, 18th Floor
New York, NY 10022
Phone: 212-752-0071

Academic Professional Organizations

American Society of Addiction Medicine (ASAM)

4601 North Park Avenue
Upper Arcade, Suite 101
Chevy Chase, MD 20815
Phone: 301-656-3920

Heroin is in a class of drugs known as opioids. Many people think that when a person uses heroin they just get high. But that is not the entire story. Heroin, much like any other opioid, produces several unpleasant after effects as well, two of which are nausea and vomiting. Nausea is the discomfort that is felt before vomiting, and vomiting refers to the expulsion of stomach contents via the mouth.

Heroin, the Brainstem and Vomiting

Heroin induced nausea and vomiting are actually normal functions of the Medulla Oblongata. The medulla oblongata is located at the lower brain stem. It runs continuous with the spinal cord, which means that there is no clear delineation between the spinal cord and medulla oblongata, but rather a gradual transition into the spinal cord. The medulla oblongata is also the oldest part of the nervous system, thus responsible for many involuntary functions, such as heart rate, breathing, sneezing, swallowing, coughing, and vomiting. For these reasons, the medulla oblongata is considered the most important part of your brain.

The Medulla Oblongata is in a unique position to detect poisonings, because it’s not protected by a blood-brain-barrier. In other words, the Medulla Oblongata is in the one location that can sense opioids before they affect the rest of the brain.

Chemoreceptor Trigger Zone

It’s actually the chemoreceptor trigger zone (CTZ) within the Medulla Oblongata that detects opioids such as heroin. If a sufficient quantity of opioids are streaming through your bloodstream the CTZ recognizes it as poison. The CTZ then directs your stomach to throw up. A common misconception is to think that the stomach tells the brain it’s going to throw up, when in fact, it’s the brain commanding the stomach to throw up.

The Process of Throwing-Up

• Stimulation of the CTZ leads to the activation of the Central Nervous System, Parasympathetic Nervous System and the Sympathetic Nervous System
• Stimulation of the parasympathetic nervous system causes increased salivation
• Deep breathing precedes vomiting to protect the lungs from aspiration
• Heaving or retching occurs just before vomiting
• Relaxation of the pyloric sphincter that guards the lower end of the stomach to bring up content from the gut
• Abdomen pressure rises and the pressure within the chest or thorax lowers.
• The abdominal muscles contract and expels the contents within the stomach
• Activation of the sympathetic nervous system leads to sweating, palpitation and rapid heart rate

Opiate induced vomiting

We know that within hospitals, nausea occurs in 25 – 30 percent of patients treated with opiates. Since heroin involves greater average dosing and subsequent amplified effects, it results in higher than average emetic responses. Another interesting opiate fact is that nausea and vomiting occurs more often in blacks than whites and more often in women than men.

The first time a person uses heroin or any other type of opiate they become susceptible to vomiting. It’s not a rule that a new heroin user will get nauseous and throw up, but it’s quite common. Furthermore, many longer-term heroin addicts glean pleasure from vomiting after using, mainly because they perceive it to mean “strong heroin.”

Treatment

Nausea is a highly distressing queasy feeling that may or may not result in vomiting. We know that “tolerance” develops to both heroin induced nausea and vomiting, and over time, both of these uncomfortable effects fade away.

Throwing-Up is the expulsion of your stomach contents through your mouth. There are two phases to throwing up, (1) the retching phase, which is recognized by stomach contractions without expulsion, followed by (2) the expulsion phase. The vomitus is generally highly acidic and malodorous.

The first line of defense against opiate induced nausea and vomiting might be to stop taking opioids (painkillers or heroin). Another common treatment for nausea and vomiting is administration of an anti-emetic.

Alphabetical

This is an alphabetical list of opiate terms and definitions. We compiled them here in one place to help people better understand what opiates are, how and why they are used, and the dangers associated with using them.

A

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Abuse: Improper use

Activity: The response a chemical substance produces after binding to a receptor.

Addiction: To use a chemical substance compulsively and uncontrollably.

Addiction Liability: The tendency of a chemical substance to produce addiction. There are two prototypical classes of drugs that commonly result in addiction; psychomotor stimulants and opiates.

Affinity: The strength with which a chemical substance binds to a receptor.

Agonist: A chemical substance with both Affinity (binds to) and Activity to a specific receptor.

Alkaloid: An organic compound that comes from a plant, that produces physiological effects on humans.

Antagonist: A chemical substance that has Affinity (binds to) but with no Activity on a specific receptor. For instance, Naloxone an opioid antagonist, binds to mu-opioid receptors but produces no neuronal response.

Antitussive: Cough suppressant.

Arousable: Able to awaken.

B

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Bioavailability: The ability of a drug’s active ingredient to enter the body’s circulatory system and thus reach the site of action. Ex. Buprenorphine in SUBOXONE has poor bioavailability through the stomach. Ingested Buprenorphine is destroyed by stomach enzymes and consequently will not reach the circulatory system in sufficient quantity to be effective. SUBOXONE must be given sublingually for its active ingredient “buprenorphine” to enter the circulatory system in sufficient quantity to activate a sufficient number of mu opioid receptors (MOR) in the brain.

BLACK : A colloquial term meaning “Heroin.”

Butrans : A brand name buprenorphine based transdermal patch.

C

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Ceiling effect: Buprenorphine has limited Activity at the mu opioid receptor. In addition there are a finite number of mu receptors. These two factors limit buprenorphine’s narcotic effects. Even if the dose of buprenorphine rises to maximum levels there is generally no difference in euphoria, analgesia, or respiratory depression.

Charles Romley Alder Wright (1844 – 25 July 1894) An English chemistry aresearcher at St. Mary’s Hospital Medical School in Paddington, England. C. R. Alder Wright is the person who invented heroin.

Codeine: (C₁₈H₂₁NO₃) Also known as 3-methylmorphine, is a narcotic alkaloid found within the papaver somniferum poppy plant. As such it is an opiate and is used to treat pain, coughing (antitussive) and diarrhea.

D

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DEA : Drug Enforcement Administration – 8701 Morrissette Dr, Springfield, Virginia 22152

Diacetylmorphine: The scientific name for heroin.

Diamorphine: The proper name for heroin in Britain.

Dilaudid: see hydromorphone

Dissociation: The rate or likelihood that a drug dissociates i.e. uncouples from a receptor.

Drug abuse: To use a chemical substance wrongly or improperly.

Drug overdose: Consumption of excessive and dangerous amounts of a drug.

F

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Fentanyl: A synthetic full agonist opioid that is 40-50 times stronger than pharmaceutical grade diacetylmorphine a.k.a heroin.

Full agonist: a chemical substance with high Affinity and high Activity on a specific receptor. As in full agonist “opioid” having high Affinity and high Activity on mu-opioid receptors (MOR).

H

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Heroin: Heroin, scientifically known as diacetylmorphine, is a highly addictive Schedule I drug. Heroin is a heavily abused and extremely potent semi-synthetic opioid processed from morphine.

Heroin abuse: Illegal or improper use of heroin.

Heroin addiction: Tenacious seeking or using of heroin despite adverse consequences.

Heroin dependence: Susceptible to withdrawal upon cessation of heroin.

Hydromorphone : Is a semi-synthetic opioid drug derived from morphine.

Hyperalgesia : A paradoxical phenomenon whereby long-term opioid use increases pain sensitivity.

I

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IV: Intravenous i.e. into a vein.

Interneuron: Two or more neurons acting in concert.

Isoforms: A structural variant of a receptor.

M

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Mixed agonist-antagonist: Two drugs, one agonist and one antagonist bound together in a single medication to treat a specific medical condition, e.g. SUBOXONE is a dual drug, Buprenorphine, a partial-agonist opioid, mixed with Naloxone, a full opioid antagonist.

Morphine (MOR): A naturally-occurring narcotic alkaloid of the poppy plant – papaver somniferum poppy plant. As such it is an opiate and is used to treat pain, coughing (antitussive) and diarrhea.

Mu opioid receptors (MOR): A receptor on the surface membrane of nerve cells that mediates opioid analgesia, tolerance, and addiction. When an opioid binds to and activates a mu opioid receptor, a series of other proteins associated with the mu receptor-signaling pathway become activated as well.

N

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Naloxone : A semi-synthetic potent opioid antagonist made from Thebaine.

Neuronal : Relating to a neuron or interneuron.

Neurotransmitter: An endogenous chemical substance that releases from pre-synaptic nerve fibers (axon) from neuron A, across the synaptic cleft and activates the post-synaptic nerve fibers (dendrites) of neuron B.

O

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Opiate: Morphine or Codeine: Any chemical substance(s) with narcotic properties produced by the Papaver Somniferum poppy plant including Opium.

Opioid: any chemical substance, either natural or synthetic, with morphine-like properties.

Opioid Receptors: There are three classical opioid receptors: μ-mu, κ-kappa, δ-delta and one non-classical opioid receptor ORL-nociception (ORL: Opioid-Receptor-Like). Opioid receptors are members of a larger family of receptor proteins, namely the rhodopsin-like G-proteins.

Opium: Opium is the dried latex obtained from the opium poppy (papaver somniferum).

Overdose: (see drug overdose)

Oxycodone: Is a powerful semi-synthetic opioid processed from thebaine. (see thebaine)

P

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Papaver Somniferum: The opium poppy is the source of many drugs, including morphine and codeine.

Partial agonist opioid: A chemical substance with Affinity with but only partial Activity on a specific opioid receptor.

Percocet: An opioid painkiller that combines acetaminophen and oxycodone. Oxycodone is an opioid painkiller. Acetaminophen is a non-opioid pain reliever.

Prodrug: A chemical substance that must change before it affects the body. A good example of a prodrug is heroin, which changes into 6-monoacetylmorphine within the bloodstream, before it enters the central nervous system (CNS) and begins attaching to opioid receptors.

Psychoactive: A chemical substance that alters brain function and consciousness.

R

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Respiratory Depression: Respiratory (RES-pih-rah-tor-e) depression is a condition whereby your lungs do not release enough oxygen into your blood. Respiratory depression is a medical condition that can quickly get worse, which may lead to respiratory failure.

Respiratory failure: A physical condition whereby your lungs do not release any oxygen into your blood.

S

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Semi-synthetic Opioid: a chemical substance with morphine-like properties synthesized from an alkaloid from the Papaver Somniferum poppy plant.

Examples: Heroin made from Morphine, Buprenorphine made from Thebaine.

Example: Naloxone made from Thebaine is a semi-synthetic opioid antagonist.

SUBOXONE: A dual-drug (Buprenorphine and Naloxone) tablet or film partial-agonist opioid medication prescribed by qualified physicians to treat patients with heroin dependence.

SUBUTEX: A brand name version of Buprenorphine tablets or film prescribed by qualified physicians to treat patients suffering with heroin dependence.

Synthetic Opioid: A chemical substance that has both Affinity and Activity with mu opioid receptors, that is synthesized completely artificially.

T

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Thebaine: A poisonous alkaloid of Papaver somniferum that is also found in raw opium.

Teryak: Afghani raw opium.

U

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Unarousable: Unable to awaken.

Unresponsive: A person who is unresponsive does not respond or react to commands or stimulus, e.g. pain. Shout, “Are you okay!”

V

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Vivitrol: Is an injectable form of naltrexone, which is a medication used to block opioid receptors from opiates and synthetic analogs.

W

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WHITE: A colloquial term meaning “Cocaine.”

Z

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Zohydro ER: A long-acting opioid pain medication. It is indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment.

Zubsolv : A brand name buprenorphine/naloxone tablet made by Orexo US, Inc.

How many heroin overdoses in 2016?

In 2016 there were 63,632 drug overdose fatalities. Of those fatalities, 42,249 or 66.4% involved opioids. Of the opioid overdose fatalities, 15,469 involved heroin.

Opioid poisoning

Signs of opioid poisoning include pinpoint pupils, slowed or stopped breathing, blue lips and fingernails, cold clammy skin, and seizures.

List of opioid poisoning symptoms

1. Miosis (pinpoint pupils)
2. Stupor (near unconsciousness)
3. Apnea (temporary suspension of breathing)
4. Respiratory depression (12 or less breathes per minute)
5. Seizures
6. Clammy and cold skin
7. Bluish skin
8. Bluish fingernails
9. Low blood pressure
10. Slow heart rate

Heroin overdose statistics

What’s so peculiar about heroin overdose is that it often occurs at home, and usually in the company of others.

• 2005 – 2,009
• 2006 – 2,088
• 2007 – 2,399
• 2008 – 3,041
• 2009 – 3,278
• 2010 – 3,036
• 2011 – 4,397
• 2012 – 5,925
• 2013 – 8,257
• 2014 – 10,574
• 2015 – 12,989
• 2016 – 15,469

How people overdose on heroin

Heroin exerts its lethal effect by depressing respiration, which leads to a rapid drop in oxygen saturation. If breathing slows too much or stops altogether, the cells in the brain become deprived of oxygen and begin to die. That’s why even a tiny heroin overdose can be fatal.

People often overdose on heroin because they can’t tell, with any certainty, what dose is safe. Heroin overdose fatalities are more likely in conjunction with another drug, such as alcohol or Xanax, or immediately after being discharged from a detoxification center, in-patient treatment program or correctional facility.

Antidote and Emergency Treatment for Heroin Overdose

The only treatment currently available to reverse heroin-induced respiratory depression, i.e. heroin overdose, is by direct antagonism of the site of action of opioid effect, the μ-opioid receptor, using naloxone intravenous or nasal spray.

Naloxone is a medicine that can treat heroin overdose, even if the person is in a deep and presumably irreversible coma, if it’s given right away. It works by removing the opioid molecules from the opioid receptors. Sometimes more than one dose is needed to help a person start breathing, which is why it’s important to get the person to an emergency room to receive additional support if needed.

Perform CPR if necessary. Do not induce vomiting. If vomiting occurs, lean patient forward or place on the left side (head-down position, if possible) to maintain an open airway and prevent aspiration. Keep patient quiet and maintain normal body temperature. Obtain medical attention

Watch for signs of respiratory insufficiency. Respiration and circulation should be maintained. Oxygen and assisted ventilation should be administered if necessary. Monitor for pulmonary edema. Monitor for shock and treat if necessary. Anticipate seizures and treat if necessary. Do not use emetics.

Groups most likely to overdose on heroin

Certain groups are at higher risk of heroin overdose, including the morbidly obese, those who suffer from sleep apnea, others with specific neuromuscular diseases, children and the very old. The elderly are the group most liable to heroin poisoning. However, those who are physically dependent to heroin are the group most likely to overdose. We also know that most heroin addicts are in their mid twenties (22-27).

List of High Risk Groups

• People with heroin dependence
• People who inject heroin
• People who use heroin in combination with other sedating drugs
• People who use heroin and have serious medical conditions such as HIV
• Household members of people in possession of heroin

Glossary: Heroin overdose

1. Apnea: Is the cessation or absence of breathing.

2. Unarousable: Excessive immobility and unresponsive

3. Unresponsive: A patient who is unresponsive does not respond or react to commands or stimulus, e.g. pain. Shout, “Are you okay?”

4. Pinpoint pupils: Medically known as “Miosis” – constricted pupils are typical signs of opioid use. Miosis in combination with depressed respiration are the hallmark signs of heroin overdose.

5. Respiratory Depression: Respiratory (RES-pih-rah-tor-e) depression is a medical condition whereby a person breathes 12 or less breaths per minute. In other words, not enough oxygen is passing from your lungs into your blood. Your body’s organs, such as your heart and brain, need oxygen-rich blood to work well. If someone overdoses on drugs, it can impair brain function and the brain may not tell the lungs to breathe. Respiratory depression can lead to respiratory failure.

6. Respiratory Failure: Respiratory failure occurs when fluid builds up in the air sacs in your lungs. When that happens, your lungs can’t release oxygen into your blood.

7. Seizures: Is generally referred to as tonic-clonic seizures. Seizures refer to quick, involuntary muscle jerks that tend to be repetitive, unwanted and lacking obvious cause. Heroin-induced seizures are a late phase adverse effect.

8. Clammy and cold skin: Clammy skin occurs when your skin turns cooler than normal and is moist, despite a cooler surface temperature. Clammy skin is often pale when the body is in any type of circulatory crisis. Clammy and cold skin may also indicate low blood oxygen levels.

9. Bluish skin: Blood that has lost its oxygen is dark bluish-red. People whose blood is low in oxygen tend to have a bluish colored skin, which is called cyanosis.

10. Bluish fingernails: Blue fingernails may indicate cyanosis of the nail bed caused by a lower level of circulating oxygen in the red blood cells.

11. Slow respiration: Medically known as Bradypnea. The normal respiratory rate for an adult is between 12 and 20 breaths per minute. Breathing that is normal in rate and depth is called Eupnea. Abnormally slow respirations are called Bradypnea and abnormally fast respirations are called Tachypnea. Apnea is the cessation or absence of breathing. Normal ventilation is an automatic, seemingly effortless inspiratory expansion and expiratory contraction of the chest cage.

12. Shallow respiration: Shallow respirations involve the exchange of a small volume of air and often the minimal use of lung tissue. A shallow respiration pattern is usually caused by drugs and indicates depression of the medullary respiratory center.

13. Gasping: A person who is overdosing on heroin may stop breathing, then start again with a long deep breath, and then stop again. This type of breathing is called gasping, and it’s also an indicator of heroin overdose. What’s interesting about gasping is that it’s a deep respiratory reflex triggered by the brain to increase survival after a period of inadequate or no respiration.

14. Slow heart rate:  A medical condition known as Bradycardia indicating less than 60 beats per minute. Bradycradia is a sign of a problem with the heart’s electrical system. Heroin use lowers blood pressure and causes Bradycardia, which is a direct result of activating mu-2 opioid receptors within the brainstem.

15. Low blood pressure: A medical condition known as hypotension (abnormally low blood pressure). Narcotics such as heroin typically cause hypotension. Optimal blood pressure is less than 120/80 – systolic/diastolic, respectively. As long as no symptoms are present, low blood pressure does not complicate the clinical picture. Common symptoms of low pressure are; dizziness, fainting, dehydration, blurred vision, lack of concentration, cold clammy skin, nausea, rapid shallow breathing, and fatigue.

Chronic opiate use inhibits the pituitary gland from releasing luteinizing hormone (LH) into the circulatory system. LH is needed to produce testosterone and sperm. Consequently, less LH ultimately results in a lower sperm count.

There is additional scientific evidence that indicates opiates may fragment the DNA within sperm. DNA fragmentation occurs when there is an alteration in one or both of the DNA strands. A high level of DNA fragmentation may cause male infertility leading to lower fertilization rates and/or miscarriage.

Can Heroin Affect Your Sex Life?

Scientific Study:

142 male opiate addicts (Group 1) and 146 healthy age males (Group 2- control group)
Testing for sperm concentration, and sperm DNA integrity.

RESULTS:

Sperm Concentration

Group 1 sperm concentration was 22.2 million sperm per ml and Group 2 was 66.3 million sperm per ml.

DNA Fragmentation

Group 1 showed approximately 34% DNA fragmentation as compared to approximately 27% DNA fragmentation for Group 2.

Whose sperm is longer?

THE HONEY POSSUM OR THE GUY HOLDING IT

The long and short of it is, the Honey Possum has the longer sperm. The Honey Possum is Master of the marsupial sperm, and the Chinese hamster is Ruler of the rodent sperm. These two tiny creatures have some of the largest mammalian sperm you can find. In general, mammals have an inverse sperm-length body-mass relationship, which is most true for the largest of the mammalians but not as true for the smallest. Most of the exceptions to this rule are small mammals with small sperm. There are no known cases of large mammals with large sperm.

Who has the longest sperm?

The longest sperm comes from the fruit fly. The sperm of a fruit fly can be as long as 2 – 2.4 inches. On the other hand, human sperm is one of the smallest, measuring only 40 microns long. So fruit fly sperm is about 1,000 times longer than human sperm.

How much sperm is too much sperm?

The volume and content of the ejaculate depends mostly upon the length of time between ejaculations. The average volume of semen is 2.75 mililiters(ml), ranging from 2-5 ml, the higher volumes follow periods of abstinence. An average human ejaculation contains about 180 million sperm (66 million/ml), but sometimes it contains as many as 400 million sperm.

Heroin targets your brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and feelings of pleasure. The overstimulation of the reward system produces the euphoric effects sought by individuals who use heroin. It also teaches the brain to repeat the behavior.

Androgens and Testosterone

Androgens are sex hormones. They are made primarily in the male testes, female ovaries, and adrenal glands. Testosterone is the most potent androgen in humans.

We know now that testosterone is an indispensable hormone for sexual health. That is why it is important to understand the full impact that opiates play on testosterone levels. 

Ironically, both men and women produce testosterone, but young adult men have about 7-8 times as much as young adult women. Production of testosterone increases during puberty to help boys develop into sexually mature men, so young men can reproduce.

Testosterone levels suppressed by opiates

As adult men and women age they naturally produce less and less testosterone, but opiate use, and in particular heroin use, has been inextricably linked to a premature collapse in testosterone production. Consequently, male heroin addicts generally have much lower testosterone levels than non-heroin addicts of similar age. This also holds true for most opiates, including methadone, oxycodone, fentanyl and more.

Symptoms of Low Testosterone

Symptoms of low testosterone include depression, fatigue, night sweats, reduced sex drive, ED, and diminished sexual arousal and satisfaction. Men may also develop osteoporosis, anemia, and diminished muscle mass. Women may also develop irregular menstrual cycles and diminished sex drive.

Consequences of Low Testosterone

Regardless if it is opiate consumption that lowers your testosterone levels or natural aging, the consequences are often loss of body hair, wrinkling of skin, increased body fat, reduced sexual performance, mood disturbances and low sperm count.

Testosterone Replacement Therapy

If you are concerned about your testosterone levels, talk to your physician. We know now that opiates such as heroin and painkillers suppress the hypothalamic-pituitary-gonadal axis in men and produce a symptomatic state of opioid-induced androgen deficiency (OPIAD). Testosterone patch therapy may normalize hormone levels and improve a number of quality of life parameters, including sexual function, well-being, and mood. If you are concerned about your testosterone levels, you should talk to your physician.

Natural Testosterone Treatment

There is a special mineral found in abundance in oysters, called zinc, which, has been shown in several scientific studies to increase testosterone production. Salmon has a high Vitamin D content, one of the highest of all foods. Optimal Vitamin D levels are strongly correlated with optimal testosterone levels. What you may not know is that it can help optimize your hormones, including testosterone levels. Broccoli (and other cruciferous vegetables) contain indole-3-carbinol, which inhibits conversion of testosterone to estrogen, so natural testosterone levels stay high. Broccoli is high in vitamin C, which lowers cortisol levels. Cortisol is a hormone that often interferes with testosterone production. Cocoa powder is high in magnesium and L-arginine, which support testosterone production. Coconut is a food with a direct link to hormone production. It’s rich in saturated fat, one of the key building blocks of all sex hormones.

Timeline of Heroin Withdrawal