After a brief period where it seemed to give way to the scourge of crack cocaine, heroine is making a comeback. According to the National Survey on Drug Use and Health, the increase in heroin use has been steady since 2007. Here are 10 facts about heroin:

1. Heroin is an Opioid

Opioids have been used by humans for millennia to ease pain. They also affect the gastrointestinal tract, which is why people take them to relieve diarrhea. Heroin, like other opioids, bonds with the mu receptors in the central nervous system. Indeed, they’re called mu receptors because they were first discovered through the use of morphine. Opioids also bond to kappa and delta receptors. These receptors are found in many areas of the central nervous system.

2. Heroin is Man-Made

Heroin is made from morphine by adding two acetyl groups, or -OCOCH3 to the morphine molecule. Because of this, heroin’s formal name is diacetylmorphine. Heroin was created to be a benign substitute for morphine.

3. Heroin Was Created in England

The person who created heroin was C.R. Wright, a British chemist. He invented the drug in 1874.

4. The Bayer Company Developed Heroin

The German Bayer company, the same company that manufactures aspirin, was the first company to recognize heroin’s economic potential. Bayer began to synthesize diacetylmorphine in 1897 and by 1898 was testing it on both animals and people. People reported that the drug made them feel “heroic,” so “heroin” became Bayer’s brand name for diacetylmorphine.

By 1898, heroin was being touted as being far more powerful than both codeine and morphine but lacking those drugs’ detrimental side effects. Bayer even claimed that heroin, unlike morphine, wasn’t habit forming. The medical community became interested in heroin not just because of its painkilling effects but because it relieved upper respiratory distress. This was important in a time and place when diseases like tuberculosis and pneumonia were rampant.

By 1899, Bayer was manufacturing a ton of heroin every year and exporting it all around the world. However, soon after it was put on the market, heroin was found to be highly addictive. Bayer stopped production of the drug in 1913.

5. Heroin Can Easily Cross the Blood-Brain Barrier

The blood-brain barrier is a mechanism that protects the central nervous system from toxins while allowing in nutrients. It’s made up of cells called astrocytes that surround the capillaries in the brain and the spinal cord. However, heroin, being very fat soluble, can cross the blood-brain barrier. This is one reason why it acts so quickly on the body.

6. Heroin is a Schedule I Drug in the United States

A schedule I drug is defined as a drug that puts a user at great risk of abuse and has very little or no medical use.

7. Street Heroin is Rarely Pure

One of the great dangers posed by heroin comes because street heroin is almost always adulterated. Pure heroin is a white powder, but when it’s sold on the street its colors can range from white to beige to pink to even dark brown. Some of the substances used to “cut” heroin include sugar, starch, talcum powder and the detritus that’s the result of processing heroin in the first place. Heroin is also cut with strychnine, a deadly poison that’s supposed to enhance the drug’s effect. Because heroin users usually don’t know how much pure heroin they’re receiving from bag to bag, they’re always at risk for overdose or injury.

8. Who Uses Heroin?

As of 2012, the National Survey on Drug Use and Health reported that about 669,000 residents of the United States had used the drug within the past year. The increase in heroin use is most prevalent in young people between ages 18 and 25, though it’s been declining among people who are between ages 12 and 17. About 156,000 people began using the drug in 2012.

9. Heroin is No Longer Just a Scourge of the City

Though heroin use is increasing among young, urban people, it has infiltrated the suburbs and even rural communities. This can be seen by the amount of people in these areas who are admitted into hospitals because of heroin overdose and by the amount of heroin seized by police and other law enforcement officers.

10. Naloxone Can Reverse the Effects of a Heroin Overdose

Ironically, naloxone is also a synthetic opioid like heroin but is considered an opioid antagonist. When it’s taken it can block the actions of opiates and opioids in as little as five minutes. However, if the person is addicted to heroin, taking naloxone will not only reverse an overdose but send the person into immediate withdrawal. The length and duration of the withdrawal symptoms depend on the strength of the person’s addiction and the dosage of naloxone. The withdrawal symptoms usually last about two hours, then cease.

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